Health
The caring profession Print E-mail
Written by Carolle Doyle, 2008   
Palliative care plays an important, supportive role in looking after patients and their families. Four dedicated nurses tell Carolle Doyle what it means to them and why they love their work so much.

"I'm at the humble end of the profession, I'm afraid," says Jane Wadley, "I'm a Community Staff Nurse."

Jane's "humble end" as a community staff nurse (a position that most of us still think of as the district nurse) is the backbone of the health service. Nursing was always looked on as a vocation because nurses were 'called' to the profession, which is a very profound thought and far removed from the idea of it being a job, however humble.

Nowhere is this more evident than when Jane's work brings her into our homes. Together with Macmillan nurse Gwenan Davies and Marie Curie nurse Eileen Jones, she visits us when we are too frail to venture out.

A fourth nurse, Bethan Williams, is one of many in a large hospital, but she also touches our lives when we are at our most vulnerable. Of all the nursing positions in our hospitals, it is the recovery nurse who sees us at that point when we are about to become completely helpless as we undergo surgery.

It is to Bethan that we voice our fear: "Will I wake up?" Bethan and other nurses like her reassure us the day before the operation and later walk down with us to the theatre. If you should ever find yourself in the world famous orthopaedic hospital in Gobowen, Wales, Bethan's might be the first face you will see on waking after an operation.

She sees herself as her patient's advocate, for not only does she monitor our vital signs in recovery, she can also speak for us when we are too drowsy or confused with the effects of anaesthetic. A recovery sister for 18 years, very nearly her entire nursing life, she says she knew she was going to be a nurse when she was nine years old.

But not everyone has such a clear idea of nursing when they are so young. Some, like Jane Wadley, just stumble into it. She remembers wanting to be a nurse when she was young but she also remembers being put off the idea very quickly by her elder brother who told her, with some disgust, that she would "just be clearing up sick".

Stumble into the job she did, however, tagging along with two other friends who had applied for training in Dunedin, New Zealand. Jane may have joined them out of curiosity that first day, but now she has been nursing for 30 years in both New Zealand and Great Britain. And she would think of doing nothing else.

Her day begins in the local surgery where she picks up her list of patients and any updates from the doctors. Then she loads her car and sets off to visit people who cannot, through age or infirmity, make regular visits to the surgery.

"It is a tremendously supportive service and something to be proud of," she says. "We bring a great deal of comfort when we make a visit, especially to the elderly who are often very lonely. I see myself as a guest when I enter a house and that, too, is a comfort as it puts the patient in charge."

Among older patients in particular, there is a reverence for the district nurse that Jane finds altogether touching. I doubt she would ever want to be at anything but at her "humble end" because she is free to give patients her full and undivided attention. She is there to assess their needs, too, and in the course of a day may talk to physiotherapists, occupational therapists, social services and the Red Cross, who provide specialised equipment.

Jane's patients are, for the most part, the elderly and the terminally ill, for whom she provides palliative care. Talking about this she says that there is a point where the balance shifts and at that point she will ask for support from nurses like Gwenan Davies and Eileen Jones.

Macmillan nurses specialise in caring for those patients who have been diagnosed with cancer, but their concern is also for the family as a whole. Gwenan Davies jumped at the opportunity to become a Macmillan nurse in Powys after a short time spent job sharing with the area's original Macmillan nurse before she moved.

Of her first contact with a family, she says: "When you have just been diagnosed with cancer it is difficult to take in exactly what is being said, so I will visit the patient and go over everything again, both for themselves and for the family too."

She is there not only to reassure but to assess exactly what is needed from alleviating the side-effects of treatment to providing financial assistance. Sometimes, of course, the illness is terminal and the care that Gwenan gives is palliative.

"I have always had a love for palliative care," she explains. "I will do anything I can for my patients and make sure that everything is right for them. It is a very rewarding job but it is really about having a good team - you cannot do it on your own."

At this point she will call in Marie Curie nurse, Eileen Jones, whom she describes as the "hands-on" nurse.

Eileen first heard about 'Marie Curies' when she was working as a staff nurse. She knew at once that this was what she wanted to be. The training includes a diploma course in palliative care and this, in turn, covers everything from care of the patient to the family.

"I get a call and go and sit up every night with the patient so that the family can rest," she explains. "On the first night they are usually rather wary but by the second they welcome me like an old friend."

Eileen always phones in advance to see if there is anything, such as shopping, she can do for the family she is looking after. She brings tranquillity with her, along with ordinary things like bread or milk.

She will sit through the long watches of the night while exhausted family members sleep; she is the listening ear to whom patients turn, with the confidence that their words will go no further. It is little wonder that she considers learning to listen to people as one of the most important skills for a Marie Curie nurse.

As Eileen talked of her work, a familiar smile played upon her lips. It puzzled me - Megan wore the same smile when talking of palliative care, as did Jane. I realised I had seen that smile before many times, usually reserved for infants, at the beginning of life, not the end.

This is also the smile of caring, shared by all those nurses who see us when we are at our most vulnerable. When we are as helpless as a baby, in fact.

Further information

Macmillan Cancer Support improves the lives of people affected by cancer, providing practical, medical, emotional and financial support. You can call the Macmillan Cancer Support CancerLine (9am to 9pm weekdays) on 0808 808 2020 or visit www.macmillan.org.uk for details of cancer information centres throughout the country.

Marie Curie nurses provide free nursing care to cancer patients and those with other terminal illnesses in their own homes. Call Marie Curie Cancer Care on 0800 716146 or visit www.mariecurie.org.uk
 
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