Ruth Brown has been the Hospice at Home Manager at Blythe House Hospicecare and Helen's Trust in the High Peak, Derbyshire, since the service began in 2016. Before this she spent many decades with the NHS as a community healthcare assistant, qualified nurse, district nurse and finally community matron. Here she tells us what a typical day is like during the pandemic.
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I’m currently working from home because I’m shielding. No alarm clock, I lie in a little longer than normal, woken at 7.30 by my 2-year-old grandson Alfie, followed closely by Dotty (my Jack Russell) with a quick lick in case there’s any doubt that I’m not fully awake.
Working at home, the structure of my day is less ordered; I miss my desk and the hospice-working environment. I also miss being face-to-face with my team and being able to quickly ask for a second opinion, or help when several things that need attention come up at once.
Today it’s my grandson Bobby’s 8th birthday, so once I’ve showered and eaten, I FaceTime to check that presents have been delivered and cards have arrived, including my other grandson Finley’s non-birthday card. Next I plan for the day, which is essential, especially during the current situation.
As well as Blythe House, I manage the Hospice at Home service for Helen’s Trust, and I check figures for their referrals since our partnership began on 1st April. I also pass on details for an update for the monthly newsletter.
Supporting patients and families
My colleague Jude Webster, also a Hospice at Home Manager usually contact each other on the phone several times each day, so I make a quick call to her.
I take part in a conference call with the local end of life care Covid group where our attention is now concentrated on the needs of care homes, both nursing and residential. The concern is that the infection hasn’t reduced as quickly in these environments as within the general population. We’re offering them as much support as possible and have a telephone support network in place.
The care homes need extra staff going forward as many have people who are self-isolating. A task and finish group is looking into re-deployment of staff who may be furloughed. We currently have these calls twice a week.
I work through a list of patients who may need further support and contact the agency or their family to get an update. On approaching one agency, I discover a patient that we had delivered extra care to died on 16th May. I plan to call the family, write a sympathy card and send an evaluation at a later date, to ascertain how satisfied the family are with the service to help us to continually improve our service.
Next I begin the process of contacting patients’ families to find who else is involved in their care, asking questions about potential other referrals such as to Marie Curie or NHS Continuing Healthcare Fast Track. I then determine what care we can provide. We are very much looking forward to expanding our team to include staff across the Derbyshire Dales and Chesterfield.
Suddenly it’s way past lunchtime and Alfie has gone for his nap. I make a few calls and grab a bite to eat before the second call of the day from Jude to pass on a referral she has received for Helen’s Trust, requesting further night support. We discuss PPE supplies, which Jude has been managing throughout this crisis. This has taken up a considerable amount of her time and will be ongoing for some time into the future.
I send a number of orders to the care agencies through our secure NHS email address, to secure outstanding sits and create a paper trail.
Companionship during the crisis
Next I check in with a couple of hospice colleagues regarding their services and where we overlap. Our volunteer service provides an extra element of support to patients and their families, such as domestic support and companionship.
In addition during the pandemic they’ve been shopping, collecting medication, offering telephone companionship and more, not just for our patients but for elderly, vulnerable or isolated members of the local community too. This invaluable support has allowed local people to understand that they are not alone through this awful crisis, and has been an essential lifeline to our elderly and at-risk, isolated population.
My last task of the day is speaking to a colleague about a patient on their shift the night before. They raise concerns the patient is becoming less well and that medication is affecting their mobility. I make a note to action a GP review first thing in the morning.
All our essential services for people who are at end of life have continued despite Covid-19, and we have proved that we can deliver this service and plan remotely. Our community are at the heart of everything we do here, and our healthcare assistants have gone above and beyond providing the good honest care we strive to deliver, even though our ‘normal’ has changed forever and some of these new patterns of working will remain.
Useful resources
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Our Frontline is a partnership between Shout, Samaritans, Mind, Hospice UK and The Royal Foundation of the Duke and Duchess of Cambridge. It offers round-the-clock one-to-one support, by call or text from trained volunteers, plus resources, tips and ideas to look after your mental health. Visit the Our Frontline site
Hospice UK’s Just ‘B’ Counselling & Trauma helpline. The service is a free confidential national helpline available 7 days a week from 8am to 8pm, providing bereavement, trauma and emotional support for all NHS, care sector staff and emergency service workers. Call the ‘Just B’ Counselling & Trauma helpline on 0300 030 4434.
