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' A remarkable service, carried out by remarkable people'

Understanding a pivotal role
Trustee Annie Hastings spent a day 'on the road' with a Dorothy House Nurse Specialist. This is her account of the experience ...

I SPENT a fascinating day with the Nurse Specialist who covers the Melksham and Corsham areas.

We visited four patients through the day. One was in hospital, with plans to go home, and our visit was to check that arrangements were progressing, and to discuss his medication and nutrition with the hospital nurses. Nurse Specialists have a key role in liaising with and advising other health professionals about medication.

Another patient was described as probably 'being near the ceiling with anxiety', and she certainly showed those symptoms when we arrived. By the time we left, the Nurse Specialist had not only brought her smoothly down to earth, but had covered all aspects of her condition and care, and suggested a respite stay in the Unit - but making sure it represented the patient's positive choice.

A third patient was nearing the end of his life, and had a bed booked at the Unit, to come in later that day for medical assessment. This visit was to ensure that everything was in place, and to clarify with him just what he wanted to happen, which was to return home to die.

The fourth patient had started attending Day Care, and was coping with severe illness in a close family member, in addition to her own.

Through all these visits, I saw the nurse using many different skills and approaches, masterfully assessing the 'here and now', but underpinning all with a keen nursing role and the ability to work out the patients' symptoms and pain levels. She took almost no notes, so could have unbroken discussions. She would write up her visits later that day or even the next morning - a considerable feat of observation and memory.

We had lunch with a couple of District Nurses in a GP surgery, which happens regularly and gave an opportunity to share work with colleagues.

By the end of the day I really understood the pivotal role of the Nurse Specialists and their links with the In-patient Unit and Day Care. I was delighted to have had this opportunity and was extremely impressed with their work as part of the hospice care offered by Dorothy House.

 

Our role in the community continues to expand

DOROTHY House Nurse Specialists provide support and advice to patients and their families, and collaborate with other health care professionals and agencies across the catchment area. They are usually a patient's first point of contact with Dorothy House Hospice Care.

In the past year, the team has been reorganised in line with the number of people served by the different GP practices in the Dorothy House catchment area. The reorganisation has resulted in better coverage of the area served and a more equitably distributed workload.

The team has started running a course for carers, which is offered twice a year.
Partnership working has been underlined over the past year, with a number of successful initiatives:

  • A district nurse joined the team on a one-year secondment, and will take the knowledge and skills
    gained back with her when she returns to her permanent post;
  • A six-month job swap between a Dorothy House Nurse Specialist and a specialist palliative care nurse at the Royal United Hospital in Bath allows both nurses to compare and contrast their roles. They will also take skills gained back to their respective jobs;
  • A six-month NHS-funded supernumary development post was created, allowing the post-holder to develop skills in palliative care and gain experience in all aspects of the work of a Nurse Specialist.
Staff have benefited from working in partnership over the past year

 

 

Hospice at Home now covers the whole area served by Dorothy House

CARING for terminally ill patients in their own homes is a core function of Dorothy House Hospice Care.

On 1 December 2003, the Dorothy House Family Carer scheme was extended to provide the more comprehensive Hospice at Home service across the region we cover.

The Hospice at Home service had run very successfully in North Wiltshire for two years, with funding from the Kennet and North Wiltshire Primary Care Trust (PCT). Additional funding from the government has now enabled us to broaden the service to the whole area we cover.

The service can provide up to 24-hour care to patients in the last two weeks of life, as well as offering some additional respite care.

 

 

 

 

1,136 patients and their families were visited by our Nurse Specialists

 

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