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.