Providing comfort and dignity at the end of life

Sue Ryder Nurse Vicki has taken her passion for community nursing to the next level, by training as an Advanced Practitioner. She provides specialist palliative care to patients in their own homes as part of the Sue Ryder Manorlands Hospice community team.

“Specialist palliative care is about quality of life, helping someone to live and die well,” Vicki explains. “As nurses we can’t change what’s happening, but we can change how a patient feels and make them more comfortable.”

“It’s about identifying what’s important to our patients and seeing how we can support them to achieve that.

“People’s goals tend to become a lot smaller with advanced illness, so it might just be that someone wants to sit in their garden and spend some time in the sunshine, and something as simple as a wheelchair can enable that to happen. It might not seem big, but it’s important to that person to fulfil that goal.”

Vicki believes conversations about death should be given the same care and consideration as those about birth.

“People have a birthing plan and do everything to ensure a baby’s arrival into the world goes well, but as a society we don’t think about the end of life in the same way,” she says.

“My role is about helping someone to die well and peacefully, and you only get one chance to get that right.”

Vicki’s journey into nursing began while she was still at school, working as a cleaner in a care home.

“I just loved working in the care home,” she says. “When I turned 18 they trained me up to be a healthcare assistant and I suppose the rest is history. I worked my way up from there and went off to university to do my nursing degree.”

“I have always been a community nurse, that’s really where my passion lies, seeing people at home in their own environment,” Vicki says.

“I worked in the District Nursing team as a community staff nurse for 10 years before moving into palliative care and have been working at Sue Ryder for five years now. I love being out and about with my list of patients.”

After joining Sue Ryder as a Clinical Nurse Specialist, Vicki took up the opportunity to do an Advanced Practice Masters and is nearing the end of the three-year course.

As a Trainee Advanced Practitioner, she now works on the hospice inpatient unit, as well as continuing to support patients in the community.

“Working on the inpatient unit has given me the opportunity to follow my patients on their journey onto the ward if they do need to be admitted,” she explains.

“I have done on-the-job training through an apprenticeship scheme, so I can examine and diagnose patients now and I’m an independent prescriber. I can initiate treatments within my scope of practice and help to avoid hospital interventions, if that’s what the patient wants.”

“Often people don’t want to go to hospital, and they don’t want to be admitted to the hospice – they just want to be at home with their loved ones, with their own things around them,” Vicki says.

“We can support people to stay at home by helping to manage their complex symptoms, promoting comfort and maintaining dignity.”

For Vicki, community nursing is about far more than clinical care.

“I really like that side of nursing, that holistic approach, spending time with patients and their families and getting to know them as a person, not just for the condition they have.

“That’s why I love community nursing. It’s more about the whole person. You meet the family, you meet the pets, you see what is important to people.

“People say it must be a really depressing job but actually it’s really fulfilling and rewarding and there is so much laughter. You may be meeting people for sad reasons but it’s not all about sadness.”