Sue Ryder Nurse Lisa Alvey joined the team at Sue Ryder Manorlands Hospice in 2017, shortly after completing her nursing degree. Here, she talks about delivering palliative care in the community and the essential aspect of expert symptom management.
“Right from the start of my nurse training, I always knew I wanted to specialise in palliative care. I spent part of my final degree placement at Sue Ryder Manorlands Hospice and I was fortunate enough to be offered a staff nurse post, so I joined the team on the inpatient unit as soon as I was qualified.
A passion for palliative care
“My passion from palliative care stems from my own personal experience. Both my parents died quite close together, and the two experiences were very different. My dad was ill for about six months, but in his last few days he received palliative care and I saw what a huge difference it made to him and to us as a family.
“I live quite close to the hospice and a big part of me wanting to work there was because of its fantastic reputation in Keighley and the surrounding areas. I’d been involved with some fundraising activities for the hospice in the past and it’s so well loved in the community.
“We only get one chance to get it right”
“As a palliative care nurse it’s just real privilege to be involved in someone’s care and to be with the family at such a precious time. It’s not about the reward, it’s taking a holistic approach and making sure we can do the best for that person and their loved ones. We only get one chance to get it right.”
Lisa moved to the hospice’s community team in November 2020 and now provides specialist care and support to patients in their own homes in the community.
“I get great support in my role from Sue Ryder, but especially within the community team here at Sue Ryder Manorlands Hospice. We’re a very close team and the management are really supportive. We have regular clinical support where we’re given space to talk about things in confidence.
Training and development
“There are also a lot of training and development opportunities available through Sue Ryder. While I was working on the inpatient unit full-time I completed the two-year level 7 Postgraduate Certificate in Cancer Care at the University of Bradford, and that enabled me to move into the community team.
“In the team we work closely with GPs and district nurses, and get involved if someone has uncontrolled or unmanaged symptoms such as pain, breathlessness, nausea or vomiting. We work closely with the patient, family and the medical team around them, and we can advise on what medication might help. We also work closely with the specialist palliative care doctors and consultants at the hospice who can offer further support.
“Symptom management means they can be comfortable for longer and it can also help prevent people from going into hospital”
“Psychological support is also a big part of our role and we work closely with the family support team at the hospice and the clinical psychologist at Airedale Hospital. We can also refer patients to other services provided by the hospice such as physiotherapy, occupational therapy and complementary therapy.
“If we manage to get the patient’s symptoms under control then we might take a step back, but the patient can re-refer into us at any point. Symptom management means they can be comfortable for longer and it can also help prevent people from going into hospital.
“Sometimes, if we’re struggling to get a patient’s symptoms under control at home, then we might suggest a short stay in the hospice as we’re able to provide more medication and increase this faster than in the community. The patient can be closely monitored by the medical and nursing team and once their symptoms are under control they can then return home, which works very well.”
Lisa is keen to change people’s perception of hospices and palliative care.
“When people think of hospices they think they’re all doom and gloom - but it isn’t like that at all. We encourage our patients and their families to bring in special things that mean the most, such as photos. We talk to them about their families and try and encourage them to participate in their hobbies if they’re able to, or to write about their life. It’s about us as staff getting to know them as a person and making the most of the time they have left.
“For a lot of people a palliative care nurse to coming into their house is a very big deal because of what we represent. It’s about education and we do a lot of work with patients and families to find out what they want at this stage of their life and then help them achieve that.”
As part of her Postgraduate Certificate, Lisa studied symptom management for a year and also completed a symptom management course with St Gemma’s Hospice. Later this year she is attending the Guildford Advanced Pain & Symptom Management course and will also start a two-year Specialist Palliative Care CNS development programme called ECHO: Extension for Community Healthcare Outcomes.
“We recently had a patient who’d been newly diagnosed with a palliative metastatic cancer and there were lots of symptoms in regards to pain and nausea, but they really wanted to be at home with their family so we looked at the medication we could give to get the symptoms under control.
“Unfortunately the illness progressed very quickly and so I had face-to-face meetings and calls over the phone with the patient and their family to keep them updated and we asked if they still wanted to be at home, which they did. The last time I visited it was evident to me that the patient was very end of life so I was able to arrange the care they needed with the district nurses, get a hospital bed for them and arrange for the medication to be delivered via a syringe driver.
“Death is the only certain thing we’ve got, so it’s important that we talk about it.”
“The patient died later that night with their family around them and when I spoke to the family afterwards for bereavement support, they stated that they felt thankful that their loved one was able to have a good death, which they’d not experienced before.
“Ultimately, we want to help improve the patient’s quality of life the best we can and make the time they have left as comfortable as possible. Our patients are at the centre of the care we deliver and their wishes are paramount. Death is the only certain thing we’ve got, so it’s important that we talk about it.”
A nursing career in palliative care with Sue Ryder
If Lisa’s story has inspired you to consider palliative care nursing, please email us on email@example.com or call 07975 235450. By joining our team, you'll support us to help people through the most difficult times of their lives.