Team Herts Hospice at Home Nurse REBEKHA BELL, gives an insight into her role with Rennie Grove Hospice Care. Here, she talks through a typical late shift, which runs from 1.30pm to 9.30pm.
Being able to make patients more settled and comfortable is immensely rewarding.”
– Rebekha Bell
IN Herts at Home, two members of the nursing team will be rostered on to a late shift with one covering the Dacorum area and the other the St Albans and Harpenden.
The late shift usually involves making planned visits during the afternoon before assuming on-call duties in the evening.
1.30pm – Rebekha arrives at Rennie House in Tring and logs onto the Patient Database.
She reads the Bulletin Board for important updates and then checks the worksheet to find two allocated visits for that afternoon.
1.45pm – The Herts Team operate a Triage system between the hours of 9am and 5pm. The Triage nurse will take all phone calls relating to patients and allocate visits to the nurses on duty, allowing them to focus on caring for patients. Rebekha speaks to the team’s Triage Nurse, who confirms there are no urgent visits for the moment.
2pm – She drives 15 miles to visit Brenda (not her real name) who is 48 and has breast cancer with bone metastases.
She receives a weekly scheduled visit from the Rennie Grove nurses to help control her pain and provide support.
Rebekha talks to Brenda and reviews her pain diary which records how much medication she has been taking. Today Brenda is uncomfortable and her medication needs adjusting.
2.40pm – Rebekha calls one of the Team’s senior nurses with a recommendation that Brenda’s dosage should be increased.
When this is approved, Rebekha explains to Brenda how to increase her dose and asks her to continue with her pain diary. 2.55pm - The regular monthly check of Brenda’s Just In Case medication is also due and Rebekha checks the box, recording batch numbers and expiry dates.
3pm – Rebekha leaves and drives six miles to John’s house.
John (not his real name) is 77 and has lung cancer with metastases. He is now approaching end-of-life and receives his medication through a syringe pump which needs reloading every 24 hours. Rennie Grove is sharing care with the District Nurses, each team taking it in turns to visit. John is unresponsive, Rebekha assesses him by monitoring his facial expressions and talking to his wife.
As the family had called out Rennie Grove when John had become unsettled during the night, Rebekha adjusts the dosage in the syringe pump in order to keep John’s pain under control. She carries out some
personal care to make John comfortable and talks to his family about what to expect during the next few days, including a conversation about what to do if John dies. She reassures the family they can call Rennie Grove any time, day or night.
4.15pm – Rebekha returns to the office in Tring. She contacts Brenda’s GP and liaises with the District Nurses about John. She updates the Patient Database and takes a break.
5pm – The Triage Nurse leaves and on-call starts. After 5pm all calls to Rennie Grove are handled by Bucks Urgent Care who take the details of the call and pass it onto the on-call nurses or to the night team between the hours of 9.30pm and 7am.
5.15pm – A call comes in from the other late shift Team Herts Nurse, who has been called to a death in St Albans. Two nurses are needed to attend to perform last offices.
6pm – Rebekha meets her colleague, Margaret. Joan (not her real name), 84, had died at 5pm from Motor Neurone Disease.
The nurses console the family, complete the verification of the death and perform last offices. While the paperwork is being completed, Rebekha gets a call from Bucks Urgent Care asking her to visit a patient who has become agitated. Rebekha and Margaret spend a few minutes talking to Joan’s family about what they need to do next and reassure them that one of the team will be in touch in the next few days.
7.30pm – Rebekha leaves to attend her emergency visit in Leverstock Green.
7.45pm – She arrives at Dave’s (not his real name) house. Dave is 46 and has a brain tumour.
He has become agitated, aggressive and uncontrollable and his wife is very worried. After assessing him, Rebekha is able to give him an injection to calm him down from his Just in Case medication box. She stays to make sure it has worked and reassures Dave’s wife.
8.30pm – Once Dave is comfortable, Rebekha leaves and returns to the office.
9pm – She arrives at Rennie House, updates the Patient Database and the Bulletin Board before handing over to the night team and leaving for home at 9.30pm.
Rennie Grove is currently looking for more nurses like Rebekha to join its team. If you or someone you know is a trained nurse who might be interested in finding out more, contact email@example.com or call the charity’s HR team on 01494 877 200.