Edi­tor's pick

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.

Buckinghamshire Advertiser - - NEWS -

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 jobs@ren­niegrove.org or call the char­ity’s HR team on 01494 877 200.

Re­bekha Bell

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