4th August 2020
In this blog, Laura Spink, a clinical nurse specialist with the Healthcare at Home cancer team, says that spending time with patients is key to the care she offers. Here she talks about why it’s also a part of the job that she really enjoys.
I joined Healthcare at Home 6 years ago as an IV chemotherapy nurse. After 8 years working on an oncology ward, I had wanted to find a position where I could provide the one-to-one care that I believe is needed to bring cancer nursing to its full potential – and that’s exactly what Healthcare at Home offers.
In September 2019 I became a clinical nurse specialist within the team and now work directly with a hospital consultant, Dr Chakarborti, supporting around 80 patients across three hospitals.
I meet with both Dr Chakarborti and individual patients at their initial clinic consultation, where I introduce myself and explain how Healthcare at Home works. I find this a real benefit as it shows patients right from the start how our team works hand-in-hand with the hospital to deliver holistic care.
I also visit each patient before their first treatment to go through exactly what to expect and answer any concerns they may have about chemotherapy, and we usually build up a trusting relationship quite quickly. The local Healthcare at Home chemotherapy nurses then pick up the visits to give the treatment, however patients can still give me a call and I see them in clinic.
The arrival of the coronavirus pandemic inevitably made a difference to how we deliver our service. During the COVID-19 response much of my work has been carried out remotely, through telephone calls and video consultations. Previously I would spend half of my week in the south and the other half in the Derby area, and the new way of working means that I can be more flexible for individuals across both areas all week. It also suits our patients who want to limit the number of visitors to their home.
Healthcare at Home clinical nurse specialists support patients with symptom control and medicines management, for example by advising on the way forward if there are potential clashes between a patient’s regular medications and the systemic anti-cancer therapy. As specialists we’re also there to support the patients and their families but also the chemotherapy nurses when they’re with patients. Our support helps them immediately deal with any issues such as patients experiencing nausea during their treatment.
We also complete a holistic needs assessments for patients which cover emotional, physical, and financial concerns, to see what extra support can be added. As part of this role, I’ve developed a relationship with local hospices such as Treetops Hospice Care in Derby and the Maggie’s cancer charity, which have been invaluable in offering further support and signposting to other local services. I also link closely with the palliative care team at Derby who offer excellent support and advice on pain relief for patients with complex needs.
As a cancer care team we also look after palliative care patients who aren’t receiving active treatment, to make sure they remain as comfortable as possible. We provide emotional support to both patients and their families and this ongoing connection means we’re well placed to call in help from hospices as soon as it is needed.
We’re also there for the family after a patient has passed away, and that’s a really important part of our job. I’ve been keeping in touch with the wife of a patient who passed away in February, and in May she called me as she was having a bad time. I went to visit her in her garden for a chat, strictly observing the social distancing rules for healthcare workers in place at that time, and she said it really helped her to not be on her own, especially during the time of national lockdown.
I find that the dedicated support that patients and families receive from our teams is one of the things that sets Healthcare at Home apart – as a clinical nurse specialist I manage my own diary so if I need to sit with a patient for a few hours, I can. It’s extremely rewarding and a real privilege to be on the journey with our patients and their loved ones.
Just a couple of nights ago I spoke with a new patient who was amazed and thrilled that he could get care at home, where he would be more comfortable and relaxed together with his wife and children rather than surrounded by strangers.
As a key support to Dr Chakarborti, our service has helped grow his patient cohort and allowed him to focus more where his support is needed while we pick up the day-to-day concerns.
Patients give us a lot of positive feedback, especially around having a dedicated nurse to contact with questions to allay their fears and concerns, and having time to go through the treatment. Our wraparound care and wide range of services really sets us aside from other home care providers; working with Healthcare at Home allows me the dedicated time that our patients deserve at this most difficult time for them and their families, and I’m proud to be there.