Jo Merritt knew early on in her nursing career that she wanted to specialise in palliative care. She was drawn to the role because of the way it looks at all aspects of a patient’s life, not just their condition.
Now Jo is one of four palliative care nurse specialists at Milton Keynes Hospital. She is based on the Macmillan unit, but can be found in many areas of the hospital.
“We follow the patient, not the ward,” says Jo. “If a patient is admitted to a ward, we will visit them there, if they need to attend a clinic or come into the unit for symptom control, we’re there to support them if needs be.”
Palliative care nurses are clinical nurse specialists who care for people with advanced illness. They are concerned with caring for the patient’s whole needs – not just physical. Jo is one of a tight-knit team which includes colleagues Emma Goodship, Anna Moore, and Wendy Black, They all work closely with Haley Coetzee, our palliative care discharge nurse, who does her utmost to try and ensure that patients spend their final days in their preferred place. They all liaise extensively with specialty doctor Ben Dietsch and consultant Dr Jane Wale.
“We’re concerned with everything that concerns the patient,” explains Jo. “Our role is to oversee their holistic care – that includes a patient’s social, psychological, physical and spiritual care. It’s a whole approach to looking after the person, helping them understand where they are on their journey. As specialists, we are able to develop a relationship with the patient that means we can help them cope better in all areas, not just with the management of symptoms and other clinical issues.”
“We work very closely with the families too, to support them as their loved one’s illness progresses. It can be hard for them. Often they think they know what’s going on, but they don’t really understand. It’s my role to try and help them understand what’s happening, and what could happen, so that they feel supported too.”
There is no typical day for a palliative care nurse and Jo can see patients and their families at a time when their feelings are raw.
“We often have to deliver bad news and different people react to that in all sorts of ways. As a nurse, you know that someone feeling angry or anxious isn’t directing it at me. They are often scared and very vulnerable and it’s important that we don’t take any reactions personally.”
As Jo gets to know her patients, she also gets to understand what’s important to them.
“It’s all about communicating with the patient and what matters to them. There may be seemingly small things that are worrying them, but they can appear a massive problem if you’re going through it yourself. By getting to know patients, we’re able to reassure and support where necessary. It’s their pain and feelings that matter most of all.
“We also work closely with the chaplaincy team and Kim Weston, our bereavement nurse. People often want to explore the spiritual side of things as they near the end of their lives, even if they are not religious.”
To that end, the team rely heavily on each other for support.
“We frequently talk to each other, to off-load whatever’s concerning us. We’re a very open team and can talk to each other about anything. It’s a high pressure environment as you’re with patients and families at a really emotional time. We also have access to a clinical psychologist if we feel we need that bit more support.”
Jo finds that after a tough day, she uses the drive home to wind down.
“The minute I get in the car, I know that I can put whatever’s happened that day behind me. It’s important to be able to do that in a role like this,” she adds.