Julie Surtees is a nursing sister on our Hospice at Home team. She tells us about her role and the support she provides to patients, and their families and carers, out in the community.
“I’ve worked on and off at Martlets for 14 years and before that I ran nursing homes with my husband. At Martlets, I’ve been a volunteer on the inpatient unit (IPU) reception and a bank nurse. In April, I started a new role as a sister leading the Hospice at Home team.
What we do
Our team of 10 responds to Martlets’ patients who are symptomatic, visiting them at home. People often prefer to die in familiar surroundings. Or at least to be able to stay at home as long as possible before coming into the IPU. We respond to calls from Martlets’ phone hub or a triage nurse. They will tell us that a patient is symptomatic or deteriorating, and we arrange to go and see them.
We might be administering pain management, or treating nausea, vomiting and anxiety. Offering personal care such as changing sheets, washing patients and so on is also part of what we do during a visit. We can arrange the right care package for people so they are cared for 24/7 if need be.
If someone is very poorly, we might go in two or three times a day. It may be really intense for five or six days as we try and manage their treatment. Occasionally, they may have to be admitted to the Hospice so that symptoms can be controlled and monitored over 24 hours. But we will always do our best to support someone in their own home if that is their wish.
There is also an emotional aspect to our role. Sometimes we might not need to do anything other than reassure carers and families that we’re here if they need us. We ensure that everything is in place to make the process of dying as pain free as possible.
Conversations about death and dying
We have frank discussions with families about what to expect as we are asked about it a lot. It is so important that people understand the stages of dying so they feel able to support their loved one. Then there is clarity on what to do and who to call for support. When carers and families are better informed, they feel less frightened.
It can still be a shock though when the time comes. Someone might say to me that only last week they were walking on the seafront with their loved one. Then suddenly a week later that person is near to death. The patient might have been diagnosed several years ago and be fairly stable until there is a sudden decline at the end. Or it may be a more gradual decline. It can be a shock for people how quickly things can change.
We get very close to families because we are seeing them at their most vulnerable in their own homes. It can be particularly difficult when they are younger. There may be toddlers around and toys, and it really hits you that they are not going to see their children grew up. The kids might be sitting on the bed with the family pets as we administer treatment to Mum or Dad. We do what we can to normalise things for children and the families, but sometimes it is heart breaking.
Hospice at Home during the pandemic
We’ve been so busy during the pandemic. GPs, hospitals and hospices have been under pressure and inpatient services for terminally ill people have been stretched. It has meant that a lot more people have been turning to our team for help at home.
I remember going to see an elderly person who was dying. His son couldn’t be with him as he lived hundreds of miles away and COVID restrictions were in place. I had to hold an iPad in front of the patient while his son said goodbye to him via video call. It was so hard – I had a lump in my throat. I looked over to the healthcare assistant who was with me and she was also struggling to hold it together.
Afterwards, when we got outside, we were in pieces, but you can’t let it get to you for too long. You shed a few tears and then compose yourself, as you then go on to see the next patient; you have to be strong for them and their family.
We usually go out in twos – a trained nurse with a healthcare assistant. Our healthcare assistants are fabulous and so supportive of us. We natter away on the journey there and then afterwards we can share a few precious minutes of reflection.
During lockdowns and with certain Government guidelines in place we weren’t allowed to share cars. We really missed that and going it alone was so hard. That little chat in the car straight after visiting is so important when you’ve had an emotional time of it. Now we are back to car sharing, but still wear full PPE. I’m looking forward to the time when I’m allowed to give little cuddles again to people who need a hug.
What I love most about my job
I support people so they can die at home in familiar surroundings with their loved ones around them. That is such an important gift to facilitate, and I feel privileged being able to do it. At the end of life, what matters is that a person is free of pain and knows they are loved. At home, they are also surrounded by the possessions they cherish and have worked hard for. It has been challenging working during the pandemic. But being able to support people at the worst time of their lives is what makes my job feel worthwhile.”
Find out more about our Hospice at Home and Outpatient and Community Services here.
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Published 20/07/2021