The challenges of providing end of life care

My four month rotation as part of the GP curriculum, based at St Wilfrid’s Hospice, has been very enlightening, both personally and professionally. I originally thought that palliative care was fairly straight forward but this is not the case.

Throughout my time here I have learnt about the intricacies of medical, emotional, physical, spiritual, social and family needs, all intertwined to provide the best possible care to our patients. 

From a personal perspective, emotions can fluctuate when seeing people actively dying.  Some struggle and are afraid to come to terms with it – I find dealing with distraught families and reaching the right balance of supportive treatment for associated family members and staff can be tough.

The nursing team are a tremendous asset not just to the trainees like me, sharing their experiences, but to the NHS as a whole as they are working tirelessly around the clock to provide patients the best possible care.

I learnt a lot about myself working with complex patients - sharing their stress and discomfort - finding a balance between work and emotions.

The common questions you get asked are;

How long do I have?

I don’t want to die as yet

Can you put me away? 

It can be very difficult understanding exactly how much information patients and their families want to know but by evaluating them on a daily basis you learn about their psyche. Even though they may not ask questions because they could anticipate a negative response, understanding this and keeping them informed about facts such as their discharge being deferred due to their worsening symptoms, can relieve their anxiety.

Working at St Wilfrid’s can be emotionally and physically draining, particularly whilst trying to achieve a work life balance but that is one of the challenges for everyone working here.  Some of the hardest days that can include deaths and admissions, with the vast spectrum of emotions associated with both, can be soothed by simply hearing a patient or family say “thank you” - that makes it all worthwhile.

I have met some amazing, selfless people who volunteer their priceless time to make a difference which is so commendable and makes me reflect that there will always be people with their heart in the right place.

As all good things must come to an end, so has my time at this wonderful establishment under the wonderful directorship of Dr Amesbury who has been a pillar of support along with Dr D Whitehouse and Dr C Williams. This experience has definitely enriched and improved my clinical acumen and more importantly bridging the gap between the hospice and primary care, when I begin to work as a GP.