None of us has to look too far to see or know somebody who has been affected by cancer.
Thankfully, there has been a lot of progress in so many areas. We now know so much more about preventing and detecting cancer. The treatment and side effects of treatment are improving year on year.
My job is to support clients and their families as they approach the end of their cancer journey. It involves symptom control through the use of medication, personal care and most importantly, psychological support for the patient and their family.
Each case is different and every patient is an individual. In a report published by the Irish Hospice Foundation entitled ‘Irish attitudes to death and dying’, 75% of Irish people would wish to be cared for at home when they are dying, but only 25% get to do so.
In conjunction with the excellent palliative care team, GP services, public health nurse and hospice care, night nurses provide a home nursing service for end-of-life care for cancer patients and their families in their own home.
All night nurses are Bord Altranais registered, reference-checked and garda-vetted. The service is available so that families and their loved ones receive nursing care, practical support and reassurance during a very difficult time. The aim is to keep the person comfortable and free of pain.
Night Nursing is a free service for up to 10 nights. The service is funded entirely by money generously donated by the public every year with Daffodil Day playing a major part in that funding.
In 2017, over 1,800 patients throughout Ireland used night nursing, providing 7,300 nights of care. Referrals come from palliative care team, public health nurses and GPs. The hours are 11pm to 7am but this can be flexible depending on the needs of the patient.
My involvement begins with a call from the Irish Cancer Society asking if I’m available to go to a particular person’s home. This could be anywhere within an hour’s driving distance, namely Roscommon, Westmeath, Cavan and sometimes Leitrim.
The Irish Cancer Society will have been contacted by mostly the Palliative Care team. The ICA will give me the relevant details - name, address, diagnoses. Then the Palliative Care team make contact and give a detailed report on the patient and directions, postcode, being very important as trying to find a house at 11pm can be very difficult without specific directions.
About one hour before leaving my house, I phone the family to introduce myself and to get an update on the client. If the family is anxious or the client is in distress, I will attend straight away.
When I arrive at the client’s house, having introduced myself to the family, my job is to assess the client and deal with any symptoms and give reassurance to the family. Having settled the patient, the aim is to give respite to the family so they and their loved ones can have a good night’s rest.
While I am a nurse and a professional, I am also a guest in people’s houses and therefore it is so important to respect and understand the emotionally-charged situation that death and dying can impact on a family.
There’s no handbook on how to deal with difficulties that arise at this sad time in people’s lives, but years of experience, wisdom and being sensitive to people’s needs helps me through every time.
There can be an array of emotions in the room at any one time - anger, frustration, sadness, inappropriateness - and as a health professional, you have to deal with each scenario as it presents itself.
My job is to promote a calm environment and, where possible, to alleviate pain and other symptoms, ie: breathlessness, nausea and above all ensure dignity is preserved at all times.
The one question families tend to ask is ‘when will it happen?’ No-one can answer that question. The person will go in their own time. People often ask ‘how can you do that job?’ The answer to that is of all the jobs I have done, this is the most rewarding.
I worked as a General Nurse and a Psychiatric Nurse in America, the UK and Australia and spent 10 years in st. Vincent’s Elm Park. But this by far has given me the most job satisfaction.
Having experienced Night Nursing from the other side when my mother died, I saw how important their support is at such a difficult time. I feel humbled and privileged to be of support to people at a critical time in their lives.
One thing I’ve learned is that in conversations with people who are dying, we can learn so much about living.
People often ask ‘does it get to you?’ Sometimes it does, but we have a great Director of Services, Mary Ferns, who we can talk to or the Palliative Care team. Confidentiality and data protection is of the utmost importance so we are limited in who we can discuss cases with. I have met the most wonderful people at the most difficult time in their lives and they have made me so welcome in their homes.