The Palliative Care Team strives to improve the quality of life of patients with a life-limiting illness and to ensure that patients have a good death in line with their preferences and wishes. The team aims to upskill ward staff and to increase their confidence so that they too can support dying patients and their loved ones. COVID-19 challenged much of what epitomizes good end-of-life care - reduced choice, if any, of the place of death; restrictions on visitors; breaking bad news over the telephone; reduced ability to use touch to reassure relatives. The list goes on.
What COVID didn't do to the palliative care team though was stop them - in fact, they went above and beyond in order that patients still had as good a death as possible, that their loved ones felt involved, whether present or not, and staff felt supported in what was often an incredibly emotive situation. They aim to see all dying patients within NGH, and they continued to need to do this. There were 300 COVID-related deaths in NGH, and they were involved in most of these cases.
The SPCT normally works an 8-4 service but it was recognized early on in the pandemic that ward staff, both nurses and doctors and other AHPs, needed advice and support, out of these hours. In response to this, they extended our service until 9 pm. This brought about its own challenges with many of the team has not worked shifts for many years, but to be able to support staff looking after dying patients into the early hours of evening was necessary and appreciated by ward staff. Whilst there has always been symptom management guidance for the last hours and days of life they recognized that these needed to be adapted in line with what they were seeing in our dying patients.
Led by the interim lead nurse and consultant, they developed symptom management guidance, and also one that proved vital to support staff who were withdrawing oxygen on patients dying of COVID. Trying to close the gap between loved ones not present and the dying patient was of utmost importance and following on from work already done by the lead nurse, they promoted the use of fingerprint mementos, many staff who, with some support and encouragement, were able to take a fingerprint memento from a deceased patient to give to the next of kin. This has had a hugely positive impact on relatives and loved ones, at a time that has been so distressing.
Members of the team have also supported newly qualified nurses to break the sad news of someone's death over the telephone, bought eggs from the canteen to make a sandwich on the ward for an exhausted relative because they couldn't access the facilities themselves, supported staff in some distressing deaths, both at the time and afterward, answered messages from upset staff to provide reassurance, delivered clinical skills training to more than 130 staff in preparation for them being deployed to wards, told inpatients that their spouse has died of COVID because family members couldn't visit themselves, bought a bottle of Bailey's to facilitate a dying patient's last wish of that delicious taste. I want to say thank you to the team for being such fantastic support to NGH patients, relatives, and staff.