Posted: 23 February 2017
It was an honour for Eden Valley Hospice and Jigsaw Children’s Hospice to host a visit from Sharon Allen, CEO of Skills for Care, not many sector leaders make it as far north as Cumbria.
As a Skills for Care Fellow I am always interested in learning, connecting and sharing. Sharon’s visit was a good opportunity for us at the hospice to reflect with Sharon on what is unique and what is universal about hospices and other services across health and social care.
Sharon highlighted three key aspects of hospice care: time, humanity and love.
“Time” remember that?! One of the things our nurses often say when they join us is that they feel they now have more time to spend directly with the patients and families and it reminds them of when they first became nurses; when care was less transactional and more relational. Our surveys demonstrate that the patients and families very much share this view with almost 100% approval ratings. Sharon asks the question: does having more time equate to having more resources? Certainly at our hospice the qualified nursing ratios appear to be higher than might be found on an average NHS medical ward and yet the costs are comparable - approximately £400 per bed per day. Of course in hospices the cost to the NHS is much less and in our case only £100 per bed per day and the other £300 comes from the unstinting generosity of the good citizens of north Cumbria.
I think there are two complementary explanations: firstly, while there are still many technical and complex nursing procedures to undertake (syringe drivers etc) the culture is one that encourages conversation and engagement - it is explicitly recognised as having value in supporting patient wellbeing. The management of pain and discomfort is much more than just drugs it is also about reassurance and helping to reduce anxiety. Secondly, this culture extends to all patient and family contact; from the volunteer receptionists, drivers and ward assistants to the housekeepers, caterers, therapists, chaplain, social workers, counsellors and doctors. The holistic approach of hospices means everybody prioritises making time.
What about humanity and love? From my experience values are important to colleagues working in all areas of health and social care and I don’t believe hospice colleagues are any different. I think what is apparent are the behaviours which make these values real: warm welcome and the courtesy of making visitors and families a cup of tea, allowing family pets to visit and stay, loving having flowers to help the brighten rooms, making a jug of custard for someone in the middle of the night etc. There is also something wholesome and mature about how at ease hospice colleagues are about physical contact - giving a grieving relative a hug, cuddling a poorly child, kissing a child goodnight, holding the hand of anxious patient - all freely given and gratefully accepted. We have no policies on human kindness!
For me the main learning or relearning has been the importance of understanding what it is most important for the people we are supporting and then trusting our colleagues to use their skills, experience and personal attributes to best effect.