It helps to listen
I have spent most of my nursing career working in cancer care and hospices.
As a palliative care nurse, your role is focused on quality of life rather than quantity. That is what makes it so rewarding – being part of a person’s last hours is such a privilege.
Soon after I qualified, I was lucky enough to get a job on a busy surgical ward, working mostly nights. I enjoyed the challenges that this brought: emergency surgery at night, the post-operative patients and those waiting for surgery. It had real variety.
One night shift, I met a young woman in her thirties. She was being nursed in a side room and was waiting for news on her bowel surgery. The news was not good – she had advanced cancer of the bowel. They had removed what they could but she needed to be referred to the oncologist, and they were hoping she would be treated with chemotherapy.
This was a new aspect of care for me. While the patient was waiting for more news, she clearly needed to talk.
It was important that I had noticed the signs, and gave her the time to be able to talk through her fears and ask questions. She was not in physical pain from her surgery, but was experiencing psychological fear of what was to come: the unknown.
Over the next few days, the news was not good. She was offered palliative chemotherapy with the prospect that the disease could not be cured. I sat with her that night, not knowing what to say, just allowing her to talk.
Pointing to a picture of a little boy, she explained it was her two-year-old son. She had experienced problems conceiving, and was not ready to leave him now after all that trying. She was not ready to die. I didn’t know what to say, so I just listened. And she said thank you.
At that moment, my nursing practice changed and I knew I had to work in this field. I wanted to try to help people live through some dark moments, but also offer them hope and focus on quality of life for that person.
This was what I wanted to do, not just for one or two patients, but for all the people I looked after. This is what we know now as palliative care.
But death is part of all nursing, from A&E to the expected deaths from some long-term conditions, and one is no easier than the other.
Nurses need to be comfortable dealing with death, and be able to talk to people about some very distressing situations. The nurse-patient relationship is an incredibly important part of this. Made up of empathy and respect, it is vital to delivering quality patient care.
Part of how we prepare students at the University of South Wales is through self-awareness. Students need to know their reactions and triggers, and our lectures help them to find these. We look at how to care for a patient and family near the end of life, what to do when someone dies and the practicalities involved.
When I am teaching end of life sessions to nursing students, the thing that they most often worry about is what to say.
My advice is that, as a nurse, sometimes less is more, and all you need to do is listen and be there for your patients.