Clinical Nurse Specialist Julie Laing explains about her role in Rowcroft’s Community Team
Asked to imagine the day-to-day life of a nurse, most people would picture a busy Inpatient Unit setting or GP surgery. But did you know that the majority of Rowcroft’s nurses work out in the community, far and wide across South Devon, in people’s homes and care homes? Julie Laing is one of Rowcroft’s 12 community nurse specialists who provide expert care and support to patients and their families in their homes across the 300 square miles that we cover. Here she provides a fascinating glimpse into her role.
“I’ve worked as a nurse for Rowcroft for 16 years and I absolutely love my job in the Community Team. I feel really humbled every time I go into a patient’s home. To be supporting someone when they’re at their most vulnerable is a complete privilege and I never forget that.
“My responsibility is to make sure that my patients’ needs are being met. We’re a palliative service –meaning that we care for people with non-curable illnesses (life-limiting illness) where it’s highly probable that the patient will die from the illness. But we can’t say when that will happen and it may be some years. Some people see the hospice as the bringer of death, the grim reaper – so it’s about trying to reassure people that we’re not.
“My role is about assessing where each patient is on their illness trajectory, and working out what support they may need, for example, physiotherapy, special equipment for the home, expert advice or medication. Sometimes there is gentle deterioration in the patient; sometimes it’s quite rapid. Sometimes we have people dipping in and out of our services over the years – being referred, then discharged, then re-referred again. Part of my role involves helping to manage symptoms, anticipating future needs, and facilitating difficult conversations about planning for the future and preparing for death.
“The beautiful thing about palliative care is that I can mix my background in psychiatry with general nursing. My work isn’t rigid – I am able to respond to the needs of that day. Every time I enter a house I meet a different situation, and I love that. And I like that I have so much autonomy in my role and I’m able to draw on my personal knowledge, experience and my personality when I’m with patients.”
“Supporting a patient to manage their symptoms is about helping them to be comfortable, but it’s often about much more than that – it’s about enhancing the quality of life. People are all different and have different goals and wishes. My role is to find out how we can help them to cope with their days, to help them expand their thinking beyond symptom control – for example the things they want to do, the goals they want to achieve if that’s appropriate. It’s all absolutely centred around each individual person. Some people don’t want to be completely pain free; they want to be more awake and that means cutting back on medication that might make them drowsy. Other people won’t even touch medication.
“Sometimes it’s about making suggestions to help bring the family moments together, for example bringing Christmas forward so that a patient can see their loved ones open their presents.
“Other patients may not want to talk about their illness, and I’m not there to challenge that – I’m walking with them, and that’s the crucial point.”
The challenges of COVID
“It has been incredibly stressful through the pandemic, especially because a lot of our nurses have lost family members during that time. I lost my father to COVID, right at the beginning of the crisis. It’s been a really painful time, but as nurses we’re going into situations with patients where we can convert all of our traumatic personal experience into something very positive for other people, and that’s what makes it all worthwhile.”
The Rowcroft way
“I couldn’t work anywhere else now, I feel completely at home. There is a Rowcroft way that’s a very unique approach. It’s totally holistic, and I love that we support the whole family including children. It is this care to the whole family that makes it so memorable for loved ones left behind.
“I work with a team that’s full of amazing people and I have so much respect for all my colleagues. I love the way that I work really closely with other disciplines – such as social workers, occupational therapists, physios, complementary therapists, doctors and music therapy , spiritual care and bereavement team– towards one common goal to provide the best possible care for our patients and their loved ones. We’re so lucky at Rowcroft to have all these wonderful resources that we can draw on when needed.”