Caring for People in Harrow & Brent

This is what it takes

The shrill ringtone on my work phone pierced the eerie silence of the world outside. No cars on the road. No people walking by. I couldn’t hear the children of the local school playing outside anymore because, well, no one was at school. The world changed in those weeks at the end of March. Life simultaneously became more insular and yet increasingly interconnected. A malevolent and life-threatening virus was amongst us and, in order to protect each other, we were forced apart; from family, friends, work colleagues and even patients.

We changed our working practices within a week, embracing laptops and virtual meetings. On these video calls, I could see into the homes of my colleagues and get a glimpse of their lives beyond work. Whilst the rooms they sat in were different, the looks on their faces were the same as I had seen in the weeks before: fear, anxiety and – as time passed – a growing emotional exhaustion. Whilst we flexed to the technological challenges easily enough (VPNs, Zoom, Skype and Teams), the human cost of COVID-19 as it swept through our borough proved beyond true adaptation.

As a palliative care nurse, I am used to having conversations with the dying and bereaved; this is what I do. However, the scale of referrals was unprecedented and the volume of discharges, to both home and care homes, alarming. Patients and their individual needs are the cornerstones of palliative care but COVID-19, at its first-wave peak, shifted that focus. Providing holistic care to patients and families forced apart during lockdown represented a very different challenge.

The fact that the dying could not have loved ones with them at the end of life created a deeper anguish and sorrow in the bereaved than I had witnessed before. Those precious, intimate moments at the end often provide great comfort to those who must carry on living. Talking with relatives robbed of the chance to hold, touch and talk to loved ones in their final days; I see this as one of the many hidden cruelties of COVID-19.

My working days were spent listening and supporting these relatives as best as I could, sometimes with meaningful silence when there were no words to say. Often they would cry uncontrollably – as the weeks went by, it became harder not to feel their tears welling up inside of me. The emotional labour, always given willingly, had never felt greater. And yet, as a team, we hung together and grew in support of each other; we listened with heightened compassion when it threatened to become too much. Our practice changed and evolved. Our skills in telephone and video assessments became more confident. Our prescribing knowledge developed. Our determination to get fast-track funding, to ensure patients had care at home where possible, increased.

What next? Like all the health professionals, we have worked incredibly hard through these uncertain times. However, as summer turns to autumn, it feels like storm clouds are gathering again. The same anxiety and fears build and we can only wait to see what the winter holds. Armed with the experience of the last six months and the support of excellent colleagues though, maybe we can feel better prepared for the battles ahead.

Elaine Sweet – Palliative Care Nurse

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St Luke’s Hospice (Harrow and Brent) CQC rating: Good

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