On the Front Line of Palliative Care

Gayle Hemlock began her career in medicine and respiratory, working her way up from a staff nurse to a senior sister ward manager. A passion for palliative care led her to undertaking a degree in palliation and ultimately to her current post as a Senior Sister Palliative Care.

What is it about palliative care that interests you?

It’s the fact that we can make a difference to a really awful situation, whether it be a complex physical problem or offering emotional support.

Do most people know what palliation is?

No, I don’t think the general public knows what the word palliation means. That’s why sometimes I say ‘Hi, I am a Macmillan nurse’ because the majority of people have heard of Macmillan rather than palliation. I have to be careful though – I can’t say ‘Hi I am Macmillan nurse’ to a patient with a non-malignant disease because I might frighten them into thinking they have cancer on top of their diagnosed condition.

What are highlights of your work?

There’s probably not a day that goes by that I don’t think “I’m sure a made a bit of a different there”. That’s enough for me, because if I can go to a patient who is in awful pain, and the next day or the day after that they’re pain free, then that’s brilliant. There’s huge job satisfaction in that. It’s also nice to be able to give psychological support: we just talk through whatever is worrying them and they get some sort of benefit from it. It sounds really cliché but I love this job – I’ll probably be doing it forever.

What’s the hardest part of your job?

That’s a difficult one because all of it’s hard. We just get used to it.

Are there any special techniques used in dealing with patients and their families in palliative care?

We all do advanced communication skills, which definitely helps, mainly because patients and families tend to be distressed.  We try to get the most out of conversations using key statements really just to try and get to the nitty gritty of what the problem might be.  I think a lot of it comes with experience really, most of us have been around long enough just to know how to communicate.

Is there anything that is particularly upsetting or stressful about your work?

If we can relate to the patients we’re supporting because of similarities with our own families then it can really hit home. So we have to try and protect each other if there is a case like that – usually somebody else will go so that it’s not quite so challenging.

From a nursing perspective, what are the greatest challenges?

It’s sometimes difficult for people to really understand what palliation is and what the palliative care teams actually do, and that can include clinicians too. Sometimes we find that doctors and nurses refer someone who is newly diagnosed, upset or in pain before they have tried to reassure the patient and given them paracetamol or cocodamol to ease their suffering.

Are there any other challenges that affect your team?

We could do with more community support – there is a definite lack of nurses and Macmillan nurses around us at the moment. Our role is to see anybody with anything that is going to end their life and to provide them with whatever they need at that time. And it’s not just about cancer. People with a COPD or heart failure also need our support, whether they’re in hospital or in the community, so we have to make sure that they’re needs are being met too.

Where do palliation nurses go to for support? 

We are pretty good at supporting each other as a team. When we have time, we have an informal chat at the end of the day, just to go through the patients and talk it down. It’s easier then to go home and become the wife or daughter that we are outside of our jobs. This works well in our team because we are all in the same boat and we all understand the patients that we are seeing,

What advice would you give to nurses who want to move into this area?

I would tell them to get a few years’ experience under their belts first. The patients that we see could have anything, it could be a gynaecological problem, it could be respiratory, it could be orthopaedic and so on. So you’ve got to have a broad knowledge base and been qualified for several years to get by.




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