A DAY IN THE LIFE OF…Chris Mitchell, Hospice In Your Care Home educator

Chris qualified as a Registered Nurse in 1992 after having worked as a Healthcare Assistant in a nursing home for two years.

Chris Mitchell, Hospice In Your Care Home educator

Shortly after she qualified, she returned to the nursing home as a trained nurse and soon developed an interest in palliative care. In 2003, she came to work at the Hospice as a staff nurse on the ward.

In November last year, Chris joined the Hospice's brand new Hospice in your Care Home team as a palliative care educator working with eight pilot care homes in the borough to improve end-of-life care in nursing homes and reduce unnecessary hospital admissions.

Chris loves her new role, as it combines her background in nursing homes with her palliative care experience, and says it is a real privilege to represent the Hospice in this way.

Chris spends her spare time with family and friends and enjoys weekends away in the Lake District and Anglesey in the family's VW camper van 'Daisy'.

Thursday 11th February 2016

9am When I arrive at the Hospice, I check to see if we have received any urgent referrals that are appropriate for our team.

When we receive a referral, one of us will go out to the nursing home to assess the situation and advise and support the staff. This enables them to provide good palliative care for the resident and their family and enables the resident to stay in the care home if they wish rather than be transferred to hospital.

9.15am There are no referrals today so I check my emails and appointments before I begin to work through actions from my recent resident status meetings. I arrange to go in to one of the care homes to work with staff, assisting residents to complete Advance Care Plans.

We meet with care home staff on a monthly basis to see how each resident is doing and if their condition has deteriorated since the previous month. We may prompt staff to explore a resident's resuscitation status or discuss completion of an Advance Care Plan with our support, so that staff and family are aware of what a particular individual would want if they no longer had the capacity to say.

This is an important part of our role as it helps us to put a plan of action in to place as well as empower staff to provide the best care possible. I believe everyone should be able to live and die in their preferred place of care. If someone does not want to be moved from their care home, they should still be able to receive the same quality of care that they would receive in the Hospice.

10.15 I start preparing a teaching pack to assist with a clinical skills workshop that I will be facilitating for nursing home staff on stoma care.

As part of our role, we deliver clinical skills workshops, such as syringe driver training, catheter care, stoma care and general hygiene skills to nursing home staff. In order to prepare for my stoma care session, I spent a few hours with a stoma specialist nurse at Wigan Infirmary and her patients to gather some case studies and talk through the theory in my workshop.

11.45 I prepare for this afternoon's formal teaching session and get the equipment ready.

This is a 12 week rolling programme covering 12 key components of palliative care. We deliver these one hour sessions on Tuesdays and Thursdays for care home staff of all levels and abilities from our eight pilot homes. As well as a lesson plan, we take with us the laptop, projector and speakers plus any 'resources' needed for that particular session.

12.30pm I have lunch with my colleagues.

1pm I head over to the care home where I will be delivering the formal teaching session and set everything up before the staff begin to arrive.

2pm I deliver the formal teaching session - today we are covering how to recognise when someone is dying.

This is important for staff to know as it is the first of five priorities of care for the dying person and instigates further actions and communication. Although a very emotive subject, the session went well with staff participating in group work and discussions. Evaluation following the session indicated that staff enjoyed and learned a lot from the session and felt it very relevant to their roles.

3.15pm Following the session, I talk to some of the nursing home staff as they are leaving, to answer some queries. I also stay behind to speak to one member of staff for their monthly resident status update - to check who has deteriorated, if they have been seen by their GP and if everything is in place that should be. I also check if any residents are able to complete an Advance Care Plan.

By identifying all these things, it helps to ensure that when someone is at the end of their life, everything is in place when they need it, making things easier for the patient, their family and the staff involved. I always remind staff that there is always someone available at the Hospice day and night for advice and support.

4.15pm I head back to the office to complete some documentation work before heading home.


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