A Day of the Life of…Hospice Counsellor Julia Sixsmith

Julia was a nurse for 25 years but always had an interest in psychology.

Julia Sixsmith

While working in obstetrics and gynaecology she mentioned to her manager she felt that the emotional needs of the women they nursed were not being met and embarked on a degree in Counselling at UCLAN.

She continued to work as a staff nurse while volunteering as a counsellor before accepting a role with Wigan Family Welfare to work with schoolchildren as a counsellor. Julia began working at the Hospice 12 years ago after successfully applying for two separate posts as a counsellor and bereavement services co-ordinator. She now works part-time as a counsellor helping patients and both adult and child relatives of patients.

8.30am I check my emails and make some phone calls to patients and other members of staff at the Hospice.

9am I spend some time speaking to a patient who I have been helping for some time but is becoming more poorly and wants me to do home visits. I tell her I will keep on seeing her for as long as she wants me to.

Every day is different: one day I can be working with a patient on the ward or sitting with a child whose dad is dying. Patients can self-refer but they are most often referred to me by the Hospice Nurse Specialists, doctors, Wigan Infirmary, Inpatient Unit nurses and our complementary therapists when they see patients or family members are in psychological distress.

10am I meet with a woman whose mum has recently died on the Inpatient Unit. She and her mum were best friends and she is struggling to come to terms with her loss.
I can see up to five clients a day and spend up to an hour with each of them.

11am I did have an appointment to see an 11-year-old whose dad died but it was cancelled. Instead a new doctor at the Hospice rang to see if I could help support a family in telling the grandchildren that their granddad was dying.

I do a lot of work with children and as much as it pains me it needs to be done and it needs to be done properly. One thing I love that is unique to here is that I can work with children while their parent is grandparent is under the care of the Hospice and right through into bereavement. We can talk about what is going on throughout the process and prepare them.

With an adult you know from the beginning what you are getting but a child might not understand the counselling process or what death is. Often we think we are saying the right thing but the child doesn't understand. I get to work with them early on and make sure they understand.

Sometimes children might not want to talk or have difficulty expressing what is going on with them so I have a cupboard full of toys, such as a toy hospital, which they play with and leads us into conversation. We sometimes play therapeutic board games which gets them talking about themselves and what they are thinking and feeling.

12noon I have lunch and a brisk walk around the Hospice gardens to clear my head.

12.30pm I check my emails and make a phone call to a bereaved client who needs to see me at short notice. It's coming up to his wedding anniversary so he wants an appointment.

1pm I speak to one of our Hospice Nurse Specialists who is referring a patient to me and wants to give me some background information. The patient is finding it hard to come to terms with his diagnosis.
Sometimes we can see people are in distress but they refuse to be referred which is a real shame. If your car breaks down you see a mechanic, if your tooth hurts you see a dentist, if you're poorly you see a doctor and if you've got emotional problems you should see a counsellor. It's not a sign of weakness: it's a sign of strength.
I also spend some time preparing for a teaching session I am leading next week on children's experiences of palliative care.

1.30pm I attend a Multi-Disciplinary Team meeting which is a regular meeting held with the Hospice Nurse Specialists. We talk about patients and what their needs are including any counselling needs.

2.40pm I read an update on a new child protection policy.

3pm I meet with a student counsellor from the bereavement support team I am mentoring. The student has not been able to come in for some time so I want to check how she is before she starts seeing clients again.
Students love this placement: they work for us but working here helps them get their qualification in counselling. We have monthly meetings when we offer advice and support.

4.30pm I return a phone call from a client and make a new appointment.

4.45pm The end of the day.


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