Penarth end-of-life nurse shares thoughts on challenging year

Alison Palmer, who works at the Marie Curie Hospice in Penarth, is part of the charity’s clinical nurse specialist team – supporting people at home with a terminal illness.

She also helps people through the end-of-life charity’s information and support line.

“Things have been so fast changing, through no fault of our own – the goal posts have changed for everybody so much,” she said.

“Nursing is all about being adaptable and flexible and you never quite know in palliative care what you’re going to walk into – so having things change so rapidly, you’re just getting used to one situation and then another one comes up.”

Ms Palmer, who would visit patients at home before the pandemic, suddenly found her role change when she was pulled in to support the hospice inpatient team during the spring.

Alison Palmer

“It was great for me in a lot of ways because it’s back to the ward nursing that I came from and seeing the amazing work that the hospice did, I think it’s probably a good opportunity for all community teams to get into the hospice and see the work the hospice does.

“It brought us much closer as a team.

“Patients were separated from families, we were having end of life conversations with families over facetime, it’s just an alien world for a palliative care team to be having these sensitive in-depth conversations over facetime.

“It’s usually a much more personal job, and when you’ve had those conversations you normally then have the opportunity to sit with the family and discuss how it’s gone, how they are feeling.

“Doing that remotely has been heart-breaking for the patients, but for the staff as well.

“It’s not what we’re used to; being so distant from families. You don’t come into palliative care to keep patients at arm’s length.”

She said the use of PPE had been difficult – especially during the heatwaves.

She then had a further risk assessment which classed her as vulnerable, meaning she couldn’t be face to face with patients and her role changed again.

She was drafted back to the clinical specialist team, but instead of seeing patients herself in their homes, she would see them virtually or speak to them over the phone.

“Having been right up there with the patients, the role changed, and I couldn't see a face to face patient at all for about two and a half months, and we had to adapt to a whole new way of working.

“The patients have adapted really well to it, and in some cases, I think some patients have found it better.

“Our patients are wonderful and even though they are palliative patients they've got to make you a cup of tea, get the cakes ready, make sure the house is tidy and they're not doing that now before the nurses come, because they can sit in a corner of the room and that's the only little corner I see.”

She will be working through the Christmas period, and last year worked on Christmas Day.

“Palliative care never stops, and Christmas is no different. 

“We are a service that needs to be here for our patients and we accept that, we come into nursing knowing you're going to be working some of these important days.”

She says her own family are flexible – as she encourages the families she cares for to be flexible – around moving Christmas celebrations.

“I think this year is going to be difficult more than other years, because if you know this is going to be your last Christmas and it's restricted, perhaps can't go out for that big Christmas last lunch you wanted to have or you can't have as many relatives around your house as you would have liked to have had.”

Talking about her work on the charity’s information and support line, she added that there had been numerous calls, both related to Covid and about terminal illness in general, which she provides information to people about from a clinical perspective. 

The support line, which also includes trained officers and bereavement volunteers as well as Marie Curie Nurses, is open to patients, families and professionals who need to talk to someone about any aspect of dying, death and bereavement. 

Sharing her final thoughts at the end of 2020, she said: “We had a lot of personal challenges in 2019 in our family, we had a bereavement ourselves and I couldn't wait to see the back of 2019 and said I can't wait for 2020. 

“I will never ever wish a year away again. Be careful what you wish for.”

If you want to talk to someone about terminal illness or a bereavement, call Marie Curie free on 0800 090 2309 or visit https://www.mariecurie.org.uk/help/support/marie-curie-support-line/christmas-story.