St Christopher’s Hospice: Nursing and the Contemporary Experience of Dying

In the midst of a pandemic, nursing for people facing the end of life has never had a more prominent place. With funding from the Burdett Trust, St Christopher’s Hospice has created a model for end-of-life care that reflects a contemporary experience of dying. 

Heather Richardson, Joint Chief Executive at St Christopher’s Hospice, and Marie Cooper, Project Lead, are both focused on celebrating nursing at St Christopher’s, as well as nationally and internationally.

We are both nurses who share a long-term commitment to the practice of nursing – including that related to care for people at the end of life. We have worked together in a variety of roles and organisations over the years, jointly committed to improving the experience of people who are dying or bereaved. In our work together we have delighted in the high-quality care we have observed at times, mused over different challenges that nurses face in pursuing their ambitions to deliver such care, and given careful consideration to ways in which nursing could be better supported at local, national and global levels.

Our focus

Our aim was to create a contemporary model of nursing that could guide care for people facing the end of life. We wanted to build on the value of earlier models of nursing that have had a significant influence on shaping approaches to training, documentation supporting nursing and similar. A very helpful nursing model focused on end-of-life care was generated in the early 1990s by Oberle and Davies but we have not found anything since that reflects a contemporary experience of dying and other challenges that nurses face today and in the future.

Whilst we wanted to generate a model that could be credible in the eyes of academics and policy makers, our main ambition was to articulate an approach that could be of value to nurses working in a whole range of settings and at different stages in their professional journey. We wanted to provide a clear articulation of the role and impact of nurses in end-of-life care that individuals and organisations could refer to in their considerations about the future of nursing and their part in it. We believe it could inform new metrics, research opportunities, leadership development and competencies for nurses, and importantly, it could help establish a new conversation about nursing at the end of life to shape its professional direction.

The impact

It could be argued that nursing for people facing the end of life, their families and others close to them has never had a more prominent place than it does currently, in the midst of a pandemic, for some a deadly one. We see nurses on the front line confronted by some patients whose condition is rapidly deteriorating, nurses in the community looking after people who are seriously ill, nurses in hospices caring for people in the last days of life and there are other nurses doing much more besides to keep the show on the road at such a challenging time.

Despite this significant contribution, we are surprised at how quiet the voice of nursing is around issues of end of life, and how low the attention is to these nurses’ development, wellbeing and resilience – both historically and currently. Our model aims to change this, providing nurses with a new vocabulary, with renewed confidence about their contribution to valuable patient outcomes, and a framework to guide and improve their practice, performance, personal development and their conversations with employing organisations about the support they require.

If nurses work according to the model patients and families can expect to see an improvement in their personal experience of end of life through increased confidence, competence and accountability on the part of nurses. Similarly, organisations involved in end-of-life care, who are interested to develop their nursing workforce to improve the quality of care for patients and families, but currently lack any guidance for this work, can draw on the detail of the model to guide their plans. We anticipate new opportunity afforded by the model to the profession of nursing in which there is a notable lack of clarity within the profession currently regarding the unique contribution of nursing to end of life care reducing opportunity for advocacy.

Finally, we believe the model will support members of the broader multi-disciplinary team and the wider system of health and social care as they seek to work collaboratively and effectively with nursing colleagues, confident that they understand their contribution and skills.

The funding

The funding from Burdett has been crucial to this work. It supported the appointment of Marie as the Project Lead, who has been crucial to the development of the model and a broader programme of work celebrating nursing for people at the end of life, including a new community of pioneer nurses from across the world.

We have plans for more. We want to share this model widely and have a programme of webinars planned to introduce the model and discuss its implications. Using funding from Burdett we are generating plans for workshops for individual teams, local systems of care and nurses who want to develop their practice and related structures and processes.

The future

Informed by the feedback from the series of webinars, we will generate plans to roll out the model, starting with a community of nurses interested to work together to consider how elements of the model could be applied to their own local context, and together generate a new body of knowledge around how nursing impacts and drives forward end of life. New partnerships will be generated and we will conduct work on how the Model could be used to inform on clinical leadership, research, metrics and nurse competencies/career pathways.

Our webinar series

We are really keen to engage colleagues in discussions about how this model of nursing could advance nursing in end of life care. To that end we are hosting a series of four free webinars. In addition to describing the model, we will cover themes of  relevance for nurses working today which the model seeks to address. These will include: the value of our model of nursing, what person centred care looks like in practice, the art and science of caring, and organisational responsibilities and opportunities to ensure the optimum care environment for high quality nursing. We are delighted that these themes will be addressed by a range of fabulous speakers each offering interesting insights and perspectives.

Our next webinar is on February 4th, 4-5 pm, and are extending a warm welcome to all to join us as we discuss what opportunities this could give us to advance practice and the nursing profession more generally. They are all free and everyone is welcome.

Find out more on St Christopher’s website or email one of us to find out more

https://www.stchristophers.org.uk/course/lantern-model-webinar-series/

About St Christopher’s Hospice

Website: www.stchristophers.org.uk
Facebook: @stchrishospice 
Instagram: @stchrishospice

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