James Rushby, Macmillan Palliative Care Clinical Nurse Specialist

James Rushby

Spring 2011

Location Macmillan and Specialist Palliative Care Team at NHS Heywood, Middleton and Rochdale

In post Since 2010 (previously in post as a Macmillan Associate Palliative Care CNS)

What was it like being involved in the documentary Super Nurses?

Taking part was an honour because there are so many nurses out there doing great work. The filming schedule was sometimes challenging and time consuming.

However, on reflection, it was a once in-a-life-time opportunity to showcase the work being undertaken with patients, and it was great fun working with the production company. I feel very proud and grateful to the patients and families who were brave enough to tell their very personal stories to the camera.

What does your role involve?

Specialist palliative care is about incorporating a holistic approach to care and recognising the complex, multiple effects that an illness has on the patient, families and their wider support network. I also offer bereavement support to carers and the wider family.

Although a palliative approach is appropriate at any time, most of the patients I see have a poor prognosis.

What are the biggest challenges?

Arriving into a complex and fraught situation where patients and families are anxious and distressed can be exhausting. But being able to leave the patient and family feeling calmer, more reassured, and with a clear plan of care, is very rewarding.

What do you most enjoy about the role?

Although it’s a bit of a palliative care cliché, I like making a difference to patients’ lives and helping them to achieve their wishes. This could be controlling their nausea during chemotherapy, or ensuring they die at home as they wanted.

It’s also professionally satisfying to be able to act as a resource to others, such as district nurses and GPs. The ‘thank yous’ go a long way to making me feel like I’ve made a difference.

What projects have you been involved with since being in post?

I have supported the introduction of theLiverpool Care of the Dying Pathway|, the Gold Standards Framework Programme| and the Preferred Priorities for Care| across both the hospital and community settings.

For the past three years we have held a successful cancer care conference, and I have been involved in all aspects of its planning and delivery. I act as the team lead for the regional user survey. The results help us to provide a quality service to patients and carers.

Education is a key component of the role and I deliver training to health and social care professionals including Foundation Year 1 & 2 doctors and district nursing staff.

Recently I contributed to a review of the drug prescribing guidance for patients at the end of life in the area.

Appropriate and timely information is an important part of the patient journey and I have been involved the development of several patient and carer leaflets working closely with our Patient Information Reference Group.

How would you like specialist palliative care to develop?

I would like to see an increase in non-medical prescribing within specialist palliative care and the introduction of clinical skills training to support prescribing. This would improve access to appropriate medication for patients and improve consistency.

I would also like to see the move to seven-day working in specialist palliative care. I think we have an important role to play in helping reduce hospital admissions at the end of life, and supporting the rapid discharge of patients with specialist palliative care needs.

What is the most unusual job that you’ve had?

In many ways this post is perhaps the most unusual. It’s unpredictable and the variety certainly gets the cogs turning in the morning. Outside of nursing, my most unusual job was probably working in the freezers in a supermarket – a job which nearly gave me frostbite every week!