Thursday 19th September 2013
Terry Capecci, Macmillan Associate Palliative Care Nurse, has been in her post since November 2012, and is on secondment in this role until November 2013. She is based at Birmingham City Hospital, Sandwell and West Birmingham Hospitals NHS Trust.
Tell us about your role
I’m currently on a 12-month secondment with the palliative care team, in a role supported by Macmillan. This is giving me the chance to learn more about the specialism of palliative care, so I can take this back to a general ward and encourage improvements.
What was your background before this post?
Before the secondment I was a ward-based staff nurse. Over the past 22 years I’ve worked in many ward specialities, most recently in gastro and respiratory. I have a degree in nursing studies and before the secondment I completed an end of life care degree module.
Why did you apply for the secondment?
On my last ward I was the palliative care link nurse. This was a role I embraced and felt passionate about. But I recognised there were areas of palliative care in the hospital, specifically within ward areas, that needed improvement. As soon as the secondment was advertised, I knew it would be an opportunity to gain experience of good practice that I could share with my colleagues.
What does the secondment role involve?
I work closely with the palliative care team, who are incredibly supportive. They’ve given me insight into the different disciplines involved in palliative care, including hospital and community Macmillan nurses, Macmillan occupational therapists, rapid discharge liaison teams and organisations such as hospice at home. I’m reviewing known patients and making decisions about their symptom management.
I’ve progressed to assessing new patients with the palliative clinical nurse specialist and am participating in the psychological and emotional aspects of their care. This can be anything from breaking bad news to offering support and advice, as well as listening to patients’ concerns.
What is the most valuable lesson you’ve learned so far?
The most valuable lessons have been around symptom control. This can often be complicated, as no two patients are the same, even with the same symptoms. The management needs to suit each patient, depending on their cancer and history. I’ve learned so much – the most important thing is to share this with colleagues.
What training options have you taken advantage of?
I’ve been to several study days on end of life care. I’ve also just started the Princess Alice European Certificate in Essential Palliative Care. This is an eight-week self-directed distance learning course delivered by the Princess Alice Hospice in Esher, Surrey.
Are there any patients who have stuck in your mind?
I’ve been involved with many patients who are at the end of life and it’s a privilege to be involved in any way, no matter how small. To be able to comfort someone just by holding their hand or listening to them talk about their disease can make such a difference.
But there are a couple of patients and their families who have particularly stuck in my mind. In the first situation, I was present when the palliative clinical nurse specialist was breaking news to two young children that their dad had cancer and was likely to die soon.
I also built up a good relationship with a newly married young woman who had just been diagnosed with advanced uterine cancer with a poor prognosis. She has since died but left a lasting impression.
What have you done, so far, to encourage improvements in palliative care?
When I was working on the ward, I created a folder of information about the palliative care needs of dying patients. It was well used by staff from all disciplines. I’ve recently adapted the folders to include up-to-date guidelines and plan to distribute them to all wards.
Palliative care link nurses play a major role in improving end of life care, both within their own areas of expertise and by sharing best practice within other areas of care. To help them achieve this, I’ve developed a questionnaire for them to share their ideas for improvement. This will be used to create a study day to expand on their suggestions.
What’s the best advice you’ve been given?
Someone advised me just to be myself. Patients are very receptive and often more open with someone who genuinely comes across as caring.
What are your plans for the future?
Macmillan Cancer Support has given me the opportunity to explore different avenues for improving end of life care and I would certainly like to stay within this field. I have many goals to achieve in this role, so who knows what the future holds?
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