A day in the life of Palliative Care Nurse Louise Watson

"Often, people think my role must be very depressing, that is not true. It is very rewarding and I feel privileged to be involved in making a difference to both patients’ lives and their families.”

I have been working at Priscilla Bacon Lodge as a Community Specialist Palliative Care Nurse for twelve years now, having qualified in 1986. Previous to this role, I was a district nurse based in Norwich and that’s what attracted me to my current post. I was already looking after patients with palliative care needs, which had given me insight into how patients and their families cope with life-limiting illness.

Palliative nursing care is dynamic and every day is different, which is one of the things that I like most about my role. My shifts are mainly 8.30am – 5pm, Monday to Friday. I also work at weekends on a rota, holding the specialist palliative care advice line for health professionals. There are 12 of us in the team and we support patients across central Norfolk. I work in South Norfolk.

Going on shift

A typical day for me would start at 8.30am in one of the GP practices I cover, attending a palliative care meeting. This would involve representatives from the multi-disciplinary team, including district nurses and GPs. We discuss patients on the palliative care register and are briefed on new patients that require palliative care. Patients’ needs are discussed and I offer advice on complex symptom control and holistic care. We all take great care and pride in our work, to ensure patients are receiving appropriate input, so current needs are addressed and advanced care planning is documented.

At around 9.30am, I would normally check messages and then head out to do my patient visits in the community. I typically have around 35 patients on my caseload. A first assessment for a new patient normally takes about an hour. I meet the patient and their family and find out what the issues are for them. Patients and those close to them have the opportunity to discuss their thoughts and feelings related to their illness, as I aim to give them the space to do that. Building a good rapport really helps to provide the best support and care. Advanced communication skills are essential for my role.

Challenges and rewards

One of the main challenges in my role is prioritising and time management, as some days I can have a number of urgent cases and therefore I have to decide who I need to visit first. I also have to remain flexible at all times, as if an urgent referral comes in, it means I can respond as quickly as possible.

I find it’s the simple things that mean the most to my patients. Enabling them and their families to have the best possible end of life care is very rewarding. If I have made a difference, then I feel my job has been worthwhile. In fact, I still occasionally hear from relatives of patients I have cared for. It is nice to know that despite the years going by, someone still remembers the care you gave to their dying loved one.

One of the aspects of my role I find most interesting is meeting people from all walks of life. Everyone has a different story to tell and I often find out amazing stories about the backgrounds of what people have achieved and accomplished in their lives. Making a connection with families and my patients is a key skill to have in my role.

Goals, achievements and aspirations

I am most proud of achieving my non-medical prescribing qualification, which means that I can prescribe medications for my patients, optimising their symptoms.

I see myself in the future very much staying in palliative care. I would like to help develop the service and grow with it. I also like training new members of the team and sharing my advice and experience with them.

If I could wave a magic wand and ask for one thing to make my job easier, it would be that paperwork automatically filled itself in, so that I could have more time to spend with my patients.

Outside of work, I have recently moved to the countryside and I spend a lot of my time in the garden and taking my two dogs on long walks beside the river. I also have a very supportive husband and four grown up children, who take up the rest of any spare time I may have! Two of my daughters have chosen careers as staff nurses in intensive care and I am very proud of all of them.

A final word

Too often people get really frightened about the words ‘Palliative’ and ‘End of Life” and treat it as a taboo subject, but it shouldn’t be and isn’t. A big part of my role is offering reassurance and information. It’s not about giving false hope, but it’s about being honest and managing people’s hopes in a safe and supportive environment.