Geraldine Bohan: Irish Cancer Society night nurse working with the Longford Homecare Team.
The Irish Cancer Society offers a free night nursing service to cancer patients who want to remain in their own homes. While the principal carers are the family members, the service gives support to these carers - especially towards the end of a patients' life which can be a very difficult and anxious time.
My job is to provide patient care which incorporates the principles of palliative care and to relieve the family members of their caring responsiblities so that they can have a night's rest. The patient's GP prescribes all medication to be used by the patient.
When I am requested to care for a patient at night, I am given a report of the patient's medical condition, told what family members will be in the house and given a detailed route map to the patient's home.
My working night begins at 11 p.m. and every night is different. After the initial introduction to the patient and a familiarisation with the household, I encourage the family members to rest but if they want to stay with the patient, that's no problem. Sometimes family members may wish to help me make the patient comfortable before they rest themselves.
Usually, the carers are tired and appreciate the opportunity for a good night's sleep. I always identify where one family member is sleeping in case I need assistance during the night. I usually stay by the patient's side through the night. In a case where a patient is sharing a bedroom, I would ask if it was preferable for me to stay outside the bedroom. In the case of a child, the parents may wish to have their little one in bed with them and enjoy some very precious time together.
When caring for someone in their own home, a calm, reassuring presence is of utmost importance and the patient is given full nursing care in an unhurried manner. Any worries the patient may have can be expressed and discussed in a confidential setting. Also, the patient is allowed to enjoy a cigarette or alcoholic drink if he/she wishes. Usually, the patient will have a syringe driver in place which I check regularly to ensure it is running satisfactorily. I also check the needle site for any signs of adverse reaction. The position of the patient in bed is also changed regularly to ease pressure areas and aid comfort.
Throughout the night, I offer whatever nursing care the patient needs. While he/she is resting, I sit quietly at the bedside, have a snack and read a book or study new developments in cancer care.
As morning approaches, I attend to the patient's personal hygiene needs, offer a drink and encourage him/her to enjoy another day.
I leave a written report for a member of the homecare team who will visit during the day. A family member takes over from me at 7 a.m. and after a chat about the patient, I leave.
Sometimes, a patient may die during the night. If so, this is treated with great sensitivity and my role is to support the family in whatever way I can while also leaving them space to grieve.
Some people may think being a night nurse with the Irish Cancer Society is a very lonely and sad job to do. However, there is great satisfaction in offering support and comfort to a patient and family members at such a distressing time in their lives. Sometimes, I do deal with very sad casesbut when this happens, I am supported by the home care team.
At present, night nurses working for the Irish Cancer Society are working in a temporary capacity. I'd love to see some permanent posts created in this area to improve continuity of care for patients. The night nurse service is a wonderful addition to the home care team and I'm priviledged to be part of it.
(Interview by Sylvia Thompson)