Fifty-two nursing homes across Southern Derbyshire have now received specialised training on how to mix end-of-life medication at a patient’s bedside. Prior to this, nursing staff did not have the skills to mix their own medications to be used in a syringe driver pump. Pre-filled syringes were made up by the hospital pharmacy, sometimes leading to delays in care.
The vital training is being led by clinical facilitators Katie Gibbins and Faye Thrasivoulou on behalf of the Derby and Derbyshire Clinical Commissioning Group (CCG). Katie and Faye are being hosted by Treetops Hospice Care in Risley which provides nursing care and emotional support for adults with life-limiting conditions and their families.
Pain relief and medication for patients at the end of life
Katie explained the huge positive impact of the training:
“We are training care home staff to use syringe drivers to deliver the same pain relief and medication direct to patients at the end of life, ensuring their symptoms are brought under control earlier and so they can spend crucial time with their family members.
“It also means residents at the end of life don’t have to be sent to hospital but can die in their own home if that’s their choice, with familiar people and things around them.
“And homes can become a completely secure unit as nothing is being bought in externally from the hospital.
“The training is crucial and an essential, key element to care homes being able to offer a Gold Standard end of life care and achieving their CQC rating. All other training has been cancelled due to COVID apart from this, because this is so critical.”
During the summer months, Katie and Faye would set up a Treetops gazebo outside care homes for training but not all homes had suitable outdoor areas, so training proved impossible during wet or windy weather.
The Treetops Facilities Team came to the rescue, adapting one of their hospice minibuses – currently not in use – by removing existing seating and fixing a table and chairs to create a mobile classroom.
We can reassure care home managers and clinical staff that it’s COVID-safe
“Although some training can be delivered remotely via Zoom or through one of the training videos we have created, there is still a need for us to go out and give detailed demonstrations for small groups of staff.
“We can now train two staff at a time in the minibus very safely. Staff enter from the side door of the minibus and we enter from the back, leaving the windows open. We are at least a meter apart from each other with a table between us and we all have full PPE.
“There’s also a plastic shield between us and the driver when we’re out and about. It looks really good and we can reassure care home managers and clinical staff when they book the training that it’s COVID-safe.”
There is a constant need to train new employees at homes as well as offering ongoing peer support.
Without the hospice, this training simply wouldn’t have happened
“When we are out and about, we promote other support that homes might not be aware of, including bereavement counselling that Treetops offers to staff in a group setting or for individuals. Treetops also provided us with hampers to take to the homes, to boost morale and remind them they’re not alone.
“We’re so lucky with what Treetops have provided. Without the hospice, this training simply wouldn’t have happened.”
We may not be able to add days to life, but we can add life to days
Katie admits the current mood amongst care homes is low:
“We know from talking to care home staff that they are under a lot of stress and the ever-changing situation with COVID makes things very difficult.
“At the height of the pandemic last year, many staff told us they felt very lonely. Things are still tough, with many homes short staffed and they are naturally worried and scared. They also have a lot of pressure on them to facilitate family members coming to visit residents and that takes time.
“But even so, homes have really welcomed us and benefitted from the training. We have had some fantastic, positive feedback and have a lot of homes booked in for training in January and February.
“We’re so proud of what we’ve been able to achieve. It’s so rewarding to be able to make a positive change to delivering end-of-life care here in South Derbyshire. We may not be able to add days to life, but we can add life to days.
“No nurse should feel like they can’t manage somebody’s end of life needs so we want to encourage all nursing homes across southern Derbyshire to get in touch with us.”
During the pandemic, Treetops has adapted its services to continue to support its vulnerable patients in the community. The hospice welcomes donations to their Treetops COVID-19 Appeal to ensure the future of the hospice and its services.