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What is the night shift at a hospice like?

By Pollyanna, Hospice at Home nurse

It’s 8pm when I get to work at St Barnabas. Although there’s a lot of bustle at handover time, the hospice is a different place at night – all of the offices are empty, and the daytime buzz is over. I love the atmosphere of calm and quiet.

The nature of this role means that there is no typical shift. The first thing I do is log onto the system and find out what patients may require a visit that evening.  Sometimes, one of the clinical nurse specialists or doctors on the day shift has left us a message asking us to go and check on a particular patient. Throughout the night, we take calls and visit any patients who need our help, via the collaborative End of Life Care Hub (ECHO), commissioned by our local Community Trust.

One of the best things about working nights is time. I enjoy feeling that I can give my absolute best to every patient. People feel more vulnerable at night, and we’ve got the time to offer them a bit more emotional support. Sometimes we see patients who don’t need a lot doing practically, but who are feeling scared and alone. I can stay and chat with them, to give them that reassurance.

That’s the best thing – the feeling that you are making a significant difference at such a difficult time for someone. But the most challenging aspect is not having access to the support available to the day team, although you know there are people on call.

Another real challenge of working out of hours is not having access to the same services you’d have during the day. If there’s a problem with a prescription, for example, you can’t just phone the GP and resolve it immediately.

Image of two nurses at work, at night

Image above: Pollyanna and colleague, Kathy, getting ready for the night shift

We make a lot of judgement calls and I think that’s one of the reasons we work so well together. We work in pairs – I work with Louise, a care support worker – and when you spend 12 hours in such close proximity, you have a lot of time to chat. We support each other.

I try to keep to the same eating patterns, having my big meal in the evening before I come to work. But sometimes we get hungry on the way back from a house call, and we end up getting a snack – sometimes even a McDonald’s (mine’s a McFlurry).

It can be difficult to prioritise health and self-care when you work nights, although I try to go for a run every other day. I also have four boys, aged 10 to 16, and my husband and I home-school. My shifts work quite well with family life, because we do a lot of groups and activities during the day. Luckily, I’ve never needed much sleep!

Sometimes on the way back from a patient,  we are lucky enough to watch the sunrise before handing over to our colleagues on the day shift. It’s such a privilege, feeling that you’re one of the first people to see the sun rise over Worthing.

We are very fortunate that the organisation has chosen to offer this service. It supports so many people and means we can offer real continuity of care. We don’t talk about targets or data when we’re evaluating out-of-hours service – we are interested in outcomes. Whether we’re there for 10 minutes or five hours, it’s about what our visit means to the patient or family in that moment.

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For Pollyanna and our night team working from dusk to dawn is full of wonderful instances, providing care while the rest of us are normally sleeping and keeping patients company during vulnerable moments.

Night to Remember is your chance to do something wonderful too. Striding through the night, you'll have the opportunity to remember friends and family no longer with us, while raising money for hospice care.

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