Hi, my name’s Claire – I started work for my St John’s Hospice in 2018.
I have a very special job looking after patients in their own homes, this could be for a few hours during the day or through the night so that the carers can have a good night’s sleep to help them recharge a little, so they can continue to care for their loved one the next day.
It’s a very privileged position because I am in a patient’s home from roughly 10pm at night to 7am the following morning, so become part of the family and their home. When I arrive at a patient’s home it isn’t unusual for the carer to be exhausted. A Respite visit, whether day or night is so important for both the patient and carer.
I have so many memories of the past three years and want to share some of them so people can understand what St John’s does out in the community.
I remember one of my first patient visits, arriving outside a patient’s home and being greeted by the patient’s daughter who came running up to me and gave me a big hug. She told me she was so pleased that someone had finally come out to see her father and was worried because she didn’t know what to do or what could help. Two hours later we left – leaving the family with a lot of reassurance that help was at hand and the ball was rolling to help her father and his family. We were needed – wanted and very welcomed.
In my first week there were times when I felt overwhelmed and out of my depth. I phoned my Mum, crying down the phone to her, telling her “I can’t do this” and that I had just been to a lady who was younger than me. Mum encouraged me, she knew I could do it and so I continued my work and learnt so much from the St John’s team. I learnt how best to interact with patients and their families, how to gather information to make their care the best it can be, make notes, record findings and above all help by caring with compassion and empathy. I realised one of the most important parts of my job was communication – with patients and families, the St John’s team and with doctors and district nurses.
What is a night visit like?
When I am working through the night I check on the patient frequently and am there for them in case they wake. A night sit often involves taking the patient to the bathroom, making a drink or a little something to eat. Sometimes patients awake feeling confused so we often chat, talk about the fact it is dark outside and is still bedtime. It’s best if the patient can stay in bed where it is nice, warm and comforting. Nights can be spent changing the patient’s sitting or sleeping position, getting those pillows just right, changing blankets, carrying out mouth care, prompting patients with their medications, changing pads and giving a gentle massage.
Anyone who has looked after someone poorly knows that nights can be restless, days turn into nights and nights turn into days. Often, I will chat with the patient until he or she goes back to sleep so that the family member or friend can get the sleep that is needed. For one patient I used to play songs and sing along to the patient to help calm and settle her.
You see that other people work in the early hours too. One patient had a relative that came home from work at 10pm, whilst the other left for work at 4am. She would get up at 3am for work so I put the kettle at for her. One thing that remains constant is putting the kettle on at 6.30am – everyone needs that first cuppa!
What are the difficult parts of the work?
I first started this role in the December, the first of many months with the dark evenings at 4pm and the dark mornings too. When I had to be given a Sat Nav by work to find homes as you don’t want to be late, and finding homes in the dark is quite a challenge! My Sat Nav is called ‘Sally Traffic’ as that’s what my Dad calls his!
Where do you work?
The Respite team and I cover a very wide area, we see patients in Arnside, Silverdale, Sandside, Dent, Sedbergh, Ingleton, Newby, Grasmere, Ambleside, Windermere, High Bentham, Kirby Lonsdale, etc.
We also cover Morecambe, Carnforth, Halton, Heysham, Lancaster, Garstang and Galgate – name a place and we have probably been there to do a day or night sit! We drive unmarked cars to protect patient confidentiality so just because you don’t see a St John’s Hospice logo doesn’t mean we aren’t out there.
How do you cope with the emotional side of your job?
All patients make their mark on me, you can’t do this job and not have marks left on your heart. What I know is that the team and I can always make a positive difference.
I remember one lady didn’t sleep very well when I first started going. Her husband used to come back down about midnight to reposition her oxygen mask, I was shown how to do this so the husband could get some rest. The oxygen used to make this lady’s mouth very dry so we always enjoyed a warm drink at 1am, 3 am and 6 am. You build up relationships, settle into patient routines and make sure patient and carer know they aren’t on their own in the dark hours.
I remember supporting a couple who had a little dog, who was very protective of the patient and would bark at me a few times when I touched the patient. I soon gained the dog’s trust and after a few visits it often curled up with me and kept me company throughout my night shift.
A patient’s position is important, for physical and emotional comfort. I once turned a sofa chair around so a son could curl up on it and see his mum as soon as he woke.
Music plays an important and emotional part of my role. I remember seeing the family around the patient, they were all very upset. I asked a daughter what sort of music her Mum liked so we played her favourite, which was George Michael singing ‘I won’t let the sun go down on me’. This lifted the mood, memories were shared and they made a new memory together that night.
Touch is important too. I remember checking what side the syringe driver was on so that a daughter could get onto the bed on the other side, curl up and cuddle her mother.
We care about our work and that means you do feel emotional about your work and yes, the tears do roll. Yet, it is incredibly rewarding – you are with families at one of the most difficult times of their lives and you can do so much to enable families to make their last emotional connections together.
My final words
Night Sitters are often called Angels or Heroes by families. In my eyes it is the families that are the Angels and Heroes because they are looking after their loved ones at the end of life whether in their own homes, a care home or St John’s Hospice. We are often touched by the kindness families show to us: families welcome us into their homes and lives, we are offered drinks and somewhere to sit… we can quickly become part of their family.
We know decisions have to be made, wishes carried out, support given – I say to any family member reading this – “It’s a very emotional time for you and you are not on your own, help is out there for you”. And to the family and friends of every patient we have looked after – “thank you for letting us be with you at this hard and emotional time.”