Q&A with Jenny Louise - AHP Lead, St Barnabas Hospice
"I qualified from Salford University in 2012 and started working on a Band 5 rotation at The Queen Elizabeth Hospital Kings Lynn. This is where I found my love for Palliative Care and Complexity. I was able to specialise in Oncology and Palliative Care where I was primarily ward-based – however, developed an element of Community-based working so that my patient group was able to access specialist support in their own homes. I developed a real rehab ethos on the ward with the nursing team and doctors to enable patients to experience an improved quality of life and outcome for discharge – weather they were recovering from an acute episode, sepsis mid-treatment, or being discharged for End of Life Care. I was able to establish and champion the value of Occupational Therapy in the acute setting for those patients with curative and life-limiting Oncological and Haematological Cancers. I experienced some of my most cherished moments as a clinician in this role.
Following a family move to Lincolnshire, I was successful in my interview for the role of AHP Lead at St Barnabas Hospice. The last 4 and a half years have been a journey both clinically and as a manager. I work with an amazing team of Occupational Therapists and Physiotherapists who strive to support our patient group in achieving a quality of life and managing their symptoms – at whatever stage of their diagnosis. It is one of the most autonomous roles I have worked in during my career – which is extremely liberating as a therapist."
What does your day to day routines involve working as an OT in a Hospice?
"Day-to-day routines vary so much at the moment. We don’t have access to our Day Therapy buildings – however, we have been able to continue to support patients throughout the COVID Pandemic via the use of technology. One of our OTs Madeleine has successfully been completing the Creative Writing Session with patients over the phone.
We have developed our role in supporting our Hospice Nursing Teams who visit patients in their last 16 weeks of life. Before my joining St Barnabas we only had OT support working from our main bases in Lincoln and Grantham. Now we are lucky to have OTs supporting the nursing teams in all 4 geographical areas. We have a real close MDT approach to our patient group – we often do joint visits with our nurses which adds real value and quality to the interventions our patients receive.
We are so privileged as OTs that we get to work with patients from diagnosis right until death. I have supported patients in dealing with changes in function/symptoms due to a new diagnosis of Metastatic Spinal Cord Compression to supporting the nurses and family in completing after-death care. Our role as OTs in the Hospice means we can support patients with difficult conversations around planning for the future – advanced care planning - and discussions around resuscitation. No topic is a taboo for us and that is something I embrace in my role as an OT in this area!!!"
How have you adapted to your role since the COVID 19 outbreak?
"One of the main focuses of our input has been around admission avoidance. The majority of our patients want to remain at home for as long as possible and we have been able to support this through the crisis by prioritising those who are most at risk of being admitted to hospital and focusing our input on this area."
What do you think the main challenges will be now that restrictions are slowly lifting?
"I think for us as Hospice Therapists we are already experiencing challenges from the pandemic. We are seeing patients who are physically and emotionally more dependent as services have pulled back and treatment pathways change throughout the Pandemic. This is something that I think will continue to impact our service for at least the next 12 months.
We have had to adapt to all being based from home and this has proved a huge challenge for us as professionals as we do not have the face to face support from our colleagues – who are often like our family. Again this new way of working will probably be our “norm” for at least the next 6 months."
What long term changes to OT services do you think your place of work will keep in place post – COVID?
"I think there is going to be a big focus on the continuation of virtual interventions for our patient group. We live in one of the most rural counties in England and delivery of services to a big but rural population is a challenge – especially when you are a Specialist Service with only 7 OTs to cover the county. I think the investment in virtual services will help us to support a wider group of patients who may be unable to travel to access our services in Pre COVID times.
In Lincolnshire, I think that strategically we will work more closely with other services to reduce duplication and establish more formal Palliative Rehabilitation Pathways – which will benefit our patients and ensure they are getting the right support at the right time."
It's certainly been a challenging time for Occupational Therapists during the pandemic, particularly working such a contact-based job in an age of social distancing.
We would like to say a special thank you here at The OT Show to all Occupational Therapists. We greatly appreciate the efforts and hope you all stay safe.