I started out my career as an enrolled nurse and after a few short term positions spent 21 years at Ashford Hospital. While I was there and aged about 33, my brother died after a short diagnosis of cancer at age 35 – way too young and with much still to give. He spent a few weeks in Daw House hospice – my introduction to this facility and palliative care. I was so inspired with the way care could be delivered and the compassion with which staff went about their work that I decided then and there that this was the way I wished to work going forward. I learnt that, at that time, there was no hope of employment at Daw House for an enrolled nurse, so decided that I would study to become a registered nurse to realise my desire to work in this field. With 3 young children, I decided to go to university and study to achieve a bachelor degree to become a registered nurse. Within my placements both at uni and as a graduate nurse, I was able to spend time in Daw House. I immediately felt that I had reached a place where people were able to spend their last days, weeks, sometimes months, in an environment which was staffed with passionate nursing and medical staff, who made the patients feel valued, comfortable, safe and nurtured, easing the emotional burden which accompanies finality of death. I felt I had finally reached the right place to see out my nursing career. Patients were supported to enable them to continue to live until they died.
The early days of my official time at Daw House as a Registered Nurse, was a time of beginning transition (2000). There was a new Professor of Palliative care, new CSC and CN who were promoting a more evidence based medical care model, and challenging the seemingly singular care and nurturing model which had been in place for many years – this came with some resistance from staff who were challenged by change. The challenge as I saw it was to combine the components from both models to offer the best care possible and be validated as a sector of medical and nursing professions which could stand alongside other specialities whilst also offering holistic care, nurturing the patient and family while also managing symptoms and end of life care with the backing of evidence based therapies. Despite this change, the patient has always remained the focus of care.
The Daw House environment has been one of care, nurturing and love. The old house offered ‘old world charm’ visually, and an inviting feel mostly provided by the staff. The furnishings, lack of staff uniforms and home like atmosphere helped patients to feel that they had entered a facility which provided care but was not a clinical 'hospital-like' atmosphere, and promoted individuality, and focused on patient needs rather than routine. As the years have gone on the old house has aged – chipped paintwork and salt damp served to make the environment look tired and less inviting. In recent years it has become challenging to explain away the fact that an admission to Daw House came with the understanding that the patient may not be able to have their own room and that all bathrooms would be shared. Individual expectation has changed and this presented challenge more and more, especially when an imminently dying patient was unable to have privacy because the single rooms were occupied – sometimes by a relatively well patient who needed to be isolated due to multi-resistant infection - this certainly was a difficulty for the staff also.
In the early days of Transforming Health I think many of us just thought it would not happen and we just went about as usual. A purpose-built hospice had been talked about before and never progressed. As time went on it became very clear to me that Daw House was going to be relocated – it would be a reality. I think I looked at the building through different eyes and noticed more and more the tiredness and inadequacies and started to recognise the advantages, not just in the aesthetics, but in being part of a wider health facility and the opportunities for our patients in being closer to the specialities they may need. Just as the speciality of Palliative Care has changed over time, so have the needs of many of the patients that enter our care, as many people now live with cancer and require admission for symptom management with a view to return home.
There has been sadness among some staff – I think more from the fact that the Repat as a whole has undergone relocation rather than Daw House alone and these staff members have now embraced Laurel Hospice with its beautiful views and brightness and recognition of the positives for the patients and families.
As the time neared and eventually when our building was completed there was an opportunity to be part of setting up the new building, working out efficient workflow in a different environment, and recognition of the advantages for our patients. I felt staff appreciated being involved and I personally noticed a more cohesive and supportive attitude between staff, particularly as they were required to work differently after working in one way for many years, to allow for the layout of the unit.
Often patients came with a need for fulfilling activities before they died. I have seen wishes fulfilled such as dying with red hair – the fun we had and the mess we made while colouring this particular lady’s hair while she was in bed, leaves me with a smile. We have had several weddings in Daw House – one in particular between a young man in his 20’s and his fiancée, in the chapel of the Repat and then a reception in the Institute next to Daw House. This was a reception originally planned for Mt Lofty House but was shifted to enable the patient to rest and receive care/medication as needed. Little did we know but they also transferred the drinks along with food and the guests enjoyed the reception as they normally would have. A colleague and myself kept a close eye on proceedings and hoped that no-one in the hierarchy ever found out, as we knew a full on party involving alcohol on the premises may not have been well received! A more recent patient, a very young lady who managed her illness by continuing to live, engaged with the staff by having competitions. The ‘crazy sock’ competition and op shop item of clothing competition engaged and inspired staff, and helped the patient with an alternative focus. The staff participated with good spirit. She was an amazing young girl we will never forget.
These are just a couple of my memories, as there have been so many family parties, dinners, celebrations and weddings with many inspiring people. Daw House has been an amazing haven for so many people over many years. Despite the ultimate sadness there have been so many happy times. Although a different environment, I see the potential for Laurel Hospice to continue to provide the same opportunities. Apart from the private space in single rooms with bathrooms, there are open spaces such as the day rooms and the rooftop garden which could be utilised for gatherings and special occasion celebrations.
Pets have always been welcomed to visit. We have had many canines and felines watching over their beloved owners and have even had a horse visit their owner before she died. While a visiting horse would be very challenging, it is envisaged that loved pets can still be welcomed, and I am certain strategies for those occasional challenges can be worked through to fulfil a need.
The new Laurel Hospice will strive to continue to provide all the care, nurturing and love which was inherent in the care provided at Daw House. The change in environment and name is merely that – we have picked up and relocated. Complementary care and art therapy are more accessible being on site in the hospice now. Our volunteers are continuing to support and are as valuable as ever - we are indeed fortunate. The staff have a new energy which will benefit the patients we will care for ongoing. The ethos which is palliative care will be embedded into Laurel Hospice and it will not be long before this beautiful new hospice creates memories just as enriching. I am proud to have been a contributor in Daw House and I look forward to watching Laurel Hospice evolve and continue to be the provider of excellence in palliative care.
Sharenne Codrington, ANUM, Laurel Hospice