‘I often have a cry on the way home’: What it’s like working in a hospice during this pandemic

Sarah Holmes, medical director of the Marie Curie Hospice, Bradford, describes what life is like in the hospice during the coronavirus outbreak and the impact it’s had on her.

Sarah Holmes with patient Lesley Harrison in a picture taken prior to coronavirus.

As the medical director of the Marie Curie Hospice, Bradford, I oversee all medical care that the hospice provides. Coronavirus is unlike anything I’ve ever experienced in medicine.

Normally, however busy you are at work, you go home and the world is still carrying on as normal. But driving home now feels like you are in some sort of science fiction film.

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I have asthma, but my patients need me more than the risk coronavirus poses to my health. I don’t feel particularly worried for myself, but my family worries about me. My 10 -year-old daughter told me that she is scared I am going to die, but I have promised her I will be safe.

That fear is present in all the staff too – they’re worried about taking the infection home to their families. Even those of us that don’t wear a uniform now wear scrubs in the hospice. As soon as I get home, the scrubs go straight in the washing machine and I have a shower.

We changed our visiting policy after the Government’s announcement on social distancing and asked patients to identify key visitors. Some people identified one person, some half a dozen. Then as the restrictions got tighter, we had to update our guidance to only allow one visitor for anyone at the end of life.

We’re trying to adapt and be flexible. When patients have their own smartphones, they’re using them, but when they don’t, the hospice are providing special iPads so people can have virtual visiting in some way.

Most patients have accepted it. I think they’re more worried about their own families and don’t want their loved ones at risk. One lady has a particularly close relationship with her daughter, and they found being separated very difficult, so the daughter has isolated and stayed in her room in the hospice rather than visiting.

I am now also conducting all of my medical consultations via videocalls. In palliative care we end up holding people’s hands or hugging or touching, and there just isn’t that closeness when you’re doing a video call. Last week a patient’s wife said she wished she could give me a hug, so we had this virtual hug where we reached out our arms on camera. It was strange, but at least we could see each other.

It’s worrying that people hold off coming in when they really need to, because they are frightened of being admitted in case they catch coronavirus, so they struggle on at home putting up with symptoms that we might be able to fix quickly.

One of my patients, who has end stage liver disease, was struggling with pain and vomiting at home. His GP suggested he go to hospital for some intravenous fluids, but he didn’t want to go as he was terrified that he would catch coronavirus. We had an empty bed in the hospice, so I suggested he come in to get his symptoms under control. He eventually came in, but it took a few days to get his head around the idea.

Driving home is the hardest time of the day. I can stay strong when I’ve got work to distract me and I know I am in control and can stay calm. But when I get in the car at the end of the day, and take a deep breath, and drive home through the empty streets, everything we’re facing just hits me, and I quite often have a little cry on the way home.

I think I spend a lot of the day absorbing the fears of others and trying to reassure everyone, and then at the end of the day all my own emotions start to leak out. Every week Clap for Carers makes me cry.

This pandemic will teach us a lot. I hope it will make people think more about the funding of palliative care. I don’t think the public realise how much of end of life care is charitably funded, rather than by the NHS. And it does worry me how we’ll continue to provide that in the future, when our fundraising income is dropping, but I know we are going to be needed now more than ever.

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