When most people are staring into the abyss as they hit ‘the wall’ about five miles from the finish line of a marathon, that’s when St Christopher’s ward manager, Patrick O’Shea, reflects on where he’s come from, how proud he is of what he’s achieved, how much he loves his work and then pushes on to the end.
You see, Patrick didn’t follow a traditional path straight into nursing – or indeed running for that matter. He did though always have two attributes that meant that, when he made his career change, he was ideally suited to working in palliative care and now can’t imagine doing anything else. As well as being a ‘people person who loves to chat’, Patrick was well acquainted with death from an early age and has always felt comfortable talking about it.
Brought up originally in a fishing village in Ireland, he followed his mother into cheffing, starting out in kitchens at the age of 12. Patrick enjoyed the work but knew deep down that he wasn’t putting his communication skills to good use.
He recalls: “I didn’t like being behind closed doors, only getting to talk to people when I nipped out for cigarette breaks. I knew deep down that I wanted to work in an environment where I could help people.”
So, aged 21, Patrick enrolled on a training course to become a Health Care Assistant. Among the many jobs he took at that time, one changed his life.
“I started working at a hospice at Marymount Hospice in Cork and I just knew then that was what I wanted to do,” he says. “It was the calmness and the individualised care given to patients and families. I loved it there and I would work 12-hour shifts at weekends while I was studying. I just couldn’t get enough.”
Patrick had known about Dame Cicely Saunders for as long as he can remember and so when he trained as a nurse he knew for sure that he wanted to work at St Christopher’s. He moved to England and to broaden his understanding and knowledge of treatments first worked at Guys and St Thomas’s – something he’d advise any aspiring palliative care nurse to do.
He’s now progressed from being a staff nurse to deputy ward manager and now manages Rugby Ward on the inpatient unit at St Christopher’s – a position that allows him to pursue two of his professional passions; making a positive impact on the lives of patients and their families while also empowering his fellow nurses to provide the person-centred patient and family care he so values.
“Being present with the individual is so important and so different to working in a hospital where you’re run off your feet. Here in the hospice, you can really achieve something and touch people’s lives. In a hospital the focus tends to be on what you do wrong, whereas in a hospice it’s on what you do right. Quality improvement and education are also huge for me.”
One of the changes Patrick is proud to have implemented on the wards at St Christopher’s is a simple but significant one. Now, the team – ideally the whole multidisciplinary team of nurses, doctors and everyone involved in caring for the patients there – meet for a 15 minute ‘huddle’ halfway through their shift. He says it’s an opportunity for everyone to check in on the patients and each other.
“It’s been really successful,” Patrick adds. “It’s a way of further improving communication, bringing people to together, identifying any patient and family risks or concerns and provides a time to learn together as a team.”
Given his early life experience, it’s perhaps not so surprising Patrick made the superficially unlikely switch to palliative care nursing. Back home in Ireland, he says he’d attended at least 20 funerals by the time he was 10. Indeed, he, his mother and sister all have their plans in place for their burial and funeral.
“Death and dying have always been massive for me. We celebrate it in Ireland, and I’ve always been comfortable speaking about it. I love understanding different cultures’ approach to death. Yes, death can be sad, but we should also see it as a chance to celebrate life and that’s why it’s so important as a palliative care nurse to get to know someone.
“That’s what I mean about person-centred care – establishing who the individual really is, what really matters to them and what makes them happy. Asking those questions means you can put all the treatments and medication to one side and focus on providing something individual for that person.”
To illustrate this, Patrick recalls touching experiences he and his colleagues have been able to facilitate.
“For one woman who was very young and acutely unwell – what was important to her was to have a cinema night with her friends. We were able to set up a projector and cinema screen so she and seven of her girlfriends could enjoy a movie night with food and drink laid on.”
Two young women who got to know each other on the ward in the summer, and who shared some of the same goals, took their children on day trips to the zoo and beach, thanks to Patrick and the team managing their medicines and all the arrangements.
“It’s very individualised what people want and we’ll do everything we can to support and accommodate that,” Patrick adds.
Communication is key and Patrick has developed his own ways of engaging patients in conversations about their wishes.
“Welcoming people is a big part of what I do and creating a space in which they can trust me. Of course, there are professional boundaries but it’s also important to create close connections and I do that by being very open.”
In case you haven’t got the message yet, Patrick loves his work.
“I am very excited every day when I go to work. When I step into my uniform, I know I am working for my patients, their families and supporting my team. I am so passionate about it.”
Sometimes, Patrick says, he struggles to switch off from death and dying away from work, but only because it’s a topic he feels so strongly about.
And then, there are his fundraising efforts for St Christopher’s. A mix of marathon running and bake sales have seen Patrick boost the hospice’s coffers by close to £4,000. Running, he says, provides him with a chance to reflect on where he’s come from and what he does.
“I’ve run seven marathons now. I feel proud and it’s hard to believe that that chef smoker, stuck away in the sweaty kitchen who’d never dreamt of running would be here now.
I write names of people who’re important to me on my hands to drive me on when I get to the 20-mile mark. At the Berlin marathon I was welling up, remembering that I’m running for my job.”
More than anything, Patrick wants the population to communicate more about death and dying and better understand what hospices are really like. He’s started making good on that public information campaign by running sessions for new volunteers at the hospice as well as care home staff.
“I would love for people to know more about what this place is really like and to have a greater awareness of what end of life care really looks like. St Christopher’s isn’t about doom and gloom, it’s about calm, about living well and sometimes about fun too. I really want to help to put that out there more.”