What's happening Blogs 10 ways being a nurse at Trinity has changed over the past 10 years Isatta Sisay, 42, is Clinical Nurse Specialist in the community palliative care team at Trinity. Originally from London, she trained as a nurse in Southampton and worked at the Royal Marsden Hospital before joining Trinity in 2006. Isatta celebrates 10 years as a community nurse at Trinity this month and explains how things have changed over the last decade. 1. The death taboo A decade ago nobody wanted to talk about death and dying. It’s changing slowly but still the taboo persists. There are so many myths about hospices which are not true. Many people still think if you come in the building you don’t get out alive. Myths like that can stop people from accessing the help we can offer. 2. Not just cancer When I started, roughly 95% of our caseload was cancer patients. Nowadays it’s changed phenomenally. Now I see people with life-limiting illnesses like COPD, heart failure, Parkinson’s, motor neurone disease, multiple sclerosis and of course dementia. That said, people still think we just support people with cancer – I get confused with a Macmillan nurse on a daily basis! 3. Holistic care Hospices have always delivered holistic care, it’s part of the ethos of the hospice movement. But the difference now is that we have the benefit of whole teams of social workers, therapists and others who bring different knowledge and experience to the care of our patients and their families. I used to help patients to claim for their benefits, now we have a dedicated welfare benefits advisor here who can help. 4. Quality of life When I first started, the community team was focused on caring for the terminally ill in the last few days of their lives. Now our remit has expanded to enhancing the quality of life for people at an earlier stage of their illness. We support people to work out how best to get on with their life. 5. Care at home People have always died at home but I have definitely noticed an increase in the number of people wanting and able to die at home over recent years. The increase in deaths at home has been made possible by the enhancement of other services, like GPs and care homes, through programmes like the Gold Standards Framework. I’ve noticed that social carers are definitely more knowledgeable about end of life care as agencies are starting to invest and train their staff in this area. 6. New models of support A major shift over recent years has been the development of innovative new models which increase the range of support we can offer. Over the last few years we have seen new services pop up like the Wandsworth End of Life Care Coordination Centre, dementia specialist nurses, the gold standards framework facilitator for care homes and the volunteer befriending service which means more people can get the care and support they need. 7. Younger nurses When I first got into palliative care, it was often perceived as a job which older nurses would get into to wind down towards the end of their career. Now there are lots more nurses getting into palliative care at the beginning of their career. I think people are finally recognising it as a career specialism like any other and one which can be dynamic, challenging and very rewarding. 8. Inpatient care Since 2009, Trinity has been blessed with an amazing new inpatient unit. The purpose built centre replaced the old wards where patients had to share rooms. Now we have 28 mostly individual ensuite rooms overlooking the gardens. Patients can come for a few days if they are struggling to control their symptoms before going back home. It makes such a difference to the quality of care we can provide. 9. Rising demand Due to the growing range of services we offer and rising demand from an ageing population, the amount we need to raise has increased each year – this year we need to raise £8million, in addition to the £3million we receive from government. I try to help out with fundraising where I can. This year some of the team are even doing the 3 peaks challenge to raise money for Trinity. 10. Changing society One thing that’s constantly changing is the people we support. Cultures and values change, and as the care we provide is personal to every patient, we need to change with them. Every day we meet different people from different walks of life and I learn something from each and every one of them.