Why goodbye matters: the hospice nurses on a mission to bring dignity to dying

About 80 per cent of care provided by Thames Hospice takes place in people’s homes, with the charity’s Hospice at Home team looking after up to 300 people at any one time.

The Advertiser spoke to the team’s leader, nurse Fran Rice, to find out what motivates them in their work.

“I think it’s the opportunity to say goodbye, and that’s what a lot of people want to have in their life: an opportunity to say goodbye to someone they love.”

For Thames Hospice nurse Fran Rice, that belief is deeply personal. She entered the medical profession driven by the care she felt she never received when her own father was dying.

Ms Rice, who is from Cookham, studied journalism at university, worked in music shops and wrote reviews in her spare time, but the death of her father, David, pushed her towards a different path.

Hospice at Home nurses (pictured) work around the clock to help care for patients

He died following several strokes when Ms Rice was in her 20s. Doctors never explained to her how serious his condition was, and that meant there was never the chance to say goodbye.

“My mantra is that I want people to have the best experience they can in the darkest of times,” said Ms Rice, 47.

“Probably the thing that keeps me going is that I don’t want anyone to repeat the experience I had.”

Since beginning her nursing career around a decade ago, Ms Rice’s mission now touches the lives of up to thousands of people who receive end-of-life care in their homes.

She is Thames Hospice’s Hospice at Home team leader, managing around 40 clinical staff.

There can be up to 300 people receiving end-of-life care through the Hospice at Home service at any one time. The service provides 80 per cent of the care at Thames Hospice.

Eighty per cent of the services delivered at Thames Hospice take place away from its base in Bray

While medicine is often associated with saving lives, for hospice nurses it is about bringing comfort and dignity at the end of life. And Ms Rice said her story is far from unique among those who choose to work in end-of-life care.

“It’s often from some personal experience,” she said. “It can be very emotive, relentless.”

As winter draws in, demand for healthcare rises — but the work continues regardless. Nurses are often up before sunrise and finish long after dark.

A typical 13.5-hour shift begins at 7.15am and ends at 7.45pm, with a nurse visiting around five patients across the Thames Valley — in Maidenhead, Slough, Windsor and beyond.

Thames Hospice’s nurses visited 26 patients on the day Ms Rice spoke to the Advertiser.

Even after a nurse’s shift finishes, the Hospice at Home team’s work does not end. They hand over to the night team, who continue caring for patients in the community.

Responsibilities range from supporting medication needs to helping arrange hospital beds.

Some patients have been under their care for longer periods, while others are new referrals following a rapid deterioration.

“There’s a term called ‘compassion fatigue’ that’s well known in this area of work, because you’re giving out compassion all day long,” Ms Rice said.

“But I’ve been here eight years and not one patient’s story has ever been the same.”

Ms Rice said being able to offer people the choice to remain at home while they are dying brings great comfort.

“Us being out there enables people to stay at home, and that means a lot to us as a team,” she said. “It goes a long way just to offer that support.”

That sense of comfort and reassurance, she said, becomes even more significant during the moments when families need help most.

Ms Rice said: “This area is very fortunate to have this service available — particularly out of hours.

“If things go wrong at night, at the weekend, even on Christmas Day, knowing there’s someone you can phone at any time in your hour of need is incredibly important.

“Keeping that service going is integral — and there’s so much more we’d like to do.”

Asked what motivates her most in end-of-life care, she said: “I think it’s giving the opportunity to say goodbye.”

Thames Hospice provides free end-of-life medical care, family support, bereavement services and more — but all of it comes at a cost to the charity. The hospice must raise more than £12million every year to keep running.

This Christmas, it is running its Christmas at Home appeal to help fund the £39,000 a day needed to operate.

Thames Hospice chief executive Dr Rachael de Caux said: “Every nurse, every counselling session, every home visit is powered by the generosity of our community.

“That is why your support is so critical.”

You can find out more on Thames Hospice's website.

'Your support is so critical': members of the Thames Hospice Hospice at Home team