I WAKE UP early on Christmas morning to shrieks of delight from the little people in the house. Santa has come!
Then I remember that I’m working today, my heart sinks a little knowing that I’m going to miss a lot of the celebrations with my family. I send out a silent prayer that the roads are clear of ice and snow.
Being a community nurse, I will be spending my day driving around visiting people’s homes that are in need of medical care. My mind goes back to two years ago, when the weather was treacherous and so bad that public transport had ceased. Community healthcare workers still had to provide care to those sick and in need of medical attention in their homes.
I know I will be visiting patients’ homes and will be faced with a variety of different medical situations. Patients’ moods and attitudes will differ greatly to having what is in some circumstances , a complete stranger coming to their house to provide essential care, and I will have to adjust quickly and sensitively for each situation that I meet.
You make yourself aware of how the patient actually is, based on what you pick up from the moment you walk through the door. Is there enough heat, ventilation, available food? Is their home safe and well lit? Non-verbally, you assess these aspects along with their general well-being in the first moments of meeting them.
One home may have somebody’s grandparent, surrounded by their family and I can enjoy some of the day’s festivities with them for a short period of time. The next home may have a patient spending the day on their own, as they have no family, or family near them. In some cases their friends may have died or be unable to leave their own home. There is a sadness associated with this as a sizeable proportion of society will not be experiencing this today. It’s hard for my heart not to break a little bit, but I hope that that my visit reduces the loneliness for them. It’s not only Christmas that people are on their own – it may only be me, the postman, or a meals-on-wheels delivery volunteer that a home bound individual may see in any given week.
I could follow on into the home of somebody who is on their final journey from this world. I may have not met this person or their family before and have to build rapport quickly as I may have to provide care that is of an intimate nature. This is not easy, as people are already suffering and have to tell their story to a stranger and allow me to care for them. Due to current fiscal restraints, many families have to play a bigger part in the care of their loved ones. Part of my job will be to educate and support them in the brief period of time that I have with them. Families are often upset dealing with their loss and often it is very difficult to witness their distress. However, it is a great privilege to be able to assist them to have their loved one at home rather than in the hospital setting.
It can be a very lonely job on this day, as I would have no professional team member to bounce off of or share the day’s experience with. Burnout in this job would be inevitable without the on-going support of my peers, who understand the complex nature of care giving in the community. The challenges for nurses’ working in today’s environment is to remain focussed on a high standard of patient care whilst operating with fewer resources than before.
Often, throughout the day, I feel the pang of missing my family and make numerous calls during the day to have some contact with them and get a feel for what’s going on at home.
When at last my working day is finished, I head home so I can start my Christmas day with my own family. Regularly on my journey home from work I reflect on how I have done that day and hope I have done a good job, that has helped patients and their families to make the day easier and more comfortable.
It is of note however, that even though I have been away from home today, one of the lovely bonuses of working Christmas day is that I don’t have to make dinner! I would like to acknowledge all the other people who are providing essential services during this holiday and wish them a happy and healthy Christmas.
Deirdre O’Hara is a Community Nurse working in the Dublin area.