Powys hospice-at-home nurses Mary Jackson and Paula Jacobsen bring compassion and care to end-of-life patients throughout the rural area they cover.

Mary and Paula admit, it’s a challenge, especially so during the pandemic. And at times it’s an emotional rollercoaster but the nurses wouldn’t have it any other way.

Mary, a specialist end-of-life hospice-at-home nurse who cares for patients in their homes, believes she has the best job in the world.

The nurse lives in Brecon and has mid and south Powys as her ‘patch’.

A specialist nurse, she has been employed by Newport-based St David’s Hospice Care for almost nine years. The 64-year-old previously worked as a district nurse in Brecon for 17 years.

Mary, one of a large team, lists places as diverse as Brecon, Ystrad, Builth, Llandrindod Wells, Rhayadar and surrounding areas covered by Powys District nurses, in her ‘beat’.

She is out in all weathers, in the dark on winter’s nights, and battling the challenges, which include lack of phone signal and sat nav ‘hiccups’, on her journey to care for her patients.

The job, Mary says, is tough, demanding, emotionally draining and hard but she wouldn’t change it for anything.

“Attending patients with clinical end-of-life needs in their homes at night has immense rewards and sometimes enormous challenges but it’s our work; it’s what we do.

“The pandemic threw a curve ball into the mix of what was already quite a challenge, attending to my patients in some of the far flung places in Powys.

“The size of the county is one thing and the nature of the countryside, with our winding narrow roads, hills and mountains, is another. Some patients live in remote and isolated places miles from their nearest hospital.

“It’s a privilege to be able to care for these people in the same way as if they were living in a town.

Mary knows that even if she is a little late her arrival is a source of immense gratitude and relief when she turns up.

“Families are just so relieved that we nurses are there and that their loved ones are cared for. Sometimes relatives really can’t bear to be with their loved one right at the end.

“I find it a privilege to share the passing of a loved one, knowing that my patient died with dignity and that because I was able to support the other services involved and that they were allowed to be in the comfort of their own home with their loved ones with them at the last.

“By being in the home, we can give prescribed medication, when it’s needed, rather than have to wait for a doctor. This means that the patient does not have to suffer and be in pain and relieves families from a measure of upset and worry.

“If our hospice-at-home service was not available to the families in Powys, patients would have to be admitted to hospitals, perhaps many miles from their homes. Especially during the pandemic with its restrictions this would have meant that they would be alone.”

Paula Jacobsen has been in nursing for 39 years, latterly employed by St David’s Hospice Care as part of its Hospice at Home team

Paula, aged 56, who lives in Caerphilly, retired from her role as a district nursing team manager and took up her present position covering south and mid Powys.

She said: “We work closely with specialist palliative and primary health care teams supporting patients and their families in respecting wishes and allowing a patient to be cared for and die at home or an environment of their choice with the necessary care, comfort and dignity.”

Paula said: “Working during the pandemic has added to the challenges. It’s been stressful at times, having to wear PPE which can cause barriers especially when caring for someone who is dying and family who need support. Being unable to give a patient or family member a ‘hug’ to show that you care is difficult. Keeping two metres away unless delivering care. Not knowing if you, yourself, will contract the virus.

“Palliative care has always been a love of mine. It is an honour and a privilege to care for someone in the last days of their life.”

St David’s Hospice Care Chief Executive Emma Saysell said: “It’s a very difficult job which is made even more challenging with the rural nature of the area in which they work in Powys. St David’s Hospice Care is committed to doing our utmost to allow patients the choice of where they want to die and doing everything we can to ensure that if that is at their home that they are as comfortable as they can be at all times especially at the end.

“Maria and Paula are excellent examples of our nurses who strive, even in the most trying of situations, to deliver their excellent care to their patients in Powys every day of the year, come what may.”

During the year more than 48,000 hours of care were provided by St David’s Hospice Care Hospice at Home service enabling patients to remain in their own homes if that was their choice. More than 99 per cent of patients who received Hospice at Home care were able to die at home or their usual place of residence.

St David’s Hospice Care strives to provide patients with real choice about where they receive their care and their pace of death. Across the entire service an average of 88 per cent of patients died in their preferred place.

A patient’s family said: “The Hospice at Home service made all the difference and allowed us to keep dad at home until the end which we couldn’t have otherwise have coped with. Thank you

Another said: “The nurse that came was a pleasure to have in our home. The night she came to care for my mum I slept for the first time in two weeks. Thanks to her care of my mother that night.”