Parish Nurse

My job as a Parish Nurse was extremely varied. In a week I could change dressings, take a patient to an appointment, arrange a cream tea or even take a group of people to the theatre. I visited Flossie most days and would often discover that she didn't like the dressings the district nurse had put on and had replaced them instead with tissue and string! I used to despair at this and made an agreement with the community nurses that I was allowed to use their dressing supply to redress Flossie's legs again.  

Flossie seemed to grow as fond of me as I had her and entrusted me with many jobs, from pulling out her 'whiskers' or calling me when her shopping was delivered so I could put it away, to times when she was more vulnerable and needed more help. My manager would often tell me not to do things that weren't in my job remit but I felt that by helping Flossie with things that took me a very short time, I could help prevent accidents and more serious issues. For example if I put her shopping away, which she found quite difficult, it could stop her from having a fall while trying to do it herself. (It always amused me to see a few bottles of wine tucked away in her fridge!). And I didn't hesitate when she phoned me to tell me she'd wet herself in the kitchen. If she'd tried to clean that up she could have slipped and broken her hip. Luckily, I was in my office which was over the road to her flat when that happened so I went round straight away. She was so embarrassed and upset and it meant a lot to her that there was someone she could trust to help. Her carers may have been able to but they only went at certain times so she could have waited for hours. 

I know her son was very grateful to have a nurse in such regular contact with Flossie, particularly as he lived abroad and couldn't visit that often as his wife had her own health concerns. It reassured him to be kept updated and have situations, that Flossie didn't always fully comprehend, explained by a health professional. It did occasionally have it's downside, like the time I had friends for dinner and she called at 10.30pm to tell me that she couldn't find her large scissors. She had her small ones but she couldn't find her large ones anywhere and was convinced the district nurse had hidden them!

I agreed to pull out Flossie's 'whiskers' as she called them because I was so impressed that at 98 years old she was still concerned about her appearance. She also made an effort with how she dressed even though she spent each day in her flat. She always wore a skirt and blouse and still did all of her own washing. I once took her a new dress and a top and she was so thrilled with them. She tried them on and asked me to take photos of her in them. Her smile was so wide that day and I loved that something so simple had made her feel so good and happy. I still have those photos and sometimes look back at them fondly.

I always remember a story Flossie told me about WW2. She had been walking home from work one evening in London during one of the blackouts. She was horrified to see a man in his first floor bathroom shaving with his main light on and the blind open. She was furious at his stupidity and jumped, waved and called out to him from the street to get his attention but when an air raid siren sounded she knew she had to run. Thankfully she was safe but his building sadly wasn't and got hit by a bomb. The resolve and strength of the wartime generation never fails to astound me. My nan often told me about the times she was bombed out. Three times she lost everything. She came home from work one day to find her house obliterated and had to start all over again with just the clothes she was wearing. I know these people had no choice than to dust themselves off - quite literally - and carry on with life but their determination is something this generation could learn from. They just coped. And despite everything - or perhaps because of everything - they had experienced they were so grateful for what they had. I have previously touched on my belief that it is so important to appreciate the everyday and I see great value in keeping life simple.

One day I visited Flossie and knew something was wrong because she told me in an aggravated state that there was a man in her bathroom and a bear outside her window! Then she told me about the doctor she'd seen in hospital who had wheeled a piano into her room and started singing hymns to her. Her bewildered state screamed out signs of a UTI so after liaising with her GP I was able to sort out a prescription and start her on antibiotics. Within a few days she was back to her old bossy self. This is an example of what a difference parish nursing makes. As a qualified nurse I was able to spot symptoms and sort out her care without having to call out a doctor. As we all know, GPs are increasingly busy and home visits are often difficult to arrange. I think that as time goes on parish nurses will play an invaluable healthcare role in the community as the NHS comes under more strain. The difficulty is being recognised as a professional. When I was making calls like this I gave up introducing myself as a parish nurse because NHS staff viewed me as some sort of religious nut meddling with the healthcare of people from the congregation. Instead I used to say I was a community nurse, which was true, just not for the NHS. GP staff would automatically assume I was part of the district nursing team and took me seriously. I also kept referral forms that I had used as a practice nurse. This way I was able to refer to physio, diabetic testing, district nurses and other NHS services with no questions asked.

I loved many aspects of the job and if I had been able to use my clinical skills to their fullest I probably would have stayed working as a parish nurse for a long time. The difficulty was that since I had taken the job as senior care co-ordinator, which had then been merged with that of a parish nurse, I also had to arrange events such as holidays at home (summer events for elderly people unable to actually travel on holiday), coffee mornings, day trips, quizzes, speakers and exercise classes. To begin with this was all quite novel and I enjoyed the pace compared to NHS work. I was really able to take time with my patients and get to know them and their needs. One of the best events I arranged was when the children from a local infant school came to sing Christmas carols for one of the groups I ran. It was such a sweet event and brought the old people so much joy to listen to and see the beaming faces of the little choir children. 

I will also always remember visiting Matthew, a man with mental health and alcohol issues. He was such a sweet soul and after seeing his flat for the first time I returned a week later with a few home furnishings that my cousin had given me before she'd moved back to Canada along with cleaning supplies. I cleaned his flat and gave him a new rug and a lamp to make his lounge more cosy. It wasn't much but he was overwhelmed to be shown kindness and I left him enjoying the feeling of the rug on his bare feet. Again, such a simple gesture had made a large impact.

The job was lovely and the groups and functions that the church provides for all people - but especially the elderly - are so important. However, I had started to miss the buzz of practice nursing. One of the surgeries I had worked at for many years asked me to do some holiday cover. I jumped at the chance and worked a few shifts. I realised that many of my clinical skills were not being used at all in parish nursing and this started to concern me. The same surgery then offered me a regular shift a week, which I took after discussing it with my manager at the church. I thought this would be enough for me but towards the end of a year working for the church I knew I had to go back to the NHS. I truly think that if I had been able to start a parish nurse project from scratch, like other nurses I have met, I would have been able to draw on my clinical knowledge more and would still be doing it now. In some ways I do regret leaving this job but it was the right thing to do at the time. I was also battling health concerns of my own and knew I couldn't sustain working as a parish nurse and a practice nurse while taking care of my family and home as well. I will always be glad I took the parish nurse job though, especially as I met so many wonderful people that year.  On my last day I posted this on Facebook;

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