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Dying Matters Awareness Week

Close your eyes and picture a nurse. Go on – it won’t take a second.

What do you see? If Charlotte “Charly” Mead is right, you’ve probably come up with a fairly common image – a nurse, clad in light blue scrubs.

But this depiction of nurses, Charly argues, isn’t entirely correct. And she should know – she is, after all, a nurse herself.

Charly works in ellenor’s Hospice at Home team. Along with her fellow nurses and the student placements she mentors, Charly and her colleagues provide vital care for life-limited patients living in DartfordGravesham and Swanley– all from the comfort of their own homes.

What Charly doesn’t do is what, she believes, most people think she does. And herein is where most common conceptions of nursing tend to miss the mark.

“When a person is asked about what a nurse does, they’ll probably say that they support their patients on the ground level; that nurses provide medication and assist the doctors.

“But that’s a limiting view of our profession – nursing is actually so much more than that. At ellenor,  our nurses work autonomously with GP’s, community nurses and other health care professionals to support people living with a terminal illness, cardiovascular or chronic respiratory diseases, cancer, or patients with learning disabilities.

So why does this narrow view of nursing exist? According to Charly, the portrayal of nurses on popular TV shows is at least partly to blame.

“Think about the nurses you see on TV. Programs never show nurses out in the community. I don’t know if it’s because they think we’re not interesting, or what!”

This depiction of nurses represents a stark disparity – particularly when you consider that, in ellenor’s case, the vast majority of its care (around 95%) takes place in the community. It’s part of ellenor’s commitment to holistic care, and to a ‘good death’: one that allows a person to pass away peacefully, with their family around them, in the place of their choosing.

This could be a hospice. But it could also be at the patient’s own home – allowing them to die with dignity, on their own terms.

Without community nurses – like those that make up ellenor’s Hospice at Home team – life-limited patients wouldn’t have access to care, treatment, and support from their own houses. That’s why it’s so hard to fathom that community nurses like Charly are so frequently overlooked.

“I think community nurses are the invisible nurses, and for two reasons. One, because when you see somebody in a nursing uniform these days, you think they’re a carer. Two, because when you mention community nursing, people automatically think of [BBC TV program] Call the Midwife. The number of times I’ve been asked if I’m a midwife!”

In the hierarchy of healthcare, the role of nursing is also changing – particularly how it’s perceived vis a vis doctoring, and the split of roles and responsibilities. Alongside this, Charly says, we must also re-examine that idea of what the nursing profession – and the 310,000 people that practice it in the UK – is.

“Again, it’s that question – what does a nurse look like? I, for example, look different to a nurse in the IPW (ellenor’s inpatient ward), but the nurses there look different to the nurses in our Living Well team. And they look different to the nurses in an outpatient unit. So there’s no catch-all definition or description.”

So, how can we bring our community’s ‘invisible nurses’ to the fore – and shout about their incredible impact to the ears of the world?

Education is a good place to start.

 “We need to start being able to conceptualise the idea of, say, an advanced nurse practitioner. The idea of a nurse that can prescribe you medication and care in the same way that a doctor can.”

This, Charly believes – this understanding – holds a wider significance. “The bottom line to multidisciplinary collaboration is having an understanding of the people that you’re working with,” she says.

We have to start somewhere. Why not nursing?

Everyone deserves the right to die in dignity: in the place and in the company of their choosing. Charly’s work with ellenor’s Hospice at Home team helps ensure that everyone has this right – that final, fundamental right to a good death.

But the importance of death and dying is often overlooked – particularly when we, as a society, dont want to confront these difficult subjects.