A light in the darkness

Away from the hustle and bustle of the health centres and main reception, the Palliative Care Ward sits in quieter quarters of Omagh Hospital and Primary Care Complex.

Unless you have cause to come here – or, perhaps, to the adjoining Rehabilitation Ward – you might go your entire life without ever seeing it.

However, for patients who do end up in a bed here, they, and their families, often develop a close rapport with the doctors and nurses who keep the service running.

When the UH recently visited Omagh’s Palliative Care Ward, we were introduced to two of its most vital members of staff: Sister of the ward, Thelma Graham, and consultant in palliative medicine, Max Watson.

“There are still some harmful myths that go around about palliative care,” began Sr Graham, who has been a nurse for over 30 years, and who worked in the female surgical ward at Tyrone County Hospital at the time of the Omagh bombing.

“However, if you think people do not understand what palliative care is now, back when we first opened; nobody knew what it was.”

Two of the most common and harmful falsehoods that persist regarding palliative care are that it is only for end-of-life cancer patients, and that once you are in, you never go home.

“Neither of these things are true,” explained Sr Graham.

“Though it is the case that many people come here with incurable cancer, we also treat patients with other kinds of conditions, too, such as serious heart, lung, renal and neurological conditions.”

Turning to the other most common misconception, namely, that people who come to the palliative care ward never leave, Sr Graham said, “Many of the patients who take a bed here end up returning home after they are stabilised. The palliative care ward is, not necessarily, a last stop.”

Interjecting to support his colleague, Dr Watson said, “This is absolutely right – the truth is that about 50 per-cent of people get to return home.”

Support

Though a large part of Sr Graham and Dr Watson’s job is to help patients manage pain and other symptoms, their approach to health is a more holistic one, than is found in other parts of the hospital.

The care they provide is all-encompassing, and is concerned not only with the body of a patient, but also their mind.

“Patients often arrive here feeling worried and fearful,” said Sr Graham.

“They wonder whether they will ever get out, or whether they will die here.”

Often, forced to confront their imminent fate, a stay in the palliative ward can be the hardest period in a person’s life.

“That is why the care we provide extends far-beyond simple pain and symptom management,” said Sr Graham.

“We have to offer the patients emotional, psychological and spiritual support as well,” she said.

“And their families, too.”

Working with loved ones

Dr Watson explained the importance of working closely with families to ensure that all decisions are truly in the best interest of patients.

“If we can get a patient stabilised, and going home is what is best for them, then they can get home, of course,” said Dr Watson.

“However, as people get towards the end of their lives, often their wishes change.

“What a patient wants when they come in is not always the same as what they want after a couple of weeks or months,” reflected the consultant.

“We work closely with patients and their families to see what is best for them.”

Dr Watson said that the ethos of Omagh’s Palliative Care Ward is one that is rooted in the belief that no patient is truly independent or alone.

“No patient exists in isolation, they all exist in the context of their family and friends.

“Therefore,” he said, “Engaging with their family is of paramount importance.

“For this reason, as you can imagine, the pandemic made things extremely hard.

“The idea of quarantine and isolation was completely contrary to the spirit and ethos of palliative care,” said the doctor.

Appreciation

Take a quick look at the paper or a brief scroll on social media, and you are likely to find a photo of yet another grateful family presenting a big cheque to Sr Graham, Dr Watson, or another smiling member of the palliative care team.

This, Sr Graham explained, is evidence of the value local which people place on the service provided by Omagh’s palliative care department

“We feel appreciated and well- regarded by the people of Omagh,” said Dr Graham, “and people regularly express their thanks through fundraising and donations.”

As a team, Sr Graham and her colleagues feel privileged to be part of their patients’ journeys.

“This is a hard time in people’s lives, and we get to share it with them, and to bring them as much comfort and ease as we can,” she said.

“As I said, they often come in fearful, but we do all we can to comfort them; we make the place a bit more personal, and we try to take the clinical look away from the room.

“Whatever we can do to help them and their family through this stage of their life, we try our best to do.”

Acceptance

“It is all about acceptance,” said Dr Watson, bringing our conversation to an end. “That, for us, is where we want people to get to.”

With a gentle hand and sensitive mind, Dr Watson, Sr Graham and the rest of the staff at Omagh’s Palliative Care Ward try to light the way for patients and their families during their darkest hours.

Though their job is one which seems beyond the capacity of most normal people, it is one which they take on voluntarily, and do not complain or moan about.

Sr Graham concluded by saying, “It might seem strange but we love what we do. We try to give people a better quality of life, often in extraordinarily difficult circumstances.

“I have been doing it for 20 years now, and Dr Watson has been with us for five.

“It can be tough, but it is also rewarding and fulfilling.”