Patient holding hands with carer green branded

The Role of a Lawrence Nurse

by Sarah Bryson, LHNT Nurse

When may a patient have a visit from Lawrence Nurses?

The aim of Lawrence Nurses’ input is to provide support for patients with a life limiting illness, who wish to stay at home for their end of life care. The team comprises a group of experienced registered nurses who are trained to provide day and night hands-on nursing care. They aim for good symptom control, and offering support to family members as well as patients.

We can take referrals from the hospice, the hospital, a GP or the District Nursing (DN) team. Or maybe a phone call from the patient themselves, or a family member. An assessment visit from one of our nurse coordinators provides an opportunity to get to know the patient and understand their needs.

What aspects of care can a Lawrence Nurse help with?

Before attending each nurse has a verbal handover, from the Lawrence Nurses coordinator, which helps the nurse prepare prior to the visit, where care needs can vary greatly.

Some visits are planned ahead as respite visits: this may offer the main carer an opportunity to have some time away from the bedside for various reasons, such as family events, or necessary appointments. Other visits are planned as health needs change. Some people may need day time visits, and others need overnight care. We do our best to accommodate the needs and prioritise our resources, while working alongside other health care professionals.

Sometimes the company of a calm, knowledgeable professional can in itself be very helpful. Sometimes the care may be ‘hands on’ responding to need. We may help with personal care, medical appliances, give general advice about symptoms and administer medications. This includes giving injections. We also offer support to those who are caring for the patient. We may assist a patient with a simple meal or help them to have a drink. All of these are just examples, and this list is not exhaustive.

We all aim to practice holistically, considering not just the physical needs of the patient, but also, their emotional needs, and spiritual needs in the context of their home and family. We also feel it is important to provide support to those who are close to the patient.

During our visit we may need to liaise with the Lawrence Nurses coordinator for advice and to let them know about a changing circumstance for example. After the visit there will always be a handover phone call to ensure that all changes are noted in the office copy of the notes, to keep the communication channels as clear as possible.

What records do you make?

At each patient’s home there will be a green folder of Lawrence Nurses notes, generated from the original assessment. On-going evaluation and re-assessment will be carried out by each nurse visiting. Our notes are an essential element of what we do, and include sections developed as a resource for patients and families. The notes offer an overview and information for those nurses coming in next to the home and importantly they are also a legal document. Many of our patients have visits from the DN teams, and we work closely with these nurses.

What’s special about this team?

I gain a great deal from being part of a small team of highly skilled experienced nurses coming together in unified purpose, with an ethos which echoes my own ethos. We all work within our clear professional boundaries and according to the Lawrence Nurses job descriptions. We all want to provide a high standard of care, and to facilitate situations which enable patients to die in their own homes in a supported way with good symptom control.

Being part of a small team means that the individual members are valued for the particular skills they bring to the team and we learn a great deal from one another.

Sarah Bryson
Lawrence Nurse