Palliative Care in the Community

My second week at Richard House was a very different experience than my first. I accompanied my supervisor to a Joint Safeguarding Meeting for the London Borough of Newham. Safeguarding is the term used to describe the system that is equivalent to the child welfare system in the United States. This meeting includes professionals across various disciplines in agencies and health systems across the borough. There were nurses, doctors, social workers, case managers, and other specialists that worked either in the National Health Service or agencies around the city of London.

Each agency or organisation has a designated Safeguarding Officer. This professional is in charge of ensuring the proper measures are taken to keep children and young people safe in the community. I was very impressed with how this meeting went. Each item on the agenda was addressed and the entire team made suggestions and assigned action items to work on the issues being presented. I felt as if there were real changes happening to the system that they knew was failing children and families in their community.. The professionals were not afraid to address this failure and brainstorm ways to attack it head-on. Having an interdisciplinary team really allowed for a full 360 degree perspective on the system and the issues being discussed.

The rest of my week consisted of shadowing the Diana Children’s Community Nursing Team. This team is a part of the Newham Community Nursing Service, and focuses primarily on children with palliative care and complex care cases. This team is made up of a Nursing Lead, two psychologists, and a play specialist (the UK equivalent of a Child Life Specialist). I shadowed Jane, the nursing lead and team manager for a few days while she did in-office and home visits for children on their caseload. This was an eye-opening experience, and I was really able to reflect and unpack what the benefits of community nursing teams like these can offer for families.

In my class in the School of Social Work that focused on Death, Loss and Grief, we learned about the complexities of grief and loss. We spent a great deal of time discussing ambiguous losses and how that affects people in their grieving processes. I spoke with Jane about the families on her caseload and how these ambiguous losses tend to add up when a child is diagnosed with a life-limiting illness. From financial strain to loss of freedoms to the loss of their family as it once was or how they imagined it – there are tons of little things every day that pile onto the grief that these families are experiencing. I spoke with Jane about these issues and how important the psychologists on their team could be in helping with this grieving for the families.

Finally, the National Association of Social Work (NASW) encourages social workers to advocate for their clients. I found a great example of this during my time with the Diana team this week. One 3-year-old girl struggling with muscular dystrophy, among other birth complications, has been in and out of the hospital since birth. The last time she was discharged from the hospital, she came home and immediately contracted an infection. We went to visit her at her home as she had just been discharged from the hospital again. The Diana team was upset about the care she received in the hospital and the lack of planning for discharge. I accompanied them to the hospital to speak directly with the nursing staff and doctors who discharged her the previous day. Sitting down and making a plan with them while advocating for the best care for the client was a great example of how important advocacy is in this field and this line of work.

This week was incredibly interesting and opened my eyes to the benefits of a multidisciplinary and community approach to healthcare. I am so thankful to Richard House, the London Borough of Newham, and the Diana Children’s Community Nursing Team in Newham for offering me these incredible opportunities. I am excited for my next [and last 😦 ]week at Richard House and look forward to learning more about healthcare and palliative care in the U.K.



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