Stress in Hospice at Home Nurses: A Qualitative Study of their Experiences of their Work and Wellbeing Karen Tunnah, Angela Jones & Ros Johnstone This Qualitative study originated as a research proposal Which I completed last year as part of my nursing degree. The study was well received in the department and I was encouraged to carry it out following approval by the ethics committee . Study was undertaken earlier this year A literature search identified studies undertaken in hospices but few concentrated on hospice at home nurses

The role of Hospice at Home Nurses 10 community hospice at home nurse Cover large rural area of Gwynedd and Anglesey Objectives of service is to offer a combination of psychological and practical support ,nursing care and advise which is complimentary to existing service comprised of district nursing and GP’s Symptom management and advise Informal education to PHCT and families Facilitate rapid discharge home when a patient expresses a desire to die At home Bereavement support Provide advice and psychological support to patient & families

Qualitative study Semi structured taped interviews. Interviews typed verbatim and anonymised. 3 researchers had copies of transcripts to identify themes. 10 nurses were invited to take part 7 accepted I on maternity leave 1 declined I was excluded as on research team Research Team discussed conclusions together using a grounded theory approach Themes were identified without loss of data

3 categories emerged: There were negative and positive aspects to the categories which include :

Lack of support Being undervalued by colleagues outside of the team Long travelling time Conflict with colleagues outside of the team, Poor communication with colleagues outside of the team, Isolation of lone working

Relaxation time which included listening to music /watching T. V Relaxation time which included listening to music /watching T.V./Hobbies and exercise Ability to switch off Good communication Support from team and colleagues Support from family and trusted others/friends The value of the weekly M.D.T. team

Recommendations: Clinical Supervision (uptake poor) Education sessions Attendance at M.D.T. Stress awareness training Primary care training in awareness of the role of the hospice nurse The study was presented as a poster at the palliative care congress in Gateshead in March this year The study has been published in the last edition of the International Journal of Palliative Care

Palliative Care Congress in Gateshead March 2012 BMJ Palliative and Supportive Care 2012 Vol 2 supp 1 pA26 Tunnah K., Jones A., Johnstone R.(2012) Stress in Hospice at Home Nurses : a Qualitative Study of their Experiences of their Work and Wellbeing. International Journal of Palliative Nursing Vol 18 No 6 283-289 Thank

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