Day In The Life: Clinical Nurse Specialist Tracy Rhodes

Our Clinical Nurse Specialist (CNS) team visit people at home across Chorley, Preston and South Ribble, including nursing homes and care homes. They provide assessment, treatment and support, and work together with GPs, district nurses and other health and social care professionals to ensure care is co-ordinated.

They are available seven days a week, offering expert knowledge of complex symptom and pain management alongside psychological support. Here, CNS Tracy Rhodes describes her typical day…

8.30am Team meeting – catch up after the weekend. Go through urgent calls and prioritise new referrals. The 24 Advice Line was busy. Advice we gave to paramedics prevented a patient from being admitted to hospital. He died at home instead, as wished.

9am Chorley Cluster meeting – go through the list of new referrals in our area. We try to keep the same CNS from the first assessment through to regular follow up reviews, based on capacity, annual leave and rotas. Sadly, learned that a patient died overnight that we only visited for the first time last week. But, with CNS-prescribed medication and DN support, he died peacefully and pain-free at home; this is what he wanted which gives some comfort to his wife.

10am Home visit with a new referral from a GP, patient with COPD. Spend an hour with them to assess their medical needs as well as psychological support; meet their family/carers. Patients often tell us they were worried about us coming, but feel so much better as to what to expect after we’ve met.

11am Meet another new patient from a care home referral. The staff really appreciate the support and specialist advice. It’s great that we can prescribe medication directly. We support people to stay in the place they call home, to live well right to the end of life.

12pm On central CNS team duty. Respond to calls and emails from across all areas. Grab some lunch!

1pm Do three patient reviews by telephone; one a recent MND discharge from the hospice. An elderly lady met and assessed last week, who was frightened and in pain, is now comfortable and well looked after at home by her family, thanks to a syringe driver and DN support.

3pm Urgent referral comes from hospital, so need to re-prioritise two review phone calls to tomorrow. Manage to speak with the family and arrange to see new patient first thing in the morning; give the carer the 24 advice line number for overnight support.

3pm-4pm Paperwork! As well as leaving handwritten notes for DNs, we update medical records electronically. All GPs are sent a letter to alert them when patients’ medications are changed.

4pm-4.30pm Got a bimonthly Gold Standard Framework meeting at a GP surgery tomorrow. Useful timing as can also report to DN huddle meeting early next week. Finish off planning home visits and telephone reviews for tomorrow.

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