A day in the life of our SPOC leader

Mel Buckley is a Team leader in our single point of contact team. She has been working at Prospect Hospice for 14 years, firstly as a clinical nurse specialist and now in her current role. We shadowed her for a day to find out what a typical day involves.

Monday 8:30am: I arrive at my desk early to catch up on any emails sent in over the weekend. There’s a few triage cases to catch up on plus an email from the hospital for a referral. I check the register of patient referrals to identify where some of our patients are and whether they are home or in the hospital. There are 12 referrals to do on my list, current referral numbers for those needing our support are high, there’s been 87 referrals this month already.

9:00am:  A message was left on the out of hours line over the weekend from a distressed patients’ wife. The patient was located on our system and we gave her a call back and reassured her.

9:10am: Time for the daily clinical leads meeting. SPOC, our inpatient unit and clinical leads meet daily to check in with each other about how each team is and discuss patients on the waiting list for admission. I make a quick phonecall to the hospital and find out there are two patients on the pending list. One of them needs help with symptom control and the other we had spoken to and her health is declining fast. I immediately refer the patients’ children to our family support team as they have young children and need help with talking to them as well as processing themselves what is happening as the speed of their one declines.

9:40am: Urgently triage our new potential inpatient. I have access to all her hospital records so can look through medical records, the referral form, scans and blood tests. We are the coordinators for all the paperwork of referrals so that the clinical team can have everything they need to know about the patient. Our job is like being a detective, piecing all the info and referrals together to create a timeline of their illness and know the full picture. When we speak to the patients it’s a relief to them when we tell them they don’t need to tell us anything about their medical background as we already know. We can concentrate on their current needs and get them the help they need.

10:10am: Another referral pops into my inbox from a GP about an elderly patient with pancreatic cancer in need of pain management. He is already one of our patients and I update his notes and refer him for pain management support from our community CNS team.

10:22am: The office sweets tin has been refilled by Sarah one of my clinical nurse specialists, it was getting down to the last few sherbet lemons. We are a small team of four, not everyone is in every day and we have a mixture of grades and skills all of which contribute to the strength of the team.

10.30am: MDT team meeting, this is where we come together with all disciplines at the hospice to discuss the telephone based case load that has developed during the pandemic. We are reviewing these cases to see if other services can be of benefit to any of these patients.

12:00: Back to my desk after the meeting and a quick check of emails. I’m back on the case of the patient I was looking after this morning and, after a call with the hospital it has been decided that the patient will have end of life care there, she has been moved to a side room and visiting restrictions lifted as she faces her last days.

1:30pm: A message has come in from a family wanting to refer a relative from London to our services. I called the brother of the patient for an update on the situation and talked through a plan for his sister’s care, focusing on checking what matters most to his sister so all the health care professionals involved and family can be working together to achieve whatever these wishes are. We take many calls which are just giving general advice and support and don’t always lead to a patient referral. This patient has been discharged from a London hospital and is back home so is back under the care of her own GP. The situation is complex and may lead to a move to our area, but if not they now have clear idea of who to talk to and the questions they need to be asking. I am able to give them the contact details for the local hospice in her area.

2:20pm: Another call for a referral comes in. There have been seven new referrals for our services so far today.

3:00pm: It’s been a busy morning so I take a few minutes out to grab some lunch. The onsite catering team makes a great soup and look after staff as well as patients and families.

3:15pm: A message of thanks comes through from a patient’s family. I had sorted transport for his transfer to our inpatient unit from the hospital as Prospect Hospice was his preferred place to die.  After he died I then sent a card to the family which was well received. These relationships we form with our patients make them feel at home at the hospice and it’s lovely that they thank us afterwards.

3:25pm: Back to the referral list. I check in with a home working team member so we don’t both start triaging the same patient next.

4:00pm: Audit of prescription pads, I am the non medical prescribing lead for Prospect’s NMP team, and I audit all of the teams prescription pads monthly.  I’ve not prescribed anything this month, but am using my prescribing skills all of the time when completing telephone consultations with patients providing medication advice, how medications work and possible side effect’s.  Everyone’s records are up to date this month, with no discrepancies or errors.

4:30pm: Continue working through my list of referrals fuelled by a couple of sweets from the restocked tin.

5:00pm: Switch off the computer and head home. Any calls now will go to our 24 hour advice line and I can pick up any that need my attention in the morning.