'People die the way they live': Palliative care nurses don't see death as the end

The concept of death can be quite off-putting for many, but not nurses in palliative care.

They see it as a way to provide patients and their families with essential support and connections as they near the end of their lives.

This journalist sat down with two palliative care nurses from Tamworth hospital to chat about their work.

Transitional Nurse Practitioner Mary Anne Dieckmann and Clinical Nurse Consultant Jonathan Gourlay say their job is mainly about providing "human connection".

Mr Gourlay said a lot of people die the way they live.

"It gives nurses the opportunity to connect with them and embrace the whole person," he said.

"What all patients are looking for is to be seen, heard, and understood. If you can do that in a palliative setting and make that human connection, it enables everything else to flow.

"It opens up communication as everyone views death and dying differently."

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When it comes to guiding patients through their final years, days, or moments, Ms Dieckmann said the nurses look at the whole person and how they lived their lives, because it enables them to "look at how to get the best out of that life while they still have time".

"Palliative care is not seen as the exciting career path that most of nurses come in wanting," she said.

"Many people come in thinking that nursing is only about saving lives in the ICU or the ED.

"But if you look at the fundamentals of nursing, it is about looking at the whole person."

When Ms Dieckmann began her nursing studies she considered both palliative care and midwifery.

"There are two very extreme ends of the spectrum: birth and death," she said.

"When I started my training in the stroke unit as an Aboriginal cadet, I got really interested in the multidisciplinary team and thought I would end up there."

But when she got a taste for palliative care, she felt "like it chose her".

Mr Gourlay said he has always accepted dying as part of life.

"Because I feel comfortable with it, I am able to support the other person in their discomfort with it," he said.

He views death as quite a personal thing that impacts not only the patient, but also their family.

In his role as a nurse consultant, Mr Gourlay travels across Tamworth and into rural communities conducting palliative care assessments.

"The average age we see is 70, but we also see people aged 18 and over," he said.

"And 80 per cent of our patients are cancer-related and the remaining 20 per cent have organ failure and neurological disorders."

He also spends time supporting GP's as they navigate prescriptions that might be needed by patients, while at the same time supporting carers.

Mr Gourlay said it's almost like a coaching role that takes people through step by step.

"People who are being cared for at home can be quite stressful on the carer. So we look at the stress on the carer and how we can best support them," he said.

"Whether that be organising services or equipment that makes life a lot easier."

More people are opting to die in their own homes and it takes a large multidisciplinary team of nurses, social workers, services, and more to manage the process.

Both find their jobs quite rewarding, but they also understand it's "not about them, it is about the person in the bed and their families," Ms Dieckmann said.

When it comes to the end of their work day they also understand the need to turn off.

Mr Gourlay said he's happy sitting in the garden, or on top of a tractor.

"Being at home with family and friends kind of nourishes my soul, and I also have a faith that enables me to keep going."

Ms Dieckmann said she enjoys disconnecting to reconnect.

"I do make sure Saturday is my day and I spend time with my family or play soccer with my team, South United women," she said.

"When I do have leave, I often go out and switch off my phone and reconnect to country with my surroundings."