A week in the life of a palliative care doctor: Inside the Northern Trust

Specialty doctor in palliative care, Jenny Wilson, works in the Northern Health and Social Care Trust

Dr Jenny Wilson, a specialty doctor in palliative care with the Northern Health and Social Care Trust, has shared a powerful insight into the daily reality of supporting patients with life-limiting conditions.

Her account sheds light on the vital role of palliative care – not only in managing physical symptoms but also in offering psychological, social and spiritual support to patients and their families.

Mondays at Causeway Hospital

Each Monday, Dr Wilson works alongside four specialist nurses as part of the Hospital Specialist Palliative Care Team (HSPCT) in Causeway Hospital, Coleraine.

“Patients are referred to us from the inpatient wards and the emergency department,” she explained. “All the patients referred to us should have a palliative diagnosis – a diagnosis of a condition that is not curable.”

These conditions range from incurable cancers to chronic lung disease, heart failure, motor neurone disease, and dementia. While some patients may be in the final days of life, others may live for months or years, requiring support to manage symptoms such as pain, breathlessness or nausea.

Dr Wilson described how treatments are tailored: “Sometimes these medications are taken orally and sometimes they are injectable medications, or given via a syringe driver.”

She emphasised that care is holistic, covering emotional and social needs as well as medical treatment: “We also talk to people about psychological issues, social issues and spiritual issues … what gives their life hope or meaning.”

Hospice care in Antrim

On Tuesdays, Dr Wilson works at the Macmillan Unit in Antrim Area Hospital, one of six hospices in Northern Ireland.

Her day begins with a handover from nurses before she visits patients. “We will adjust their medications and find out if there are other ways we can help them,” she said.

“Sometimes this means trying to identify if there is an issue such as infection that we can fix … Sometimes we think they are less well because their underlying palliative condition has got worse, and we can’t fix that.”

Families are supported to spend as much time as possible with their loved ones. The hospice provides ensuite rooms with patio areas and space for relatives to stay overnight.

Dr Wilson acknowledged the emotional demands of the job: “Lots of our patients die, and we also have to have big, important conversations with our families about how things have not turned out as they hoped. So we as a team try to look after each other.”

Beyond the Hospice walls

A common misconception, Dr Wilson noted, is that hospices are only for dying patients. “Hospices are all about living the best life that you can, and trying to help with all the issues that stop a good quality of life, such as pain or emotional distress,” she explained.

Many patients are discharged home once symptoms are under control. Others remain in their own homes or care homes, supported by community nurses, with about 50% of people still dying in hospital.

On Wednesdays, Dr Wilson works with community nurses from the Northern Ireland Hospice, who visit patients in their homes. “Sometimes if they are finding symptom management particularly difficult, I will visit the person in their own home,” she said.

Teamwork at the heart of care

Dr Wilson highlighted the vital contribution of nurses, healthcare assistants, physiotherapists, occupational therapists, chaplains and social workers. Weekly multidisciplinary meetings ensure patients and families remain at the centre of decision-making.

Reflecting on her role, she said:

“My job is incredibly interesting and satisfying. Every patient is different, and I get to walk a little bit of their journey with them. Unfortunately really sad things do happen to people, and I can’t stop those things happening, but often I can help to make it a bit easier.”