Inpatient Support

In NSW about 29% of palliative care volunteer services have volunteers in inpatient settings only, and another 34% have volunteers in inpatient as well as other settings (such as community visiting).

Their roles include:
• Companionship and psycho-social support
• Meeting and greeting
• Tea trolley, jolly trolley, hospitality
• Assisting the clinical team in comfort care

The inpatient setting provides an opportunity for the person’s condition to be assessed by a team, for them to be supported, for their condition to be monitored and stabilised, and for their particular needs at end of life to be best met. Not everyone receiving palliative care will come to an inpatient setting.

Volunteers help to orientate the person and their loved ones and they have time to spend with the person which the clinicians may not have. In paediatric settings the volunteer will spend time interacting with family and siblings. They support, but not substitute for, the parents.

Time alone is part of the equation. The use of that time for reflection, discussion and silence is what people in palliative pare often value the most. And not only with the person in palliative care but also their loved ones.

As for all palliative care volunteers the inpatient volunteer should be confident to talk to people from all walks of life and to help bring peace and calm into their lives. This will involve competent interpersonal skills and sound emotional intelligence on the part of the volunteer.

Hospitality is a valuable gift for a volunteer, as catering is a practical way to express and share their humanity. Depending on the health service policies they may assist at meal times in unwrapping food items, they may walk with people, go on outings to the garden or grounds or coffee shop, and perhaps give light hand and foot massage.

As manager you should check your organisation’s policies and procedures for specific instructions about inpatient volunteers.

A willingness to work in a team is also valuable for the inpatient volunteer, both within the clinical team and within the volunteer team. This highlights another important attribute of an inpatient volunteer, the need for them to understand the dynamics within a clinical setting between the various occupational specialities. Being teachable is a valuable quality of an inpatient volunteer.

Typically volunteers in an inpatient setting are rostered-on as a small group on a rotating roster with regular shifts or days. A small group might be one person, or as many as 4 or 5 people at a time. Shifts vary in length but generally are focussed around the needs of the patients and the service. For example if volunteers are used to assist with the morning routine then a shift might be timed for 0700-0900. In this way a volunteer who has committed themselves to giving 4 hours a week will fulfil their time in 2 shifts.

The needs of the service may vary and the demand for volunteer support may change accordingly. The routines of the ward, the familiarity of other staff and the habitual patterns of the roster and tasks can evoke a sense of loyalty and commitment for the inpatient volunteer. The flipside of these virtues is a sense of ownership which can manifest itself in resistance to change and direction, particularly for volunteers who have maintained the same pattern of attendance for some time.

Part of the role of the manager is to manage on the one hand the preferences of the volunteer for regularity, and on the other hand the needs of the service to manage their volunteers as and where needed (within reason)

In many services inpatient palliative care volunteers are managed day-to-day by staff on the ward. They continue to be supported by the manager of volunteers but the manager takes on a coordinator-type role, focussing on recruitment and background ‘human resource’ tasks.

At times the manager will need to be more closely involved. This is the case when the volunteers are new on the ward, or where there are particular performance issues or challenges in communication between clinical staff and volunteers. In general however the layers of supervision by the palliative care team for volunteers mean that they need less intensive support by the manager in an inpatient setting.

In any case the manager should clearly explain the lines of reporting for volunteers, clarifying to whom they report and from whom they take direction.
The inpatient setting makes for relatively easy recording of volunteer hours in a book on the ward, which are easily transferred to the manager’s spreadsheet or database.