This fall, the Laval Center for Integrated Health and Social Services (CISSS) launched a unique project created by one of its teams, Night Lightsto help families who are often grieving but also overwhelmed by the end of a loved one’s life.
This is a long-standing project that CISSS de Laval has successfully implemented.
“The mission of the night watchmen is to give respite in the last three nights of life to families who care for users,” explains the head of the home palliative care service, Sylvie David.
The project comes from a personal initiative born in 2018 before being tested in the field.
“It doesn’t exist anywhere else, to continue Sylvie David. We built it internally, started it in 2018, and then tested it overnight in 2019 to see how it was going. Then came the pandemic.”
On the ice
The pandemic bringing its complications, the logistics of the project became unfeasible. The Night Watch team had to resign to put their project on ice indefinitely.
“We didn’t have a mask to go home and thus protect the workers who had to go to their families. It should also be said that you have to stay eight hours in patients’ homes, which did not make things easier.
Not knowing when the night lights would be able to start their mission again, the team decided to use this time to consolidate their project.
“This stop still allowed me to unlock positions and no longer be in experiments, that is, to have an actual practice, says Sylvie David. Now, in our services, we must have a night watchman, or have a professional presence day, evening and night.
More complex than it seems
The Laval project was presented at the Congress of the Order of Nurses and Nurse Auxiliaries of Quebec (OIIAQ) on October 12.
With the nature of the project and nighttime schedules, implementation involves some logistical challenges.
“It’s too heavy for one person and that’s why we want to open some more positions. Just the fact that it’s a night shift isn’t very attractive. Many prefer to work during the day, so candidates are absent. Moreover, it is truly a specialty, palliative care. It requires specialized training and a special interest in this clientele.”
Death is never easy to face. “We don’t always want to see that, of course, so it takes a solid team to support people,” Sylvie David said.
Julie Dubé, nurse practitioner, is the first night watchman in practice within palliative care. Beyond the complexity of the work, Mrs. Dubé must also give confidence to the family and the person at the end of life and this in a very short time.
“The first thing is to contact the family, comments Julie Dubé. When I arrive at people’s homes, I take a quick look at the person I have to take care of. However, what is prioritized is contact with family. They are going to leave me their boyfriend, so I really need to take the time to establish contact and thus ensure that a bond of trust is established. When this step is done, I invite the family to come with me to give first aid, so they can see my way of working, the way I do things.”
The night watchman must also explain what he must observe during his work.
“At the same time as my related duties, I take the opportunity to learn the symptoms that I am able to observe. I also give people a ballpark of what I’m going to do. When the bond of trust is established, families have only one desire: to go to bed!”
Julie Dubé also explains how families are tired and working on adrenaline. However, when the bond of trust, which is essential, is well established, they agree to go and rest.
“One day after my arrival, for example, they recognize me, open the door and say: ‘Juli is watching, the documents are there, I’m going to sleep’, so I know that trust has been installed. because they trust their loved ones, their home, they trust me after all. So that’s really the main thing when I start, the person to be treated and the loved ones.
Although such work can seem arduous and very intimidating, Ms. Dubé explains that for her it is more a matter of a logical continuation in her career.
“I worked in palliative care at CISSS de Laval for a long time,” says Sylvie Dubé. However, I wanted more. For a long time I wanted to work in home care. I’m really getting what I wanted in my career.”
Ms Dubé goes on to say that although night work can be difficult, she says it is above all very rewarding.
“Working at night brings a completely different closeness to loved ones. I have a full seven and a half with the patient and his loved ones. So you can imagine the exchanges I have with them. It’s super rewarding to work like this, even if it’s a tight schedule.
Acting as a precursor to such a project, the CISSS de Laval home palliative care team now hopes to open more positions for night guards like Sylvie Dubé, also hoping to see the project grow elsewhere in Quebec.