• Name: Mary Walding 
• Job title: Lead Specialist Nurse for Palliative Care 
• Joined the team: It's complicated! Since Feb 1992 I've worked for either Sobell House, Katharine House or both! 

How did you get into your role and come to work for Katharine House? 

I wanted a job in a hospice to learn how to care for the dying properly, as it is something that happens on every ward at some point and I wanted to provide good care. I got to Sobell House and quickly found it was ‘proper nursing’. It was my niche where the patient is central to care. I worked for nine years on the ward, moving up from staff nurse to team leader to ward sister. I then did a practice development role before moving to Katharine House to work in the community. I thought I was a ward nurse, but found I actually loved community work. 

I then moved back into management as more of a challenge and managed the hospital and community services at KHH  before becoming Lead Specialist Nurse. 

What’s a typical day like?  

There is absolutely no typical day! There are always too many meetings and not enough patient contact, but I also know that it’s important to have someone like me, with the background knowledge I have, in those meetings as I understand how the services work in all areas.  

Within my role I manage the hospital and community nursing teams – around 40 people. The hospital service is based across four sites and the community team are obviously mostly out doing visits or ringing patients. It is difficult to keep track of everyone, but I try to check in regularly with each team. Fortunately, I am supported by an absolutely brilliant deputy in Paula Johnson.  

Each team has a weekly multidisciplinary team meeting where we discuss patient issues of concern and develop a plan for anyone whose symptom isn’t improving. I also sit in referrals meetings for the community team and the daily clinical check in when I can. 

There is also rostering, managing new staff and leavers, mentoring and developing staff, doing appraisals, dealing with complaints, supporting relatives who have questions about the service, developing the service, liaising with the charity, etc., etc. I also do some patient calls to help out when the Palliative Care Hub (our telephone service) is busy and occasionally see patients in outpatients. 

What are you proudest about working at Katharine House?  

The two things I am most proud of since being in this role is how well we managed to facilitate the two teams merging when the Katharine House team came into the OUH palliative care department. It was a lot of work, but so many staff showed such good will and I think most patients barely noticed. 

The second is the project we have undertaken to increase patient choice at the end of life so there is better care in the community if people wish to die at home. This isn’t for everyone, but so many people say this is what they would want and now we have the wonderful Home Hospice team who deliver care at home. We also have the Hospital Rapid Response service, which gets patients home quickly if they are in hospital and coming towards the end of their life and would now rather be at home.  

The final phase of the project is the Hospice Outreach that launched in March this year, where we support the Oxford Health community services to maintain patients at home, even when their symptoms are troublesome.  

What do you wish people knew about hospice care?  

That patients and families are always surprised how much laughter happens, and that we are about living with the best possible quality of life, not about dwelling on short time spans. The research evidence shows not only do you have a better quality of life with palliative care support, but that people also live longer. 

How does it feel to work for the hospice? 

It feels like a large extended family where we are all working towards the same goals (even if there is a bit of squabbling about the best way to do things sometimes!). 

What makes Katharine House so special?  

Its community roots and the very real engagement of the founders with the development of the service. Neil and Heather Gadsby started a special legacy for the community, which is absolutely community owned within Banbury and the surrounding areas. Everyone values and supports it, even if they have not been here.  

When you drive or walk up the approach to the hospice, it’s such a beautiful setting, with gorgeous grounds and the building nestles into the gardens. Then you walk in and it’s light and welcoming and everyone is so friendly. 

As this week is Dying Matters Awareness Week, what are your tips and advice on starting honest and transparent conversations about death and dying to help people feel informed, supported and empowered at one of the most vulnerable times of their lives?  

My biggest tip is something that is so obvious, yet so hard – that talking about dying won’t make it happen, won’t make it happen faster, but will allow people the chance to say what is important.  

I have been involved with care of so many families who have tried to protect the person who is dying by not mentioning it, so they don’t lose hope – but I can guarantee that that person always knows and is usually desperate to say something important, but doesn’t want to upset others. The more we talk about death, the less scary it is. It happens to us all and we can’t avoid it, but those people whose relatives have been able to say the important things they want to say can die more peacefully and their relatives always have those words to remember. 

I would never say ‘Let’s talk about death’ but I would listen for what people are telling me. I might ask ‘What’s most important to you?’ and see where the conversation leads us. If someone has been in hospital or more unwell recently, I might ask how they are feeling now, how it was when they were being treated and, if they were less well in the future, what would they want to happen? But the important thing is the listening, so that what I hear is what people want to tell me, not what I think needs to happen – and if someone changes the subject, then that is fine – that’s enough for today. 

It is hard to think of not being here and our own death, but writing a will or advance decision statement <add links> so your family know what is important when you are less well or dying (‘I don’t want to be in hospital’, ‘make sure the dog is with me’ type things) can be helpful. Similarly, making a Lasting Power of Attorney <add link> so your family can make the critical financial decisions if you can’t, or speak for you about health care decisions, empowers your family and they will know they have done what you want. Living without regret after a death is the best legacy someone can leave their loved ones. 

Now for some quick-fire questions…  

My highlight since joining Katharine House is: the amazing people I work with (though the opportunity for tea at Downing Street is high on my ‘events’ list). 

If I could go anywhere in the world, I’d go to: wherever most of my family are at the time – or to see the one I haven’t seen for the longest. 

My favourite dessert is: apple and blackberry crumble. 

My all-time greatest song is: so, so hard to choose, but my daughter would insist that my most popular go to is Eva Cassidy’s Fields of Gold. It’s a happy peaceful place for me – but there are a lot of other contenders. 

If I won the lottery, I would buy: a new car. I always find better things to spend my money on and don’t really care I drive a rust bucket. I cycle when I can! 

People are often surprised when I tell them: I have four children. 

My idea of a perfect day is: I’m not sure I have one as there are delights in all sorts of days, but I’d want it to include a walk somewhere beautiful with my husband, family, friends, whoever wants to come. A good meal, lots of chat, some ‘me’ time to read, and a clean and tidy house (ideally not done by me), so that I can walk in and can feel relaxed! Nothing super complicated. 

My favourite thing to eat is: a slightly over ripe banana – my team do not understand it and often save their off casts for me! 

I never miss an episode of: nothing. I miss loads of TV and am more likely to listen to podcasts. I would be lost without a book on the go and a pile to go to next! 

Without doubt, the best animals are: dogs. 

The best advice I’ve ever been given is: ‘do not let the behaviour of others destroy your inner peace’. It is from the Dalai Lama and is up on my wall to remind me when it feels everything is being blamed on me. My lovely ex-colleague Karen Pope, who worked at Katharine House for many years, shared it with me – I love a little bit of Karen balance in my life! 

My proudest moment was: each of the births of my children – no way to separate them! 

My favourite way to unwind is: a good project. If I have to sit, then reading, sewing or knitting, or with people. I cannot just sit unless I am so tired I should really be in bed.  

My all-time favourite film is: Dr Zhivago closely followed by Casablanca, closely followed by Mamma Mia! 

I’m currently listening to: The Life Scientific podcast – I find them a fascinating mix of nosiness and education! 

If I had one superpower, it would be: to really be able to see through walls and ceilings as my children believed when they were little! I wouldn’t really want to do anything with it, but it would be so funny to be proved correct. Sadly, my youngest believed this for longer than the ‘mummies know everything’ line that he challenged aged four with some complex enquiry and still reminds me of all the time!