What is it like to work on the Gold Line? We find out about the transformative work at the Gold Line from Senior Nurses on the frontline

Fran Duxbury and Alex Blake are senior nurses. Both work on the Gold Line, answering calls from patients in the last year of their lives, and their carers. The service runs 24 hours a day from Airedale Hospital. We spoke to Fran and Alex about what it’s like to be on shift and why they think the Gold Line service is so important.

Creating an effective service

‘It literally started with a telephone,’ Alex says. ‘There was a telephone in a room and we waited for it to ring.’ Since then, the Gold Line developed to provide a broad-ranging service to significant numbers of people.

Calls to the Gold Line are answered by nurses with different backgrounds, each bringing important skills and experience to the service, and creating a lively and relaxed environment. Supporting each other is important, as calls can be traumatic and it’s important to acknowledge and manage the impact that has on the nurses. Alex says the service is introducing action learning sets, where small teams meet for structured sessions to discuss difficult cases and share learning.

An important aspect of the Gold Line service is that calls are answered by senior nurses, who can handle a range of calls. One call might be around something technical or clinical, such as using syringe drivers (small battery-powered pumps used to give a continuous infusion of medication) or controlling symptoms, and the next call might be about giving emotional support. Callers may be very distressed, or frightened, and, as Alex says, ‘we’re managing very complex ethical issues as well.’ Nurses also need to have extensive knowledge of other local services, particularly out of hours.

Talking to patients using video calls

Some patients registered with the Gold Line are given an iPad, so they can have video calls with the Gold Line. This is much like Skype, or Facetime, but on a secure NHS network. For the patients and carers, it can help to see a friendly and familiar face and for the nurses, it helps with their assessment of what is going on clinically. Fran says, ‘To see a familiar face is very reassuring for people and we get told time after time how reassuring it is.’

The impact of the Gold Line on end-of-life care

Before the Gold Line, if a person nearing end of life was experiencing symptoms, they would have called a doctor or an ambulance, and often would have been admitted to hospital. Now, with the help of the Gold Line, the same situation can often be managed at home.

Fran explains, ‘We can give people advice. What to do, what to try. Quite often having a voice they know, it calms them. So they can listen to instructions clearly. You build up a close relationship with some people. They will listen to you and take your advice, where they wouldn’t listen to someone else.’

Alex agrees that end-of-life care in the area has been greatly changed by the Gold Line. ‘Whereas prior to the Gold Line being active, people’s choices were not being followed through, what it’s doing is allowing people to make choices that can actually happen.’

Both Fran and Alex have a passion for providing good end-of-life care. ‘You get one chance to get it right,’ Fran says. ‘We’re absolutely passionate about making sure, that for every patient and every carer, that death is as good as it possibly can be, and the patients and carers are actually involved, and it’s all on their terms, as much as they want it to be.’