Inside The Living Rooms Where Hospice Care Happens

Leanne didn’t set out to be a hospice nurse.
 
She joined the NHS at 19 and went on to work across several frontline roles – including A&E during the COVID-19 pandemic and a community urgent response team – before joining ellenor’s Adult at Home team as a Clinical Nurse Specialist (CNS) in March 2025.
Straight away, she knew it was the right fit.
 
“In my role in urgent care, we’d pick up palliative crises on evenings or weekends and I just really enjoyed those visits. I felt a great sense of accomplishment turning awful situations around. When I came for my interview at ellenor, I had a look around the hospice and just really enjoyed the vibe. I walked away and said, ‘If I don’t get the job I’ll be gutted’ – I knew, immediately, that it would be such a nice place to work.”
 
Like her previous roles in healthcare, Leanne’s work at ellenor centres on caring for people. The difference is the setting. Here, crises and care don’t arrive through swinging doors – they happen in ordinary homes. Her patients are not hidden behind curtains or strip-lights, but in the familiar rooms where they live and love.
 
ellenor is a hospice charity that provides vital care and support for people living with life-limiting conditions — on our inpatient ward in Northfleet and in the homes of families across Dartford, Gravesham, Swanley and Bexley. This means local people receive specialist symptom management and support in the place they feel most comfortable, reducing hospital trips and time in GP waiting rooms by bringing care straight into the patient’s front room.
 
That changes the work. It changes the relationship. But for Leanne, it was exactly what she wanted.
 
“Caring for patients in a hospital, you don’t always get that time with them, and people aren’t their most authentic selves there. But when you care for people at home, you get a true reflection. It’s their space – things feel more equal, more give-and-take. It means you can bring far more of what matters to them into the plan.”
 
Of course, community hospice care isn’t without its challenges – and, as Leanne is the first to admit, there’s no ‘typical day’ in the role. The same job title can mean something entirely different from one hour to the next. One visit to a patient’s home might simply be about reassurance and looking ahead to anticipate future needs, while the next could involve urgent, high-stakes symptom control.
 
“You put on different hats depending on the person in front of you,” she says. “Today I saw a lady with dementia whose function has declined. She’s palliative because that decline isn’t reversible, but she’s comfortable at home with good carers. My role was to make sure her husband felt supported, put a ReSPECT form in place – that’s a personalised plan that records a patient’s wishes and clinical recommendations for future care – and organise anticipatory end-of-life medication so nothing is missing in a crisis.
 
“This morning, it was the other end of the spectrum: a patient in the final weeks of a cancer battle, with no carers or equipment, and a young grandson caught between work and caring for his grandparents. I arranged equipment, care, pain management, and began the conversations about preferred place of care and death. Same job; completely different work.”
 
Leanne’s patch is defined by GP surgeries – Meopham, Longfield, Hartley, towards Northfleet and Pelham – but in reality, the urgent demands of the work pull her across boundaries. And, even alongside a busy caseload, Leanne supports newer colleagues and helps with the more difficult visits. “I’m part of the senior nursing team for our Gravesend community area,” she explains. “Day to day that means taking on the trickier cases, backing up less-experienced staff, and being available when there’s a wobble – clinical or emotional.”
 
A&E taught her the value of a clear head when everything else is spinning, and hospice work asks for the same steadiness – only delivered quietly, at the kitchen table. “A lot of our patients and families are living the worst days of their lives. You need to think straight, be kind, but also assertive enough to bring order to chaos. My job is to keep a clear head, to prioritise the patient and the family, and to be absolutely honest with them.”
 
That commitment to honesty and open communication means that, when a patient’s choice conflicts with clinical advice, Leanne explains the consequences plainly and supports the route they choose.
 
“It’s always a challenge when you don’t see eye to eye. I don’t shy away from saying, ‘If you choose X, these could be the consequences.’ But at the end of the day, it’s their decision. I’ll support them and we can change course if we need to.”
 
People often ask how she carries the work. The truth? It carries her sometimes – and that’s the hazard.
 
“It’s the first job where I’ve had a caseload I really know, so switching off is harder. I do think about them on my days off. But my family and my mental health come first. I try to leave work at work – my colleagues are more than capable – and be present with my little boy. I’m still learning, but that’s the aim.”
 
So, what lies ahead for Leanne, as a personal and professional?
 
Professionally, Clinical Nurse Specialist is now aiming for advanced practice and prescribing – both to speed decisions and to cut avoidable delays for patients. “I’d like to do my Master’s and become an Advanced Clinical Practitioner. We’ve got very experienced nurse prescribers here who can’t currently prescribe in role, and it creates a middleman. We’re basically telling the GP what to prescribe and they just do it – when it would be better for patients if we could do that ourselves.”  INSTEAD At the moment, we identify the required medication and then must ask the GP to issue it, which adds an unnecessary step.
 
Personally, though, ask her what she loves most at ellenor, and the answer is simple: people.
It’s the privilege of walking into a stranger’s worst day and making it better – either through managing their symptoms or simply having a cup of tea and a conversation. “You meet the most interesting people here,” Leanne says. “And there’s a huge satisfaction in getting it right – whether that’s turning a crisis around or holding the hand of someone who’s dying so they’re not on their own. I couldn’t imagine doing anything else.”