Member Spotlight: Helen Harrex

For the last 5 years, I have worked as a Clinical Nurse Specialist for the Otago Community Hospice in the Residential Care sector. I support facilities in the Central Otago, South Otago and West Otago areas. I am a designated nurse prescriber who has recently graduated with a Master’s degree in Clinical Nursing.

Last year, I was fortunate to receive a scholarship from the Otago Community Trust to attend the National Rural Health Conference in Christchurch. I was amazed at the depth of knowledge and experience that the rural sector has, and came away excited about how supportive the Hauora Taiwhenua Rural Health Network was.

In palliative care, having timely access to medications to manage symptoms at the end of life is important. The loss of Primary Health funding for palliative patients in Residential Care has led to reduced practitioner availability in some rural areas. This is an area we are working on in collaboration with primary health care to advance and improve.

Over the last two years, I have enjoyed  completing two research projects on symptom management in palliative care. I first focused on end-of-life secretions and now have a deep understanding of the benefit of early discussions and education on what types of symptoms a dying person is likely to experience. I also learnt the importance of understanding that every symptom does not need to be eliminated. Secretions are not believed to be distressing for the dying person. They can be distressing for the Whanau and health professionals to hear, but treating them with anti-cholinergic medications is more likely to cause harmful symptoms than relieve the secretions. Repositioning and mouth care are the most effective interventions.

Having little understanding of what techniques were recommended in mouth care led to my second research project.

There are limited resources on how to complete mouth care effectively, and I discovered in my research that there are a number of cost-effective interventions that can be administered by staff and whanau when a person is no longer able to eat or drink.

Ice, mint flavouring and water/oil mouth spray, to name a couple. I am hopeful I can, at some stage, help develop a resource.

I am always interested in hearing how other rural health professionals navigate the diverse sectors we work in.  I love brainstorming and am always happy to be part of discussions relating to rural health, residential care or palliative care, and I can be contacted via my work email at the Otago Community Hospice. Helen.harrex@otagohospice.co.nz