A Day in the Life of a Respite Unit Carer

31 May 2017


Nomthandazo Ngcobo (pictured below) is one of HACT’s longest serving carers having worked in the centre’s Respite Unit since it opened eleven years ago in 2006. Despite the long hours and the often emotionally draining work, the 42 year-old, single mother of two is completely dedicated to her work and sees her position as a calling rather than a job.

Like almost all of HACT’s Respite Unit staff, Nomthandazo lives in the Valley of 1000 Hills and first learnt about HIV/AIDS while attending one of the centre’s home-based care training courses. Soon after Nomthandazo completed her course in 2005, she was selected to work in the newly opened Unit and hasn’t looked back since.

“I was doing nothing before I came to work in the Unit. Caring for the patients is my life now and I can’t imagine ever doing anything else!”

However, like many of HACT’s Respite Unit staff, Nomthandazo faces a very long and tiring journey to work and back every day, often travelling in the dark, while the rest of us are still fast asleep…“If I’m working day shift, I have to get up at 4:15am to catch a taxi by 5am” says Nomthandazo. “It takes just over an hour to get to the centre for handover which happens every morning at 6:45am. The handover is very important so we cannot be late even if it means running all the way from the taxi rank in Hillcrest to the centre!”

At morning handover, the team walks from bed to bed, enabling the night shift nurses and carers to update the day shift staff on each patient’s progress including when they last had their medication, how they slept that night and anything else that is important regarding their care and treatment.

After each patient has been handed over, all staff join hands and form a circle in the middle of the Unit in order to give praise and say prayers.  One caregiver from the group leads this and it is done spontaneously depending on who feels moved to lead the praise and worship on that particular morning. 

“It is always a beautiful start to the day and often our patients can be heard singing along from their beds” explains HACT’s Nursing Services Manager, Julie Hornby. “If a patient has passed away during the course of the night a candle is always lit the next morning in the centre of the circle to honour their memory.”

After praise and worship the nurse in charge for the day updates the team on any news or notices from the Centre and thereafter the day’s duties get underway starting off with bed baths for those patients who are bedridden or helping those patients who are able to walk to the Unit’s male and female bathrooms for a bath or shower. Fresh dressings and bandages are gently applied for those patients suffering from bedsores and other open wounds with all patients clean, back in bed and ready for breakfast which is served promptly at 8am.

In addition to helping the patients to eat their breakfast, there are several duties which make up the carers’ general morning routine including helping patients take their medication, mouth care and pressure care as well as changing bed linen. Each task and procedure is meticulously documented and signed off by the supervisor. If there are any available beds in the Unit, the nurses and supervisors will also use this time to phone patients on the Unit’s waiting list and make the necessary arrangements to get them admitted as soon as possible.

After breakfast those patients who are able to get out of bed often go sit outside on the Unit’s verandah or sit inside in the Unit in the small “lounge area”. This is also a time when home visits may be done on patients who need follow up or who are on the waiting list. Carers usually have their first short break after 10am but sometimes as late as 12pm depending on how busy the morning has been. “In between daily duties there are also often emergencies to be dealt with including transferring patients to hospital if needed. This also involves contacting the patient’s family which in itself can be a very challenging and time-consuming task! If there is no family member available then one of our casual carers is usually contacted to accompany the patient.”

The patients’ lunch is served at 12h30 with carers once again, having to feed those patients who are not able to feed themselves. Duties such as pressure care to prevent bed sores is performed every two hours on all bedridden patients and some patients require twice daily dressing changes with some dressings taking up to half an hour per patient.

Additionally one carer does rehabilitation and strengthening exercises with those patients who need to be mobilised and also collects newspapers from the local shop so that patients can read and keep up to date with what’s going on in the world. Another carer will be responsible for counselling and talking to those patients who have challenging family situations.

Each carer in the Unit is personally responsible for up to six patients on any given shift. There is also always another carer who is available to sit with any patient who is in the dying process, thus ensuring that no dying patient is ever left alone. Once a patient has passed away their body is washed by our team and wrapped in a sheet. All curtains in the Unit are closed while the body is moved to the chapel where they are covered with a shweshwe cloth and family members can go visit them and say their final goodbyes if they so wish. If the family members only arrive after the patient has passed away the supervisor and nurse on duty will sit and comfort them and help them with any paperwork that needs to be completed.

Afternoons are usually the quietest part of the day with staff using this time to catch up on their paperwork in between ongoing duties. Most new admissions to the Unit tend to arrive in the afternoon, but can of course arrive at any time of the day or night. Processing and admitting a new patient often takes up to an hour as it’s crucial our team gets a detailed and accurate history from the patient and or his/her family members. Some days there are up to three admissions per day!

Day shift draws to a close as 4:45pm with the outgoing day shift staff now having their turn to handover to the incoming night shift staff, whose list of duties are just as full as those on day shift!  For Nomthandazo, she usually departs the centre a little after 5pm and begins her hour and half journey back home by bus or taxi.

After a long day at work, Nomthandazo says her trip home is often her time to reflect on what’s happened in the Unit that day. Her favourite duty is usually helping to bath the patients and apply dressings as it’s during this time that she gets to really talk to the patients and learn more about their personal stories and journeys.

“Each patient is different and has their own story. Some like to talk to you while others don’t. But it’s important to let them know we are here for them and are interested in who they are and where they’ve come from,” says Nomthandazo.

Apart from loving her job and getting to know the hundreds of patients she has cared for over the past eleven years, Nomthandazo says the thing she’s most grateful for is that her job as a carer at HACT has enabled her to provide for her two sons, the eldest of whom is busy completing his third year as a law student at the University of KwaZulu-Natal and the youngest who is completing high school this year.

“I am proud to have been a good example to my sons. They’ve watched me work hard and they see how happy my job makes me. I hope they do something that also makes them happy and where they can make a difference in the lives of others,” says Nomthandazo.