INTERVIEW: Dundalk cancer night nurse Irene Barr

Tonight and every night, including Christmas, Irish Cancer Society night nurses will be in homes across Louth supporting families to fulfil their loved one’s wish to die at home.

The Night Nursing Service is available so that loved ones, including children, can receive expert nursing care, practical support and reassurance in their own home at the end of their life.

Night nurses use all their skills, training and experience to keep loved ones as comfortable and pain free as possible.

One of these night nurses is Irene Barr from Dundalk, who has been an Irish Cancer Society Night Nurse since 2020.

Having worked as a secondary school teacher for two decades, she describes her decision to retrain as a nurse as a late vocation.

“My mother had been ill for a few years with Alzheimer’s, and she had been a nurse, working right up until she was 65,” says Irene.

“She actually didn’t want me to apply for nursing when I was doing my Leaving Cert – she said teaching was a much nicer job.

“It was really while she was in hospital and was being cared for locally here in Dundalk that it planted the seed with me. The year that she died I applied for nursing.”

After she qualified, Irene worked in various places including four years in a nursing home taking care of elderly patients, and the palliative care ward of Louth hospital.

“Up until January 2020, I was working in the Louth Hospital in Dundalk and I had been a nurse there for a good few years in the stroke, rebab and palliative care unit.

“So I kind of had an interest in looking after people at the end of life, that sort of area.

“During the first lockdown, the Irish Cancer Society had an ad running on the TV looking for night nurses.

“Things were very difficult during the first lockdown for people who were very ill in hospital. They couldn’t have visitors and a lot of people were very restricted.

“So a lot of people who were very ill were choosing to spend their last days at home rather than be in a hospital.

“So it meant that services of the night nurses were stretched, and the Cancer Society was recruiting.

“Something just struck me when I saw that and so I applied and started working as a night nurse in September 2020 and have been doing it since.”

Night nurses can provide respite and support to families who have been caring for a sick loved ones and are often a welcome sight.

Night nursing is a valuable service, she says, although it is often the case that people are not aware of it until they find themselves in a situation where they need it.

“Sometimes when you arrive, families will have been wondering for weeks how they were going to cope when it came to the stage that they needed help.

“They are then so relieved that the Night Nursing service is there for them at this time.

“We work a couple of nights a week and put ourselves on call for nights we’re available and it’s coordinated through the palliative care home-care team.

“We usually go to the families at eleven at night and stay there right through till seven in the morning looking after the patient.

“Throughout the night we monitor the patient’s condition and give them pain relief and sometimes they might be very ill and be within a few days of slipping away so it’s a very difficult time for the families and you’re there to support them too.”

Irene’s care is not just for the patient, but for the family as well. “When families know that a night nurse is coming, they feel such a sense of relief that they can just step back for the evening,” she says.

“A lot of times the family is very happy to see you coming so they can get a few hours of sleep.

“Usually, they have been up all night for a few nights and they can be exhausted.”

Irene was thrown right into the thick of it during Covid, which presented its own unique challenges to the night nursing team, and indeed still requires them to be careful.

“It’s still a little bit of a challenge because there is still Covid around in the community and for people who are going through chemo or are very ill they have to be very careful with who they come in contact with, so we still have to be very careful.

“Over the winter of 2020 into 2021, we actually weren’t allowed to stay the whole night. We had to go and do a support visit.

“Which meant we’d be there with the patient for about an hour and give them medication if they needed it, and then we would provide full support for the family through the night if they needed us. If we lived within a reasonable distance, we could go back during the night if needed.

“But they were trying to keep us safe because if we were out of action, that’s even fewer people on the ground to help.

“It was a challenge and [Covid] was very difficult for families whose sons and daughters were far away or maybe stuck in America or Australia while a loved one was ill.”

Irene says that every night is different, every patient is different, but that despite it sometimes being hard, most mornings she comes home feeling that she’s done something positive.

“Obviously, there are times when it’s a difficult night when it’s hard to get control of a patient’s symptoms. They’re very unwell and the families upset.

“[It’s particularly difficult] if it’s a young person with a young family that’s involved, that can be very challenging because the family are dealing with such difficult times saying goodbye to loved ones, and they maybe have small children and it can be difficult for them to absorb everything that’s happening.

“There are nights when you have to get the family up when somebody has come very near end of life, but the nights that you can leave the family, they often come in the morning and say that they can’t believe they slept all night, that it’s the first time they’ve slept in days or weeks.

“Most days when you’re going home, even if it has been a tough night you feel like you have done a good job and you feel like you’ve helped the patients and you’ve helped the family, even if they’ve only got four or five hours sleep, they’re better placed to have more energy and face the day ahead.

“You have to look after your own health and your own mental health, too. Whilst things that happened during the night do affect you and be on your mind, with experience you learn to deal with that and move onto the next thing that you’re facing.”

Night Nursing support is available for up to 10 nights (subject to Night Nurse availability) of care at no cost to the patient or family and nurses will once again be working right through the Christmas period.

“Obviously, there are a lot of night nurses with young families and children and they may not be as available as some of us who are near retirement and might have a bit more time available,” says Irene.

Irene says that while every effort is made, families may not get all the nights that they would like to have because there are only so many to go around, which emphasises how important the donations the society gets from the public are. There are approximately 220 Irish Cancer Society Night Nurses in Ireland. In 2021, Night Nurses provided 7,303 nights of end-of-life care to 2,232 cancer patients across the country.

None of these vital services provided by the Irish Cancer Society would be possible without the support of the public. Typically, the Society receives only 3% of its funding from the Government, so they rely heavily on voluntary donations to run the Night Nursing Service.

“The service carries on 365 days a year and we try to provide the best possible care we can.

“The night nurses are funded totally through voluntary donations. A lot of the funding would come from the Daffodil Day that’s held every year and from donations that are made by families and by friends of the Irish cancer society.

“So we’d urge people to remember the service, and I know there are so many demands at this time of year, particularly this year, when everybody is stretched for cash,but as they say every little helps and even a small donation can make a big difference and we’d be very very grateful for it."

For more information, visit cancer.ie. If you have questions or concerns about cancer, contact the Support Line for free, confidential advice on any aspect of cancer. Freephone 1800 200 700 or email supportline@irishcancer.ie