St Bartholomew’s to Romania: a patient’s journey home
Nurse Kulveer Rehsi reflects on the efforts of the palliative care team and oncology doctors on ward 5A to help a patient spend their final days in their native Romania.
“I had been told that her preferred place of death was Romania, but when she came to St Bartholomew’s Hospital, she was determined to get treatment and be discharged.
“‘I’m only 37 I want to have children,’ she told me.
“This statement was a striking moment for me: what I could see from the end of the bed was a young, bed-bound, deteriorating patient in pain with advanced cancer.
“I needed to control her pain and get her back to Romania to her family.
“I knew she would sadly never have children. She did not want her hopes taken away and she did not want to talk about negative things.
“She wanted the chemotherapy and to be better and this was a positive outlook for her.
“However, during her stay she deteriorated further.
“She was eventually informed by the oncology team that she could not have any more treatment as it would make her worse and she would not get better.
“Her next of kin in the UK were also informed and a tearful meeting ended in discussions about supporting her to go home.
“We explained the risk of death enroute, the ambulance journey through four countries and the lockdown of borders because of Covid-19.
“The family were resilient and said: ‘she will not die alone in the UK.’
“Our doctors and nurses we were worried: Are we doing the right thing? Will she make it home? What if she dies in transit? What about medical insurance through Europe? Who will translate the medical letters?
“The decision for transit challenged my 27 years of experience. We thought these difficult questions would deter the next of kin and the patient but they had the private ambulance ready after one week.
“We had information of the hospital she was going to in Romania and had even managed, with the help of our Whipps Cross Hospital palliative care team, to identify a Romanian palliative care doctor to meet her when she got home.
“Medical letters and medications were ready to be sent and a palliative care social work team were trying to help with the funding of the journey.
“On the day of her journey home she was smiling and looked the brightest I’ve ever seen her.
“Our 5A ward staff did an amazing job getting her ready for the journey home and her partner was happy.
“They were travelling through Germany, Austria, Hungary and then on to Romania. I had some hope but reserved the pride knowing it would take 30 hours to drive from the UK to Romania.
“I had a sleepless night. After a tense day and a half of waiting we received the email to say that she had reached home safely.
“As a team we clapped and cheered for each other, and for the family, for the amazing effort and determination they had.
“She made it home, home to her family.
"For us, there is hope in getting patients home despite the barriers and the challenges we face.”
For further information about end of life care please visit the Barts Health webpage.