The regional town of Alexandra is home to Victoria’s first Advanced Care Planning Clinic, thanks to the determination and passion of local nurse, Jeanie Hurrey, who spent five years campaigning to the make the clinic a reality.

A nurse for more than 20 years, Ms Hurrey has been working for the Alexandra Health District on the Acute Ward and in Urgent Care since 2004.

However, it was during her very first nursing rotation on the oncology and haematology ward that she fell in love with palliative care.

“My interest and passion has long been palliative care, and advocating patients’ wishes,” says Ms Hurrey.

“Throughout my nursing career I’ve witnessed too often the emotional stress families experience when trying to second guess what their loved ones’ wishes are when it comes to making decisions about their medical treatment.

“I have also experienced that stress first hand several times with my own family.”

Ms Hurrey first became aware of Advance Care Planning after hearing a feature on radio news some years ago.

“It piqued my interest and inspired me to gain the skills and knowledge to implement ACP at Alexandra District Health, starting with the Respecting Patient Choices workshop at the Austin Hospital.

“After implementing ACP at ADH and a process by which ACDs are recognised and stored, I endeavoured to promote ACP in GP clinics.

“It was important to try and aim for people to do ACP while they were well rather than in hospital whilst they were unwell.”

However, Ms Hurrey says she quickly recognised that GPs are time poor with their appointments, and ACP wasn’t itemised on Medicare.

“As much as I tried to see patients during my shift, time allowed to see them was dependent on how busy the ward and Urgent Care was.

“And so my idea of the clinic hatched.”

Ms Hurrey first suggested the idea of an ACP Clinic about 5 years ago, however with ongoing changes in senior management, getting it off the ground proved a challenge.

“I persisted with increasing community awareness of ACP as well as promoting it to patients and colleagues alike at ADH.

“The present senior management of ADH recognises the importance of ACP and the value a clinic would be to our community, so in April this year during the first National Advance Care Planning Week, ADH
launched the ACP Clinic.”

The clinic is run fortnightly from the Primary Care Services of ADH. Members of the community have the opportunity to book an appointment with Ms Hurrey so she can guide them through appointing medical treatment decision makers and/or making an advance care directive.

Appointments for individuals run for an hour, while couples have an hour and a half. They then take their documents to their GP to sign, and once signed, the documents are directly scanned into their file before providing certified copies to those who are/would be involved in their healthcare.

“The clinic has been received extremely well,” Ms Hurrey says.

“Since the launch of the clinic, I have been booked out each fortnight.

Ms Hurrey believes that having access to an ACP clinic is important, particularly in regional communities where access to professional advice is limited.

“People are very protective of their bodies but they’re even more protective and passionate about preserving how they live their lives.

“This is evident in our district as I am often asked to provide information talks about ACP to community groups.”

Ms Hurrey says the impact of the clinic is clear, not only through numerous positive outcomes, but by taking into account, some of the unfortunate consequences to patients who have not made their wishes known.

“Recently we lost an elderly patient who had been unwell for some time and had been reluctant to complete an advance care directive.

“They had recently been discharged from hospital when their condition deteriorated rapidly and they were returned to hospital.

“The hospital staff knew that they would not want to be transferred to Melbourne and would opt for comfort care in Alexandra but we had to transfer them.

“There was no advance care directive and we couldn’t reach their substitute decision maker.

“They died the following day in Melbourne.”

Fortunately, the patient’s family was with them in the end, however Ms Hurrey says this case was a good example of just how important advanced care directives are.

“I have been very fortunate with the support provided to me by my managers and my colleagues, but also from other healthcare providers such as the GP clinics, our local ambulance crew and the local residential aged care facilities.

“We’re all working together to ensure our community is well informed about their options, and have the opportunity to document their values and preferences.”