Miguel is as a Nurse on the Medicine for Older People, Rehabilitation and Stroke ward. He works closely with the staff on the G4 ward, and interacts closely with our patients and visitors. Miguel was nominated by patient’s relatives for the Trust Employee of the Month scheme for January 2013 due to his compassion and communication with them.
“I'm fortunate to be able to take care of those who are our grandparents and parents. Most of these patients contributed a lot to this country during harder times, so I enjoy working with these patients and listening to their stories.
“This is all possible through having a great nursing and clinical team to support you. While a large part of my job is taking vital signs observations, drug rounds, bathing, feeding, dressing and many other nursing roles, I also like to make my patients laugh! Although a simple method, it helps me to establish a more personal contact with the patients and allows me to really understand who they are, their fears, their life stories, their families and their needs.
“As nurses our patients are our priority, so we must give both them and their relatives everything we can in order to give as good a hospital experience as we can. I feel that the more we give, the more we receive. To know that we are being appreciated ourselves on 12 May is really special for me.”
Is a Sister for the Department of Critical Care and Critical Care Outreach at Queen Alexandra Hospital, and has been working for the Trust since 1999.
An average day at work for Natasha involves overseeing the arrival and transferring of patients and caring for those that are critically ill. As a sister of the department Natasha is also responsible for the coordination of the Critical Care Unit.
In addition to these duties, Natasha ensures that once a patient has left the Critical Care Unit they are continuing to improve and if necessary provides additional support for the patient.
Being able to think quickly under pressure and react to changes in a calm and efficient manner is a must for nurses in the unit. When a patient is referred to the unit Natasha must provide a full assessment of a patient’s health and begin essential therapy and, in some cases, stabilise a patient.
Upon reflecting on her role as Sister in the Critical Care Unit Natasha said: “The role requires excellent communication and time management skills, as well as being flexible. This is a very acute and challenging job that requires us to support all areas within Queen Alexandra Hospital. I thoroughly enjoy working within the department as I feel my contribution allows me to make a difference to my patients, families and my co-workers.”
She works in the Emergency Department at Queen Alexandra Hospital (QAH) and is also the clinical lead for the Minor Injury Unit (MIU) at Gosport War Memorial Hospital.
She qualified as a registered nurse in 1986 and worked on an orthopaedic ward and in the operating theatre before starting her career in emergency care. Her first role was as a staff nurse in an emergency department in 1989, so she has extensive experience within the field working in Lincolnshire and Devon before moving to Hampshire.
In 2001 Anne completed her registered sick children’s nursing before moving to Gosport in 2003 where she joined the nurse practitioner group after completing a nurse practitioner course with the University of Portsmouth. Anne became a consultant nurse in 2008 and now leads a group of nurse practitioners that work at the emergency department in QA and at the MIU at Gosport.
No doctors work at the MIU, which is manned solely by nurse practitioners. Nurse practitioners are senior nurses who have extensive emergency care experience and have undertaken additional training to allow them to treat certain injuries and perform roles that traditionally were undertaken by doctors. Prior to undertaking this training the nurses must also be able to stitch a wound, apply different types of plaster casts and take blood.
In addition, the nurse practitioners undertake more advanced training that includes how to obtain a detailed history from a patient following a minor injury, how to assess an injury and how to document the findings of the assessment. They are also taught how to request x-rays and interpret the findings. The nurses can then treat the injury according to the diagnosis and arrange follow-up to the appropriate specialist as required. Training currently takes one year.
There are currently 26 nurse practitioners that work across both the emergency department at QA and the MIU in Gosport with two more qualifying in September 2012. There are always two nurse practitioners on duty from 8.00am until 9.00pm at the MIU, and one 24 hours a day at the emergency department at QA. A healthcare support worker also works the late shift at the MIU to assist with treatments.
The nurse practitioners are all able to independently assess and treat minor injuries including cuts and abrasions, sprains, broken bones, burns, nose injuries and eye injuries, this frees up doctors to see the more seriously ill and injured patients attending at the QA. In addition to all these skills, six of the nurse practitioners and Anne are able to independently prescribe certain medicines.
The MIU in Gosport saw over 17,000 patients last year, and the numbers have risen by 33% since moving from the Royal Hospital Hasler in 2009. Most minor injuries can be treated at the MIU in Gosport however in some instances patient may need to be diverted to the QA for further treatment. These include patients with broken bones that need to be pulled back into place and those that require admission to hospital.
The nurse practitioners are not trained to deal with coughs, colds, rashes, chest infections, earache, or sore throat as these should be managed by GPs. In addition, patients with chest pain, shortness of breath or history of collapse should not attend the MIU as these need assessment by a doctor.
A lot has changed in the past few years in terms of what it means to be a nurse.
TEAMS (Teaching Education and Assessment by Medical Simulation)
Clinical Educator and Clinical Fellow in Simulation (NHS South of England)
Simulators can be high or low fidelity patient mannequins specifically designed for training purposes.
The high fidelity mannequins are designed to replicate human physiological parameters and respond accordingly to medical management e.g. the simulator parameters that can be altered are the heart rate and rhythm blood pressure, respiratory rate, temperature, oxygen saturations, urine output and carbon dioxide levels. I have a whole range of simulators from women, men, children, and a pregnant lady.
Kirsty started in her role in 2008, as a member of the teaching team she regularly assisted with Intensive Care Unit induction simulation training. From February 2009, she started as a part-time Clinical Educator in TEAMS and became part of Learning and Development in April 2011. January 2012, Kirsty was successfully awarded a Clinical Fellowship in Clinical Simulation by the NHS South of England.
Kirsty's fellowship is about improving patient outcome in stroke care by increasing thrombolysis rates with multidisciplinary simulation training and increasing public awareness in collaboration with the Stroke Association.
Kirsty trained as a nurse in Portsmouth and qualified as a Registered General Nurse (Adult) in 2000. She completed a surgical, medical and acute rotational job for 18 months and then went to work in intensive care. She successfully completed the intensive care modules and went on to complete a Certificate in Education and a Masters degree in Advanced Professional Practice.
Kirsty's role is to provide simulation training for all PHT multidisciplinary staff in the TEAMS centre and/or in the wards and departments to improve patient safety. The fellowship involves stroke simulation training with: paramedics, emergency department staff, radiographers and the thrombolysis team to improve door to needle time. This includes scenario development and curriculum mapping for stroke thrombolysis with all members of the multidisciplinary team.
After 16 years of working for both for Royal Military Police and now the Ministry of Defence as a staff nurse, Kathleen Wells is a self-determining, courageous, strong woman who has served in various countries across the world – Afghanistan, Northern Ireland, Canada and Bosnia to name a few.
Known as Cpl Kate Wells, 34-year-old Kate drags her body out of her camp cot at 5am in order to go running. ‘I hate running,’ she writes in her diary. ‘But somehow I have learned to love these 20 minutes of solitary calm.
‘It is already very warm but bearable and the sun has yet to ramp itself up to its full 40 + degree heat,’ she continues. ‘ The air is often acrid from the burn pit and the dust takes some getting used to but by the time I make it back to the tent I am ready for the day ahead.
‘And today I am in luck, no wait for a shower and the cold water refreshes my overheated body. There are approximately 54 shift workers in my tent and five showers between us. The water is supplied from reservation tanks on camp Bastion so conservation is key - no long, luxurious showers here! Dressed and ready I make my way to breakfast, throw some food down and get myself to the hospital complex to begin my shift at 7.15am.’
It was April 2007 and 29-year-old Kate decided to leave her job in the Royal Military Police where she worked for the Special Investigation Branch (the Police’s equivalent of CID). Kate’s Police career had taken her to Germany for two and-a-half years, Bosnia for six months, Northern Ireland for two years and Catterick for three years, but she was about to embark on a new challenge of working as a military nurse. ‘I needed a change of career and I love working with people so I decided that a military nurse would be a good fit for me,’ she says. ‘So I completed three years at the Defence Healthcare School in Birmingham City University and went on to become a military nurse in Portsmouth.’
Less than a year after qualifying Kate was deployed to the British army training unit in Canada treating sick and injured exercising troops and providing medical support to permanent staff and their families. ‘The experience was incredible and the training I received was fantastic,’ she says.
Within six months of returning to Portsmouth and her nursing role at QA, it was April 2012 and Kate was deployed to Afghanistan to be a staff nurse. ‘The conditions of Afghanistan were incredible - I’d never experienced anything quite like it. Even with my military police background nothing could have prepared me for it.’
Kate says for many the turn-around time for a critically ill wounded soldier was very quick. ‘Upon impact a critically ill wounded soldier would be sedated and flown back to the UK within 24-hours of being injured, so they weren’t in my care for very long, ‘she says.
‘Often soldiers were brought in as the only survivors of a rogue attack after losing their fellow colleagues. That emotional rollercoaster was hard to watch but every few weeks we held a memorial for the fallen soldiers, each time drawing as a stark reminder to just how dangerous the conditions were out there.’
Kate says there was even an occasion when she was nursing and her camp got attacked, ‘it’s bizarre how you deal with it but everyone just mucks together,’ she says admirably.
In the ward I treated multi-national troops, local Afghan nationals (military & civilian) each group presented its own special challenge and no day in Bastion was ever the same,’ says Kate.
Reading Kate’s diary once more it says: ‘1600hrs and I am called to the Emergency Department to help with incoming casualties. I make it to the department with my heart pounding as I consider what I may see and already the trauma teams are busily organising themselves for the arrival of the Medical Emergency Response Team (also known as MERT). They’re the medical teams in a Chinook helicopter who treat casualties at the point of wounding, often in hostile environments and transport them to the hospital whilst providing emergency lifesaving treatment en-route.’
There is no military history in Kate’s family, she was simply a quiet girl from a small northern town and was desperate to venture out and see the world. ‘I’m extremely lucky to have the career that I do and have experienced all that I have to-date. When it will end who knows!’ she says as she sits opposite me eight months pregnant with a little girl.
‘I am about to go on maternity leave for one year and what direction my career will go thereafter I’ve no idea.’
I look at Kate’s last entry in her diary: ‘2030 and I’m settled in my camp cot as I think about my upcoming rest and recuperation back home in the UK. I can’t wait to see my partner, family and friends who I last saw in April. It is a long six months to be away from loved ones. I am on day shift again tomorrow so I close my eyes and wait for sleep to find me. Even though the lights stay on in our tent till 2200 it is not long before I am far away in the land of nod, dreaming of the sea and the green grass of home, which is far removed from the dusty environment I’m currently inhabiting …’