As part of the NHS response to Coronavirus (COVID-19), we have made changes to the services we provide
Ann has been working in the caring profession for 33 years, although she only joined the NHS in January this year. She loves being a member of the Home First team and has nothing but praise for the support and encouragement she receives from colleagues and managers. She particularly values the opportunity to get to know her patients and spend whatever time is needed to assess and meet their individual requirements. Ann and her colleagues work out how best to look after each person they see and develop caring strategies based on what they need. One patient has advanced vascular dementia and can react quite violently to attempts to provide her with personal care. Ann and a colleague visit together and one holds the lady’s hands and chats to her, keeping her calm, whilst the other washes and dresses her.
Zoe has been looking after people for the last 30 years, initially with the council but more latterly with the NHS. She says she has learnt a lot since joining the Home First team and has had lots of opportunities to develop her skills and gain responsibilities, for example she is a medication champion and a local expert on assistive technology. She is also enthusiastic about the way team members share information via their mobile phones which enable them to check their visits and record their observations and assessments. This keeps everyone up to date and informed. Zoe knows she can make a real difference to her patients, for example a gentleman had recently come out of hospital following a serious urinary tract infection. His daughter was concerned he was becoming unwell again and would need to go back to hospital. Zoe was able to carry out a urine test there and then, contact the man’s GP and get antibiotics delivered within the hour.
Jane has a background in fashion but wanted to do something different. She joined Home First 15 years ago – though it wasn’t called that then, and offered a slightly different service.
In particular she likes doing the first visit when someone comes out of hospital, meeting the new patient and finding out how to help them get back to where they were before they had to go to hospital. “As the first member of the team to visit it’s up to you to find out what’s needed and respond to how that person is”.
Much of what Jane does is caring for her patient’s physical needs such as washing, dressing and encouraging them to eat and drink. But it’s much more, constantly evaluating and checking on all aspects of the patient’s wellbeing and also being mindful of the needs of carers and family members, and even pets. The focus is always on getting the patient to do as much as possible for themselves and encouraging them to regain as much independence as possible.
Her patients might have had a fall, such as Bob, who also suffers from dementia and doesn’t really understand what has happened to him. He needs to be encouraged to get out of bed and get dressed. Olive is just out of hospital and was struggling to remember to take her medication. Jane needed to liaise with the family to get permission from the GP to help her, although the hope was this would only be for the short-term so Olive could go back to looking after herself. Terry is living upstairs so Jane can help him access the bathroom as its all on the same level. She explains this is much better because it’s the normal thing to do and offers a break from the same four walls. Jane has helped Freda use a piece of equipment called a ‘dog lead’ which features a loop to hook over your foot to lift your leg up, and as Freda’s muscles have built up she is more able to get into bed herself.
No two days are the same, every person needs something different, and those needs change. “We don’t watch the clock; just do what we can to help the patient get better, even if it’s just sitting with them to make sure they eat something. During Covid-19 when family members may be isolating, we can offer a friendly face – even if we have to wear full PPE, mask, apron, gloves etc”.
“I enjoy meeting so many lovely people and it’s great when you see the end result, though it can be sad knowing you won’t see that person again. Our aim is not to be needed and there’s no better feeling”.
Katherine joined Home First in June and is loving the opportunity to give something back to the community. She has worked as a personal carer in the private sector but enjoys the variety of her new job. On one day she experienced two contrasting situations. Visiting a gentleman who had broken his knee and had to keep his leg up for a couple of weeks she found him recovering and ‘buzzing’ because he had got himself up and made his own breakfast. However the next visit was to a lady who was very poorly and would need ongoing care. In the one case Katherine knew she would be able to step down the number of visits, but in the other she needed to begin the process of getting others involved in making a longer term arrangement. Katherine says it can be quite emotional, but so rewarding when you feel you have made a difference.
Clinical Inpatient Matron
Sarah has led on improving the sexual safety of service users on inpatient wards at the Redwoods Centre in Shrewsbury. She has developed, introduced and embedded cultural and procedural changes on wards and across multi-disciplinary teams. These have included changes to incident reporting, new admission procedures, new patient information, introduction of reflective practice, supervision and role modelling, multidisciplinary team discussions, training sessions, trauma-informed care plans and developing a collective approach to consistent leadership on these issues.
As a result, there is a significant and measurable difference with sexual safety incidents being now negligible on the Redwoods wards, demonstrating the continued impact of the quality improvement work. The wards have been formally commended by CQC on this work. Sarah and colleagues have presented at a number of national events and many NHS trusts have visited the wards to understand the work further.
Sarah would say that involving staff, being honest and open and helping them to form solutions so that they are invested in the innovation is crucial to success.
Becky Williams always wanted to be a nurse but back in 2007 she didn’t feel university was right for her so she joined MPFT’s bank as a nursing assistant.
For the next 5 years she worked in a number of teams before successfully applying for an Assistant Practitioner role with the community dementia service which enabled her to complete a Foundation degree, attending university one day a week for two years.
At this point Becky was offered an academic secondment and the opportunity to gain her nursing qualifications. As she had completed the foundation degree, this meant two further years of university study alongside her nursing placements. She graduated in September 2017 and gained a post in the Memory Service, applying for and gaining a further Band 6 position after 18 months.
Then, along with NHS services across the country, MPFT needed to review how services were provided due to the Covid-19 pandemic. Staff were asked if they were willing to be redeployed and Becky, feeling that it was important to lead by example, said she was happy to go wherever her services would be most useful. With her experience of older adult mental health care she was placed as a Staff Nurse on Oak Ward at the Redwoods Centre in Shrewsbury.
Becky feels that working on an inpatient ward is very different from her role in the community, highlighting the awareness of physical health needs and the importance of communication with family members. Visiting patients in the community there was more opportunity to get to know the family, but Becky also reflected that it could be difficult to accept the limitations of a service that couldn’t offer the same 24/7 level of support as the ward environment.
However, Becky really enjoyed the post on the ward and when a Ward Sister position became available she applied for that and then for a vacancy for Ward Manager, an appointment she commenced in October this year.
“When I was first training, my mentor Ann always said take every opportunity that is offered and I have really embraced this. My managers have always been very supportive and encouraged me to apply for posts, even if it was just for interview experience. I have been able to build a successful career and would recommend the various nursing trainee roles as great stepping stones. A nursing degree course may be right for some people, but there are lots of other ways to get into the profession.”
Becky says “Nursing is hard work, but very rewarding and offers real career satisfaction. The NHS offers lots of opportunities to develop and grow, with different roles and training available.”
Anne was selected as one of just 12 NHS staff whose portrait was captured by acclaimed photographer Rankin as part of a collection unveiled to celebrate the NHS’ 72nd Birthday.
Throughout the pandemic, Anne has not only been an excellent and caring District Nurse, but has worked hard to support her colleagues and raise their morale, organising local school children to share pictures and messages, and coordinating a mass sing along to ‘This is Me’ from 'The Greatest Showman’ to mark International Nurses Day.
She also demonstrated her commitment to her patients and their families, even going so far as to help foster a pet dog to allow a couple needing hospital treatment to be admitted without worrying about their precious pet.
The story generated national and international headlines and Anne’s image has been displayed across the country, most notably on the Piccadilly Circus lights.
Anne said: “I’m not a hero. I’m a nurse just trying to do the best I can. I was inspired by an aunty but I also think being a nurse is ingrained in you.”
Specialist Practice District Nursing
When I was eight years old, my grandad had terminal oesophageal cancer and was receiving palliative care by a local district nursing team. It was at this young age that I saw the compassion and care nurses gave to him to keep my grandad at home and very comfortable.
At eight years old I could only describe them as ‘superheroes’, but not like Superman or Batman – something more, something real.
Obliviously through my school and teenage years, I never realised men could be nurses, and I found it difficult to settle on a career suitable for me. I returned to college in my early 20s with the intention to be a paramedic. However, everything changed when I volunteered on a ward at my local hospital.
I will never forget my first day on that respiratory ward where I was greeted by a male nurse. It was then I realised that staring back at me was the start of my journey to become the nurse I always wanted to be; to become that superhero figure that inspired me and cared for my grandad all those years ago.
Nursing to me is not just a job or even a career – it has been and is my life. I feel that as nurses we go over and beyond by putting our patients at the heart of everything that we do and with that in mind, I just wanted to take this opportunity to thank those nurses that looked after my grandad and inspired me to be the person I am today. I also want to thank everybody that has been part of my journey and has given me the opportunity to shine.
Nursing has truly brought out the best in my character and it is an honour to work in such a fulfilling job.
Community Mental Health Nurse
I was a Student Mental Health Nurse studying at Staffordshire University in the September 2017 cohort. We were due to head out on our final sign off placement of our degree at the end of April. For me this was due to be in the community with the South Staffordshire Memory Service. Due to the increased risks attached to this patient group, face to face patient contact was stopped and it was felt that they would not be able to facilitate my placement and learning. I was then re-allocated to Ellesmere House (Forensic Learning Disabilities) at St. George’s Hospital Stafford. The whole cohort had their first day on placement and then found out that night that we were all being withdrawn from placement due to safety risks re Covid-19. This left us all in a state of limbo where we didn’t know whether we would be allowed back out on placement or whether we would able to complete the rest of our course. Thankfully the government and the trust initiated an opt-in system whereby we could finish our final placement in an extended format with our own preference in mind. I had already gone through the interview process to get a job in the community in the Psychosis Pathway in Lichfield, so this is where I opted to complete my placement.
The weeks prior to getting assurances of being able to complete our degrees were quite anxiety provoking and uncertain. Once I found out I was going to Lichfield, I felt much more relaxed and calm. I had been there on placement previously in my first year, so knew the team and it would mean I got a head start on preparing for my role once I qualified. The idea of being in placement during a pandemic was a little nerve racking, but honestly was just happy that I could still complete my training and contribute at a time when needed. The team have been brilliant in supporting and nurturing my learning as well pushing me towards becoming an independent clinician. I was able to manage a small caseload and develop all the skills required to move into my role as a community mental health nurse. This massively helped with my confidence and overcoming some of the anxiety issues I had had prior to placement about the transition from Student to Qualified Nurse. Albeit we are seemingly heading towards another serious wave of the pandemic, which may disrupt service provision, I feel in a good place to manage what comes and to provide care as best I can to my service users.
Michelle worked as a care assistant in a care home before she had her family. Once her three children were all at school she decided she was ready to go back to work and keen to be challenged a bit more. She completed her nurse training at Staffordshire University and qualified in 2008.
She initially worked on the female acute ward at what was then Shelton Hospital. Although she gained a lot of useful experience this wasn’t where she wanted to be so she moved to Whitchurch Cottage Hospital to work with people with dementia. She took the opportunity to gain some community experience and when the cottage hospital closed took up a permanent post with the community mental health team which went on to become the Memory Service. By this time she realised her passion lay with the assessment and diagnosis of people with dementia and this has been the focus of her subsequent career. Along the way she has also gained qualifications in physical health and in prescribing as well as becoming a student mentor.
Michelle has held a management position with the memory service but has now returned to a more clinical role as a Nurse Practitioner which she prefers. The role involves the assessment and diagnosis she is passionate about, as well as a medication prescribing role.
Michelle says “No one wants to hear that their loved one has dementia, but if the assessment and diagnosis is done well it can make a difficult situation so much easier. You need compassion, patience and knowledge to carry out the role but it offers me real job satisfaction.
The Coronavirus pandemic has presented some interesting challenges. I was redeployed onto a ward which was a bit of a learning curve as things had changed. We also went virtual and had to work out how to carry out assessments via video calls. I was sceptical at first but it has proved successful and will certainly make us more flexible and resilient in the future – coping with bad weather for example.
I never thought when I started caring for people aged 18 that I would be where I am now, but I have been given lots of opportunities and supported to gain the confidence to make the most of them. I feel MPFT is a very forward-thinking trust which recognises the value of a nurse-led service”.