May 12, 2014 - nursing teacher to help drive the work. ..... As well as going into schools, our 20-strong School Nursing
Media Pack Date issued: May 9, 2014
International Nurses Day Monday, May 12, 2014
Contents PR:
Nurses thanked for their dedication, compassion and commitment
Case studies:
Andrew is in no doubt about his choice of profession (Dereham Hospital Ward Manager)
‘Compassion’ is the most important part of nursing (Modern Matron in south Norfolk)
Innovative project aims to deliver harm free care (Countywide initiative)
It’s been the ‘ideal career’ for Maria (Health Visiting Service)
Helping to keep Norfolk’s children safe (Safeguarding)
Working together to boost patient care (Continence Service)
Read more:
Find out about even more of NCH&C’s dedicated staff within the International Nurses Day special publication, attached to this pack.
For more information or photos, please call 01603 697352
Nurses thanked for their dedication, compassion and commitment The senior nurse at Norfolk’s community-based NHS Trust has thanked frontline NHS staff for the fantastic care provided to the county’s patients, ahead of International Nurses Day, the event held annually on May 12 to coincide with the anniversary of the birth of Florence Nightingale.
Norfolk Community Health and Care NHS Trust’s (NCH&C) Director of Nursing, Quality, and Operations, Anna Morgan, said: “International Nurses Day has been celebrated annually for around 40 years, but the important work of nurses – as well as therapists, allied health professionals, and support staff – in Norfolk and around the world is as crucial to patients today as it has ever been.
“Today’s nurses have to be experts in identifying patients’ holistic needs, taking into account the needs of families and carers. In doing so, we strive to deliver high quality care which makes a positive difference to their lives.
“As somebody who is a nurse by background, I am deeply proud of the way in which our staff from a vast range of disciplines work together to deliver exactly the right care, where and when patients need it most.”
NCH&C’s staff manage the county’s community hospitals and deliver a range of services which are delivered in community clinics and even people’s own homes. These services include community nursing and therapy, a stop smoking service, health visiting and school nursing, and highly specialist services for cardiac and neurological rehabilitation, stroke rehabilitation and palliative care.
“Florence Nightingale is a symbol of pioneering nursing and I am delighted that, in Norfolk, we are at the forefront of this ethos; we are unafraid of breaking new ground in the pursuit of improving support for our patients,” said Anna.
“For example, NCH&C has embraced the use of mobile technology, with hundreds of our staff now able to update patient records on the move, reducing the time they need to spend in the office and giving them more time to spend with patients.
“We have also taken big strides in joining up our services with our partners, including GPs, councils, other NHS Trusts, and voluntary groups, to ensure we provide care in an integrated way.
“It is clear to me that for so many colleagues, working in healthcare isn’t just a job, it is a calling. On behalf of the Trust, and patients across the county, I’d like to thank Norfolk’s nurses for their dedication and care.”
Read about the some of NCH&C’s committed, skilled staff over the coming pages. Further information is available in the special publication, attached to the end of this pack.
Media Contact: Matthew Barnard Communications and Marketing Officer Norfolk Community Health and Care NHS Trust Tel: 01603 697352
[email protected] Elliot House, 130 Ber Street, Norwich, Norfolk, NR1 3FR www.norfolkcommunityhealthandcare.nhs.uk
Andrew is in no doubt about his choice of profession Ward Manager Andrew Pover always knew nursing was the career for him. And after 32 years, he still has as much enthusiasm for the role as he did on his very first day.
Andrew joined NCH&C five years ago, after previously working in mental health and general nursing. Since then, he has focussed on ensuring care on the Foxley Ward at Dereham Hospital is of the highest quality while improving safety by reducing pressure ulcers and falls, and working on the introduction of the Norfolk Early Warning Score system for inpatient units, which allows staff to identify early signs of medical deterioration.
Andrew was also involved in the successful trial of sensors which alert staff when a patient at risk of a fall begins to get out of bed or gets up from their chair without assistance. As a result, the sensors have now been rolled out to other units.
“There was never any doubt in my mind that nursing was the career for me, and working as a ward manager brings so many rewards,” said Andrew. “That includes having a happy team, being able to apply knowledge and skills to make a difference to people, seeing patients get better and receiving really nice feedback from patients who have appreciated the care they received. I would recommend it as a career to anyone.”
For Andrew, nursing brings with it a sense of public duty and social responsibility. He is so passionate about the profession and the difference the role makes that he is currently trying to persuade one of his sons to follow in his footsteps.
“Since joining NCH&C, I feel well supported and respected and have been given opportunities to use the skills I’ve developed through my career to make improvements for patients,” he said.
“But it is not an easy job and there will always be challenges, not least meeting the needs of an evergrowing aging population and finding new ways of working.
“We are seeing more patients with complex needs who are therefore dependent for longer, which means there won’t be a shortage of nursing jobs in the near future. Instead, the profession must make sure there are enough nurses to meet demand, and that they are equipped with the right skills and abilities to meet the changing needs of patients.”
‘Compassion’ is the most important part of nursing for Christine A patient safety champion and talented leader, Christine Harvey received special recognition at NCH&C’s Recognition of Excellence and Achievement in Community Health (REACH) Awards 2014, held in March.
Christine, who is Modern Matron in south Norfolk, received the Clinical Excellence Award after she played an important role in the development of NCH&C’s Pressure Ulcer Strategy, piloted new initiatives and motivated others to embrace change.
The first matron to include patient safety data on her ward, she has also played a lead role in developing new quality goals to maintain our focus on improving quality.
Recently, Chris provided clinical leadership to a project which aimed to reduce delayed transfers of care. As a result, our Trust is now planning to recruit a discharge coordinator to work across all of our community hospitals, making sure patients enjoy a smoother journey through the system.
What made you want to become a nurse? Nursing was a second career for me. I committed to the training following encouragement from a staff nurse colleague while I was working as a carer, and was hooked within a month.
What do you like best about your job? The daily challenge – working with lots of different teams and professions means there is never a dull moment. I also enjoy seeing how patients have benefited from our services while looking for opportunities to further improve the way care is delivered.
What makes you proud about the profession? The feedback we receive from patients, which is so heartfelt and always about the small kindnesses.
What difference do you think you make in your role? I feel my role gives me the opportunity to make a difference to patient care, work across services and teams to promote safety and quality and influence the way care is designed and delivered in the future.
What do you see as the most important part of nursing? For me, it has always been compassion.
What’s the biggest challenge you face as a nurse? To balance all of the demands which are made on services while making sure the patient’s needs are met.
What is important about nursing in 2014? To clearly demonstrate the profession’s pivotal position in providing safe, quality care for patients within an ever-changing service environment.
Is nursing going to be even more important in the coming years? Some element of nursing has been innate in the human condition throughout history, so it will certainly remain important in the future, regardless of political and societal change. As a profession, we need to identify these changes and make sure nurses are ready for the challenge.
Innovative project aims to deliver harm free care A nurse-led pilot designed to reduce three major harms and improve quality of life for vulnerable, frail and elderly care home residents has been launched across Norfolk.
The project, delivered by NCH&C in partnership with Norfolk County Council (NCC), has seen nine homes provided with a bespoke toolkit so they can assess risks daily and implement early intervention measures to prevent pressure ulcers, falls and infections associated with urinary catheters.
The pilot is being led by Harm Free Care Project Manager Marie McDermott, who is transferring some of the experience she has built up during a 28 year career as a nursing teacher to help drive the work.
“I have always been interested in care of the elderly and quality and safety enabled through workforce development, so this role was an ideal opportunity to work specifically in those areas,” said Marie, whose post is being hosted by NCH&C. “I have absolutely loved it so far, and would like to develop a career working in a community setting in the future as it has been the biggest and most challenging learning curve to date.
“My background in nursing and education has been vitally important throughout the project. Even though we are working in care homes rather than acute hospital settings, a clinical understanding of what constitutes quality care has been essential.
“It is a superb project which should have a huge impact on people, and would not have been possible without my colleagues Jayne Jode, Annette Paul and Caroline Lester, the wider team and the support and input of the subject matter experts across NCH&C and NCC.”
The pilot began on May 1 and will run to August 31. Once complete, it will be evaluated by the Harm Free Care Board using data on ambulance call-outs and A&E and EAU admissions, as well as feedback from residents and staff.
Marie is currently applying for Better Care Funding so that the project can be rolled out across the county and an electronic version of the assessment tool, which can be used on mobile phones and tablets, can be developed.
It’s been the ‘ideal career’ for Maria NCH&C’s Health Visiting service has changed significantly over the past few years, with national investment seeing the team more than double in size with the recruitment of around 120 students onto the training programme and Health Visitors joining the Trust from other NHS organisations.
The change means even more Norfolk families are now able to access important support from pregnancy through the early years, in turn ensuring their children get the best possible start in life.
“There has been a lot of change over a short period of time, and for us the biggest challenge has been supporting the students who are coming through,” said Maria Richardson, NCH&C’s Clinical Lead for the Healthy Child Programme and the Health Visitor Call to Action Plan.
Maria started her own nurse training in 1985, inspired by a first aid course after originally dreaming of becoming a music teacher. She then spent time working in general nursing, mental health and midwifery before training as a Health Visitor in 1997.
She became our clinical lead in 2012 after helping to develop the national Health Visitor Implementation Plan, which aims to expand and strengthen the service provided across the country. The initiative has given our Trust the opportunity take on new staff from a wide range of different backgrounds, many of whom are already making a difference to the health and wellbeing of local families.
“Health visiting encapsulates everything I always wanted to do,” said Maria. “It gives me the chance to work in the community and make good use of all of the different elements of my nursing career. Plus, working with children and families is the best thing ever, and although I’m no longer on the frontline, my passion still lies in making sure we get things right for children from the beginning through to leaving school with the service our School Nursing Team deliver to the 5-19 year olds across the county.
“Public Health Nursing is one of the toughest jobs there is as you do have to have some very difficult conversations with children, young people and families. It is also a hugely rewarding career and you really feel as if you are making a difference. It has been the ideal career for me.”
Helping to keep Norfolk’s children safe A key member of the team responsible for helping protect children and ensuring NCH&C’s staff can act on concerns about the welfare of young people in their care has spoken of the enjoyment she gets from her “varied and challenging” role.
Catherine Knox began a year-long secondment as Named Nurse for Safeguarding Children in June 2013 after spending her whole career specialising in child health.
As part of our Trust’s safeguarding team, she is responsible for supporting colleagues who work with children, offering guidance to anyone who has concerns and helping staff called to court as witnesses in abuse cases. As well as coordinating training and development, Catherine also provides assurance to our Board while working closely across partner agencies to share information and best practice.
“I’ve always worked with children, and began my career as a nurse at Great Ormond Street Hospital before training as a health visitor then moving to a clinical leadership role,” said Catherine, who works closely with fellow nurse Anita Bagge. “This secondment gave me the opportunity to move away from operational management and develop my skills at a strategic level, which I have found incredibly rewarding.
“Working with children and families can be very challenging, and can cause lots of anxiety and stress. I enjoy being able to support staff through the difficult times, both emotionally and professionally, and having the ability to influence and advocate for children at a multi-agency level.
“Our team helps to ensure that staff have access to robust supervision and the necessary training and support, which is incredibly important and makes us feel like we are making a real difference.
“Working well as a team and supporting each other is particularly important when you are dealing with sensitive areas of work, and is one of the elements of the job I’ve found particularly enjoyable.”
Working together to boost patient care Of course it isn’t just nurses that NCH&C is recognising on International Nurses Day. The Trust is also looking at the way in which nurses, doctors, therapists, and support staff all work together to provide people with the care they need.
The Trust’s Continence Service, which operates across the county, offers a specialised team of nurses and physiotherapists dedicated to providing an assessment and treatment plan for adults who have bladder, bowel and or prolapse problems.
A senior nurse who heads NCH&C’s south Norfolk continence team has spoken of the importance of working closely with therapy colleagues and the positive effect it can have on patient care.
Jo Clatworthy, Team Leader and Senior Continence Advisor, helped to set up our continence service around 14 years ago after developing an interest in women’s health and urology while working in an acute hospital. Since then, she has taken great pride in helping people overcome what can be an embarrassing problem.
“Traditionally, patients with issues ended up being given a pad and were expected to accept they would have a problem for life,” said Jo. “We set up the service to look at the causes before finding solutions which would either cure or improve their situation.
“Having continence problems can have a huge effect on people – we’ve had patients come to us who have had issues for several years and have lost their job or partner, but have been too embarrassed to ask for help. It is absolutely marvellous when they come to the end of their treatment and tell you things have been resolved and you have helped make a huge difference to their quality of life.”
As well as working closely with care homes to give lifestyle advice to staff looking after older people, Jo’s team also run outpatient clinics for patients of all ages. Wherever possible, they try and organise clinics alongside therapy colleagues to ensure patients can get the best possible care to meet their needs.
“I am lucky enough to have two part-time physiotherapists on my team, and we all work very closely together,” said Jo, who is based at Wymondham Health Centre. “We share the patient’s care so that the most appropriate person responds to their particular issue.
“It is really important to work so closely together as it helps us to learn from each other – our nurses have learnt a huge amount about pelvic floor dysfunction, for example, while the physios are now more aware of the impact of the medications used by our nursing team.”
Specialist Physiotherapist Hilary Kelly, who works in Jo’s team, provides a variety of treatments for continence patients, including muscle exercises for people who have trauma after childbirth or pelvic floor dysfunction. She described the relationship with her nursing colleagues as “really useful”.
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Because we care... Celebrate Nurses’ Day with us
“Our dedicated staff make such a difference...”
In the hot seat: “There’s never a dull moment!”
Andrew is in no doubt about his choice of profession
Working together to boost patient care
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Nurses’ Day 2014
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Thank you for your expertise, dedication, and compassion Each and every year, our Trust pauses on May 12 to reflect on the invaluable role that nurses play in helping people to remain as healthy and independent as possible.
International Nurses Day has been celebrated annually for around 40 years, but the important work of nurses – as well as therapists, allied health professionals (AHPs), and support staff – in Norfolk and around the world is as crucial to patients today as it has ever been. As somebody who is a nurse by background, and in the context of the modern age of healthcare, I want to mark this year’s event by focusing on three key areas: Caring for patients; Caring for our people; and Caring for our organisation.
Caring for patients
in identifying patients’ Today’s nurses have to be experts the needs of families holistic needs, taking into account e to deliver high quality, and carers. In doing so, we striv e a positive difference to harm free care, in order to mak their lives. s with the anniversary International Nurses Day coincide gale, a symbol of of the birth of Florence Nightin ghted that, in Norfolk, pioneering nursing, and I am deli os; we are unafraid we are at the forefront of this eth pursuit of improving of breaking new ground in the support for our patients. working, including We are embracing new ways of electronic records, the use of mobile technology and we can provide. so we can further improve the care who are key to our You can read about three nurses pages 12 and 13. Transformation Programme on
Caring for our organi
sation
We regularly measure and compare our Tru st’s quality, productivity, and fina ncial performance an d I’m pleased by the big steps we ha ve made over the last two years. Having already joined up our services to wo rk more closely together, we are currently discussing wi th Norfolk County Council how we may be able to enhanc e our integration work by rec ruiting a joint manage r structure, ensuring a seamless an d responsive service fo r patients. These are exciting tim es for our Trust and ke eps us at the forefront of delivering fantastic, modern healt h and care services to local patie nts.
Thank you for caring I’d also like to take this opportunity to thank our nurses, therapists, AHPs and suppor t staff for being such dedicated, caring individuals.
Caring for our people I want to encourage all of our staff to suppor t one another at all times, so we can achieve our sh are d goal of delivering the very best care to our patie nt s. I ha ve committed to setting out a clear direction fo r all staff, celebrating the things that are working well, while offering opportunities to collaborate over so lut ions to further improve. Supporting this vision Trust-wide are a numb er of experienced, senior cli nicians, including Beck y Cooper, Assistant Director in th e North Locality, and Ch ristine Harvey, Modern Matro n in the South Locality . Both of these inspirational cli nicians received recog nition at our recent REACH Award s and you can read mo re about their roles on pages 6 and 7.
It is clear to me that for so many colleagues, working in healthcare isn’t just a job, it is a calling. I am delighted and deeply proud of the way in which staff from a vast range of disciplines work togeth er, using your expertise to deliver exactly the right care, where and when patients most need it. You can see this in action in the Continence Service on pages 18 and 19. And so, on behalf of our Trust’s Board and our patients, thank you all for your dedication , and compassion.
Anna Morgan Director of Nursing, Quality and Operations
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Inspiring the next generation Last year, NCH&C became the country’s only community Trust to offer placements on the Pre-Nursing Experience Pilot, which gives people the chance to gain a valuable insight into the world of nursing before pursuing it as a career. Our three new recruits joined our Trust in October 2013, and have been thoroughly enjoying working on the wards while completing additional training at City College, in Norwich.
Enthusiastic and keen to learn, Lucy Softley has quickly become a valued member of the team at Caroline House in Norwich. “I’ve found working on the ward really enjoyable and rewarding – to see the progress which some of the patients have made is quite amazing,” said Lucy, who was previously deputy manager in a shop.
Our dedicated staff make such a difference... One of our most senior nurses has spoken of the pride she has taken in caring for others throughout her career and her optimism for the future of the nursing profession. Marcia Perry put on her NHS uniform for first time on 15 May 1986, and has fulfilled a wide range of jobs since, including general nursing, children’s nursing, paediatric intensive care, health visiting and commissioning services. She joined NCH&C as Deputy Director of Nursing, Quality and Operations last May after leading national projects with the Department of Health and managing services at Wye Valley NHS Trust in Hereford. “There have been lots of exciting times and opportunities during the past year, but also challenges and work to do,” said Marcia, who has always been passionate about caring for others and the crucial role and importance of high quality nursing care. “I really enjoy my role with NCH&C as it gives me the chance to use the skills and experiences I’ve gained during my career on a daily basis. I also make sure I do one shift a month in one of our community hospitals or with a Community Nursing and Therapy team or specialist service, so that I can see first-hand the quality of care we are delivering. This enables me to directly engage with patients and staff in practice. Clinical work is something I would never let go of – I think it’s so important.” Marcia is responsible for providing clinical leadership and supporting staff to deliver the highest quality care.
“Nursing is always something I’d been interested in. I’ve done a bit of everything so far, including patient care, helping with feeding, washing, changing dressings and doing observations. I’d definitely like to do a degree in adult nursing when I’ve finished this course.”
Bethany Ainscombe
Some areas of focus include supporting a programme of internal visits to check patients have a positive experience of our services. It is also important that we continue to both train our future workforce and support existing staff with opportunities for training and development. The role includes ensuring we have the correct education and training programmes in place, and in the last year has included new initiatives, such as participating in the national Pre-Nursing Year of Experience Pilot. “Nurses are the lynchpin in the provision of care – the compassion and commitment they show can make such a difference to patients,” added Marcia. We are fortunate to have dedicated, motivated staff who are doing some really innovative work and providing excellent care under often difficult circumstances. They should be proud of themselves. “It’s also been refreshing to work with students starting their careers and see the commitment and enthusiasm they have for the role. It shows there are some well-motivated, really high calibre young people wanting to join the profession, which is a cause of great optimism for the future. “It is our job to build on that enthusiasm by showing even more people just how rewarding and varied a career in nursing can be.”
Lucy Softley
For Bethany Ainscombe, the pilot has played a pivotal role in helping her come to the decision that nursing is the right career for her. “Before the pilot started, I wanted to apply for nursing training but had no experience and felt I might be jumping in at the deep end,” said Bethany, who is working on Foxley Ward at Dereham Hospital. “I was worried that it may not be what I had in mind. But the pilot has actually helped me to realise how much I love caring for people.”
Fellow new recruit Meg Simmons, who is based at Norwich Community Hospital’s Alder Ward, saw the pilot as the perfect chance to take the first steps towards her dream job. She said: “I have always wanted a career in nursing, so this was a perfect opportunity for me. I’ve already been shadowing other staff members, learning about some of the things I will be doing after my initial training.” Meg is now confident the experience she has gained with NCH&C will put her in a strong position when she applies for a place on a nursing degree.
Meg Simmons
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In the hot seat Earlier this year, we celebrated the skills, dedication and commitment of staff from across NCH&C at our REACH (Recognition of Excellence and Achievement in Community Health) Awards during a glittering ceremony. Among the winners were Modern Matron Christine Harvey, who is based at Wymondham Health Centre and was recognised in the ‘Clinical Excellence’ category, and Becky Cooper,
There’s never a dull moment!
Assistant Director, north, who won the ‘Inspirational Leader’ accolade. Read about why they were nominated at: www.norfolkcommunityhealthandcare.nhs.uk We asked them to share their thoughts on the nursing profession and tell us what they enjoy the most about their challenging yet rewarding roles. This is what they said...
Becky’s journey from concrete slabs to the six Cs What made you want to become a nurse? I left school at 16 with no qualifications but had always wanted to be a nurse. I started off as a junior aide working with people with learning disabilities, making concrete slabs and laying patios. After a while I felt I needed to gain some qualifications, so did my O-levels while working in various roles as a healthcare assistant. What do you like best about your job? Working with dedicated staff who want to give their best to patient care.
What made you want to become a nurse? Nursing was a second career for me. I committed to the training following encouragement from a staff nurse colleague while I was working as a carer, and was hooked within a month. What do you like best about your job? The daily challenge – working with lots of different teams and professions means there is never a dull moment. I also enjoy seeing how patients have benefitted from our services while looking for opportunities to further improve the way care is delivered.
What makes you proud about the profession? Those staff who go the extra mile.
What makes you proud about the profession? The feedback we receive from patients, which is so heartfelt and always about the small kindnesses.
What difference do you think you make in your role? I feel that I’m able to influence change to improve the care we provide to our patients.
What difference do you think you make in your role? I feel my role gives me the opportunity to make a difference to patient care, work across services and teams to promote safety and quality and influence the way care is designed and delivered in the future.
What do you see as the most important part of nursing? There are many facets to nursing. It is important that nurses maintain the true profession of nursing and are able to give high quality care to patients, whatever their needs, condition or setting.
What do you see as the most important part of nursing? For me, it has always been compassion. A patient safety champion and talented leader, Christine Harvey’s REACH award came after she played an important role in the development of our Pressure Ulcer Strategy, piloted new initiatives and motivated others to embrace change. The first matron to include patient safety data on her ward, she has also played a lead role in developing new quality goals to maintain our focus on improving quality. Recently, Chris provided clinical leadership to a project which aimed to reduce delayed transfers of care. As a result, our Trust is now planning to recruit a discharge coordinator to work across all of our community hospitals, making sure patients enjoy a smoother journey through the system.
What’s the biggest challenge you face as a nurse? To balance all of the demands which are made on services while making sure the patient’s needs are met. What is important about nursing in 2014? To clearly demonstrate the profession’s pivotal position in providing safe, quality care for patients within an ever-changing service environment. Is nursing going to be even more important in the coming years? Some element of nursing has been innate in the human condition throughout history, so it will certainly remain important in the future, regardless of political and societal change. As a profession, we need to identify these changes and make sure nurses are ready for the challenge.
The passion which Becky Cooper shows for patient care was a key factor in her success in this year’s REACH awards – and has been a constant focus throughout her career. Becky was recognised for putting our patients at the heart of everything she does. She also won praise for her inclusive management style, which encourages collaboration and creates an environment in which everyone is valued and can actively participate. Always willing to embrace new approaches while still placing patient safety and dignity at the forefront of any discussion, Becky inspires colleagues to take the initiative and drive through small changes which make a big difference to patients.
What’s the biggest challenge you face as a nurse? Ensuring the voices of patients and their families are heard, and that I can highlight their needs to the relevant parties. Having the ability to articulate priorities in the current financial climate is also a challenge. Is nursing going to be even more important in the coming years? Absolutely. Nurses will need to take on more skills to care for people in all settings while maintaining the six Cs – the true essence of nursing. Nurses have so much to offer, are an integral part of society and play a key role in maintaining standards, ensuring patients can receive high quality care, whatever their needs. Nurses need to continue to strive to improve patient care as well as their knowledge and skill base, and be at the forefront of change.
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Giving children and young people the best possible start in life Health visitors are trained nurses or midwives who have had additional specialist training to support children and families in the early tears. They are skilled at spotting problems that can affect a child’s health and wellbeing.
also demonstrated in our Family Nurse Partnership service who work with young mothers having their first baby and our Sure Start Children’s Centres who work closely with colleagues in Norfolk County Council to improve outcomes for some of Norfolk’s most disadvantaged children
They have a crucial role to play and are the backbone of the Healthy Child Programme , in partnership with other health and social care colleagues. This model of integrated working is
Read about our clinical lead, Maria Richardson’s perspective on Health Visiting, alongside the views of two specialist nurses working within our Healthy Child Pathway.
It’s been the ‘ideal career’ for Maria Our Health Visiting Service has changed significantly over the past few years, with national investment seeing the Norfolk team more than double in size with the recruitment of around 120 students onto the training programme and Health visitors joining us from other NHS organisations. The change means even more Norfolk families are now able to access important support from pregnancy through the early years, in turn ensuring their children get the best possible start in life. “There has been a lot of change over a short period of time, and for us the biggest challenge has been supporting the students who are coming through,” said Maria Richardson, NCH&C’s Clinical Lead for the Healthy Child Programme and the Health Visitor Call to Action Plan. “Everyone has grasped the nettle and is demonstrating the benefits our service brings to getting good outcomes for children. I personally feel the future of the service is exciting for us here in Norfolk.” Maria started her own nurse training in 1985, inspired by a first aid course after originally dreaming of becoming a music teacher. She then spent time working in general nursing, mental health and midwifery before training as a Health Visitor in 1997. She became our clinical lead in 2012 after helping to develop the national Health Visitor Implementation Plan, which aims to expand and strengthen the service provided across the country. The initiative has given our Trust the opportunity take on new staff from a wide range of different backgrounds, many of whom are already making a difference to the health and wellbeing of local families.
School nurse Sarah gets a real ‘buzz’ from working with young people Sarah Archibald saw the perfect opportunity to combine her medical background with an interest in education when she was given the chance to become a school nurse 13 years ago.
“Health visiting encapsulates everything I always wanted to do,” said Maria. “It gives me the chance to work in the community and make good use of all of the different elements of my nursing career. Plus, working with children and families is the best thing ever, and although I’m no longer on the frontline, my passion still lies in making sure we get things right for children from the beginning through to leaving school with the service our School Nursing Team deliver to the 5-19 year olds across the county. “Public Health Nursing is one of the toughest jobs there is as you do have to have some very difficult conversations with children, young people and families. It is also a hugely rewarding career and you really feel as if you are making a difference. It has been the ideal career for me.”
Now Professional Champion for the service as well as a Practice Teacher, she still gets great satisfaction from helping young people with a wide variety of emotional and physical issues, such as sexual health, puberty and weight management. “It makes you proud when you have worked with someone and they leave the room feeling they can carry on with life,” said Sarah, who is based in south Norfolk. “It feels like you have made a real difference.”
As well as going into schools, our 20-strong School Nursing team also work in community clinics and carry out home visits. Another important part of their role is liaising with other agencies on safeguarding issues. “Nursing was something I had always wanted to do – I never wanted to do anything else,” added Sarah. “I really enjoy working with young people, and particularly adolescents. When you feel you have done some good, you get a real buzz from it.”
Being ‘part of the journey’ gives Amanda her sense of achievement Inspired by the staff who nursed her father through renal failure, Amanda Wagg had very personal reasons for joining the NHS. She is now helping to make sure hundreds of babies get the best start in life through her role as a health visitor and NCH&C’s Infant Feeding Lead. Since her appointment four years ago, Amanda has introduced a variety of initiatives to help increase breastfeeding rates across Norfolk, such as recruiting mums as peer supporters to help others who may be struggling. She is also driving the Trust’s bid for full Baby Friendly Status from UNICEF and, having been awarded the first two stages, hopes to achieve the final stage later this year. “I really enjoy feeling like I’m part of something and seeing initiatives I’ve been involved with develop,” said Amanda.
“It brings a real sense of achievement when you reach a milestone and know that you’ve been part of the journey. “I really love health visiting. To me, working proactively to help people to stay well in the first place makes more sense than reacting after they had already become poorly. It gives you the opportunity to make a real difference to people’s lives, which makes you feel great.”
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Innovation in action Community services are an increasingly important part of modern care in the NHS and in addition to working hard to care for our patients every day our nursing and therapy staff are continually pioneering healthcare innovations that can improve the quality and efficiency of our services.
Andrew is in no doubt about his choice of profession Ward Manager Andrew Pover always knew nursing was the career for him. And after 32 years, he still has as much enthusiasm for the role as he did on his very first day. Andrew was also involved in the successful trial of sensors which alert staff when a patient at risk of a fall begins to get out of bed or gets up from their chair without assistance. As a result, the sensors have now been rolled out to other units. “There was never any doubt in my mind that nursing was the career for me, and working as a ward manager brings so many rewards,” said Andrew. “That includes having a happy team, being able to apply knowledge and skills to make a difference to people, seeing patients get better and receiving really nice feedback from patients who have appreciated the care they received. I would recommend it as a career to anyone.” For Andrew, nursing brings with it a sense of public duty and social responsibility. He is so passionate about the profession and the difference the role makes that he is currently trying to persuade one of his sons to follow in his footsteps. “Since joining NCH&C, I feel well supported and respected and have been given opportunities to use the skills I’ve developed through my career to make improvements for patients,” he said.
Andrew joined NCH&C five years ago, after previously working in mental health and general nursing. Since then, he has focused on ensuring care on the Foxley Ward in Dereham Hospital is of the highest quality while improving safety by reducing pressure ulcers and falls, and working on the introduction of the Norfolk Early Warning Score system for inpatient units, which allows staff to identify early signs of medical deterioration.
“But it is not an easy job and there will always be challenges, not least meeting the needs of an ever-growing aging population and finding new ways of working. “We are seeing more patients with complex needs who are therefore dependent for longer, which means there won’t be a shortage of nursing jobs in the near future. Instead, the profession must make sure there are enough nurses to meet demand, and that they are equipped with the right skills and abilities to meet the changing needs of patients.”
By developing new ways of working and successfully implementing technologies and processes our staff aim to deliver improved care and better outcomes for their patients. Here are just a few examples of initiatives taking place in both inpatient units and community settings.
Sara’s new surgical skills Sara has been undertaking further specialist training, which will mean patients can access surgery closer to home. Sara Burr, a Community Dermatology Specialist Nurse, has been studying at the University of Hertfordshire to enable her to carry out a number of different surgical techniques.
Having completed the module, Sara will now work with a number of different practitioners to gain experience and to develop her competency to practice safely. She will then work alongside the service’s medical staff to provide effective interventions for people requiring dermatology surgery.
Until now, dermatology patients requiring surgical intervention, either to identify their lesion type or to remove it, would be required to access secondary care services.
Sara said: “Historically this work has been undertaken by a doctor, but my training will now mean that patients can be seen closer to home, which will be more convenient for them.”
Diagnosing rare form of diabetes Anita Murphy, Diabetes Specialist Nurse, has taken on the additional role of Genetic Diabetes Nurse for East Anglia. Anita works with GPs and clinicians to help identify patients who may have a rare form of diabetes, known as MODY which stands for maturity-onset diabetes of the young. It only affects 1 to 2% of the diabetic population and 90% of those people are misdiagnosed as having type 1 or 2 diabetes. Anita said: “ Since last year we have identified more patients whose diabetes has been diagnosed as different types of MODY. In several cases insulin was not the most suitable treatment
option and these patients are now taking oral medications, which has given them much better diabetes control. “I continue to work closely with clinicians to help identify these patients and their families as MODY is a genetic condition that is passed from one generation to the next. Correctly identifying these patients can make significant changes to their treatment which can improve their quality of life.”
Wanda improves patient experience Wanda has been instrumental in developing our new virtual ward for the benefit of patients in west Norfolk. By liaising effectively with other organisations, Wanda has developed a model carefully tailored to address the specific issues faced by the locality. The ward is now improving patient’s experience by ensuring they can return home quickly from an acute hospital with the appropriate, and often intensive, support in place.
Her energy and drive, coupled with her excellent clinical skills, played a huge role in launching this new initiative. For more information and to view a video about our new virtual ward, visit the NCH&C website at: www.norfolkcommunityhealthandcare.nhs.uk
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Nurses help ensure our Trust is fit for the future Three nurses who have played key roles in developing new ways of working to ensure our Trust remains fit for purpose in the modern NHS have described the importance of making the clinical voice heard throughout the Transformation process.
Clair Anderson, Carol Mahon and Luise Balding have spent around a year working on our Transformation Programme which will enable us to deliver improved care to our patients through the redesign of our services and investment in technology.
To enable our clinicians to deliver high quality care our teams will work more flexibly as ‘mobile workers’, which means that frontline staff can spend more time with their patients. This, in addition to centralised management, improved processes and access to ongoing training and mobile devices means that our Trust will become more efficient and effective in the future.
Clair Anderson
said “We support clinicians to translate the changes into practice,” l Lead Clair, who was previously a community nurse and is now Clinica for the project. mme, and “Our clinical experience has been absolutely vital in the progra work has helped us to influence the changes and make sure they will e and practic l clinica en betwe bridge a on the ground. I view my role as out back and t projec the service development – I am there to feed into time. same the again, and still get to do some hands on clinical work at to “I absolutely love the job, and feel we are making a difference are We . whole a patient care, our colleagues, and within the Trust as we but s, conscious that we are asking people to take on a lot of change hopefully are here to support our fellow clinicians through the process, us.” with along ues colleag our winning hearts and minds and bringing
Our clinical experience has been absolutely vital in the programme, and has helped us to influence the changes and make sure they will work on the ground...
We want our nursing staff to be at the centre of this process and the trio have made full use of their nursing skills during the project, feeding in the clinical perspective to make sure that patient care remains the focus at all times. Jayne Rose, Transformation Programme Lead talking about these key roles said: “These three posts are part of the team
Carol Mahon
Practice Development Nurse Carol has played a key role in the educational elements of the project, training band 3 and 4 colleagues to carry out basic interventions so that registered staff are freed up to deal with more complex cases. “I have really enjoyed teaching clinical skills to the healthcare assistants,” she said. “I hope that I’m able to instil confidence in my colleagues so that they realise the benefits of a new streamlined system which gives them more time to provide high quality care.”
We are here to support our fellow clinicians through the process, hopefully wi n hearts and minds and bring our colleagu es along with us...
that help to support our nursing staff with the new ways of working and make us fit for purpose in the modern electronic NHS. Their skills as nurses ensure we never lose sight of the quality required to ensure that everything we do has the patient firmly at the centre.”
Luise Balding
As clinical lead for SystmOne Optimisation, Luise has used her expertise as a nurse to help her research, write and develop more than 100 electronic care plans which are currently being rolled out across the Trust. “I believe it is of great importance for nurses to be involved in the Transformation Programme,” said Luise, who joined the Transfo rmation team last July after previously working as a Community Link Nurse in North Walsham. “They have the knowledge and understanding of the systems which are being changed as well as the ‘little things’ which may otherwise not be considered. “I very much enjoy supporting the clinicians and helping them to understand and move forward with the changes made throug h the Transformation Programme, and feel it will help us to work more efficiently and much smarter in the future.”
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Nurses’ Day 2014
Nurses’ Day 2014
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The many faces of nursing today... Nurses’ Day gives us an opportunity to celebrate the remarkable difference nursing makes. We are reminded of this every day through the many compliments that we receive from patients passing on their thanks to our nursing and therapy staff for the care they have received.
Integrated project aims to deliver harm free care
As well as showcasing their work and exploring what is great about the profession we also wanted to look at what nursing means to our staff, why they joined the profession in the first place, and why they continue to work tirelessly for their patients. You’ve already read some of their stories, but here are some more examples of the impact that they have on the health and lives of local people.
Respite in a home away from home For Sarah Watling, caring for people with learning disabilities is the best job in the world. Varied, rewarding and immensely satisfying, it gives her the chance to make a difference to some of the most vulnerable patients cared for by NCH&C.
A nurse-led pilot designed to reduce three major harms and improve quality of life for vulnerable, frail and elderly care home residents has been launched across Norfolk. The project, delivered by our Trust in partnership with Norfolk County Council (NCC), has seen nine homes provided with a bespoke toolkit so they can assess risks daily and implement early intervention measures to prevent pressure ulcers, falls and infections associated with urinary catheters.
“For me, it’s the small things that make such a difference. Because of communication difficulties, our patients are not often able to say what they want or how they feel, so getting it right for them can be difficult. But when we do, it is hugely satisfying.”
The pilot is being led by Harm Free Care Project Manager Marie McDermott, who is transferring some of the experience she has built up during a 28 year career as a nursing teacher to help drive the work.
The family-focused service currently supports around 35 people with very complex needs, the majority of which are wheelchair users and unable to communicate verbally. Five people can stay at Mill Lodge at any one time, and staff will try and arrange this respite so that patients who have become friends during previous visits can return to the unit together.
“I have always been interested in care of the elderly and quality and safety enabled through workforce development, so this role was an ideal opportunity to work specifically in those areas,” said Marie, whose post is being hosted by NCH&C. “I have absolutely loved it so far, and would like to develop a career working in a community setting in the future as it has been the biggest and most challenging learning curve to date. “My background in nursing and education has been vitally important throughout the project. Even though we are working in care homes rather than acute hospital settings, a clinical understanding of what constitutes quality care has been essential. “It is a superb project which should have a huge impact on people, and would not have been possible without my colleagues Jayne Jode, Annette Paul and Caroline Lester, the wider team and the support and input of the subject matter experts across NCH&C and NCC.” The pilot began on May 1 and will run to August 31. Once complete, it will be evaluated by the Harm Free Care Board using data on ambulance call-outs and A&E and EAU admissions, as well as feedback from residents and staff. Marie is currently applying for Better Care Funding so that the project can be rolled out across the county and an electronic version of the assessment tool, which can be used on mobile phones and tablets, can be developed.
As our Adult Learning Disability Respite Service Manager, Sarah manages a 16-strong team of nurses and nursing assistants working at Mill Lodge in Taverham. The respite unit, which relocated to its new state-ofthe-art premises from its previous base in Aylsham’s Mill Close last September, offers residential placements to people with learning disability and other complex physical and health needs. By offering periods of respite in a home away from home environment, they not only help their patients to gain confidence and socialise with others, but also give their families a vital break from their demanding roles as full time carers. “It is a fabulous and diverse role working with a fantastic group of people,” said Sarah, who trained as a learning disabilities nurse 20 years ago inspired by a work placement she completed at school. “You never get the same day twice, and that’s what I really enjoy.
“The unit has a fantastic holiday atmosphere at times, and we have a real laugh,” added Sarah. “I count myself extremely lucky that I work in such a great place with such wonderful people. “Without a doubt I’d recommend nursing to anyone. I can’t imagine doing anything else.”
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Sharing expertise makes impact on patient care David Smith has dedicated the vast majority of his career to patients at the end of their lives, championing their rights and playing his part in ensuring they receive the best possible quality of care. Since becoming Palliative Care Education Coordinator for our Trust three years ago, he has found a new way of making the most of his nursing experience by using his expertise to develop new education programmes for staff from across NCH&C and beyond. “I had a very special reason for going into cancer care,” said David, who was awarded the title of Queen’s Nurse in 2012 in recognition of his dedication to improving end of life care through education.
Protecting children after a career specialising in child health A key member of the team responsible for helping protect children and ensuring our staff can act on concerns about the welfare of young people in their care has spoken of the enjoyment she gets from her “varied and challenging” role. Catherine Knox began a year-long secondment as Named Nurse for Safeguarding Children in June after spending her whole career specialising in child health. As part of our Trust’s safeguarding team, she is responsible for supporting colleagues who work with children, offering guidance to anyone who has concerns and helping staff called to court as witnesses in abuse cases. As well as coordinating training and development, Catherine also provides assurance to our Board while working closely across partner agencies to share information and best practice. “I’ve always worked with children, and began my career as a nurse at Great Ormond Street Hospital before training as a health visitor then moving to a clinical leadership role,” said Catherine, who works closely with fellow nurse Anita Bagge. “This secondment gave me the opportunity to move away from operational
management and develop my skills at a strategic level, which I have found incredibly rewarding. “Working with children and families can be very challenging, and can cause lots of anxiety and uncertainty. I enjoy being able to support staff through the difficult times, both emotionally and professionally, and having the ability to influence and advocate for children at a multi-agency level. “Our team helps to ensure that staff have access to robust supervision and the necessary training and support, which is incredibly important and makes us feel like we are making a real difference by improving outcomes for children. “Working well as a team and supporting each other is particularly important when you are dealing with sensitive areas of work, and is one of the elements of the job I’ve found particularly enjoyable.”
“My grandfather died of stomach cancer when I was five and just disappeared from my life. I wasn’t allowed to visit him at home or in hospital, and I wasn’t told what his diagnosis had been until many years later. This told me that there was a big problem around cancer in my family, which I decided to tackle head on. “As well as that very personal reason, I also had professional reasons as I wanted to challenge myself to see whether I could maintain relationships with people with very serious illnesses. “I see the educational work which I do now as clinical practice by proxy; I’m carrying on the things I liked about working in cancer care through helping other people to develop their practice.” David is responsible for delivering specialist palliative care training across NCH&C, as well as to colleagues working in social care, care homes and acute settings. “Training has become so important as it impacts hugely on patient care by ensuring that people are given a choice as they reach the end of their life,” he added. “I run specific workshops about advance care planning and the national end of life competencies, such as communication and symptom control, as well as sessions specifically for care home managers. “The participants often learn a lot about other roles and different ways of thinking, which is almost as important as the things we are teaching. “I really enjoy the role, and like meeting people with a passion and talking through things. I thrive on that lovely feeling you get when the light goes on behind someone’s eyes and you realise they’ve got it. “But the achievement I’m most proud of during my career was being voted the most supportive person in NCH&C by hundreds of my colleagues in 2012. I found it very humbling.”
The participants often learn a lot about other roles and different ways of thinking, which is almost as important as the things we are teaching...
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closely together as it It is really important to work so helps us to learn from each other…
Jo Clatworthy Yvonne Coleman
Working together to boost patient care The NCH&C Continence Service, which operates across the county, offers a specialised multi-disciplinary team of nurses, physiotherapists and healthcare assistants whose combined expertise helped to provide an assessment and treatment plan for adults who have bladder, bowel and or prolapse problems. Jo Clatworthy, Team Leader and Senior Continence Advisor, helped to set up our continence service around 13 years ago after developing an interest in women’s health and urology while working in an acute hospital. Since then, she has taken great pride in helping people overcome what can be an embarrassing problem. “Traditionally, patients with issues ended up being given a continence pad and were expected to accept they would have a problem for life,” said Jo. “We set up the service to look at the causes before finding solutions which would either cure or improve their situation. “It is really important to work so closely together as it helps us to learn from each other.”
“Having continence problems can have a huge effect on people – we’ve had patients come to us who have had issues for several years and have lost their job or partner, but have been too embarrassed to ask for help. It is absolutely marvellous when they come to the end of their treatment and tell you things have been resolved and you have helped make a huge difference to their quality of life.” As well as working closely with care homes to give lifestyle advice to staff looking after older people, Jo’s team also run outpatient clinics for patients of all ages. Wherever possible, they try and organise clinics alongside therapy colleagues to ensure patients can get the best possible care to meet their needs.
Hilary Kelly
We share the patient’s care so tha t the most appropriate person responds to their particular issue...
“I am lucky enough to have two part-time physiotherapists and healthcare assistants, such as Yvonne Coleman on my team, and we all work very closely together,” said Jo, who is based at Wymondham Health Centre. “We share the patient’s care so that the most appropriate person responds to their particular issue. “It is really important to work so closely together as it helps us to learn from each other – our nurses have learnt a huge amount about pelvic floor dysfunction, for example, while the physios are now more aware of the impact of the medications used by our nursing team.” Specialist Physiotherapist Hilary Kelly, who works in Jo’s team, provides a variety of treatments for continence patients, including muscle exercises for
people who have trauma after childbirth or pelvic floor dysfunction. She described the relationship with her nursing colleagues as “really useful”. “We learn from each other and from our past experiences,” she said. “And although our knowledge and training are different, the skills we have complement each other. For example, if I have a complex patient with bowel problems, I’ll discuss the case with my nursing colleagues and sometimes carry out a joint assessment. “This is really important as the nurse can explain any specialist equipment straight away, which makes my job easier. It’s also much better for the patient as it means they can get the help they need as quickly as possible.”
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Going the extra mile Every day, we see fantastic examples of generosity across our Trust as so many of our nurses go the extra mile and volunteer or fundraise for causes close to their hearts on top of their already busy jobs.
Vital voluntary role for NCH&C’s Jenny A Clinical Link Nurse who juggles her day job with voluntary work helping young children to cope with bereavement has spoken of the enjoyment she gets from her varied roles. Jenny Maddox has been giving up her free time to volunteer with Norfolk-based Nelson’s Journey for the past two years. Inspired to find out more after speaking to another volunteer, Marion Bird who works in the Integrated Nursing and Therapy Team in Holt, she now supports children at residential weekends where they can talk about the person they have lost, share their experiences and create special memory boxes to help the grieving process. “As a district nurse, I often deal with palliative patients and their families and have also had friends who have passed away and left young children behind,” said Jenny. “These experiences in my work and personal life have inspired me to want to volunteer. “During the weekend camps, children are encouraged to talk and share memories of the person who has died and take part in activities, giving them the skills to cope in the future. Meeting children in the same boat often makes it easier for them, with many of them exchanging contact details. “There are emotional times and it can be tiring, but I get a lot out of it, especially when you see the benefits it brings to the children and their families. The main skills I would say you need in both my role as a district nurse and as a volunteer are to be able to take time to listen.”
Mayor’s honour for volunteer Trudie
Here we celebrate some of our dedicated colleagues who put in hours of hard training to complete marathons, give up their free time to help those less fortunate, share their skills with vulnerable communities and think up exciting ways to raise charity cash.
Year-long fundraiser in best friend’s memory
A Community Learning Disability Nurse who has spent nearly a decade volunteering as a custody visitor has been honoured for her achievement with a special Mayor’s award.
A dedicated Community Matron who lost her best friend to breast cancer has raised nearly £3,500 in her memory following a year-long fundraising drive.
Trudie Needham, who supports adults with learning disabilities across north Norfolk, was presented with the accolade for her work ensuring detainees at King’s Lynn Police Station are being treated fairly and procedures are being correctly followed.
Annette Yeomanson, who works with the North Walsham Community Nursing and Therapy Integrated Team, held a variety of events, including bake-offs, car boots, concerts and raffles in memory of Tracey Howard, who passed away in January 2013. She capped off her fundraising by taking part in this year’s London Marathon in aid of the Breast Cancer Campaign.
“I enjoy (my voluntary role) and I feel I make a difference,” said Trudie.
Reaching new heights to raise charity cash TB Nurse Specialist Jo Hadley and daughter Becky raised an impressive £1,192 with a leap of faith when they completed a charity skydive to raise money for TB Alert. The daring duo were harnessed to an instructor before free-falling at speeds of 120mph at Beccles Airfield in Suffolk. The money raised by Jo, who is based at Norwich Community Hospital, will be used to support projects both in the UK and overseas to control and eliminate TB, which kills 1.4million people worldwide every year.
Jenny spends 12 months caring for children in China A caring occupational therapist (OT) has returned to our Trust after taking a year out to care for children with a range of health problems at a foster home in China. Jenny Rawcliffe also trained around 50 therapists in basic OT knowledge, to help support hundreds of children across orphanages in China. “Seeing the smile on a 12-year-old girl’s face when she was positioned in a good chair and able to eat independently for the first time in her life spoke a thousand words,” she said.
Sharing skills overseas One of our Community Specialist Palliative Care Nurses has made a difference to end of life care in Ethiopia after spending ten weeks sharing her knowledge and skills with healthcare staff working in the country. Sue Mumford, who is based at the Priscilla Bacon Centre in Norwich, travelled to Africa with her GP husband Jamie late last year. During their visit, they gained an insight into the services provided by charitable organisation Hospice Ethiopia, visited patients with illnesses such as AIDS and cancer in their own homes and were able to make recommendations and offer training to further improve care.
Marathon Mandy makes her mark A specialist nurse who only took up running 18 months ago has completed her first London Marathon to raise funds for a local group close to her heart. Mandy Beresford, who is a Community Respiratory Nurse Specialist and our Clinical Lead for Pulmonary Rehabilitation, decided to take part in the 26.2 mile race to challenge herself before celebrating her 50th birthday in July. She completed the course in 4hrs 56 minutes – beating her target of 5hrs – while also raising around £600 for the Sheringham Breathe Easy group, which supports lung patients.
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Nurses’ Day 2014
Our specialist stroke nurses, therapists and doctors provide care to
60 new patients each month
Our health visitors see more than
5,000
new patients every month
We have over 560 staff within our Community Nursing and Therapy teams and every month they have
54,000 face-to-face contacts with patients
NCH&C receives around
23,400
new referrals from GPs and other healthcare professionals every month Every month, nurses and GPs at City Reach Health Services care for around
Our school nurses hold around
900
face-to-face appointments with children each month
50 new patients
and offers around
500
appointments
80%
of our staff are healthcare professionals
Produced by Norfolk Community Health and Care NHS Trust, May 2014 www.norfolkcommunityhealthandcare.nhs.uk
Looking after you locally
