Case studies

"One of the most rewarding aspects of my job is helping empower those under our care achieve independence and an enhanced quality of life, as a result of something we have done."

I work as part of a multidisciplinary team, supporting patients who require long-term ventilation or cough augmentation outside of the hospital setting.  

My background is intensive care nursing.  I was originally part of the home ventilation specialist interest core group, then successfully achieved a substantive position as Nurse Specialist within the team 21 years ago, moving into the newly developed nurse consultant role in 2017.

As part of the team, my role includes: 

• independent patient assessment (in clinic or in the community); 
• establishing treatment (invasive and non-invasive ventilation, cough augmentation and airway clearance); 
• hosting a flight assessment clinic; 
• delivering education and training to patients, family members, professional care teams, other healthcare teams and at conferences or events; 
• facilitating the discharge of patients with complex healthcare needs; 
• conducting telephone and outreach clinics, home monitoring and analysis; 
• liaising with other healthcare personnel, organisations and the commissioners of care;

I also co-ordinate a national network group of nurses and allied health professionals (SiLVaH – Specialists in Long-term Ventilation at Home) from both within the NHS and private sector, who are involved in the support and delivery of long term ventilation in the community setting.

Any future aspirations?

There is still a misconception about the perceived quality of life of this patient group, and this can have a negative impact on their access to appropriate health care. I would like to see further improved understanding within health care teams of the potential that those with disability can achieve, and will aspire to raise awareness about that.

What do you love about your job?

I have always loved my job!! We care for a profoundly disabled cohort of patients, and one of the most rewarding aspects of my job is helping empower those under our care achieve independence and an enhanced quality of life, as a result of something we have done. 

I play a small part in enabling them to lead meaningful and independent lives, and this is very important to me. Our support means these individuals can remain in their own homes, rather than a hospital or long term care facility, despite significant dependence on technology. I get a kick out of seeing the difference my contribution makes to their quality of life.

Working alongside our bioengineering team, we have been able to support adaptations to promote independence for our patients.  For example: 

• seeing a young lad get to the football match, because we can mount his ventilator on the back of his wheelchair; 
• giving a 30-year-old man some time away from his parents to walk the dogs, as a result of bespoke switches to maintain his autonomy with his own equipment; 
• making adaptations to allow a young lady to live independently with minimal carer support in line with her wishes.

As a nurse consultant, I have 50% of my role as protected time with my patients.  The remaining 50% is divided between research, education and service improvement.  This is a perfect split of activities, as it allows the opportunity to develop services, improve patient care and share our learning with others, without compromising time spent delivering hands on patient care.

What has been your proudest moment so far?

I have so many proud moments!!

Achievement of my MSc!

Being invited as a ‘visiting expert’ by the Ministry of Health in Singapore, to conduct a weeks’ lecture tour and share our practice in various health and academic facilities.

Being appointed as Nurse Consultant in a job that I love!

Ultimately, working with a team member to accompany one of our tracheostomy ventilated patients (who was on critical care at that time), so that he could attend his granddaughter’s wedding. Our team received a Personal Touch Award for this, but the proud moment was seeing how important it was to this gentleman and his family for him to be there, and being able to contribute to that was possibly my proudest moment!

Any tips for finding a job that you love?

Follow your heart! We spend a lot of our life at work, and this time should be spent doing something you value and enjoy. I believe we are better at what we do if we enjoy it!

Tell us about any unusual aspects of the job

This job involves a lot of working outside of the hospital, and allows the privilege of seeing people in their own homes. For someone with significant disability, being in their own adapted environment facilitates more effective patient assessment and management. However, this raises many challenges, for example, effectively donning and doffing PPE in someone’s garden or porch, in light of the COVID-19 pandemic. Also, eating ‘on the run’ and never having time to go to the toilet!

What are your usual working hours?

The service is covered Monday to Friday from 08:30 until 18:30. We also provide an on call service outside of those hours for urgent equipment replacement for this vulnerable patient group.

What training is needed for your job?

A background in either respiratory medicine or critical care is helpful, as it provides a knowledge and skill set that is applicable to this role. However, the majority of the specific training required takes place once appointed.

Did you get any development support from the Trust?

Yes, and this continues to be supported. We are a specialist regional service, with a large geographical footprint. It is important to support team members to continually develop their knowledge and skills to ensure our patients receive the most up-to-date, evidenced based, high quality care. 

I feel that this Trust invests in that to a high standard.

Why should someone come and work in your department?

Working in a small specialist team has huge advantages. We share a set of agreed goals and objectives about patient care and service delivery. 

Our team is made up of a wide multi-disciplinary group, with completely flattened hierarchy, where the contribution of every team members is encouraged respected and valued. 

Final tip:

Ask the patient……they usually know best!