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Saturday, 23 February 2013

"Joining the front line..."

The title comes from a quote by a  family member visiting our hospice on Thursday. They came to ask me how their relative was, and thinking they had seen me the night before (it must have been Ray they spoke to)  I had to explain who I was and what I was doing.
I publicly promised to do this a while ago, on Twitter, encouraged by the NHS Change Day team. The site asks those working in the NHS to make a pledge to change something on March 13th 2013.  The website won't allow independent sector pledges; I had however wanted to do this for a while, I am after all a Registered Nurse too. I thought it would help me understand what working on our front line meant. I could also claim to have recent "hands on" nursing experience.
So there I was, a surprise to the team; I hadn't wanted them dreading the boss coming in. Instead with the help of our Head of Care I picked a day when those on duty would be ready to adapt and let me join in.
Once the penny dropped as I appeared in my uniform we were fine. My nerves settled once I had been given permission to approach the medicine trolley and unlock it. The night before I had begun to wonder what I had committed to. I felt as apprehensive as my first day on any ward or in any job. I found that reassuring in a way; I knew I would be cautious and observant, with the certainty that all my experiences and training had stood me in good stead thus far.
So we administered medicines; found people less well and in need of reassessment.  Some needed a wash; help with toileting or taking food and fluids.
It all came back though finding items like gloves was not so easy; admitting a new inpatient and getting to grips with the electronic records were two sides of the coin. For the first I could get someone comfortable in bed, ask a few questions and take their observations. Then I had to navigate the electronic records and with the help of the team the figures were put in the right place.
What of the team? well, Liz, Fern, Trudy and Tracey looked after me by answering my questions, showing how they perform tasks, making (appropriate and politically correct) suggestions, and questioning me. I loved the interactions with them and especially the patients  Here we were making a difference that day,  as happens every day, enabling us to leave the shift certain we'd made that difference.
The outcomes? I said earlier I hoped it would help me understand what being on the front line meant; I got to see what that is like from the first floor where we were. It will help me when I talk about the need for the re-provision and making life nicer for our inpatients and more efficient for our staff. Other observations about running the ward, organising the work can wait for another time; I plan to repeat the experience soon and want to be certain my 'gut instinct' is right before I share with the team.
My own learning? Facing my fear, and knowing at the end of my time it had been a positive experience for the patients, for me and the team was reassuring. Some things, such as needle safety, use of PEG feeds etc have made life simpler and safer for all. Other skills such as bathing and creating a safe, comfortable and dignified place to be in don't change; these need passing on to those we're training. I know now not to be so apprehensive about such activity; it gives me a foundation to reinforce my work in taking services forward, in seeking funding from service commissioners and the supporters of the hospice. 
The hospice team too I hope, can take heart from having a manager and leader who has some insight into what it is like to be at our front line.


1 comment:

  1. Well done Philip - leading by example. I feel that clinical credibility as a manager is important. My medical colleagues who are managers all practice once a week. I continue mine as a Marie Curie nurse and occasionally in the Trust that I manage in. I feel staff respect our commitment to understanding and experiencing the realiies of practice.

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