A day in the life of ... a senior web site nurse practitioner

Andy Brittin has been a web site nurse practitioner for more than 15 many years and thinks the future choices for his work are countless. Photograph: Andy Brittin

On operate nights I get up all around five.30pm, have a shower and anything to eat and then head out to whichever web site I am rostered to perform in. I typically cycle in, as I can not bear the tube in the mornings when I am on my way home to bed. As soon as I arrive, I quickly look over my emails for anything at all critical which could be relevant to the night ahead just before we consider over from the day group. As the senior practitioner, I oversee all of the trust internet sites overnight, so I may well also chat with my colleagues functioning in our other hospitals and guarantee they are Okay.

After this, it is time for the first of numerous visits to the emergency department to examine in with the nurse in charge, using this opportunity to place any individuals who require to be admitted to inpatient beds. At eight.30pm we join our health-related colleagues for the hospital at night handover to hear about the patients admitted that day and go over any person on the wards who may well give us result in for concern. We also get a handover from the outgoing outreach teams, who tell us about any patients they want us to review overnight. The beginning of the shift is when we make sure our wards are safely and adequately staffed, which can often involve asking employees to go and work in a diverse location for the evening if we’ve got an sudden shortfall somewhere. This is by no means a popular request and has to be handled sensitively, nevertheless it is crucial to make sure our patients are stored in a secure setting.

Following handover, we verify on any sufferers who have been flagged to us, and choose up any urgent jobs. We’re quite great at putting IV cannulas, so typically we get asked to see “tough” sufferers whom other men and women have experimented with and failed to cannulate throughout the evening there’s a particular fulfillment in acquiring the line in very first time so that the patient can finally get their remedy.

At 10pm I chair a conference get in touch with which entails all of the internet site nurse practitioner teams functioning across the a variety of trust web sites. We discuss our activity, highlight any concerns or challenges and make our programs for the evening. Then it really is time for our 1st hospital round, selecting up the clinical work as we go along – reviewing individuals, ordering tests, inserting IV lines, performing catheterisations, to name just a number of. About half of the staff are independent prescribers, which permits us to pace up patients’ access to medicines at night, and we all have acute care abilities. In in between job-primarily based operate, the pager does not stop – much more bed requests, clinical or managerial queries from the wards, plus crash calls for cardiac arrests or other health care emergencies. At times we get a lull in exercise in the little hrs, but other nights we’re kept on the go for the complete shift. In reality, something could happen – we have had to use our key incident strategy at night more than after.

My background is HIV/isolation nursing, but I’ve been a web site nurse practitioner for more than 15 years now, with no ideas to depart. When I consider how different the job is now in contrast with when I commenced out, the long term choices are limitless. I would never ever have thought we would finish up as nurse prescribers and innovative practitioners, yet here we are, and with the move to a safe, productive 24/7 model of care in the NHS I am hunting at ways we can roll our night-time clinical part out into anything that operates in the course of the day as effectively. I believe the biggest challenge is encouraging all our employees to think about the ward setting at evening – just simply because we’re awake, it does not indicate the individuals must be.

Soon after a last hospital round I catch up on admin and paperwork ahead of handing more than to the daytime management and nursing teams. Then it is time to cycle property and get to bed. The journey home is usually ample time for me to reflect on the evening and clear my head, so I am normally asleep as quickly as my head hits the pillow. Operating predominantly at night does not suit every person, but for me the mix of a clinical and operational role is just perfect, whatever the time of day.

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A day in the life of ... a senior web site nurse practitioner