We are profiling amazing practice and community nurses, and midwives, during the Covid-19 pandemic as part of our Nursing Stars campaign with New NHS Alliance.
What is your usual role?
I’m a community matron and Queens Nurse providing clinical leadership, delivering specialist clinical practice and supporting clinical developments within Adult Community Healthcare Services (ACHS) within NHFT.
The area I cover has two bases housing the community nursing teams which consist of around 50 staff in total, covering the Kettering and Corby areas. My role is split between seeing patient’s face-to-face, clinical development and transformation work and projects.
I work closely with service managers, GPs, practice nurses, specialist doctors, community geriatricians and other multi-disciplinary colleagues to deliver outstanding clinical practice in the Northamptonshire community. In clinical practice, I provide holistic seamless care to patients who often have complex needs using my prescribing skills to diagnose and treat avoiding hospital admission and managing patient care in a community setting. I also provide support and clinical advice and guidance to colleagues to ensure quality care for the patients in my locality.
How did your role change during Covid-19?
I think it is important to say that during the pandemic it has been business as usual for community nursing and we have had to adapt our ways of working to ensure a continued service to vulnerable patients in their own homes.
At the start of the pandemic, the Clinical Commissioning Group in our area identified that some care homes were struggling due to COVID-19, as well as other issues such as staff anxiety, PPE orders, guidance and staff training and we were asked to be part of a project to support this. We created a Care Home Task Force made up of community nursing staff from all localities across the county. Care homes were identified, and a visit was arranged to ascertain the concerns, and a plan was put in place to offer support. Whilst part of our role as community nurses is going into residential homes, we wouldn’t have usually gone into nursing homes but the project was inclusive of all care providers.
The benefits of this were that it reduced footfall into the care homes that had closed their doors to visitors to reduce transmission risk, improved communication, allowed integrated working and a sharing of knowledge and skills, allowed relationships to be built to ensure the best possible care for the patients. The task force also completed the planned care within the home while they were there. It was a real team effort to manage this as the community teams had to release capacity to allow staff to be part of the task force, which ran from March until July during the height of the pandemic when our service was under considerable pressure. The teams have received very positive feedback from the care homes involved, the support was very much appreciated by the staff who recognised the need for additional support.
More recently I was asked to support the trusts Adult Continence Advisory Service working alongside the existing team to understand the service they provide and consider what could be done to best manage the large waiting lists that have developed due to the pandemic. The Continence team are a small team of eight people – during the pandemic all team members had become unwell with Covid-19 and the impact of this was that clinics were cancelled and a backlog of patients built up. I provided clinical support and leadership and co-ordinated staff to help reduce a growing waiting list of 1,600 patients. Community nursing supported this service by providing a task force of ten nurses who were shielding or working from home to support. Virtual clinics were set up and patients were contacted and their needs assessed over the telephone; appropriate treatments were then sent out and advice given. The overall aim was to deliver safe care and the right outcome whilst reducing the waiting list and therefore the time that the patients waited from initial referral to be seen.
Healthcare assistants continued to carry out bladder scans in patient’s homes when this was required following appropriate PPE guidance. Through restructuring the service delivery and being able to provide patients with the option to have virtual assessments/reviews, we were able to reduce the waiting list time from 13 weeks to just two weeks from when someone is referred to the service and the waiting list currently is 20 patients (down from 1,600).
Why would you say you are a Covid-19 Nursing Star?
None of the above would have been possible without the support from our amazing nursing teams, so I would like to say I’m one star in a constellation of stars. It’s through the hard work and determination of the teams that we’ve been able to achieve what we have, during what has been an immensely challenging time.
How do you think Covid-19 will impact the way you work in the future?
Covid-19 has shown us that some of our services can work well virtually and I anticipate that we will continue to adopt this approach. During the pandemic, we have used technology more, for instance, the use of Microsoft Teams to have meetings, deliver clinical supervision and handovers remotely, which we will continue. We also introduced e-learning instead of face-toface sessions for the Continence service. This has increased nurse capacity in the team and is a more effective way for staff to be able to access training. Rather than having to commit to attending physical sessions, nurses can access the sessions when it suits them. It’s the same for meetings nurses are often short of time so being able to attend a meeting virtually will have a positive impact on how we work in the future.
Northamptonshire Healthcare NHS Foundation Trust is part of the ‘Best of Both Worlds’ recruitment campaign that brings together the University of Northampton, Northamptonshire Healthcare NHS Foundation Trust, Northampton General Hospital, Kettering General Hospital (KGH), St Andrew’s Healthcare and Northants GP and aims to recruit nurses, doctors and healthcare professionals to live and work in Northamptonshire.