ED nursing great but I miss chance to chat to patients

Matthew Osborne likes the pace and variety of emergency nursing, a tough but rewarding specialty that tests his ability to cope, while a passion for education has led to a dual role as a lecturer

Matthew Osborne likes the pace and variety of emergency nursing, a tough but rewarding specialty that tests his ability to cope, while a passion for education has led to a dual role as a lecturer

Matthew Osborne sees emergency nurses taking on more roles traditionally reserved for doctors

Why did you become an emergency nurse?

I was very fortunate when I was a student to have a placement in St Thomas’ emergency department (ED) and I had a great mentor who made it an exciting learning environment, so I had my eye on the ED back then.

What might you have done otherwise?

I have a passion for education that I now get to fulfil in my second role as a lecturer educating healthcare assistants up to band 4 level, so they can fulfil assistant practitioner roles. So I would probably have been a practice development nurse or full-time lecturer.

How and where have you developed your emergency care skills?

I’ve taken several postgraduate courses including independent prescribing, advanced assessment skills, electrocardiogram rhythm analysis and interpretation, acute care and emergency care. I have also done advanced life support and trauma life support courses.

What do you enjoy most about your job?

The variety and pace of my day makes emergency nursing attractive to me. It can really test your knowledge, skills and resolve to the limits. Every day I seek to push my limits further.

What achievement makes you most proud?

We undertook a series of clinical audits to highlight the quality of our care, and while we did quite well there was room for improvement. I partnered up with an ED consultant and we assembled a team of doctors and nurses to work on several integrated care pathways to enable all ED staff to use high-impact interventions in several conditions. One of these was a sepsis pathway that means we now recognise and treat more than 91% of sepsis cases within an hour of arrival in the ED, and this rises to 100% within an hour of initial assessment. We created similar tools for other conditions such as asthma and paracetamol overdose, so I feel I have helped my colleagues to help patients when I’m not even on shift.

What would you change if you could?

I often feel I can’t deliver the care I want because of the pace of modern ED nursing. There are times when I would like nothing better than to sit down next to a patient having given them a cup of tea and a sandwich and explain to them what is going on and have a quick chat about their personal and social circumstances. It is things like this that really help establish a relationship with a patient and that I miss most from ward work.

Where would you like to be in five years’ time?

Working as an advanced practitioner in emergency care.

What makes a good emergency nurse?

A broad knowledge and skill base and a flair for applying them to the patient in front of you in often challenging circumstances. Plus the ability to thrive on adrenaline!

What advice would you give a nurse who’s starting out in emergency care?

It’s a tough speciality that will at times drive you to the edge of your ability to cope clinically and emotionally, but it will reward you too. I recently had to help care for a little girl who had a post tonsillectomy bleed. She was quite poorly and scared when she came in by ambulance but by the time she left resus she had perked up and I got a cuddle and a kiss on the forehead as a thank you.

What is likely to affect emergency nurses most over the next 12 months?

Ongoing recruitment issues for nurses and doctors will mean our roles evolve, and more traditional nursing tasks will be taken over by band 4 staff while nurses take on roles traditionally reserved for doctors.

Matthew Osborne is charge nurse in the emergency department at Southend University Hospital NHS Foundation Trust and a lecturer in foundation degree adult care at the University of Essex

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