My job

Emergency nurse appointed to medical college committee

April McKay on why emergency nursing inspires her so much

April McKay, the first nurse to be appointed to the Royal College of Emergency Medicine’s best practice committee, explains why emergency nursing inspires her so much

What is your job?

I’m an advanced clinical practitioner (ACP) in emergency medicine and am currently completing credentialing in adult and paediatric emergency medicine. I work in a large teaching hospital emergency department (ED) as part of a 15-strong ACP group.

What are your main responsibilities?

I work autonomously seeing a full range of undifferentiated patients, including leading the trauma team with support from an ED consultant, and I’m on the best practice and quality committee for the Royal College of Emergency Medicine (RCEM).

Why did you become an emergency nurse?

I went into emergency nursing straight out of university and had a choice between that and intensive care. The pace, constant changes and variety of the work attracted me. You need to know a bit about everything and be a ‘Jack of all trades’.

What might you have done otherwise?

I worked as a healthcare assistant in a community hospital and I was inspired by some of the nurses I worked with. When I applied to university to study nursing as a mature student I was also offered a place in medical school but I was attracted by the ethos of nursing, without that inspiration and those role models I’d have gone to medical school.

What do you enjoy most about your job?

The patients, the variety, working as part of a large team and the chance to make a difference. Recently I had the pleasure of representing the RCEM at the launch of a new charity, myelopathy.org. This involved going to a launch event at the House of Lords, a fantastic opportunity to represent my profession, my employer and RCEM.

How and where have you developed your emergency care skills?

I’ve worked in EDs across the UK and in Australia, and worked in autonomous practice in acute stroke and critical care outreach. There are places to learn emergency care other than in EDs.

How did you progress through your career?

I’ve always liked to move on and look for chances to develop my skills and learn. I’ve always wanted to be an ACP or advanced nurse practitioner, so I looked for opportunities to learn skills and develop based on that goal. I have taken every academic opportunity that I could grasp. Within a year of qualifying I was doing master’s modules. At the last count I’d done ten or 11. Emergency care is such a large and complex field that you can never know too much. You need the academia to underpin your practice.

What is the greatest challenge you have faced and how have you overcome it?

I’m sure it’s not unique, but overcoming ingrained ideas and institutional inertia. Change can be good – experience and ideas from outside aren’t things people should be afraid of. Sometimes you must swim against the stream and show a better way. Day to day I’m completely committed and never stop. Recognising when you need a break and when you need to step back and slow down is important. Burnout is a big threat to us all, and being self-aware is the first step to combat it.

What inspires you?

I’ve worked with some inspirational colleagues. I take their best bits and try to incorporate them into my style.

What do you do in your free time?

My e-portfolio for the RCEM fills the time left between my work and my young family.

What achievement makes you most proud?

Professionally, I’m proud of being on the level 1 ultrasound register with the RCEM and completing my level 2 course. I’m especially proud to sit on the college’s best practice committee. To sit in a room filled with inspiring, dedicated people who want to make things better is special – to be part of that group it would be very hard not to feel inspired.

What makes a good emergency nurse?

Perseverance, motivation and empathy, as well as openness to change and the ability to adapt.

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

Know where you are going and work towards it. Don’t look for reasons you can’t do something, look for the ways you can.

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

The review of the four-hour target will affect us – anything that replaces it needs to be an improvement. Graduation of nursing associates and increasing numbers of physician associates will change the way we work. Neither are a threat to us but we have to find the best ways to work together.

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