‘Persist and be ambitious: nothing that comes easy is worth having’

University of Wolverhampton Institute of Health Professions senior lecturer Jim Bethel outlines the changes in emergency nursing over his career.

What is your job?

I am a senior lecturer in the Institute of Health Professions at the University of Wolverhampton. I teach nurses, paramedics, physiotherapists and pharmacists how to independently manage caseloads of patients in a variety of settings, including GP surgeries, pharmacies, urgent care centres and emergency departments (EDs). I also work as a nurse practitioner in the ED at Sandwell and West Birmingham Hospitals NHS Trust, where my work principally involves caring for children.

What might you have done otherwise?

The only options I recall being interested in were working as a cartographer for the Ordnance Survey or print journalism. Either option could have seen me swept away by digital technology by now so I am sure I made the right decision and have been happy in my career as an emergency nurse.

Why did you become an emergency nurse? 

When I qualified as a registered general nurse, I was asked by a then nursing officer to work in casualty, as it was then called, because so many of the other staff were on maternity leave at the time. So it was by accident rather than design.

How and where have you developed your emergency care skills?

I have worked in 14 different EDs in Birmingham, Dudley, Walsall, West Bromwich, Shropshire, North Staffordshire and Wales, and most of my learning has been work based or reflective rather than formal.

How did you progress through your career?

Mostly by moving around in search of jobs and promotion, which I think was much easier for me to do then than it is for others now. A nursing qualification is a global passport to work – despite the drawbacks of Brexit – as people will always need nurses. I took the old ENB199 accident and emergency nursing course early in my career, took an honours degree in 1993 and have been a nurse practitioner since 1996. All of these things have, along with my experience, made me more employable.

What have you learned in each role?

Most of my early career was focused on task proficiency and role development. Since then, I have learned to appreciate the value of caring and being with people at critical times in their lives. I have also learned how privileged we are to positively influence such events. In particular, I have come to understand how vulnerable some patient groups, such as children, are and how they need advocates for their needs when they cannot express these themselves.

What do you enjoy most about your job?

The patients. They are all special in one way or another.

What achievement makes you most proud?

Staying the course from 1 September 1986 until now.

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

Work hard, play hard, don’t fall in with a moaning culture and do not treat patients as enemies. Be prepared to network and lead inside and outside your department. Persist and be ambitious: nothing that comes easy is worth having.

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

Things have changed enormously over my career – triage, nurse practitioners, quality standards, digital technology were all unheard of or unimagined. But over the next 12 months, the biggest change will be the negative effects of leaving the European Union. Recent migrants with whom I work are planning to leave, or have left, the UK, a country they were hoping to call home but which they feel no longer wants them.