Don’t be afraid to speak out – you’ll be more respected for it

If you don’t like the way a service is run say so, advises Michael Hurt, head of older people and dementia at NHS Walsall Clinical Commissioning Group

What is your job?

I am a commissioner and a nurse. That means I have some additional roles other commissioners do not have, such as clinical audit. My job involves assessing the needs of the local population, looking at any gaps there might be and filling those gaps with appropriate services.

Why did you become a nurse? What might you have done otherwise?

I became interested in nursing as a three-year-old in traction with a fractured femur. I decided quite early on that nursing was what I wanted to do and started training age 19. I might have become a solider but joined the Royal Army Medical Corps TA as a combat medical technician, so I got to do both.

Where did you train?

I trained at Pastures and Kingsway Hospitals in Derby. Both were Victorian hospitals with a supportive family feel. I completed my general placement at the old Derby City hospital and thoroughly enjoyed my training.

Why did you choose to specialise? Or if you didn’t choose, how did you come to work in the field?

I decided on specialising in older people while still in training. My plan was to complete RGN training after mental health. However, I remained in mental health but enjoyed the tripartite challenge of working with older people – functional, organic and physical health issues.

You’ve worked in practice, academia and have now moved into a clinical commissioning group. What did you enjoy most and why?

There is satisfaction from seeing people benefit from services you have designed from scratch, written the service specification for, carried out procurement and worked with providers to deliver a good service. However, I was surprised to find that I get a lot of pleasure from seeing people enjoying the jobs that I created.

How do you use your skills and experience as an older people's nurse in your current role?

Nursing skills allow me to have a vision of what is required for a group of people I am trained and experienced in, and knowing what to do to achieve that vision. I am used in clinical audit, writing shared care agreements, writing the dementia drugs shared care protocol (as I am a nurse independent prescriber too), in un-announced visits to clinical areas and introducing evidence-based tools to support clinicians.

What is the greatest challenge at work?

This might be controversial, but trying to get very senior people to understand that their role doesn’t necessarily mean that they are experts in this area, but as an experienced and well-qualified nurse, I generally am! Funding is always an issue of course.

What nursing achievement are you proudest of?

Probably nurse independent prescribing, and stopping injections people no longer needed after 40 years without relapse. Sometimes it’s just giving people hope that their life can be better and helping them with the tools necessary to make those changes.

What would you change if you could?

I wish I had completed general training, as I had originally planned.

Outside work what do you enjoy doing?

Photography and researching soldiers who fought in the Great War. I get to do the odd talk to willing branches of the Royal British Legion and speak to like-minded people.

What advice would you give a newly qualified nurse in your field?

If you aren’t certain what you want to do, try a few things out. If you don’t like what you are doing or the way a service is run, vote with your feet, but don’t be afraid to speak out. You might think it will make you unpopular, but in my experience, I feel you are more respected for doing so.