Career advice

A hands-on role where you’re trusted to use your own judgment

Advanced nurse practitioner Christy Samuel says the challenges of her job are what makes it satisfying

Advanced nurse practitioner Christy Samuel says the challenges of her job are what makes it satisfying


Picture: Barney Newman

As an advanced nurse practitioner in head and neck surgery and plastics at one of London’s busiest hospitals, Christy Samuel is never quite sure what each shift will bring.

It could be a patient who is a victim of violence, often knife or even gun crime. Or it could be someone who has suffered serious burns and needs surgical input as a result.

The one thing she is pretty sure about is that it will be professionally satisfying.

‘The surgical advanced nurse practitioners are first on-call for the night shift,’ says Ms Christy, who works for St George’s Healthcare NHS Trust in South London. ‘We have a high level of autonomy – there’s no registrar on site, although there is one on call from home. 

‘For me personally, I find it satisfying that we are trusted to use our judgment. We do it very well and are well respected within the multi-disciplinary team. That’s very empowering.’

Injuries from violence

Inevitably a significant proportion of patients are victims of violence, frequently having knife wounds in the head or neck area. The surgical nursing practitioner team is called when anyone with major injuries is brought into the resuscitation unit and has been assessed by the emergency department team.

‘We take over the care,’ she says. ‘Depending on the injury we might be involved in securing the airways and making sure the patient can breathe. If the patient needs surgical input then we escalate to the registrar. 

‘If it’s minor, then we’ll admit them and treat them, give them antibiotics and tetanus [treatment] and do any suturing that’s needed. If necessary we can escalate to other departments, depending on injuries.’

Toughening up

Remaining professional even when treating teenage victims of violence is crucial, she says. ‘It can be very stressful. I can expect to see at least two patients with knife injuries per week, and there was one occasion when I was treating two at the same time. 

‘Sometimes they are very young – high school students – and we have to persuade them to phone their mum or dad to tell them they are in hospital. We see people of all ages – sometimes in their fifties and sixties, sometimes victims of domestic violence, women and men. 

‘It can be distressing for the nurses too. But we all work together and support each other: in a way you have to toughen up, but you have to retain your compassion.’

Training and qualifications

Ms Samuel was born in Sri Lanka and moved to India for her nurse training. She moved to the UK in 2002, and since then, has taken several more qualifications, including a master’s degree in advanced nurse practice at the University of Bradford.

Before moving to London and taking up her current role three years ago, she worked as a head and neck oncology nurse at the former University Hospital of South Manchester NHS Foundation Trust (now part of Manchester University NHS Foundation Trust).

The surgical nurse practitioner role requires a high level of qualification, she says. A master’s degree is essential and she is also a prescriber. Ms Samuel is also keen to take up in-house and external training opportunities to further enhance her skill set. 

Saving lives

She is hugely enthusiastic about the opportunities that working in surgical nursing can bring, and particularly recommends working as a surgical nursing practitioner. ‘It’s the best role: it’s hands on, you’re working with patients, you’re doing minor procedures, sometimes you’re first assistant for surgical procedures. It’s very varied.

‘You know that what you’re doing is using your skills to save people’s lives, and that you are valued as part of the team.’

Having moved to London from Manchester, she has also found that she is in demand for another reason. ‘I enjoy working in South London and because I speak Tamil, I’m often asked to interpret as well,’ she says. ‘I feel at home here.’


Jennifer Trueland is a freelance health journalist 

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