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Join us in Guernsey and gain the autonomy you crave

There are 600 nurses on the Channel Island of Guernsey, but that's not enough so opportunities abound

Nursing shortages are everywhere, and Guernsey is no exception.

Last summer, the Channel island’s Princess Elizabeth Hospital closed ten medical beds while it searched for recruits.

Where its fans would say Guernsey differs is in the opportunities it offers ambitious nurses keen to progress to autonomous practice, those who want to work across the community-acute boundary and those who understand integrated care.

Juliet Beal (pictured) joined Guernsey’s Health and Social Services Department as chief nurse in November last year after 33 years in the NHS, latterly at the Care Quality Commission.

She arrived at the tail end of a torrid time for nursing and midwifery on Guernsey. Nurse training had been suspended and serious concerns expressed about the safety of maternity services.

Despite sitting outside the UK and the NHS, Guernsey uses Agenda for Change banding, and its nurses and midwives register with the Nursing and Midwifery Council.

Just before Professor Beal’s arrival, the NMC had reported on significant improvements. Students were back in training, maternity services were judged safe and NMC chief executive Jackie Smith praised nurses for their ‘commitment to doing a good job for patients’.

Solving the nursing shortage is a top priority. The vacancy rate is 18%, with a 7% shortage in the acute hospital and 11% in the community. Not so different to the UK, but in an island health system where there are no junior doctors, the ramifications are different. ‘We cannot book an agency nurse for a single shift,’ says Professor Beal. ‘But we do have excellent agency nurses who come for a month or even three.’

She is keen to have a stronger permanent workforce ready for the challenge of working across health and social services.

Professor Beal says: ‘We want to get band 5 nurses up to band 6 in a relatively short time, and that is about making sure they have the expertise they need.’

Band 5 nurses now rotate through medical and surgical wards, with an elective in high intensity care or theatres and six months in the community, making them ready for anything.

She is phasing out band 2, and creating pathways into nursing that will allow students to continue to receive a bursary and grant even once these have been removed in England; all this in return for a commitment to work on Guernsey following training.

Picture credit: Corbis

In addition, she is introducing new nurse specialist and consultant roles, mentorship, preceptorship and revalidation programmes. ‘We have good support for revalidation, which has been highly commended by the NMC,’ says Professor Beal. ‘We have a revalidation and practice learning lead who trains our nurses on how to do their folders and what revalidation means.’

Today’s plans are about the workforce of tomorrow. ‘It is important that all our nurses are prepared to work in our new models of care now being developed. Health and social care are already joined up here, and we have nurses working in social care. There are some fantastic opportunities,’ she says.

Clinical nurse specialist in diabetes Alison Place agrees. She has been nursing on Guernsey for 25 years. She took on her specialist role two and a half years ago.

‘All the diabetes care used to be done by one nurse, but she was looking to retire so we have developed a team, with me and a paediatric nurse specialist serving the community and the acute hospital,’ says Ms Place.

She took a distance learning postgraduate diploma in diabetes where she learned how to harness social media, and now keeps in touch with a wide network of professionals via Twitter (@AlisonPlace2).

Her professional life is hectic, exciting, challenging, and ‘different every day,’ she says, and describes the nursing culture on Guernsey as supportive of professional development.

Ward sister Clare Davis, who moved to the island two years ago, says the attraction of nursing on Guernsey is applying standards of care she believes are long gone in the NHS.

Ms Davis had been at band 6 for 12 years. She was not willing to take on a high-pressure ward sister role in the NHS. She says the mixed medical unit where she now works is varied and always challenging.

‘People told me I’d be bored, become deskilled and be back in a year’, she says. ‘I am not bored. The care standards here are very high, something I had not seen in the NHS in a long time.’

Population: 64,000

1 health and social services department

1 hospital with 125 beds

2 mental health wards>

600 nurses

500 healthcare assistants

0 junior doctors

Elaine Burgess came to Guernsey in 2003 to set up a nurse-led infection prevention and control team. For her, the joy of the job is the autonomy.

‘We don’t have a consultant microbiologist here, but we have an agreement with Birmingham Heartlands Hospital so I have expertise on the end of a phone,’ she says. Beyond that, she is in charge professionally.

‘Working here, you can develop and become autonomous. If that’s what you’re striving for, this is the right place’.

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