New to nursing – but determined to tackle gaps in care
The student finalists in the RCNi Nurse Awards 2018 describe their impressive projects
The student finalists in the RCNi Nurse Awards 2018 describe their impressive projects
Katie Dutton: ‘I wanted to make a difference in sepsis awareness’
Three years ago Katie Dutton was given a 15% chance of survival after contracting sepsis in hospital. Her PICC line (peripherally inserted central catheter) was left in for too long, her arm was infected for two weeks and the signs were not noticed quickly enough. It was a long recovery.
The experience inspired her to become a nurse and do everything she could to prevent sepsis happening to someone else. Her campaign to improve sepsis training for nursing students saw her named winner of the Andrew Parker Student Nurse Award at the RCNi Nurse Awards 2018 in a strong shortlist.
A voice for those who didn’t make it
‘I had been given a chance to make a difference – to be a voice for all those that didn’t make it,’ she says. ‘I was determined to be a nurse, so during my long recovery I did an access to nursing course by distance learning from my hospital bed.’
‘Students are the fresh faces of the NHS, free from organisational culture and bad habits’
Katie Dutton, winner of the Andrew Parker Student Nurse Award
Ms Dutton, who is in the second year of her adult nursing degree at De Montfort University in Leicester, decided to harness the enthusiasm of her peers through a training programme, creating sepsis champions to cascade knowledge to their student colleagues and while on clinical placements.
The first Sepsis Champions event, held in January 2018, included contributions from the clinical environment, education, the RCN and a sepsis charity. More than 100 nursing students were trained to spot the signs of sepsis on placement.
Advocating for patients
‘Students are the fresh faces of the NHS, free from organisational culture and bad habits,’ Ms Dutton explains. ‘I wanted to empower students to advocate for their patients’ care.’
The university was so impressed by the impact of the course that it is now part of its undergraduate curriculum, but Ms Dutton wants to do more on a national scale.
This year she has spoken at national patient safety events and conferences and is in discussion with other universities, including Birmingham, Edinburgh and Leeds, to roll out her programme.
On 20 September she delivered a second Sepsis Champions event at De Montfort and continues to campaign for sepsis education to become a mandatory part of nurse training.
Catherine Hind – Dispelling myths about self-harm and depression
Drawing on her experience working with the Samaritans, Catherine Hind developed an emotional well-being project that helps nursing students and nurses support others with confidence.
During a scenario day at the University of Cumbria some students expressed concerns about supporting people who were self-harming or in emotional distress.
Dispelling myths around distress
‘I went into practice and found this was also true of many qualified nurses, who felt they did not know what to say to someone in distress,’ says Ms Hind, who was a hospital outreach team leader with Lancaster and District Samaritans before starting her nursing training. ‘This can lead them to ignore the issue as they are afraid they will open a can of worms.’
‘With my Samaritans background I thought I could do something about that, dispelling myths about distress and self-harming and giving practical guidance, such as advice on how to structure a conversation. The project just snowballed.’
Her emotional support guide is an interactive electronic resource that includes a question-and-answer section about distress, self-harm and suicide. It offers guidance on how to support someone during difficult conversations and on further support that can be offered to individuals.
‘Many qualified nurses... felt they did not know what to say to someone in distress’
The guide is available to Morecambe Bay Hospitals NHS Trust staff through their intranet, to students at the university and integrated care communities around Lancashire.
A safe environment
To support it, she developed guidance sessions that are run quarterly at the trust and incorporated into the nursing degree.
‘It has grown and grown,’ says Ms Hind. ‘The project is also unique in that it allows clinicians to discuss their own concerns about approaching people in distress and how any anxieties may affect their ability to care for others.
‘They are given a safe environment in which to talk and to process any issues they may be feeling, which in turn helps them develop confidence to support others.’
Rebecca Goadsby – Improving assessment at a gender identity clinic
There is a national waiting time of two to three years to be seen at an NHS gender identity clinic (GIC), but an audit carried out by Rebecca Goadsby – at that time a third-year mental health nursing student at the University of Northampton – is improving access for people in the area.
Her study highlighted the scope for health professionals to undertake assessments to reduce waiting times, and improve the assessment for diagnosis and treatment of gender dysphoria – where an individual feels a mismatch between their biological sex and their gender identity.
‘Making a difference to patient care was my incentive, but the audit gave me the opportunity to lead a project and liaise with the research department, clinical governance department and the GIC,’ says Ms Goadsby.
Direct impact on patients
In response to the recommendations of her audit, nurses have been recruited and patients now have an appointment with them before seeing a consultant.
The audit also found that half the people attending the clinic were already accessing peer support but there was no record of this. ‘If conversations were happening, they were not being recorded,’ she says.
She recommended that the team put together an information pack and provide people with a hard copy, something which the nurses are now doing.
‘The audit made me understand the importance of equality, no matter your sexuality or gender,’ says Ms Goadsby, who now works as a staff nurse on an adult acute mental health inpatient admission ward for women.
‘Occasionally I doubted my capability, but with determination and passion I achieved my goal’
‘I gained many skills that will play a vital part in my future career,’ she says. ‘The patients were at the heart of this project and gave me the motivation to complete it. I learned the power of patience, listening and good communication.
‘Occasionally I doubted my capability, but with determination and passion I achieved my goal.
‘I am very happy that my audit made a difference. That’s why I wanted to do it in the first place.’
Raluca Vagner and Pedro Simas – Emotional and practical support for amputees
While on a surgical ward placement, Raluca Vagner met a patient in his fifties who had just had his leg amputated. Despite struggling emotionally, he was medically discharged a week later. ‘This had a massive impact on me,’ she says.
She joined forces with Pedro Simas, a fellow student at Oxford Brooks University, and together they pitched for and won grants to research and create Stumped!, a website bringing together the different phases of the amputee care pathway: prevention, pre-amputation, rehabilitation and home.
Patients might fall through the net
To gain a better understanding of patients’ personal experiences they met the founder of the charity Limbcare and its clinical psychologist for the west of Scotland.
They conducted a focus group in Glasgow with more than 20 amputees, explored literature and engaged with healthcare professionals.
‘After about six months of investigations, we discovered various establishments that offer some sort of support, but frequently they are out of sync or do not link to each other,’ says Ms Vagner. ‘This makes searching for the right service difficult and creates a risk that patients who are mentally or physically unwell might fall through the net.
‘The website helps patients and their families find emotional and financial support’
‘Our website has the amazing potential to offer both reassurance when people are most vulnerable, and to create a reliable working network for professionals,’ she adds.
‘We are now working alongside professionals from Guy’s and St Thomas’ and King’s College Hospital in London and Oxford University Hospitals to populate our website with the most relevant and up-to-date information for patients.’
Mr Simas adds: ‘People know they are not alone after amputation. The website helps patients and their families find emotional and financial support, and charities that can help. They can ask questions and talk to people who have gone through similar situations.’
They have launched a crowdfunding campaign to help them continue to develop their website.
Karen Whitehead – Befriending and mentoring in a deprived area
Driven by her passion for improving public health and addressing health inequalities, and having won a National Lottery grant, Ms Whitehead started Society Inc, a non-profit befriending and mentoring service in Little Hulton, a deprived area of Salford in Greater Manchester.
‘This area has its challenges,’ says Ms Whitehead, now in the third year of an adult nursing course at Salford University. ‘It is known for high levels of poverty, alcohol-related harm and unemployment.’
Life expectancy for men in the most deprived areas of Salford is 11.5 years lower than in the least deprived areas, according to figures issued by Public Health England in 2016, and Ms Whitehead’s research showed these men wanted someone to talk to and work with to help them make changes.
‘Mentoring can have such an enormous impact’
‘They wanted someone they saw as on their side to provide support and advocacy – someone who could see potential in the area and its residents,’ she says.
The majority of volunteers for her service are recruited from the area. ‘Mentoring can have such an enormous impact on people’s lives. We focus on the relationship, so if it takes months, so be it,’ she says.
‘Empowering someone to make positive lifestyle changes is a better way forward than trying to spoon-feed them. And they are learning skills by making changes.
‘Empowering someone to make positive lifestyle changes is a better way forward than trying to spoon-feed them’
‘We are able to help our clients in all aspects of their life, whether it’s addiction, mental health, loneliness, employment and so on. I truly believe that Society Inc has made a real difference to the area and the local residents.’
From strength to strength
Building the service has also given Ms Whitehead invaluable skills and experience. ‘Not only have I developed my communication skills, but also leadership, governance and strategy, to a degree that I did not feel possible so early on in my nursing studies,’ she says.
‘This will be invaluable in my career. I have increased confidence and resilience, and rapidly developed my high-level thinking skills over a brief period of time.’
Society Inc continues to grow from strength to strength. ‘We are receiving more and more client referrals and volunteers,’ says Ms Whitehead. ‘We are now in the process of applying for Reaching Communities funding and have recently registered to become a charity.’
Elaine Cole is editor, RCNi projects