My job

Award winning nurse leader wants you to challenge the typical medical model and inequalities in the profession

Tanya Strange pioneered  a prescription for loneliness – after findings suggested elderly patients were visiting GP surgeries because they were lonely, and not ill

Tanya Strange pioneered a prescription for loneliness – after findings suggested elderly patients were visiting GP surgeries because they were lonely, and not ill. Her work has been rewarded with two RCN Wales awards: Innovation in Nursing Award and Lifetime Achievement Award.

What is your current role?

I am a divisional nurse and associate director of nursing for primary and community care in Aneurin Bevan University Health Board. My role encompasses professional accountability for nursing across primary and community care, workforce planning, patient experience and safeguarding. I am the corporate nursing lead for older people and professionally accountable for a number of clinical services.

Why did you become a nurse?

I was working as an unregistered ‘officer in charge’ of a residential home and over time many older people coming to live in the home had dementia. Our workforce was not skilled to manage this condition, and I really wanted to learn more about it as well as be able to support people with dementia. I qualified as a psychiatric nurse in 1991.

What do you enjoy most about your job?

Being a strong voice for the profession, and influencing positive shared visions and drive to tackle inequalities in health and social care across our communities. I love that I am able to innovate and take forward ideas that benefit patients and challenge the typical medical model.

Your QNI Award was based on an initiative that has resulted in patients dying in their preferred location. How did you do this?

In 2008, an audit was undertaken by our palliative care consultants, which identified that only 34% of patients were dying in their preferred location. Too many people were waiting for more than 40 days for care packages, time patients did not have. Cumbersome assessments and waiting for a funding decision were adding to unacceptable delays in securing care.

Working with palliative care leads, I developed a fast track process, securing a budget for nurses to commission care (removing the need for approval through a funding panel), worked with the voluntary and independent sector to increase provision of domiciliary care, stripped back the assessment process, negated the need for a multi-disciplinary team meeting and set up a single point of contact.

As soon as a fast track assessment was received, they were prioritorised and nurses were able to organise care immediately. We reduced securing care from six weeks to six hours. Today, 99% of patients accessing care through the fast track process die in their preferred location.

Your RCN Wales award was for your work on ‘prescription with loneliness’. Why did you set this up?

The ‘prescription for loneliness’ idea started following a conversation with a GP who had identified that many older people were attending the GP practice not because they were ill, but because they were lonely. I secured funds from the Health Technology Wales scheme, established a partnership board and held an engagement event. This was attended by those affected by loneliness and partners who provided befriending services.

We have recruited volunteer befrienders, established social activities, for example a bilingual scrabble club, set up a volunteer-led friendship group and introduced intergenerational befriending onto wards and into nursing and residential homes.

What has given you most satisfaction?

Identifying something that needs to change (or be developed) to improve patient’s experience of, and access to, healthcare and being able to do something about it.

We have engaged people in our Pimp My Zimmer initiative to try and reduce falls and are now lobbying manufacturers to produce zimmer frames in dementia friendly colours. This initiative has appeared on BBC World News and had 2.6 million views.

What advice would you give a newly-registered nurse?

Understand the world from the perspective of people who are disempowered and challenge inequalities. Asking people what matters to them, rather than focussing on ‘what’s wrong’ with them speaks to the heart of the nurse-patient relationship.

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