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Critical care in the community: how a secondment has expanded my skills and experience

RCN Nurse of the Year Ana Waddington is pushing her boundaries in a mobile response unit role

RCN Nurse of the Year and paediatric emergency nurse Ana Waddington is pushing her boundaries in a six-month role with a mobile response unit

For RCN Nurse of the Year 2020 Ana Waddington , a trailblazing secondment with the London Air Ambulance Service (LAAS) is boosting her emergency nursing skills and improving her practice.

Its a new and exciting opportunity for nursing, says Ms Waddington, who is only the fourth nurse to work for the LAAS Physician Response Unit (PRU) and the first paediatric nurse.

Having a nurse on the team completes the circle

She combines her post as a

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RCN Nurse of the Year and paediatric emergency nurse Ana Waddington is pushing her boundaries in a six-month role with a mobile response unit

Ana Waddington (right) has been part of the London Air Ambulance Service's Physician Response Unit

For RCN Nurse of the Year 2020 Ana Waddington, a trailblazing secondment with the London Air Ambulance Service (LAAS) is boosting her emergency nursing skills and improving her practice.

‘It’s a new and exciting opportunity for nursing,’ says Ms Waddington, who is only the fourth nurse to work for the LAAS Physician Response Unit (PRU) – and the first paediatric nurse.

Having a nurse on the team ‘completes the circle’

She combines her post as a sister in the emergency department at the Royal London Hospital with a part-time role with the PRU, which brings emergency care directly to patients in the community.

‘I’d heard this was an exciting team,’ she says. ‘They always seemed to have such a good understanding of the patient’s journey and their needs.

‘I wanted to work for a team that puts the patient at the forefront and shows such compassion. I felt I could learn from the experience.’

Ms Waddington, whose six-month secondment with the PRU ends this month, does two shifts a week, one of which is clinical. This involves being part of a small team that includes a doctor – usually from an emergency or anaesthetic background – and an emergency ambulance crew member.

‘Having a nurse brings extra to the team, joining the dots and completing the circle,’ says Ms Waddington, who qualified in 2015.

RCN Nurse of the Year initiative

Ana Waddington

Last October, she was crowned RCN Nurse of the Year 2020, after being nominated for her work in setting up YourStance, an organisation that teaches basic lifesaving skills and haemorrhage control to young people at risk of serious youth violence.

Her initiative was inspired by an event she witnessed at work, when a young man died after being injured in a knife attack.

‘Had his friends only known that they needed to put pressure on the wound, rather than get him up walking, there was a chance he could have survived,’ she says.

How we help keep patients in their homes

Based in a car, the PRU attend a wide range of emergency situations in the community, treating injuries and wounds and assisting ambulance crews that are are already with a patient. The team provide critical care and help to keep patients at home where possible, for example, working with oncology patients whose condition has deteriorated and supporting those at the end of their lives.

‘These are my favourite because rather than taking someone to hospital, we can facilitate a dignified pathway that enables them to die at home, making it so much better for them and their family,’ says Ms Waddington.

‘Once we’ve finished a case, we discuss every part of it, step by step. This allows you to raise any concerns or queries. It means you get better, learning from every encounter’

The team spends as long as necessary to make sure everyone is comfortable and that the right plan is in place.

‘We’re not restricted. The patient is the priority and if it takes time, it takes time,’ she says.

Specific skills based on my nursing experience

Ms Waddington feels her experience of working in a hospital adds to the team’s dynamic.

‘A lot of my role in the emergency department is advocating for patients and making sure their voices are heard,’ she says.

Other skills include her in-depth knowledge of adult and child safeguarding.

‘You get lots of problems in the emergency department and need to figure out different ways to resolve them,’ she says.

How to make the most of career opportunities

  • Challenge yourself ‘I’m not a confident person, but I’m good at doing things that scare me,’ says Ms Waddington. ‘As a nurse, you should always be trying to learn new things and push your boundaries, rather than staying with what feels comfortable’
  • Talk to people who inspire you ‘Listen to how they got to where they are’
  • If you are interested in pursuing something, ask if you can do it ‘There’s nothing wrong with having the conversation. Sometimes it’s just that no one has ever tried it before. The worst that can happen is they say no, for now. But at least the door has opened a little’

Understanding other roles and breaking down barriers

The post has also altered Ms Waddington’s own practice, improving her understanding of the challenges faced by emergency responders.

‘It’s changed everything for me,’ she says. ‘I hadn’t realised that I had a bit of compassion fatigue. I also had a lack of understanding about the experience of the ambulance crews before they bring the patient to the hospital.

‘Some will have spent a long time trying to avoid having to bring them in. We then feel frustrated or disappointed because the emergency department isn’t the most appropriate place, but there is no other option.’

The role has many aspects she enjoys, not least the non-hierarchal approach, which also breaks down professional barriers.

‘Sometimes the doctor is a consultant, which I may have felt quite intimidated about before,’ says Ms Waddington. ‘But we’re all there to do the same thing and share the same goal.’

Thorough debriefing is crucial. ‘Once we’ve finished a case, we discuss every part of it, step-by-step,’ she says. ‘This allows you to raise any concerns or queries. It means you get better, learning from every encounter.’


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