My job

Why communication is the bedrock of all nursing care

I used to listen to patients so I could advise them – now I listen to understand

Advanced nurse practitioner Ian Hall practises in an island community in Orkney. His scope of practice is broad, enabling him to provide truly 'longitudinal' healthcare to a whole population.

What is your job?

I am an advanced nurse practitioner providing 24/7 cover to the population of Shapinsay in Orkney. I work with a population of 300 people across the lifespan. The skills for this role are diverse, covering all primary care, community care and emergency care needs. There is really no scope of practice boundary when you have to deal with every need that presents itself. There is support from a visiting GP practice twice weekly and access to the hospital, which is a 30-minute ferry ride away.

Why did you become a nurse?

I have been drawn to healthcare since childhood. I did hospital work experience aged 16 and

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Advanced nurse practitioner Ian Hall practises in an island community in Orkney. His scope of practice is broad, enabling him to provide truly 'longitudinal' healthcare to a whole population. 

What is your job?

I am an advanced nurse practitioner providing 24/7 cover to the population of Shapinsay in Orkney. I work with a population of 300 people across the lifespan. The skills for this role are diverse, covering all primary care, community care and emergency care needs. There is really no ‘scope of practice’ boundary when you have to deal with every need that presents itself. There is support from a visiting GP practice twice weekly and access to the hospital, which is a 30-minute ferry ride away.   

Why did you become a nurse?

I have been drawn to healthcare since childhood. I did hospital work experience aged 16 and this confirmed my career choice. Nursing has been a fantastic career, allowing me to have time out to do other studying in theology and to work in Niger, Africa and still come back to take up where I left off.

What might you have done otherwise?

I was a good musician as a teenager so music was my second option at that stage. I am also a trained church minister but felt that nursing was my main strength and have incorporated my other learning into my nursing skills. 

Where did you train?

I trained at Manchester University back in the day when degree nurses were viewed with suspicion as being too academic. I am glad nursing is now a graduate profession and that lifelong learning is viewed as a positive.  

What do you enjoy most about your job?

I love the continuity of being personally responsible for the wellbeing of an island population. The term ‘longitudinal healthcare’ describes it perfectly. I know my patients and their history really well and that allows me to offer a ‘gold standard’ service.

What are the challenges of being the only healthcare professional on Shapinsay?

Maintaining a boundary between personal and professional life is a real challenge as I live and croft in the community I serve.

What nursing achievement makes you most proud?

I have been privileged to be involved in several projects I am proud of. In Derbyshire, I won an innovation award for creating a long-term conditions outreach in the days when Quality and Outcomes Framework excluded housebound patients. In Niger, I was able to create a unique community healthcare programme among Tuareg nomads in the desert. We trained village healthcare workers and created micro pharmacies for each community. This succeeded as we also ran a health education programme, which created trust in the local trainees. And now in Orkney I have been awarded the Queen’s Nurse title.    

What or who inspires you, and why?

Successful and strong leaders. People who see the world around them and have the vision to make it better.

Outside work what do you enjoy doing?

My wife and I live on a 17-acre croft and we keep about 30 sheep, six goats, and ducks and hens. We have recently taken on a micro flock of rare breed Boreray (St Kilda) sheep. I also love to fish and I catch brown trout in the loch from my back garden.

What advice would you give a newly-registered nurse?

Listen to people. Really listen to people, especially older people. Learn how to ask the right questions. I think communication skills are the bedrock of good nursing, whether in primary or secondary care. For too long I listened to people because I wanted to give them the right advice. Now I listen to people primarily to understand them.    

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