“I hope you’re wearing comfy shoes” – words from Divisional Chief Nurse Louise Fox when I arrive to shadow one of her team, Clinical Site Nurse Practitioner Cherry Jordan, for the morning. After a few hours of accompanying Cherry I can see why!
Cherry joined ASPH in 2002 and has worked her way through the ranks from a Healthcare Assistant, to a Senior Sister before becoming a Clinical Site Nurse Practitioner in 2011 - one of a team of 17 who cover St Peter’s Hospital around the clock and Ashford Hospital at night. They are experienced, senior nurses whose role includes clinical, education, capacity and management responsibilities.
First on the list today is capacity; Cherry starts her shift at 7.30am with a handover from the night CSNP, then it’s straight into the 8am bed capacity meeting. It’s Monday, which is always a difficult day after the weekend. There are currently eight patients in A&E and five patients in the Clinical Decisions Unit waiting for a bed on a ward. As the meeting wraps up, it’s estimated that 17 patients are ‘potential discharges’, but as Cherry explains, this depends on a wealth of different factors.
‘Even if we manage to get all 17 patients home, we have 13 patients already waiting for those beds, and more will come in throughout the day. It’s going to be a tough one and I need to get onto the wards and see what’s happening.’
First stop is the Acute Medical Unit, a large short stay area for patients who need further tests or observations, which Cherry describes as ‘crucial’ to the flow. She enters the ward the way she always does – with a warm smile and a ‘how are you’ – describing the importance of empathy. ‘You can’t just go onto a ward and assume you know what kind of day the team are having’, Cherry explains, ‘I’ve experienced ward pressures first hand; they may be short staffed or looking after patients with complex issues and having a tough time.’
‘When you’re racing around on a ward it can be difficult to see the bigger picture – such as the importance of moving one patient to make room for another coming from A&E. It’s my job to help with that; identify patients to be moved or go home, troubleshoot any issues holding up their discharge etc.’
After visiting all of the other medical wards – Holly, Swift, Aspen, Cedar, May, Maple and Cherry, it’s time to take stock. A patient is moving from AMU to a ward, so another can move up from A&E shortly but lots more beds are needed and Cherry has a list to work through – calls to make to social services to speed up care packages and patient transfers to and from other hospitals to arrange.
She will return to the bed capacity meetings at 1pm and 4pm, visiting all of the wards again in between, before finishing her twelve hour shift at 8pm. On her way round the wards Cherry will also look out for any, less experienced, nurses who need help or support. ‘Helping colleagues with their clinical skills is another important part of my role; if I ever see anyone unsure of something or they need an extra pair of hands I will step in.’
The night shift
Along with all of her CSNP colleagues, Cherry works a mix of day and night shifts, at both St Peter’s and Ashford.
‘There is less discharge planning overnight, but patients come into A&E round the clock so we still need to monitor patient flow. In addition, we hold the emergency bleeps overnight and are the first point of contact for any issues. These range from cardiac arrest priority calls, deteriorating patients, fire alarms, powers cuts, patient or family complaints to staffing difficulties. We deal with anything and everything and no two nights will be the same. It can feel like quite a responsibility, but we have a great team here and there is always someone to call on for help and advice if needed.’
Cherry’s parting words from every ward are the same – ‘page me if you need anything’ – words she lives by. She tells me she loves her job and the fact that it’s both challenging and rewarding. ‘Some days everything flows and other days we hit stumbling blocks. It can be frustrating but overcoming those obstacles is part of the job. We all have the same aim – to provide the best possible care for our patients – and we achieve that best when we work together.’