All the fellows together now

​January has flown by like Storm Dudley. I am now found my feet and my “buddy” Helen has also started her secondment, working with me two days a week.  We have a weekly meeting with our mentor and lead Julie Clennell – Region Chief nurse. Steering up in supporting the objectives that we have for the regional work and influencing how we may look at things differently.  Having that support is making the transition from acute clinical work to national strategic work much easier – compassionate leadership .   Meeting so many people and learning about some many outstanding pieces of work  - “What good looks like” digital work . The Aging well work in the Yorkshire and North East region which is amazing and the safe staffing work that has involved some 55,000 people. Some early work which I really have been identify a gap and then support and shape has been the delegation of insulin administration. This work has been developed from the national voluntary framework in partnership with Diabetes UK. Many trusts in the region and in England have already rolled this out but many are still to undertake this. I have been able to support Central London Community trust with their roll out and link Bristol and Wakefield to share best practice and the integration into care homes. Some collaborativeworking with Caroline at MAAPP helped with a piece of work to navigate the core data sets, competencies and framework for the delegation of insulin admission has meant, I was able to produce a QR code directly to support this work – my next step will be how we can digitalise those competencies rather than paper.   I am beginning to see where the gaps are  - we need better data capture, we need to improve on digital enablement  - it really isn’t about finding that “digital nurse” but instilling this into all nursing  - we need to have adaptable nurses who can lead everyone to drive the use of digital and data in the community setting.  Thereare some really great examples – the wound care strategy ,and the digital age work that the QNI have previously undertaken.  But what is our aim as a community nurse fellow?  In my mind one of the important aims, is about improving population health. I was invited to the Child Protection information sharing board meeting by Catherine Randell  - Safeguarding director  - wow! She is so passionate about safeguarding, children and young people – a group that is often under represented. Digital is very much the “moment” the fact that we can change things in real time rather than going through a process of change. So much work is being put into a single shared record – no small task with over 200 local authorities, different information governance, legal aspects, home office, police, social and health care all around the table working towards the long term plan in creating that link. Digital enablement being that fundamental key. It is a tight timescale, and not without issues. It is fast changing, with masses of information, and the amount of acronyms was unbelievable  - Google was my friend that morning! I did think though – how can we make that community nurse voice louder? How can we influence and assist in this work? We are an advocate for this sort of work – we as community nurse fellows who have those advanced clinical skills it takes to be the advocate for visibility and voice. 

My journey has connected me with Antonia Brown Sussex Lead CNIO , another amazingly passionate nurse – leading on some really good examples of the work they have been doing, developing “Blueprints” within NHS Digital , exemplar sites, You tube presentations  - the pandemic has really accelerated the use of digital health in nursing practice. 

Lastly in these past 20 days, I was invited to attend  theremote monitoring board meeting with Sam Sherrington. The strategic overview on the virtual wards, care at home and the long term recovery.  Again great examples of oximetry at home, developing digital diaries in their kit lists. Jane Sproatleading on the service design and assurance monitoring. The support for the virtual wards and remote monitoring is again fast paced and ICS teams are being guided for acute respiratory and fragility roll out in the first instance. 

So many thoughts are going around in my head and so little time to get them going. I feel that there are still many barriers to this work – who is working with offender health?(something that I am passionate about) What work is going on for pregnant women ? – We must have great examples out there but we need to “shout about it” I remember working on some NICE guidelines a few years ago, and the frustration is “if it is not published, we can’t use it” We need more people to publish – come forward, there is help and support for those who are keen to (in fact there are 2 wonderful fellows who are driving research at part of the national community nursing plan).  Only last week I had a chat with a nurse who is doing her masters and would love some guidance around this – we chatted over a virtual lunch and within half an hour managed to get a plan on a page with some clear guidance on what to do next.  If the pandemic has taught us anything , it is about what amazing things we can do in a short period of time – from virtual reviews and remote monitoring for people who would usually attend an out patient clinic or practice to AI works, apps and online learning. 

Nurses this is a chance for us to advance in our careers  -we are great clinical practitioners