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'Preparation, preparation, preparation is the key to a successful operating list'

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Norma Davies swapped retirement for the chance to oversee a fleet of mobile surgical units.

Norma Davies retired as an NHS nurse in January 2001. It’s a funny sort of retirement, though. She is now a senior theatre manager working in and overseeing the Vanguard fleet of mobile operating theatres, wards, endoscopy units and clinics, travelling an average of 2,000 miles a month.

“I worked at Derriford hospital in Plymouth before I retired and I returned periodically from where I was living in retirement in the south of France to retain my registration,” she says.

“I realised early that retirement was not all it was cracked up to be, and I knew I needed to work for my mental wellbeing. So, when I found out about Vanguard on one of my return trips to Derriford, I thought it was for me.”

Ms Davies, who comes from Northern Ireland and moved to England in the 1970s, returned to England from France in 2004 to join Vanguard’s clinical staff.

Vanguard is the world’s largest supplier of mobile healthcare facilities, equipment and staff, and its fleet is expanding. It helps with capacity and community services, and during refurbishment projects, as well as in emergencies and disasters.

Vanguard can supply nursing teams, normally with two scrub and two recovery/anaesthetic practitioners. It works mainly for NHS trusts, although it works for private hospitals too.

The mobile units have an anaesthetic room, a theatre, a recovery room and a small staff changing area. There is a dirty utility room for clinical waste and used instruments.

The largest part of the work is joint surgery, which accounts for 20% of cases.

“Most patients are genuinely impressed with the units. They are totally white inside and very clean. A lot of people say that it resembles a tardis as the units appear smaller from the outside.

“I am extraordinarily proud of our infection control standards. Staff clean the theatres at the end of each working day and each theatre is audited on a monthly basis.”

Satisfaction rates are impressive, with a 2011 survey finding that 95% of patients would use the units again.

Nurses typically work a five-day week starting on Sunday, travelling to wherever the contract is, staying in a hotel for five nights, and going home on the Friday.

The travelling provides opportunities to see many places. Vanguard has run units from Inverness to Hayle in Cornwall and across the sea to Northern Ireland and the Republic of Ireland.

“Being away from the main theatre suite is often great for surgeons; it means they can just get on with it,” says Ms Davies.

“But there can be logistical challenges. The mobile units can be placed in all sorts of places, and we need to make sure we have all our consumables and instruments.

“Theatre nurses need to be able to troubleshoot – and ensure the temperature is right and the air conditioning working, and liaise with the maintenance team should problems arise.

“Every theatre nurse will tell you that preparation, preparation, preparation is the key to a successful operating list. This work is about relationships and planning.”

Working with different surgeons and anaesthetists also means it’s about relationships, but Ms Davies says this is what plays to the strengths of nurses, who are great at putting patients and fellow staff at ease.

“To ensure a safe working environment, Vanguard staff need good relationships with the host hospital staff, and a great deal of planning is involved before a unit arrives. The staff are amazing, they work brilliantly together and with the surgeons and anaesthetists,” she says.

“What I like is the variety – every day is different.”

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