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'The opportunity for me to shape future patient care?'

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Ted’s new role gives him more freedom to develop the ideas he believes will benefit his trust and, ultimately, his patients’ care. Still relatively new to the role, he talks us through his first few weeks.

I’ve just been given an amazing opportunity to be the Chief Nurse Excellence in Care Junior Fellow for my trust - Nottingham University Hospitals (NUH) - with 30 hours a month to dedicate to this role.

I came into nursing straight out of A-levels and I’ve been qualified just three years this year, safe to say I’m still finding my feet in the trust. I’ve worked in haematology for two years and I’m now on an admissions ward which deals predominately with cancer emergency admissions.

I have felt at times a bit like a worker ant that comes to work and leaves, without having much impact on the greater good. I have felt a little ignored too if I’m honest so far in my career. I’m enthusiastic and full of ideas but it seems that there is little time and resources in the NHS to address them.

My new role currently involves looking at the merits of using a shared governance approach within the cancer and associated specialties directorate - one of five directorates in the trust. Within this role I will see how shared governance is having a positive impact on the frontline and see the effect it has on the day-to-day running of wards. I have no idea what I am going to discover and I can only pick one project from the many that the shared governance deals with.

In my first discussion regarding the role I discovered that although it was created to help NUH invest time and resources into the emerging workforce, the role plays a bigger part of the NUH journey towards Magnet status.

Magnet is something that NUH is trying to achieve, the gold standard creating a sustained platform for attracting the best staff.

Week 2:

Working out where to start, I quickly discovered my project idea. I’m going to look at improving safety in my own day-to-day workplace, which I know well and can therefore identify what can be done to make it safer.

The ward only has a finite number of beds so with increasing pressures around the hospital the capacity can and does breech. So what can we do to make it safer? I’ll need to do research into the area and devise a plan for how this can be completed.

Week 4:

In a discussion about my idea with my seniors, it became clear I haven’t yet looked at all the options. I’m now going to go back to my research and dissertation days to address the fundamental issues and attempt to use a more structured idea to plan the issue and the potential way forward.

At least I’ve learnt my lesson for now and it is something that I’ll remember for next time!

I’m now going to start to plan and draft a project proposal for the idea using research frameworks such as PICO and SMART targets. I will also need to outline a suitable timeframe for the project. I feel I have been too quick to dive in and worry I have ended with little to show for it.

Week 6:

I’ve had my first proper meeting in the role now and even acted as chair! It was a bit nerve-racking but went well. I was able to lead the group and came away with what I wanted in terms of ideas as well as where to find the resources I need to make progress. I now have a clearer idea of the constraints of the project and what to focus on. I just need to plan it now, that’s the next challenge!

The main aim is to still remain focused on the final goal and remain shared governance focused. Whilst also being mindful that I only have limited time and resources to create a project. This whole journey is a massive learning curve but looking at what I have learned already shows I have something to show for my efforts - even if it’s not yet the final outcome.

Edward Randall is a staff nurse and chief nurse excellence in care junior fellow at NUH


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