Award-winning nurse Mark Holmes created a new community role to offer service users a supportive alcohol liaison service
One of the most memorable moments of Mark Holmes’s career is the night of the Nursing Times Awards last year, where the community matron from Nottinghamshire Healthcare Trust won the Nursing in Mental Health award.
“I remember seeing all the judges there,” he says. “Their response was one of the most touching moments of the whole night - they had tears in their eyes and hugged me, and I just thought the whole evening and experience was brilliant. It makes you proud to be a nurse.”
Mr Holmes’s pride was further enriched because he felt he was boosting the profile of substance misuse nurses. “As a specialty, our skills are not that respected, and yet 10% of medical admissions are alcohol related. People shouldn’t just dismiss us.”
It was trying to change that imbalance that inspired his award-winning project. Mr Holmes says that many of his colleagues would cast aspersions on his service users, and have little faith in them but he said his belief he could make a difference to these people drove him on. “I’d see a patient on a Friday, and then they’d be back again on a Monday. It’s tempting to ban ‘frequent flyers’ but someone needed to sit down and think about why these people came back again and again.”
The community matron role he created does just that.
“We had one service user who phoned 999 and said he was having a heart attack or couldn’t breathe, just to get some attention from the nurses. My goal in this project was to put someone in place who could go and speak to him or people like him, change their behaviour and get rid of some of the chaos around them,” says Mr Holmes.
After inventing the role, he found that the service user and others like him would phone up Mr Holmes when they got low, instead of phoning 999 because there was no other option to get some company and someone to talk to.
“You have to see it from the patient’s perspective and look at what is going on behind the admission,” he says. “I visited one service user weekly to support him and his wife. I would remove the fluid retained around his abdomen, so sometimes my job is more about physical support.”
Having trained as a psychiatric nurse, specialising in hepatology after being based in the general hospital setting, observing the effects of alcohol on the liver, he has a good understanding of the need to connect physical and mental health.
“We have lots of multi-agency meetings to talk about cases, and I’ve met some not so supportive nurses and doctors, but also some really great ones. One of our service users had 12 agencies involved - social services, fire service, police, GP - but we got everyone together to decide what to do for the best. The power of the whole group works.
But to Mr Holmes, the emotional support is a vital part of the role. “I went to one patient’s funeral, whom I’d nursed for years and got to know her daughter well, and it was a very proud moment when they mentioned me and the care I’d given her at her funeral.”
And yet, he still feels more can always be done. “As a nurse, you are always reflecting on your practice and thinking where you can do better for the patient next time, that’s why I knew we needed to strengthen that alcohol liaison service.
It was reflection that led him to change from his original role working in care of older people. “I moved into substance misuse nursing in 1996,” he says. “I told a friend I got sick of just doling out medication to the patients and not giving them any psychological support, so she suggested I moved to substance misuse nursing. I did in 1996 and I loved it. And I still do.”
● To register your interest in the 2013 Nursing Times Awards, go to tinyurl.com/ntawardsregister