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'There is so much changing here all the time. And every time I’ve got itchy feet, I’ve had a promotion'

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Caroline Cassels supervises more than 100 staff, oversees many departments - and finds time for direct care.

“I am proud to be a nurse,” says Caroline Cassels, matron of the private King Edward VII’s Hospital Sister Agnes in London.

She’s proud to be matron at that hospital, having worked there for 27 years. She started out as a staff nurse and was a ward sister before she became matron 17 years ago. She still very much enjoys working there.

“There is so much changing here all the time. And every time I’ve got itchy feet, I’ve had a promotion,” she says.

As matron, Miss Cassels is in charge of 135 staff, who work in the pharmacy, the three theatres (a fourth is planned), three wards, critical care, consulting rooms and with resident medical officers. She also oversees the physiotherapy area, which includes a hydrotherapy pool.

The hospital was set up in 1899 by two sisters, Agnes and Fanny Keyser, to care for officers injured in the Boer War. Today, military personnel and their families make up fewer than 10% of patients, but Miss Cassels is happy to have cared for some of the older soldiers.

“It was a real honour,” says Miss Cassels. “They were very brave but extremely modest and wouldn’t tell you any of the things they’d done. Sometimes, it wasn’t until they’d died and you’d see this great full-page obituary and you’d realise that they had been war heroes, but never told you.

“Often the consultants reduce or waive their fees for military personnel.

“We have top consultants and cover most specialties. We undertake some very complicated surgery, which provides some challenging nursing for the team, keeping us sharp and focused.

Miss Cassels has a lot of paperwork, but says she never neglects direct care. This is one reason why she has stayed at the King Edward VII.

“Matron’s office is always staffed 24 hours a day, and that means patients always have access to me or one of my senior nursing team,” she says.

“I spend sometimes half my day visiting patients. We may have a patient who’s really worried, and I can reassure them. I don’t get involved in administering drugs or observations - my role is more pastoral.”

Miss Cassels’ knows her patients so well she can tell visitors exactly which ward (all with single rooms) their family or friend is staying, without having to check.

The reasons why she is so devoted to King Edward VII’s include its nurse to patient ratio of one to four (or more nurses if patients need it) and its discharge programme. This involves home visits, and telephoning most discharged patients within five days of leaving.

Nutrition is vital to Miss Cassels. At handover, nurses say how much a patient has eaten, and the chef visits patients if they are not eating.

“It makes me so angry when I see water having to be prescribed in hospitals,” she says.

infection control is part of her remit. There is a zero rate of hospital-acquired MRSA and C difficile. The hospital uses materials that are easy to keep clean and employs in-house cleaners, not contractors. As a result of its high standards in this area, the hospital won the Laing & Buisson Healthcare Award for Hotel Services.

She takes training and mentorship seriously. Staff attend mandatory and other training, and can attend study days and courses.

“Innovation is an issue when you have such a small number of staff,” she says. “We have set up working groups on topics such as pressure care and nutrition, infection control, urology and diabetes. We network with other professionals in these fields to bring back the latest thinking.

“I get out and network too. We are a small hospital and can be cocooned, so I make an effort to go to RCN conferences, and meet up with fellow matrons.”

Looking back, she says: “I wanted to be a speech therapist when I was a child. I only trained in nursing as a temporary thing. But, once I started training, I never wanted to leave. I’ve spent over half my life in a nurse’s uniform - I don’t think that will change.”

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