Lilian Awino

Personal statement

I am a band 6 specialist practitioner qualification district nurse (SPQDN) working for Berkshire Healthcare NHS Foundation Trust in Bracknell. Being a district nurse has given me a new understanding of holistic assessment and enabled me to develop a deeper understanding of how to support patients within the community to minimise unnecessary hospital admission. My district nurse role includes carrying out holistic assessments of patients living with multiple long-term conditions, complex health needs including mental health and palliative care. I ensure that patients and families are included in decision making about their health as it is likely to improve collaboration between DN team and patients, this not only has a potential to improve patients’ concordance but also improve patients’ experience and outcome.

I have 7 years’ experience of community nursing during which I have supported patients with IV therapy, syringe drivers, catheterisations, and other treatments. These have enabled patients who are stable enough to be discharged home to continue with their treatment in the community. These have also promoted patients’ choice especially those approaching end of life and wants to be at home. Similarly, When I am triaging, and a patient is being discharged from acute hospital to continue with IV therapy at home, I liaise with the discharging hospital ward and high-tech team in the community to ensure that everything that the patient will need are organised and ready before the patient comes home to prevent re-admission to hospital.

Part of my responsibilities is managing a team of nurses and healthcare assistants. I support, coach and teach different members of my team according to each member’s needs by having joint visits. This not only gives me the opportunity to know the competency level of each member but also allows me to offer the necessary support such as arranging joint visits between junior and senior members. I also support and encourage members of my team to go for necessary training. I ensured that I had time for all my staff by having 1:1 meeting, team meetings and clinical supervisions where each member is given a chance to participate and express their views freely. I have been a preceptor to newly qualified nurses, this involved supporting each nurse with their developments and competencies by explaining what is expected of them, encouraging them to attend training, showing them how to access eLearning then allocating the time needed for the training by not giving them any patients to visit.

Previously, I was able to start a buddy system for some new members in our team so that they had a point of contact if they were struggling or just wanted to talk; this was very beneficial in helping new members to settle in their new work environment. I also mentored some student nurses during their placement in our team. I ensured that they got the best learning experience from their placement, by giving them the opportunity to participate in different patient’s care under supervision. This included dressing different types of wounds, female catheterisation, shadowing different professionals such as community matron, practice nurse, mental health specialist and to attend clinics such as leg ulcer and catheter clinic to improve their knowledge and skills.

I work collaboratively with other multidisciplinary teams; I do attend Goal Standard Framework (GSF) meetings regularly where I join doctors on monthly meetings to discuss patients who are palliative or approaching the end of life. In these meetings we also discuss the patients on district nurses' caseload that need a doctor's review or those that may benefit from referral for counselling and other health needs. I attend Cluster meetings where I join social workers, mental health Representatives, community matrons and doctors to discuss complex patients that required multidisciplinary input to improve their wellbeing. I ensure that all patients who are on the district nurse’s caseload are informed in advance prior to the meeting and that they have consented for their case to be discussed at the consultation. I then follow up with the patient to ensure that the plan discussed in the meeting was carried out and to make sure it was what was right for the patient.