Maxine Cregan

In my current role as a senior sister I am responsible for assessing ,planning, implementing and evaluating patient care I do this by taking physiological observations using the National Early warning score (NEWS) and talking to the patient and their relatives to obtain an accurate history and using the Manchester Triage system to effectively prioritise patients to the correct area. I then escalate any patients who are scoring highly on NEWS score or are unwell to the senior doctor to ensure the patient is assessed urgently.

I plan and implement care by ensuring all relevant tests and treatments are commenced as a matter of urgency.

I then evaluate this by checking observations in accordance with trust and News policy. I then escalate further if the patient has deteriorated.

I am often in charge of co-ordinating the department which involves supporting junior staff ,students and health care assistants ensuring they escalate unwell patients effectively and these patients are assessed promptly. I also assist with procedures they are unsure of and teach skills to student nurses and junior staff. I conduct sickness reviews and appraisals respond to complaints and investigate incidents and allocate staff to work in areas ensuring a good skill mix.

I have completed the prep for mentorship course and have mentored many students and been a preceptor for newly qualified nurses.

I am a member of the palliative care link nurse team and attend meetings to ensure practices are up to date after the meetings myself and the team feedback any changes that the department needs to make and share practices from other areas. I also assist staff in ensuring that end of life care is given with respect and dignity and all documentation is correct. I run a teaching session on palliative and end of life care to new staff starting in the department which ensures they know all the procedures and where all the relevant equipment is.

I have completed the Acute psychiatric emergencies course which has given me confidence and a greater knowledge when assessing patients who attend the department with mental illness, I am also able to risk assess a patient for effectively and hand over to the mental health liaison team with more accurate information. Following this course I have been involved in compiling a topic of the month board about mental illness this gave staff a better understanding of how to assess the patient and gave more awareness of the different types of mental illnesses and behaviours to look for when assessing.

I teach new staff mental health awareness to give them the skills and confidence to look after mentally unwell patients.

I have completed courses such as Male catheterization suturing and how to take and interpret arterial blood gases these skills enable the patient to have safe and efficient care as they don't need to wait for the doctor to perform these tasks, being able to interpret the arterial blood gases gives me a better understanding of the patients condition.

In 2018/2019 I had a secondment to a band 6 role of clinical navigator this role involved liaising with North West ambulance service paramedic crews, managers and control centre. I was responsible for patient safety and flow through the department, ambulance turn around times ensuring they where back in the community in a timely manner.

I was also in charge of co-ordinating the staff working on the corridor to ensure patient safety for those who where nurses on the corridor this gave nurses working on the corridor someone to escalate unwell patients to and I would then ensure the patient would be moved to the appropriate area . One of the improvements to the care of patients on the corridor was to set up trolley numbers and a laminated board with sections for NEWS score, when observations are due to be taken and what patients are with for this made the corridor more organised.

I was responsible for completing route cause analyse for ambulances in the department for over 60 minutes and then with the ambulance management find strategies to prevent this happening.

I have been involved in auditing in the department and have completed audits for neurological observations and documentation audit.

From this role the ambulance navigator role was developed which I now participate in as a band 7.

During my time working in A and E I have worked on the A and E obs ward where I have been responsible for discharge planning which involves working with the multidisciplinary team.

Over the 9 years I have worked in A and E I have gained lots of skills and knowledge about a vast variety of illnesses and injuries, I have gained confidence and become more assertive especially when escalating unwell patients or patients I am worried about. I use a variety of communication skills and am easily adaptable to different situations.

I work well within the team but regularly show initiative. I am approachable and often approached from junior staff who ask me for advice.

Since becoming a senior sister I have developed my leadership skills and lead the team in a professional approachable manner and am always willing to assist a staff member.

• Additional courses.
• Advanced life support 19/10/2022
• Paediatric advanced life support 30/06/2022-1/07/2022
• Advanced Nurse Trauma course 01/11/2023-03/11/2022
• Introduction to leadership 25/04/2022
• Accelerated leadership 08/11/2023-09/11/2023
• Central line training 08/06/2022
• CBRNE 23/06/2022