Rachel Brogan

Currently training to become a 111 clinical advisor

My main responsibility as Vascular Access Nurse was the co-ordination of access creation and preservation of access for dialysis. Working closely with patients and members of the MDT to ensure Access creation takes place in a timely manner. In this role my responsibilities include data collection, collating and reporting this information for audit purposes. I was responsible for referring patients for access surgery alongside managing outpatient clinics and the waiting list for access surgery. I was responsible for referring patients for scans and interventions for access preservation as required. I was also responsible for organising and providing staff and patient education.I organised monthly Vascular access (VA) MDT's and attend ward MDT's as required. I also attended and presented in Post Infection Reviews (PIR). I was responsible to ensure items were stocked for access creation. I have been involved in writing VA policies, national guidelines and presenting at the British Renal Society conference.

During this period I worked as a band 5 nurse progressing to a Band 6 haemodialysis nurse, I was responsible for assessing patients, planning their care, implementing this care and continuously evaluating their care. I had the responsibility to carry out haemodiafiltration and plasma exchange. I worked closely with the other members of the MDT to provide the best care the patients. I had to communicate effectively with patients and their families, other nursing staff and other members of the MDT. I regularly took charge of the clinical area and offered advice and, where necessary, structured guidance to other members of staff. I dialysed patients in ITU and on the renal ward as required. I was on the on-call rota to provide dialysis out of hours when required. I had the responsibility to have appropriate knowledge during emergency situations. I had the responsibility to be able to trouble-shoot problems that arose with the dialysis machines and problems with dialysis access. I had the responsibility to report any incidents or accidents via the appropriate channels. I had the knowledge of local and national policies and procedures relevant to my area of work.

During this period I worked as an evening round and a day time community staff nurse my duties included visiting clients in their home environment, delivering a variety of care appropriate to their needs. Assessing, planning and implementing the care needed. My duties included administering medication, monitoring and redressing wounds appropriately. Providing palliative care to patients. This care included monitoring, supporting and providing all care to clients and providing support for their families and other carers. The role also required me to allocate the workload between myself and other members of the team appropriately to offer the team members support both internally and to be aware of external support that could be accessed by members of staff. I had the responsibility to arrange cover for staff at short notice when required. Another essential requirement during this employment was effective communication between myself and other members of the evening round. Furthermore, effective communication between other members of the MDT was essential as these staff members mainly worked during office hours so it was very important that detailed and clear information was given.

During this employment my duties included visiting clients in their home environment. Assessing the care needed, implementing and evaluating the care given on a regular basis. Other duties included male and supra pubic catheterisations, administering immunisations and medications carrying out venepuncture, wound care and giving all care and support to palliative patients and their families. Other responsibilities included working in the leg ulcer clinic. Monitoring and assessing student nurses during their placement in the community. Effective communication was essential to liaise with all agencies involved with the patient care, other care workers and members of the family and other carers involved with working with the client.

During this employment I worked in a busy Accident and emergency department. In my role as staff nurse, I dealt with a wide variety of patients. The role focused on working in the 5 areas of A+E. The 'minor' area, the 'major' area, the resuscitation room, triage and the paediatric area. The 5 areas covered all degrees of injuries, medical and surgical complaints and medical emergencies. In this role working effectively as part of a team was essential. Alongside this, it was important to liaise with the patient (whenever this was possible), ambulance staff, ward staff, staff in the community and the family of the patient in order to deliver appropriate care for each individual.

Whilst working in the accident and emergency department I dealt with a wide variety of patients varying from minor injuries to working in the resuscitation room. My duties also included liaising with ambulance staff, ward staff, staff in the community and the patient's family to ensure that the appropriate care was delivered to individual patients.

Duppas 2 ward was a busy ward specialising in neurology, cardiology and haematology. My main duties on this ward included the assessment, implementation and regular evaluation of the patient’s condition and of the care given. The duties included providing and assisting patients with personal care as needed, giving patients medication and having the knowledge of the medication which was given. Monitoring patients during blood transfusions, having a basic understanding of ECG's and being able to recognise abnormalities in cardiac monitoring. To carry out neurological observations. I also had the responsibility to report any abnormalities to the appropriate member of staff or on call medic. To assist and enable patients in all aspects of their activities of daily living. To communicate effectively with all members of the MDT and to ensure a safe and effective discharge of the patients.