Stacey Rushworth

I have worked as a Clinical Nurse Specialist role within the REACT (Responsive Emergency Assessment Community Team) team as I felt ready to commit and upskill in palliative care.

• Working in A&E with the palliative care consultant patients are identified and reviewed by the Consultant or and the REACT ACNS.
• The supportive and palliative care indicators tool (SPICT) is applied to identify our patients.
• Assist with the discharged process back into the community.
• Complete FAST TRACK nursing tool if patient deemed in the last 12 weeks of life.
• Worked closely with fellow nurses, doctors and clinicians for consistent communication and continued best care practices.
• Practiced working knowledge of current policies and procedures, addressing issues of non-compliance.
• Supporting patients return to their own home.
• Supporting patients to stay in their own homes when they do not want to attend hospital.
• Looking at anything that could be reversible
• Performed health assessments and designed specialised treatment plans.
• Managed nurses in delivering impeccable patient care to palliative care patients and supporting families and carers.
• Administer medication and treatment for patients following assessment of symptoms.
• Promoted dignity, safety and independence for service users .
• Eased family anticipation by updating regularly on patient progress, developments and treatment changes.
• Communication skills
• Having difficult conversations, end of life care, advanced care planning
• Ongoing RESPECT conversations with patients and families, discussing advanced decision making and future plans.
• Controlling symptoms in the last days of life, providing end of life care and supporting the patient and families.

REACT is a new service identifying patients in Accident and Emergency whom do not want to be admitted to hospital. The palliative care consultant will review the patient and if the patient can be managed at home with support from the REACT team then they will be discharged under our care for around 72 hours. longer if symptoms are uncontrolled or dying.

• Carrying out holistic nurse assessments
• Completed comprehensive patient assessments to determine individual needs and develop care plans to reflect the patient needs
• Implemented and updated holistic care plans in collaboration with the patient, Consultant, CNS and doctors.
• Monitored patient vitals and necessary signs if appropriate, escalating to the right service.
• Administered medication with meticulous attention to detail ensuring that the prescription is specific to the patients.
• Developed and updated initiatives to improve patient care and quality of service.
• Assessed, planned and implemented treatments with precision and care, prioritising patient wellbeing.
• Counselled caregivers and families on end-of-life planning and informed them of patient care options.
• Delivered consistently high standards of individualised nursing care, best maintaining patients' health and wellbeing.
• Assessed patients' condition and reported changes to CNS, Doctor, palliative consultant - those appropriate and then to family or care providers.
• Responded to emergency situations quickly within appropriate procedures. Escalating to the right person or place of care.
• Monitored, assessed and recorded patient condition and coordinated patient discharge planning.
• Performed all tasks with patient-centred focus while seeking opportunities for improvement of processes and treatments.
• Used strong assessment skills to determine necessary patient care.
• Set appointments for care required and maintained schedules on the ledger.
• Assisted with the creation of SOPs for the REACT team
• Developed a comprehensive handover of care of the patients journey under the REACT team
• Pressure ulcer management link worker for the team implementing the purpose T as best practice

Joined the Bingley district nurse team as a community staff nurse

• Administered medication with meticulous attention to detail.
• Implemented and updated treatment plans in collaboration with my team and the MDT.
• Worked closely with fellow nurses, doctors and clinicians for consistent communication and continued best care practices.
• Monitored patient vitals and necessary signs and recording on the NEWS. Escalating to appropriate team - Matron, Gp, 999
• Implemented and maintained core measures in patient safety, patient satisfaction and holistic approaches to nursing.
• Assessed, planned and implemented treatments with precision and care, prioritising patient wellbeing.
• Applied wound management protocols and procedures to facilitate patient recovery goals.
• Developed healthcare plans for individuals and families.
• Updated files using system one electronic health record management systems.
• Coordinated specialist referrals to assist patients.
• Continually assessed individual needs to evaluate and implement optimal care programmes in line with NHS best practices.
• Used strong assessment skills to determine necessary patient care.
• Provided organisational leadership to establish patient care benchmarks, standards and best practices to deliver consistent care.
• Delivered consistently high standards of individualised nursing care, best maintaining patients' health and wellbeing.
• Provided palliative care in patients own homes assessing, developing and implementing of care plans.
• Creating care plans following holistic assessment to provide best care for the patients and so that when the nursing team follow to provide cares a care plan is unique to the patients' needs.
• Discharging patients from the caseload when appropriate
• Mentoring student nurses, nurse associates in each year group.
• Providing students learning resources and carrying out training to build confidence and then working on there competencies.
• Counselled caregivers and families on end-of-life planning and informing them of patient care options.
• Complete Datex/ incident reporting within the desired time frame ensuring that documentation is precise
• Refer to the safeguarding team if unsure about a particular situation or to seek advice.

• Working along the CNS palliative care nurses. My main role was providing psychological support to patients and there families
• Ensuring that the EPPAcs template up to date and information correct
• Working alongside District nurse teams ensuring to communicate any changes to the team and onto system one.
• Worked closely with fellow nurses, doctors and clinicians for consistent communication and continued best care practices.
• Assessed, planned and implemented treatments with precision and care, prioritising patient wellbeing.
• Developed healthcare plans for individuals and families.
• Discussions about advance care planning with the patient and families. Open questions and time to facilitate thoughts about how they all feels when appropriate.
• Referral to appropriate services ie Goldline, ordering equipment
• Monitored, assessed and recorded patient condition and coordinated patient discharge planning.

New to the trust this time was to work along side the District nurse team and complete the mandatory training dates and online Elearning to build up competencies to work within the BDCT.
Learning a new way of working with system one.
Administration of insulin and medications
Basic wound care

I see myself as a knowledgeable staff nurse however at this time required to build up working through competencies as required by BDCT

Working agile within the community in patient and residential homes utilising System One mobile. Managing a caseload of patients ensuring care plans are personalised and individual to patients needs, assessing, reassessing, planning and implementing care as required. Working as a team and autonomously seeking advice and referring to relevant MDT, Gp and escalating to Acute Care if required.
Leading handovers to discuss our patients and manage a large caseloads, updating care plans - patient specific

Management of staff allocation for the next days visits and if required over a three day period using system one live.
Applying evidence based practice and agreed formulary within the trust.
Duties

• Catheter changes, planned / Acute intervention
• Enteral feeding/administration of medications
• Medication/ Insulin administration & transcribing of medications on appropriate prescription charts
• Care of Palliative Patients and their families, meeting their needs and providing optimum care in their own homes.
• Personalising care plans and referring to Palliative Specialist Nurses for support
• Care of Syringe Driver ensuring prescriptions are correct and the patients symptoms are managed effectively
• Care after death & verification of death
• Providing bereavement support to families and friends
• Wound Care
• Care of leg ulcers / compression Bandages
• Care of PICC line/ disconnect chemo
• Taking observations manually following NEWs and escalating if appropriate.
• Creating care plans following holistic assessment to provide best care for the patients and so that when the nursing team follow to provide cares a care plan is unique to the patients' needs.
• Mentoring student nurses, nurse associates. Teaching sessions on wound care and leg bandages,
• Link worker for enteral feeding providing education to the team, power point presentation to new starters and students.
• Ensure training is up to date
• Audits of hand hygiene

• Working on a busy Acute Medical Admissions ward with 44 beds at full capacity receiving patients from A&E and Gp referrals. Patients have been admitted with chest pain, sepsis, falls & pneumonia to name but a few.
• Clear and precise documentation is carried out, gaining as much information during admittance so an accurate history and background is sought. This aids in the patients journey whilst in hospital, and assists in the nursing process to assess plan and implement holisitc care and patients needs.

Duties

• Using System One to input data, administer medication, discharge patients, ensure patient flow
• Administration of medicines & antibiotics
• Intravenous fluids
• Recording vital signs on the NEWs chart & GCS
• Care of Telemetry
• Catheter care
• Pressure area care
• Care of the dying
• Syringe driver
• Been first to see the patient it is important the MDT are refered to ASAP for example safeguarding issues, wound care or infection control.

• Working on different wards within the BRI such as medical, surgical, breast care, infectious diseases, accident and emergency, elderly and orthopaedics.
• Working as part of a team and on own initiative I’m flexible in any working environment and thrive on a challenge.
• Experience with various medical conditions including Parkinson's, dementia, diabetes, cancer and Alzheimer's.
• Assisting doctors with minor surgeries and non-invasive procedures.
• Assist patients with activities of daily living
• Medication rounds, commencing IV fluids as prescribed and ensuring VIPS/ CLIPs checked
• Follow infection control procedures and ensure other people do to.

• PCU is a 24 bedded male/female surgical ward, caring for colorectal, upper gastro Interstitial, breast, general surgery, vascular, urology and digestive diseases patients.
• Caring for patients post operatively, or those who require intensive monitoring. These patients are not serious enough for the ICU or HDU but too complex for the regular hospital wards.
• Close monitoring of patients using the NEWS charts, fluid balance, CVP, and working alongside the MDT to provide the best possible cares and outcome incorporating the patient and family.
• Evaluating patients and prioritizing treatment and cares.
• Taking charge of the ward ensuring the MDT are aware of any changes in the patient's condition.
• Managing and supporting staff members, maintaining staff morale during busy periods and professionalism whilst ensuring the smooth running of the ward.
• Managing patient flow and communicating with theatres, wards and managers.
• Caring for patients with TPN, Central Lines, monitoring CVP if required, care of PICC, IVI, drains, wounds, VACs, pressure area care, stoma care, syringe drivers to name some responsibilities.
• Following oxygen therapy guidelines but also using own knowledge and research if patient deteriorates and life saving interventions required.
• I was the link worker on the ward for enteral and parental feeding and moving and handling. Audits carried out within these areas if required.
• Supervising and mentoring student, newly qualified nurses and healthcare assistants.
• Liaise between patients and doctors to ensure patient understanding of treatment plans.