andover war memorial hospital basingstoke and north hampshire hospital royal hampshire county...
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Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
“Modern Matron”
Rachel AdamPhysiotherapist
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Clinical Service Lead – Orthopaedics
• Hampshire Hospitals Foundation Trust– Across 3 sites
• 3 Fracture clinics • 3 Trauma wards• 2 Pre assessment clinics • 2 Elective wards• Staff– 164 Nursing / 64 medical / 56 admin
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
How did the opportunity arise?
• Previous experience:–MSK outpatient lead for HHFT– Leading multi professional teams
• Hungry for new challenges and seeking greater responsibility
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
How did the opportunity arise?
• Actively seeking new opportunities• Open to stepping outside the known • AHP highlighting opportunities where AHP can deliver
what is required• Convince others to take a risk to provide a personal
opportunity– Highlight qualities and skills AHP’s offer
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Qualities and Skills • Training / academic entry
– Problem solving / goal setting– Organisation complex information– Theories and frame work – Autonomous – Decision makers – Communication skill – Influence and have confidence in different unknown situation – Credibility with others
• Career structure– Exposed to variety of role, leaders and experiences to learn and develop – Lateral thinking
• Fresh eyes / not historic thinkers
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Challenges faced………… personal and professional
• Painful learning curve – Challenged my personal resilience – How a ward runs and how performance is evaluated – Nursing practice and language – My role
• Volume of work Urgent and High Importance• Eyes wide open
– Level of responsibility, challenge and accountability within the main frame – Myself and nursing team– Challenged my beliefs of the practices of other professional groups
• Delivering safe and quality care, preventing harm to patients and staff– Ensuring patients receive safe, high quality care with dignity and respect– Safe Staffing: 24 /7 with significant staffing vacancy – Communicating and influencing a work force on shift
• Forgiving myself for not being a nurse
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Thoughts on the future• The right person with the skills to deliver what is expected of the role
– Look past perceived professional boundaries
• Need to make seek and create opportunities to demonstrate what we have to offer as credible senior leaders within the NHS– AHP’s need to rise to the challenge– Accept responsibility outside of professional boundaries and usual
practice – Opportunities within a structured leadership pathway
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Pulling it all together,
• Meeting challenges– Ward level leadership– Observation of inefficiency in ward processes – Observed professional accountability mismatch at ward level
• Gap in leadership pathway opportunities
An existing AHP lead taking responsibility for the elective orthopaedic ward……combined role trial.
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
An AHP in a combined clinical and ward management role
Laura WinesPhysiotherapist
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
The Role
• Clinical Specialist Physiotherapist working on trauma, elective and day surgery wards
• Responsible for a team of physiotherapists and a 7 day physiotherapy service
• Managing a 16 bed elective orthopaedic ward including staff management and day to day operation management
• Working with the Orthopaedic Unit nurse lead to develop services provided by the whole Orthopaedic Unit
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
How did the opportunity arise?
• Elective ward charge nurse retired• Clinical services lead for orthopaedics opened up job
opportunity to all AHPs as well as nurses• Actively seeking new opportunities
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Qualities and Skills • Rotational physiotherapist, observe different leadership styles, different
ways of operating a ward• More opportunities as an AHP to move from band 5 to band 7, gaining
management skills and experience as a leader• Clinical reasoning/evidence based practice/problem solvers – embedded
from undergraduate level and used every day• 5 years in orthopaedics at RHCH – aware of the challenges and the potential
of the ward. Objective for the new ward lead was to integrate nursing and therapy.
• Elective Orthopaedics – rehabilitation integral to patient flow • Natural progression – wanting to gain more responsibility and seek new
challenges and still remain in the service which I had already invested in
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Challenges Professional•New role – no set precedent. Working out daily, weekly, monthly activities and balancing clinical physiotherapy duties with ward management•Increasing awareness of my dual role, uniform challenges•Exposure to the divisional operations taking place outside of the ward, no previous experience had provided a basic understanding – steep learning curve•Understanding the 24/7 ward activity•Ward staff VS staff on ward – non-professional ward activity and accountability for care and quality and facing inequality between professional groups in particular access to professional development•Trying to bridge the gap between nursing and AHPs through stereotypes, historical processes, using my combined leadership role
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Challenges
Personal•Being under two management structures•Being patient – no immediate change•Feeling like a small fish in a big pond all over again•Humbling experience – having to reflect back on who I was prior to the new exposure and help others to see/learn through my experiences
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Putting into practice•Ward management recruitment - where possible, to consider applicants regardless of their professional degree but for the knowledge, skills and qualities they have gained during their experiences•Managers of AHPs to support progression into ward management posts/speciality specific leadership opportunities•Integration of AHPs and nurses on the ward-To ensure accountability for care and quality which is non-professional specific-To support each other to allow equality for non-clinical responsibilities-To therefore create a dynamic workforce which can deliver the needs of the patient at the time of need-May require combined leadership where there is potential for resistance
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
AHPs interested in ward management
• Feeling truly part of the NHS, being at the centre of activity and involved at every level, increased job satisfaction
• Understand the way the NHS works not just the ward or the department you work in
• Potential for your work/ideas to spread to other wards and then to other Trusts, high impact
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
From OT to Sister
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
The Skills of an AHP
• Problem Solving• Empowerment
• Working Autonomously• Team Work• Rehabilitation
• Discharge Planning
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
The Challenges
• Knowledge of a ward
• Perceptions of others
• Managing nursing staff not therapists
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital
Advice
• Preparation
• Learn the ropes
• Support network
• Keep the patient at the centre
Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital