From a very young age I knew I wanted to work with children. I was fortunate that throughout my GCSEs and A levels, I had the opportunity to complete different work experience schemes, which varied from schools to children's wards and the ambulance service. These experiences strengthened my desire to work with children and I decided I wanted to complete a degree in children's nursing. I secured a place on the children's nursing degree at Keele University (an intake of only 11) and I graduated as a paediatric nurse in 2008.
Towards the end of my degree, it was made clear that paediatric nursing jobs were rare but, despite this, I successfully gained a staff nurse position in the paediatric intensive care unit (PICU) at Birmingham Children's Hospital. To be honest, PICU wouldn't have been my first choice, so to say that I was nervous would be an understatement, but I was excited to start my nursing journey.
I spent the first 11 years of my nursing career in that role. I completed a variety of courses from foundations in paediatric intensive care to the specialist course in paediatric intensive care and a mentoring qualification. These courses equipped me with the relevant skills to be able to assess, care and manage extremely unwell children and their families. Upon completion, I was able to care for children who needed the highest level of support and intervention in any specialty, including cardiac, hepatology, oncology and renal.
To expand my knowledge and experience, I then completed an 18-month secondment with another team in PICU: the Tech Team. In this role I was part of a small but crucial team supporting the unit and hospital with all equipment and with patient transfers, working with the medical team to review deteriorating patients on the wards and attending all resuscitation and trauma calls. Completing this secondment was one of the most valuable experiences of my career. It gave me the ability to troubleshoot various types of equipment used across the hospital, developed my skills in handling difficult situations, and strengthened my clinical assessment and patient-management skills. After this secondment, I was promoted to junior sister, which led to further courses, including advanced airway assistant, continuous veno-venous haemofiltration and extracorporeal life support/extracorporeal membrane oxygenation.
After 11 years at Birmingham Children's Hospital, I made the difficult decision to leave the NHS and move to Calea, a specialist parenteral nutrition homecare company as a clinical nurse advisor. This was not a decision I took lightly, but at that point in time I needed to prioritise my children and the lengthy commute to the hospital made this an impossible task.
When I first joined Calea, my work involved ensuring safe administration of parenteral nutrition in the community to adults and children. At this stage, I was predominantly caring for adults as the paediatric service was not fully developed, so instead I became an active member of the Calea Paediatric Forum, where we developed the resources, training and documentation to ensure all protocols and guidance were relevant and up to date, ensuring we provided the highest standards of care possible.
After 18 months, I was appointed to the paediatric clinical lead role in addition to my role as a clinical nurse advisor. This was a new role, but one that would be instrumental in growing the paediatric service within Calea. This allowed me to focus on projects that would strengthen the services we could offer to children and their families.
I began by becoming the chair of the Calea Paediatric Forum and my first focus was to expand the group to involve all nurses who cared for paediatric patients across both parenteral and enteral nutrition. This ensured collaborative working and allowed for the sharing of best practice as well as providing a forum for peer support. I then focused on the Calea 24-hour Advice Line Service (a telephone service that gives our patients direct access to a nurse), where I introduced a set of paediatric-specific guidelines that would ensure any advice given would be accurate, evidence based and up to date, ensuring safe out-of-hours practice.
Following this, I co-led the creation and implementation of a paediatric risk assessment tool. This takes into consideration all ages, disabilities and circumstances that a nurse may face when caring for a paediatric patient with complex medical needs. Based on the outputs from the risk assessment, we can then plan and reassess care to ensure we fully meet the needs of the child.
I also reviewed the paediatric training slides that are used by all our nurses to ensure they are equipped with the relevant knowledge and skills to help understand and care for a paediatric patient.
When COVID-19 hit and schools were limiting the number of visitors to their sites, I developed a set of emergency line care training slides to provide teachers, teaching assistants and other staff members with an overview of a central venous catheter (CVC) line and the purpose of parenteral nutrition. The slides also advised the school what to do in certain circumstances, including if the child were unwell or if the CVC line had fractured.
My next project was to review and relaunch the Paediatric Care Profile. This is the documentation all the nurses complete during their patient visits. It includes the child's medical history, infusion device details, CVC line assessments and medication administration records.
Following this I piloted a condensed training programme for the carers of paediatric patients, teaching them how to safely disconnect and connect parenteral nutrition, providing a valuable source of respite for families. The training was completed over 3 full days (rather than the standard training, which is spread over a 28-day period), to ensure sufficient time for teaching and practising. Following this successful pilot, condensed training is now a standard part of our offer for both adult and paediatric patients.
More recently, I have developed a multidisciplinary team (MDT) document to be completed at all MDT meetings before a paediatric patient is discharged to the nursing service. This helps capture all relevant information with respect to the child's care and promotes continuity of care between services.
Lastly, I have developed a new transitional framework for young people wishing to become independent in their own care and procedures. This is a new initiative within Calea, as previously it would have fallen on the shoulders of the parent or carer. The framework places the young person at the centre of the training and can accommodate varied learning needs and requirements. It also ensures there is good communication between Calea, the patient, and the hospital. Following positive feedback from patients during the pilot phase, the documentation has been implemented for all transitional Calea patients.
‘I then focused on our 24-hour telephone service that gives our patients direct access to a nurse … I introduced a set of paediatric-specific guidelines that would ensure any advice given would be accurate, evidence-based and up to date, ensuring safe out-of-hours practice’
On a side note, given that there is currently a drive to ensure that transition for young people is completed to a high standard, I took the decision to present it to the National Paediatric Parenteral Nutrition Nurses Group, where fortunately it was very well received.
The Paediatric Team within Calea has now grown to include a clinical excellence manager, paediatric specialist nurse, and a paediatric clinical lead. The expansion of this team is vital to our business. It allows us to support and educate our nurses to provide outstanding paediatric care and ensures we deliver a truly holistic nursing service to our NHS customers.
During my past 3 years at Calea, the paediatric service has gone from strength to strength, and this has been recognised and praised by our service users. I am honoured to have been nominated and awarded the Complete Nutrition (CN) magazine Paediatric Nutrition Professional of the Year award. However, without the collaboration of the Calea team, these projects would not have been as successful, and I am grateful and proud to work with a team of nurses who share the same focus and drive to improve patient experience and outcomes.