A day in the life of…a trauma nurse practitioner

It’s just before 8am and Jenny Goodman’s shift starts in the trauma meeting room.

This is a daily meeting where doctors and senior nurses in the unit discuss all of the patients on the ward, update on their care plan and talk about any patients due to be transferred in.

The team read patient notes on a large screen in front, while studying numerous x-ray images and scans.

“This man has the worst left leg I’ve ever seen, really awful looking leg, I’ve warned him he may lose it”, says one doctor.

“This young female has been complaining about leg gangrene”, says another doctor.

Jenny’s role is to care for patients who have had traumatic injuries – such as car accidents or falls – and which can be life threatening.

The team split into two groups – one is headed by consultant Rajesh Nanda while the other is led by fellow consultant Raj Logishetty. Between them, they cover both orthopaedic wards on the top floor of the University Hospital of North Tees’ tower block.

This is so that the teams can get more of an understanding about what stage each patient is at and whether some patients can go for surgery or if others can be discharged.

“His wounds look okay…we will need to speak to the plastics team, it needs a review by general surgeons. He’ll probably be in over the weekend”, Mr Nanda says to Jenny about another patient while on their travels.

The nurse practitioner role which Jenny carries out is specialist role. She can provide more advanced patient care and can prescribe medication.

Jenny, who has worked at the trust for 11 years ever since she qualified as a nurse, explains: “Nurse practitioners can assess a patient, make a diagnosis and provide treatment, just as a doctor would.

“We can interpret the results of assessments and make a diagnosis, prescribe and manage medicines and help manage a patient’s health and social care needs.

“It’s a role which means patients can be cared for more quickly because it can often prevent the need to have to refer a patient on to a doctor.”

After assessing the rest of her patients on ward 33, Jenny spends some of the morning helping treat patients in orthopaedic outpatients over on the other side of the hospital site, while also shadowing a registrar.

A young woman comes in with a fractured leg, a school-boy comes in with a fractured wrist and has cast fitted by a member of the plaster team. Then a young man who has fallen off his motorbike and hurt his left knee arrives to be assessed.

Jenny explains: “I am here to help treat patients but also to get an understanding of some of the patients who might be on tomorrow’s surgery list.

“This means that we have already built up a knowledge of these patients and can be more prepared ahead of any further treatment which may be needed.”

After returning to the seventh floor, Jenny logs on and has a quick check for any important emails before getting back to treating patients in the unit.

James has been experiencing complete numbness down one side of his body. While here, he also mentions to nurses about a lump he has had on his testicle for some time. He is asked several questions – when he first noticed it, has it been checked before and so on. He is then checked and referred on for further treatment.

He says: “All of the staff here have been fantastic – nothing is too much bother for them. I couldn’t speak highly enough of everyone.”

After several more patient cases, Jenny heads over to a meeting on the other side of the hospital site, grabbing a sandwich and drink on her way.

It is around a new initiative being run at the trust for patients needing long term intravenous treatment.

Jenny says: “The idea of this new service is for nurse practitioners to provide a dedicated vascular access service for inpatients, under the supervision of a team of anaesthetists.

“This is all around using our skills and knowledge effectively to treat our patients in the best way.

“It’s a new challenge and is something which will help further improve patient care.”

After a detailed and length meeting, Jenny is back on her way up to the seventh floor.

The rest of the afternoon includes a steady stream of patient cases, before a flurry of activity as the evening draws in. Among the patients seen are a woman who needs an ultrasound carrying out to find a vein in her arm, while another female patient needs treatments for severe pain in her toe and for urinary issues.

It’s something which means Jenny ends up staying almost an extra two hours – but it’s something she thinks nothing of as long as patients are getting the right care.

Jenny says: “Being a nurse is a privilege – there’s no other role quite like it. We can make that real difference to a patient’s life.

“And in my role as a nurse practitioner I feel like I can do more for the patient than I’ve ever been able to do before. I’d recommend it to anyone wanting to follow a career in nursing.”

 

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