For the first time, the British Journal of Nursing Awards celebrated rheumatology nurses with a new category. This year’s overall winner was Diane Home, consultant rheumatology nurse at Chelsea and Westminster Hospitals NHS Trust; the silver award winner was clinical nurse specialist Robert Clark from Mid and South Essex NHS Foundation Trust. Here we talked to them both about their awards.
Tell us about the work you did to win this award?
Diane: I've recently been involved in the service improvement journey for patients referred with new or suspected early inflammatory arthritis, in particular the contribution that nurses can make towards best practice in this area. The whole pathway has been restructured, with a new process to identify and book patients into timely appointments and to ensure that patients are seen by the most appropriate member of the team (either nursing or medical) at the correct time interval.
As a result of the pandemic, this now includes virtual and in-person appointments with the nursing team. We also created a business case to expand the medical, nursing and administrative staff within the department. The pathway will be benchmarked against NICE guidance through a national HQIP audit.
Robert: I’m pleased to have been chosen. I was nominated by one of our rheumatology consultants, who quickly picked up on my ethos and passion for the digital projects I’m developing to improve patient outcomes.
My aim is to completely modernise clinical advice lines by moving away from a voicemail system and bringing in an online platform. It’s time-consuming listening to voicemails, particularly when you don’t have any admin support, which means that we also return calls; which can be very time consuming. A more digital approach would help deliver a more efficient service with improved patient choice and better outcomes.
We’re also bringing in a new rheumatology database which will better identify the activity that the nurses provide. This means we can establish a better financial reward for the department by reinvesting efficiencies back into patient care.
How do you think winning will affect your practice in the future?
Diane: It provided an opportunity to increase the profile of rheumatology nursing. It also encouraged me to continue the work we're doing as a department to improve the service we provide to patients with rheumatic conditions.
Robert: I feel immensely proud to have achieved this career milestone. I hope it brings more recognition to my colleagues across rheumatology. I also hope it brings recognition to the projects within my Trust. I’d like digitalisation of advice lines in rheumatology to become the norm; I want to help raise awareness regionally and nationally by working closely with the RCN and BSR. Eventually, I hope it becomes a normal practice across the board.
How has winning this award changed people’s perception of your role?
Diane: Winning the award increased the visibility of my role and rheumatology as a whole within the Trust. It's been lovely to be congratulated as the news about winning the award has spread!
Robert: This award is a real opportunity for nurses in rheumatology to build up recognition and increase outside appreciation for the specialty. Since winning, I’ve been invited to take part in activities with BSR and the RCN. I would urge colleagues to consider nominating other rheumatology nurses next year to be awarded and celebrated for everything that they do.
What's the most important aspect of your role and why?
Diane: My consultant nurse role includes clinical care as well as service improvement. This means that I have an overview of the patient’s journey, not only providing care, but also influencing, developing and optimising pathways for patients towards improved outcomes in the most efficient way.
What do you most enjoy about your role?
Diane: Having the opportunity to directly impact an individual patient’s care, working in partnership with patients, and working collaboratively with my nursing, medical and administrative colleagues within the rheumatology team.
Robert: Being an autonomous practitioner. I’m skilled in non-medical prescribing and my consultation and assessment skills allow me to give all-round care to patients. I make clinical decisions within my scope of professional practice unless there’s an issue I can’t solve, such as a big change in how we provide safe and effective care to our patients.
What are your main concerns about your role?
Diane: My main concern is ensuring our resources keep pace with increased demand and developments within rheumatology practice. For example, recent changes to NICE guidance increased patient numbers who meet the criteria to start biologic treatments. Rheumatology's not a well-known career option for nursing and therefore succession planning, particularly at this stage in my career, is also a concern.
What are your top tips for bringing in digital resources?
Robert: Digital ways of working are needed more than ever before. When you’re looking to bring in digital, look at your services as a whole and where it could most benefit. The way forward is to communicate via text message to patients especially for short answer responses or requests. Being able to offer an online booking system is ideal as it means choice and flexibility for patients. Information governance can be tricky in many Trusts – keep pushing.
What advice would you give to nurses aspiring to achieve positive change?
Diane: Don’t try to do it single-handedly or reinvent the wheel. Build networks within your trust, locally or nationally, both informally and more formally with specialist interest groups. I've greatly benefited from links with the RCN Rheumatology Forum, BSR and patient groups such as the National Rheumatoid Arthritis Society and Versus Arthritis. Identify and be inspired by good practice from elsewhere, and adopt and adapt it to fit your service, with permission of course.
How do you work with BSR?
Robert: BSR has created a team tasked with educating new nurses coming into the specialty. We hope to deliver an online platform full of resources around rheumatological conditions and skills needed to help develop rheumatology nurses; BSR is putting a strong level of investment into improving nurse education using a mixture of learning methods.
I’m currently working with the Education Committee developing a resource for psoriatic arthritis. It includes a video of a psoriatic arthritis assessment, with me going through the process with a patient, helping new nurses to develop the skill of a psoriatic arthritis response criteria (PSARC assessment). In years to come, it could be regarded as a formal induction process and learning package for new nurses coming into rheumatology, which is extremely exciting.
Congratulations to Diane, Robert and all the winning nurses. Diane's interview is copyright of RCN.