Siobhan Corbett
How did you expand into advanced practice?
I finished my Masters in advanced practice back in 2008 and I had been very fortunate in the right place at the right time to begin the masters programme, I had been looking to challenge myself and develop and just happened to grab an opportunity that was available not completely understanding where it would lead or the end result. Thankfully I had a very forward-thinking proactive manager and by the time I finished the masters there was great support and a framework to practice.
What challenges have you faced on your journey to advanced practice?
There are always new challenges when instigating any change, especially one so innovative that it involves blurring traditional role boundaries and challenges people’s perceptions. Both individually, culturally and institutionally. However, healthcare is ever changing and so we should always be challenging ourselves to keep up or indeed be the actual driver of change. Personally, it was a very lonely and isolating place when I first qualified, so it is great that there are now many more numbers and much more support for those training and practising.
How do you see Advance Practice developing at DVH?
I think that DVH is a perfect place and platform for advanced practice to thrive. There are multiple health challenges and hurdles we all face to deliver the best care, and I see advanced practice as key to contributing to meeting those challenges. Training and developing experienced staff to expand their abilities in their disciplines will result in great care received directly by our patients.
Amanda Russell
How long have you been an ACP
Hi my name is Amanda and I qualified as an ACP in Paediatrics from London South Bank University in 2016. I work with Emma who also qualified from London south bank in 2020.
Briefly describe your role in the multidisciplinary team:
I work on the middle grade rota within the paediatric and emergency department. The paediatric directorate has 2 ANP’s that cover the assessment unit as well as the general paediatric ward and outpatient clinic. As ANP’s we bridge the team between medical and nursing care providing holistic care and ensuring a positive patient experience.
What were your roles prior to becoming ACP’s?
My background is that of Paediatric Emergency department and since qualifying as an ACP I have been working across a variety of Paediatric areas in secondary and tertiary level care. I have also worked within safeguarding, epilepsy, outpatients. My colleague has a background in Paediatric PICU, general paediatrics and ward sister. This allows us to have a broad understanding of a wide variety of conditions and great peer support.
What advantages does having an ACP in your area bring to patients and colleagues?
The ACP is a valuable resource for both nursing colleagues and medical staff alike. We provide consistency, experience and leadership. We enjoy teaching the multidisciplinary team and have a reflective approach to ensure learning from all team members. We also undertake quality improvement projects to continuously ensure excellent care is provided.
How do you see the role of ACP developing at DVH?
Our vision is to have a 24hr ACP service for the paediatric assessment unit. This will allow us to support our medical and nursing team members, whilst being able to provide high quality advanced care ensuring an excellent patient and family experience. We also would like to develop senior nurses to undertake the ACP qualification to improve retention and skills of staff.
Aljie Elazegui
How long have you been an ACP?
Hi my name is Aljie Elazegui, I am a trainee ACP for Acute medicine in Ambulatory Emergency care (AEC) undertaking the final year of non-apprentice MSc in advanced clinical practice program 2019-2023.
Briefly describe your role in AEC team
I take part in patient consultation activities such as clerking carefully risk-stratified patients streamed from Emergency Department, ensuring appropriate pathways are used. I also attend to referred patients requiring follow up medical reviews. To ensure quality and compliance of patient consultation, I must present these patient cases with the attending consultant of the day. Although My role as trainee ACP (tACP) predominantly supports AEC medical workforce, I still function as a source of support for my junior nurse colleagues if needed.
What advantages does having an ACP in the MDT bring to patients and colleagues
The value of ACP in acute medicine can be seen from developed attributes for example, the flexibility of a qualified ACP as an autonomous clinician working within the level of middle-grade doctors can help address the challenges faced by the medical workforce particularly on busy areas in Acute medical unit (AMU), Ambulatory Emergency care (AEC), medical take team including ward on-call team. Considering this approach may improve clinical outcomes as well as patient experience.
How do you see the role of ACP developing in medicine at DVH
Working towards the pioneering role as an ACP in acute medicine signifies the initial phase of development. Establishing ACP role in medicine is achievable. However, it can be a lengthy process. There are also many factors that need to be considered, such as employers' views in selecting the right skillful candidate for MSc advance practice program, and aspiring health and care professionals are required to undertake the 3 yrs. MSc ACP programme in addition to clinical workplace learning. The Most important factor will be the applicant’s readiness to learn and commitment to practice. Alternatively, employing a qualified ACP for medicine can be considered.
What has been the biggest challenge so far in your training to be an ACP?
Undertaking ACP training has pushed the boundaries. Engaging on Every level of advancement welcomes new challenges. The emergence of the global pandemic in 2019 has indeed transformed many practices affecting teaching and learning. In medicine, I was the only trainee undertaking ACP role . This cluster of unfavourable situations created an opportunity that aligned my discipline to meet the 4 pillars of advanced practice. at present, I have only just overcome the consequences of role transition “from novice to expert” and “impostor syndrome”.
Matthew Reeves
What were your roles prior to starting your ACP training?
Prior to starting as a trainee ACP, I worked as a pharmacist within the acute hospital setting. I experienced a wide range of specialities as part of my clinical rotations and when the opportunity to train as an ACP in the emergency department arose, I applied to further my clinical skills and knowledge as well as help in developing the future role of a pharmacists and pharmacist ACPs within the four pillars of ACP, clinical practice, leadership and management, education and research.
What advantages does having a pharmacist as an ACP bring to the multidisciplinary team?
Having a pharmacist as an ACP brings a clinician with an in-depth understanding of medication and medication related issues to the multidisciplinary team. Although ACP is characterised by a high degree of autonomy and complex decision making, these skills can also be used within the multidisciplinary team to discuss problems and find innovative solutions with clinicians from a multitude of different professional backgrounds.
How do you see the role of the ACP developing for AHPs at DVH?
The role of the ACP at DVH is evolving and developing rapidly at the moment. As a trainee ACP with a background in pharmacy this is a new and innovative role. I hope that by undertaking the additional training of a MSc in advanced clinical practice it will open a path for further pharmacists to undertake the ACP programme and lead to further integration of pharmacist ACPs into many different specialities within the hospital. This will enhance patient’s experience and improve outcomes.
What has been the biggest challenge so far in your training to be an ACP?
The biggest challenge I have found as a trainee ACP is learning and developing my clinical assessment skills. As a pharmacist, examination and assessing patients is a skill that is not taught or undertaken as part of the undergraduate degree or needed as part of the pharmacist's role on the ward. Therefore, learning these skills was particularly difficult compared to my ACP colleagues whose professional background is as a nurse or paramedic.
*Matthew is in the white coat
Lorena Medina
How long have you been an ACP?
I started my ACP training at Darent Valley Hospital in 2011. I left in 2014 and completed my masters in advanced practice in 2015. I worked in Harlow as an ACP and I was asked to come back to the department in 2017, and I was delighted to re-join what I have always considered my work family, serving the lovely population of Dartford and surrounding areas.
Briefly describe your role
I work in the Emergency Department (ED) and I am currently working to complete my credentialing with a complete eportfolio at ST3 level competencies via the Royal College of Emergency Medicine. The ACP rota compliments the registrar rota in a 24-hour period. I work in all adult areas of the department, majors and minors, the resuscitation room, isolation ward, ambulance assessment areas, and urgent treatment centre, seeing all adult patients with undifferentiated undiagnosed conditions and am able to assess, diagnose, manage, discharge or refer to other specialties, including the prescription of medicines. My non clinical responsibilities centre around education and teaching. I am the simulation lead for the department and organised bimonthly multi-professional major trauma days, as well as a 'Learning from Incidents' simulation day. I also help facilitate Trauma Intermediate Life Support for nurses. Other responsibilities include working with the clinical director and governance lead in audit, quality improvement projects, and service development needs.
What advantages does having an ACP in the MDT bring to patients and colleagues
ACPs bridge the gap between medical and nursing staff with knowledge and skill set in both disciplines. I feel blessed to be part of this team who works so hard day in and day out, and absolutely have taught me invaluable lessons, knowledge, compassion, excellent care, resilience, and the drive to do better for our patients and colleagues, and excel. I believe having ACPs in the department has meant that we truly learnt to appreciate each other's contribution to healthcare and patients' outcomes.
How do you see the role of ACP developing in medicine at DVH
The ACP role has created a path for nurses and other professionals from non medical backgrounds, who are looking for promotion but do not want to go into management routes. I see many of my colleagues interested in this clinical role, where patients will directly benefit from their years of experience, expertise, extensive knowledge and skill. This has got to be a good thing. The ACP role is being developed in the trust quite extensively with great leadership and support from medical and nursing colleagues.
What has been the biggest challenge so far in your training to be an ACP?
The best things about being an ACP is being part of this amazing family in DVH, being able to be of service to others, being able to be helpful to people in need. I have great job satisfaction from doing this role.
*Lorena is far left in the photograph.