Community nursing: ‘They come in as a patient and leave a friend’

Working in the rapid response nursing team at Western Health and Social Care Trust is Melaine Stronge’s dream job.

Based in Enniskillen, Northern Ireland, the service facilitates early hospital discharge and avoids hospital admission by delivering intravenous (IV) therapies for people at home and in clinic.

Melaine works to precise and stringent protocols, preparing patients for pre-transfusion blood sampling, blood collection, changing peripherally inserted central catheter (PICC) dressings, and assisting administering of IV antibiotics and iron infusions.

They’ve got a diagnosis that has floored them, and they might be scared or anxious about the future

Patient comfort and safety is paramount to Melaine. She gets to know them and their families, supporting them through often difficult transitions from acute care to palliative care.

Earlier this year in the RCN Northern Ireland Nurse of the Year awards, she was presented with the Health Care Support Worker Award.

We asked Melaine about her unique role.

What attracted you to your job?

After school, I wanted to work in education or social work but started working on a hospital ward as a health care assistant I love caring for people and enjoy ‘hands-on’ work, so it suited me.

I saw an advert to work in the rapid response team; having a young family at the time, the flexibility and shorter hours fitted into family life.

Tell us about a typical day at work?

We cover a large geographical area in Northern Ireland. People visit the clinic in person, or we will go into someone’s home. I take blood samples, do observations and assist the nurses in other procedures, such as blood transfusions. I make sure the equipment and medicines are available, book appointments and if required, accompany nurses to people’s homes.

We might see around 10 to 15 people in one day, all with differing needs and requiring different treatments. We have many regular visitors, some spend 4 hours a day in the clinic receiving treatment, so I get to know them quite well. 

As part of the role, I sometimes clean PICC lines for those going through chemotherapy. This can be hard, so I provide a listening ear if needed.

I make sure all medical equipment, such as syringes, needles, and tubes are ordered and replenished because we get through a lot. This is an important part of the job as we don’t want people going into hospital for these procedures if unnecessary, so I make sure everything runs smoothly.

Many patients are immune-supressed and susceptible to infection. Everything is wiped down after use and in between patients.

What do you enjoy most about your job?

Every day is different. I enjoy the variety, meeting people from all walks of life and using the skills I’ve acquired.

What’s most important to me is patient-centred care and supporting the wider team. Many people that I treat have quite serious illnesses, and some just want to talk or need a bit of reassurance.

I enjoy being part of the team and get on well with my colleagues – there are around 13 nursing and clerical staff in the clinic – and I enjoy that we’re all supportive to each other and flexible.

How do you ensure the comfort and safety of patients?

I try and show empathy for each individual. I’m professional and the role requires good communication skills, but I also want them to feel that I’m someone cares. 

You get to know people and their families well. For many, they’ve got a diagnosis that has floored them, and they might be scared or anxious about the future. I’m a great believer in treating people how you wish to be treated.  

What would it surprise people to know about your job?

The name rapid response makes people think I work in a fast-paced ambulance service, but it’s not that at all. 

We’re a nursing service providing nursing outside of an acute setting. Many of our referrals come from A&E; we complete the treatment for people who may have started off being treated in hospital. When people are clinical well and stable, we will complete the treatment plan away from the hospital. For example, if someone has cellulitis, they don’t need to be in hospital to be treated for that, so we adhere to their treatment plan. 

If you can make one person smile in a day you’ve done something important

We run out-of-hours care and have a team here until midnight. We collect blood from the hospital, we could have 10 transfusions happening in one day, so it’s busy going back and forth to the hospital. 

What’s it like to be an award-winning health care assistant?

I’m flabbergasted. To get recognition for doing my job – that someone took time to nominate me – I was really humbled and shocked. I never would’ve thought I’d win. Everyone does their best, so I was taken aback by it all. The award ceremony has been a highlight this year and it has been a great opportunity to show what my team does.

What’s your advice to other nursing support workers?

Always be committed to doing better. Every day is a new day with different aspirations and challenges, so don’t get complacent.

Always be part of the team and contribute as best you can. Keep going; if you can make one person smile in a day you’ve done something important.

It’s true that for many of the people I’ve treated over the years, they’ve come in as a patient and have left as a friend.