I am an Orcadian - a native of the Orkney islands - and like many fellow Orcadians, I had to leave the islands to follow my chosen career. I started my Enrolled Nurse training in Orkney in 1990 and left to do the Bridging Course in Aberdeen in nursing in 1993. I then worked in Aberdeen, Angus and Dundee. In the end, I was away from Orkney for 14 years.

I was delighted to be able to return to Orkney with my family in 2007 to a British Heart Foundation Heart Failure Specialist Nurse post. Cardiology Specialist Nurse posts are still small in number across Scotland and I count my blessings every day for having been given the opportunity to come home to work in my chosen specialty.

Back in 2007, a cardiology team from Aberdeen was providing cardiology services in Orkney, running only six clinics per year. In between clinics the hospital was run by GPs with a special interest in acute medicine. Today The Balfour Hospital follows a consultant-led model, with Consultant General Physicians, Surgeons and Anaesthetists.

Demand for cardiology services grew steadily and I helped set up a videoconference clinic for Orkney with cardiologists in Aberdeen in 2010. Back then videoconferencing was clunky and expensive, but it was the best way of trying to get patients seen in a more timely manner without Aberdeen Consultants having to make additional trips in person to Orkney, or patients all travelling to Aberdeen.

Then, also in 2010, an opening as a Cardiology Specialist Nurse arose after a colleague retired, and I was appointed to the role. What an extreme learning curve I found this to be. In bigger heath boards nurses specialise in cardiology, for example, cardiomyopathy nurses, arrhythmia nurses, cardiac rehabilitation nurses and adult congenital heart disease services. But in Orkney everything with cardiology in its name comes my way and I find it challenging to keep up to date in a constantly evolving specialty.

Over the years in the role, I have had to expand my skills to meet demand on the islands. Since lockdown I have taken on leading exercise tolerance testing and have recently passed the Society for Cardiac Science and Technology (SCST) ECG Diploma in ECG interpretation. I have helped to support a nurse to develop into a Heart Failure Specialist Nursing role and restart the nurse-led service. We have taken part in the SCOT: Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) study, which proved that a home-based cardiac rehabilitation programme was effective in a remote and rural area. Traditionally patients from remote and rural areas are under-represented in research and clinical trials as trials are often run from large centres. So we are working with NHS National Research Scotland to see if we can continue to be included and help increase local research opportunities. On top of all that I represent Orkney at regional and national meetings and have helped to develop SIGN guidelines and the HeartE Chest Heart and Stroke Scotland learning resource.

Nursing in remote and rural locations, such as Orkney can raise difficulties in keeping skills up to date, developing new skills and progressing your career. I have had to face some of these challenges head on since returning to Orkney. I’ve not always found it straightforward, but my experience is it’s possible to overcome or work around them. And I can definitely say that it has been worth it and led to a satisfying nursing career.