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Clinical practice and leadership are not confined to conventional healthcare settings, which is why nursing offers such diverse career pathways
From monasteries to oil rigs, nursing skills are in demand in many different settings and organisations. We talk to the nurses working in unusual places.
Emergency Nurse. 31, 5, 12-14. doi: 10.7748/en.31.5.12.s8
Published: 05 September 2023
Karen Harrington leads the healthcare team at Ampleforth Abbey in North Yorkshire
As matron of the monastic infirmary, I look after the health and welfare of about 30 Benedictine monks who are aged between 30 and 92.
I’ve been here 11 years now. It’s not something I planned, but after a 25-year career in the NHS, mainly as a senior nurse in community hospitals and services, I thought I’d like to try something a bit different.
The abbey is close to where I live in North Yorkshire, and it’s certainly different. We’re working in a stunning setting – when you come here, you sense the feeling of peace and calm.
The role is autonomous. The care we provide covers everything from chronic disease management, mental and physical conditions, to palliative care.
I work 23 hours a week, usually over three to four days. I’ve been able to hand-pick my team of ten HCAs, who work different part-time hours. They’re an excellent team.
You have to be confident and experienced because we don’t know what we’ll be faced with. As well as looking after the monks, we provide a service to the abbey’s staff, visitors and guests – so we see everything from minor injuries to medical emergencies.
It can be challenging, because the abbey has vast grounds and attracts large numbers of visitors. We don’t know the individuals or their medical history and being in a rural setting means it can take a long time for an ambulance to reach us. But we’re committed to doing what we can to take care of everybody, and we provide an excellent service.
My lifeline is the RCN, which has provided a tremendous support network. I sit on the RCN learning representatives committee and, because I’m outside the NHS, I feel I bring something different to it.
‘Working here is rewarding and the love and kindness I’m surrounded by has been life-enhancing’
My RCN network was so important during COVID when, because we’re not regulated by the CQC, we were outside the system and had to manage alone.
Although having a faith isn’t relevant in this role, it’s very important to have respect for the monks’ way of life and their values. They treat us as much a part of their family and we are included in feast day celebrations, walks and tours.
Working here is rewarding and the love and kindness I’m surrounded by at work has been life-enhancing in so many ways.
Maria Hughes is head of medical services and well-being for North Wales Police
It was a leap of faith after 29 years in the NHS to apply for something completely different, but I was ready for a change and wanted to cut down my long commute, when I answered the job ad.
I was a tissue viability nurse consultant and I’m still using the clinical and management skills – just in a different way.
As head of medical services, I’m responsible for all clinically related areas across the force here in North Wales. I look after the police officers themselves, but also manage small teams that look after custody nursing, the sexual health referral unit and occupational health.
It was quite a culture shock coming here. Policing has its own language, with lots of acronyms and unfamiliar terms. It took a while to understand what people were talking about.
Looking after the physical and mental health of police officers has been rewarding. I set up a prostate screening programme, which identified 12 cases of prostate cancer where there were no symptoms – so we literally saved lives.
The police are good at looking after their people, providing fast-track services and post-trauma support, for example. I see it as looking after police officers so that they can do their jobs and look after others. I’ve also cut my commute from an hour to ten minutes, which has had an impact on my own well-being.
I now swim at 7am and get to my exercise classes after work.
Angie Brooker is an occupational health manager in the construction industry
It’s actually quite hard to pinpoint my role some days because no two days are the same.
I split my time between one of our large construction sites in Vauxhall, London, where I’m the site nurse, and visiting our other sites as occupational health manager. Construction workers start early, and it’s good to be around when they are, so I generally work Monday to Friday 7.30am to 4.30pm.
‘The rate of cancer in construction workers is much higher than average, and there’s a high suicide rate’
I qualified as a nurse in 2002, and worked in various roles in the NHS, including in the emergency department and later moved into occupational health.
Making the move into the construction industry has been quite a change, but I enjoy that my role is autonomous and I can take a proactive approach.
Part of my role is to deal with whatever first aid emergencies come my way. We’ve had everything from fall injuries, to cardiac arrests and even a brain haemorrhage on site. I run first aid training and mental health first aider training.
I manage the first responders across the company and ensure the sites have the right equipment and accreditations.
My employers are aware that the rate of cancer in construction workers is much higher than average, and there’s a high suicide rate, so they’re very supportive of health awareness initiatives.
I talk to the workers about the long-term health effects from hazards such as dust and noise, and how to work in ways that reduce their risk. I record data and use it to spot trends – I can then put in place further prevention strategies.
It’s not just about safety on site. My talks cover general health themes, for example high blood pressure, or exercise. I enjoy the job. It’s a privilege to help construction workers with their health and well-being.’
Bob Gardiner is senior medic and health and safety adviser on an offshore oil platform
In my 38 years as an offshore medic, I’ve seen everything from helicopter crashes to major gas explosions. Whatever I’m faced with, I find my training just kicks in and I get on with it.
Before I started this role I was already based in Aberdeen, where most of the UK’s oil and gas industry was, and a few of my colleagues had moved to offshore work. The rewards were good and I had a young family to support, so I thought I’d give it a go. It meant leaving behind the structure of the health service to be a lone practitioner.
Part of the role is running a primary healthcare service, so I see the full range of conditions similar to those seen in a GP surgery. I provide an emergency response service for any major medical incident, and an occupational health service, managing and advising on health hazards from asbestos to radiation.
It’s not the normal commute to work: I fly from Aberdeen to Sumburgh Airport in Shetland, then board a helicopter for the final one-hour journey to the offshore platform, which lies 130 miles north east of Shetland.
My working pattern is two weeks on, three weeks off – although some of that time may be taken up with training. While at work, I do 6.30am to 6.30pm, plus I’m on call 24 hours a day. I’ve got used to the hours, but it can place a strain on family life.
Although I work alone, the organisation I work for has a total of 20 medics, working across its offshore platforms, and we have a support network and regular catch-up sessions. I’ve always had regular training sessions in the NHS, and have found people are interested in what I do.
Raubina Kauser is senior nurse on the Discovery Princess
I always wanted to combine my loves of travel and nursing so this role was an ideal opportunity to seek adventure. I’d been a nurse for 11 years when I moved from land to sea and had previously worked in acute care and emergency nursing, where I’d built up useful experience in critical care.
A typical day at sea begins at 8am when the clinic opens. We run two daily clinics for guests and crew as well as being available 24 hours a day for emergencies.
We tend to see cases similar to those you would in a land-based setting, such as common respiratory illness, chronic cardiac problems, limb injuries, infected wounds and so on.
However, we also see serious cases, such as acute myocardial infarctions, cardiac arrests, strokes, orthopaedic injuries and surgical emergencies, so it’s varied and interesting.
After clinic, I’ll catch up on administrative tasks. I manage the ship’s medical centre, including overseeing stock inventory, ordering medication and other supplies. I’m also responsible for the roster.
If a patient has been admitted to the medical centre and I’m the nurse on call, I’ll work alongside the doctor so the patient receives the treatment they require and/or prepare them for any further investigations that may need to be arranged ashore. If I’m not on call, there’s time to go ashore and enjoy the ports.
‘My clinical background gives me empathy and helps to make sure the patient is at the centre of what we do’
Working in a multidisciplinary team of doctors, nurses and paramedics means you get to know each other well. There are huge opportunities to learn from colleagues, as we overcome medical challenges in a close-knit team.
I’ve also gained additional skills, such as running bloods tests in our on-board laboratory, performing X-rays and having the ease of being able to dispense medication from the stock we carry. And I get to travel to some amazing places.
Sophina Gapare is director of global quality and process improvement for a medical insurance company
When I had my son, I decided to look for a role where I could use my clinical nursing skills, but in a job where the hours suited me. I actually took a pay cut to make the move from oncology nursing to insurance initially, but I’ve worked my way up to a senior role. In the private sector, you can’t necessarily do extra shifts to boost your income in the way you can in the NHS.
When you’re one of a few clinicians in the organisation, you’re regarded as an expert.
I have to be sure of my knowledge and do my research, but I’ve learned when I need to ask others. Over the years, I’ve been intentional about building a network, so I can reach out for advice – it includes nurses in the community, occupational health, psychiatry. Our work in insurance touches on many different areas.
My clinical background gives me empathy and helps to make sure the patient is at the centre of what we do. As insurers, we’re in the middle. We are paying for the care, but we’re not just the payer. We have a vested interest in the patient getting the best treatment at the best price.
There’s still a bit of a disconnect between the NHS and clinicians who work outside it, but things are getting better. For example, I’ve noticed when keeping my NMC registration up to date, there are now more options given for places of work.
I’ve enjoyed developing my management and people skills, though there are certainly days when I miss working more directly with patients.
I’m the only healthcare professional on an oil rig rcni.com/oil-rig-nurse
When you’re an emergency nurse, you see it all rcni.com/ENs-see-it-all