Working in A&E can be extremely fast-paced and no two days are the same. Rachel McCrate shares an insight into her day-to-day role as an A&E sister in the busy emergency department at Gateshead Health NHS Foundation Trust.
When did you start your career in nursing?
“I started working at the QE Hospital in Gateshead while at Northumbria University as a student nurse in 2008 and A&E was my final placement as a nursing student in 2010. I fell in love with the department, the diversity and unpredictability of patient presentations, opportunities for learning and being surrounded by an amazing team of professionals saving lives every single day. In time I progressed to a senior staff nurse and a sister in 2016 and 12 years later here I am.
“A&E has played a big part in my life and I spent a lot of time with my team. I have always said A&E team = A&E family. I may see things in one day that some may not see their entire life, good and bad. Emergency care is certainly not for the faint-hearted. I have acquired a lot of emergency skills and training since qualifying and have been fortunate to reattend university several times since then. I am now working towards completing my master’s degree – the opportunities are endless. Emergency nursing is something I am extremely passionate and driven about.”
What does a typical day look like as a sister in charge?
“A typical shift for me starts with a whole department handover and as a sister in charge of A&E I need to know about every single patient in the department at all times throughout the day, why they are here and if they have been assessed by our medical team and what their plan of care is. This could be a home plan, admission to an assessment ward or direct onto a specialty ward for further care and treatment. We also transfer patients out of our department to other hospitals for emergency treatment with the help of the North East Ambulance Service.
“My job is to always manage the risk and safety of patients and staff, support the nursing and medical teams and check in regularly with our registrars and consultant in charge throughout the shift. I must plan for expected ambulances attending A&E so each patient can be accommodated safely, liaise with our bed management team so we have constant flow and movement in the department, update the service line and deal directly with specialty medics when required.
“My job is all go, and I must be always available for different situations that may arise. I never know when our emergency red phone will ring, this is an emergency line used by NEAS to alert us to an emergency presentation arriving, I need to make sure we have a bed space and our nursing and medical team ready to assist on arrival, we can often have only minutes to prepare for this. The ability to be calm and collected always is a must in my job role as well as having the ability to pull anything out of the bag you could say.”
Has your job become more challenging since the pandemic?
“My job has always been extremely challenging but the covid restrictions over the past few years meant we had to change not only the layout and working of our department but restrictions of departmental working. This meant staff often went for considerable lengths of time without being able to visit their friends and family. This has been one of the most emotionally and physically challenging times I have witnessed since starting in the NHS but as a team, we continue to push through this and support each other. It can often take me several hours after a busy shift to switch off and relax.”
What do you love about being an A&E nurse?
“I love the diversity of patient presentations, the emergency skills and the experience I have acquired over the year. We can run from 5mph-100mph in a few minutes. Being able to care for someone on what could be, and often is in A&E, the worst day of their life, and provide them with the care and support they need, as small as that may be, is the most rewarding thing. Believe it or not, I can remember every single patient I have looked after and I still get that ‘buzz’ every single shift.”
What else does your job consist of?
“I am also the Manchester triage lead for the trust and provide the A&E staff with the training and skills they need to effectively and safely assess all patients presenting through the department. Triage has always been my passion since qualifying and I constantly strive to improve our triage services. I am also hugely passionate about the health and well-being of our team – something we must all take priority in – particularly since covid. I have recently introduced the Endometriosis friendly employer scheme into the trust – something I am keen to develop and share among staff to improve the working lives of those affected by Endometriosis – something close to my heart.”
How do you manage a busy department like A&E?
“We have over 55 staff now in A&E as well as our medics – we are a huge team! We are the receiving point of the hospital for patient admissions so it is important A&E flows as smoothly and efficiently as it can do daily. We understand long waiting times can be frustrating for some and often a lot of our emergencies are hidden from plain view but managing a busy department on risk and safety is always our priority – we certainly try our best in this.”
Describe your job in three words
“My job is unpredictable, eye-opening and ever-changing. But I wouldn’t change it for the world.”
At Gateshead Health we are looking for experienced and newly qualified nurses to join us. Visit our website for more information and to see our current vacancies.