Emergency teams sharing the load

Emergency Nurses Day on October 11 has provided a timely reminder of how the elite cooperation between Grampians Health campuses has impacted positively on the teams.

The development of Grampians Health has highlighted the diversity of the different campuses involved and nowhere is this more evident than in the initial presentation of care at Emergency or Urgent Care. That diversity spreads from an urgent care team you could count on one hand at Edenhope to the clockwork structure of a 200-plus emergency department at Ballarat.

Where the Ballarat team are large enough that everyone knows their part and there is always someone available with the right skills for each situation, the smaller campuses are required to possess multiple skill sets. These rural campuses can still have very serious emergency care presentations and the teams are always ready to step up when needed. It’s what makes the Grampians Health team so unique.

Edenhope’s Director of Nursing Tricia McInnes is a great example of a multi-skilled nurse. Ms McInnes has acquired a limited radiation license so she can X-ray limbs. She is also completing Rural Isolated Practice (RIPRN) training which will increase her skill set in the emergency setting.

Stawell Urgent Care also has both RIPRN nurses and Nurse Practitioners as part of its team who have extended ability to treat and manage patients in collaboration with, or in absence of, medical staff.

Horsham has the only Emergency Department in the Wimmera and while the unit is only a fifth in size compared to its sister campus at Ballarat, the team includes a dedicated stroke care unit that has won multiple national awards for its achievements. There is great connection however, between all of those initial point of care teams at each campus who work collaboratively to ensure the patient is at the most appropriate facility for their care requirement.

Emergency nurse unit manager at Ballarat Base Hospital Kirsty McLean said the ED management team travelled to Horsham and Stawell for introductory meetings soon after the merger of Grampians Health.

“We had initial discussions then that helped us understand the workings of each department and since then we catch up regularly on Teams meetings,” Ms McLean said.

“Having that initial face-to-face contact has made our meetings and phone calls more congenial.

“I feel very comfortable ringing Horsham ED’s NUM Odette Richards and asking her for help with forms or around programs they’ve adopted. In return, Odette is happy to ring me to ask about things like our short stay pathways and I can provide support there rather than us reinventing the wheel each time.

“It’s no different with Stawell’s Urgent Care. Stawell NUM Amy Yole and I are also in regular contact. Right now, we are supporting Stawell’s urgent care nurses to consolidate and maintain skills by working in a supernumerary role in our resuscitation bay at Ballarat.

“We have also offered to our staff the opportunity to work in Stawell and Horsham,” she said.

“I feel it hasn’t really been a hard transition and I’m quite comfortable that as Grampians Health, we are working together and striving for the same thing.”

Odette Richards echoed Ms McLean’s thoughts and said teams were sharing policies, practices and team members in what had been a collaborative approach.

Ms Richards said Horsham’s ED team was small compared to the 200-strong ED team at Ballarat.

“What makes our team work strong is the cooperation of doctors, nurses, orderlies and ward clerks all supporting each other,” Ms Richards said.

“Every team member who works in ED talks about how well we all work together to meet each challenge and get the job done.

“It’s what makes people such as nurses on placement want to come back to work at our organisation.”

Ms Richards said her department was currently implementing the Timely Emergency Care Collaborative which aimed to improve timely access to emergency care by delivering strategies to improve patient flow.

“A lot of the initiatives that we have introduced have been driven by our nurses and they are leading to significant improvements to our ‘seen-by’ times,” Ms Richards said.

“There are examples of how they have initiated things like taking blood tests and getting them to Pathology much quicker or giving pain relief for a patient while they are waiting to see a doctor.

“Not only that but when the patient goes home, we are doing a lot more referrals to allied health. For example, a patient might present with back pain, so we make sure they get followed up with an allied health professional and that will lessen the likelihood of them returning with the same problem.”

Amy Yole and Kylie Davey share the role of nurse unit manager at Stawell’s Urgent Care Centre. Ms Davey said her team had a great attitude toward supporting each other and had built a positive culture that has nurses contacting them to join the team.

“Our team is well-equipped to support and stabilise all presentations no matter the complexity and we have access to further internal and external support when it’s needed.” Ms Davey said.

The team has many years of experience working remotely and are well respected by the community. Team members are very passionate about ensuring the community has access to emergency care and are all ready and willing to assist when needed.”

Ms McLean was also grateful of the teamwork at Ballarat and proud of the culture and welcoming attitude of her colleagues.

“I’ve worked in this ED for 20 years and in my various roles, I’ve seen all sides of support and what it looks like,” she said.

“It’s become more evident just recently where we did a swag of interviews for education programs and in each interview, nurses were asked why they wanted to work in Emergency at Ballarat and the answer was always’ because the culture is so good, and I feel supported and looked after’.

“We support everyone, and we pride ourselves on that and I want to see that continued.”