My experience transitioning from frontline nursing to a digital role

Working on the wards after graduating

I was eager to graduate and start my first job as a Registered Nurse in Major Trauma and Orthopaedics at Leeds General Infirmary (LGI). Every day, patients came in with severe and traumatic injuries and my small team of healthcare professionals had the responsibility of caring for them. This job required me to be efficient at wound care management, pain control and medication administration. I learnt to operate in high pressured and critical situations, which demanded professional competency, excellent communication skills and strong teamwork.

It was during my time on the ward that eMEDs (electronic medications) and eObs (electronic observations) were rolled out. eMEDS allowed clinical teams to prescribe and issue medications to a patient through an electronic system. Similarly, eObs allowed clinical observations (Pulse, Blood Pressure, Temperature, Respiratory Rate, Oxygen saturations – all part of NEWS2) to be recorded via an iPad by a healthcare practitioner and the results to be fed back into the Electronic Patient Record (EPR). These systems helped the clinical teams to improve patient safety and reduce medication errors in different ways:

• eMEDs flags drug interactions or patient allergies when a new medication is prescribed, acting as a safety net that was non-existent with written medication charts.
• eMEDS removes the challenges of illegible hand-written medicines and associated errors.
• eObs requires a double signature if a patient is above a certain NEWS2 threshold, meaning that the nurse is always informed if a patient reads to be unwell.
• The integration of eObs with the EPR allows visibility to other healthcare professionals to track the patient, even if they are not on the ward (e.g. a doctor on the other side of the hospital can login, see the patient’s observations over time and intervene if necessary).
• eMEDS allows a Doctor or Nurse Prescriber to login and prescribe medication from another ward permitting faster treatment and interventions.
• eCharts were also rolled out during my time at the LGI, helping to more accurately assess, plan and record patient care.

Big changes with better patient outcomes

I felt really lucky to see such big changes happening that simplified how we cared for patients. Moving some processes to digital made a real difference to their health outcomes while in hospital.  It was this transformation of care from paper to digital that made me keen to pursue a role that could have an impact on transforming the way the NHS works.

Today I work four days a week as Project Support Officer at the Health Innovation Network (HIN), Academic Health Science Network for South London. My fifth day of the week is spent nursing on a day surgical ward, which I think really helps me to understand the opportunities that might make the biggest difference to patients.

At the HIN, I support the Digital Transformation and Technology team in health technology projects to drive the adoption and spread of innovative ideas and technologies across large populations. It occurred to me that, this combined with my nursing, put me in a position where I could capitalise on my clinical experience to help drive digital transformations for patients, clinicians and other stakeholders.

To further enhance my digital learning, I applied to join the digital pioneer fellowship in September 2020. This was with the ambition of applying my learning from the fellowship to support the Dermatology Improvement Collaborative programme. The programme aims to provide NHS Trusts with a framework to improve their dermatology services.

Research drives meaningful change

Research is very important to implement change and transformation in the NHS. I have seen firsthand how proving a new process works can accelerate the uptake and eventual benefits to patients. I learnt that whilst the rollout of eMEDS and eObs had a large technological component to the project, for it to be successful, it required strong clinical and senior managerial engagement to drive the service transformation forward. This links to a few of the learning modules that I have studied as part of the fellowship. The psychological aspect of change management to properly engage stakeholders and how strategic influencing can impact the success of a project, are elements of the digital pioneer fellowship which I have found extremely beneficial to study and which I will be able to apply to my projects time and time again.

“As a nurse, something that is always emphasised to you is the importance of evidence and evaluation. It’s important to understand what the evidence base is for treatments, and clinical research is of course vital for innovation. That is something that I think can be applied to my work at the HIN as well – a lot of the work we do is about real-world evaluation and there are definitely parallels in the mindset and approaches required”.

The benefit of networks

Equally, the network of like-minded people and senior NHS mentors taking part in the Digital Pioneer fellowship, willing to share their experience, has been invaluable in understanding what is going on in the system, helping to link up projects and share common problems with a group who all have similar goals, all involved in digital transformation and innovation programmes.

Finally, each digital pioneer fellow choses a mentor from a pre-selected list at the start of the fellowship. I have been linked up with a digital nurse consultant at Oxford University Hospital, who has helped me to revisit the day-to-day life of technology projects being rolled out in hospital, looking at both the challenges but also the direct benefits this can have on staff and patients.

I hope to continue using my learning, research and understanding of the evolving landscape to be involved in both the digital and clinical world. I am proud to be a nurse driving digital health projects forward focusing on the improvement and redesign of NHS services to best impact patient care and staff satisfaction.