Meet Francesca, Rapid Response Nurse | Bristol Community Health Careers Bristol Community Health
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Francesca

Francesca

Band 5 Rapid Response Nurse

“I chose this type of work as I found it more rewarding. I was able to complete a whole care episode.”

  • Tell us about your role. What do you get up to on a typical day/week?

    A typical morning for me is starting work with a number of new referrals alongside our current caseload of 22 patients. Our new referral has been referred by REACT at the BRI via the Single Point of Access (SPA). Rapid Response has been asked to visit for clinical assessment, mobility review and support with new medication for gout and UTI.

    Before I visit the patient I check our computer system to see what the past medical history shows and if there are any safety alerts known and what information the GP and others involved have documented prior to admission to A&E. I also check with my colleagues at REACT to see if any equipment has been supplied or if I can take any equipment in with me. I arrive at the patient’s home where I start my initial assessment by introducing myself and explaining what our service is about. I explain Rapid Response is a team which provides acute care in the home to avoid having to remain in hospital.

    I take the patients observations to check they are clinically stable, I then go through the medications and ensure they match the discharge letter. I check to see if the patient is ok taking their new medications and knows how long to take those for so they can treat their gout and urine infection.

    I proceed to assess them with a wheeled zimmer frame that they were sent home with. They are a little unsteady but with practice the patient is deemed safe. I check to see the patient can manage their own personal care, meals and toileting. It is decided together, that the best plan at present would be for Rapid Response to visit once a day in the morning to assist with their personal care, monitor pain, monitor swelling and redness in their knee, and if no improvement to take bloods for infection markers. I have also suggested that a physiotherapist can visit next time to help build confidence.

    When I have returned to the office I hand over my new patient to the coordinator. After this we have our official handover at 11:30 where we discuss all our current complex patients utilising all our teams’ skills such as Support Workers, Nurses, Physiotherapists, Occupational Therapists and Advanced Practitioners.

  • What’s the best thing about working in the community? What made you choose this kind of work?

    Research shows that patients often heal better in their own environment so to be able to offer this service to people in their own homes to prevent admission or facilitate early discharge is extremely rewarding. You work mainly autonomously but have the support of your clinical leads. This has enabled me to develop my working knowledge further and develop my clinical skills. I love working within the community because it has made me think in a different way around patients’ nursing needs. I still provide a wide range of clinical skills but also offer solutions which would not be available in the acute trusts.

    I chose this type of work as I found it more rewarding. I was able to complete a whole care episode for a patient instead of just supplying an initial acute need. Within Rapid we provide acute care to help support a patient who is unwell, however during our care input we are also able to highlight the patient to other services if required, for example, district nurses, palliative care services or social workers. I love the fact I am able to provide a whole assessment of care for a patient.

  • Describe the working culture here?

    The working culture within Rapid is excellent. We work a range of 3 shifts – 07:30-15:30, 11:30-19:30, or 08:00-16:00. This provides a good range of flexible working with a good work life balance. Rapid Response is a great team to work for who provide excellent team work and are extremely supportive. I class my team not only as colleagues but friends who I know I can rely on if I am struggling with a certain patient or if the patient is deteriorating. I know they are only at the end of the phone.

  • What do you think makes someone successful here?

    What makes someone successful within the Rapid Response service is positivity and willingness to work hard and learn. Rapid Response is a team where hard work goes a long way and helps not only the patients but the team work as a whole. A positive attitude with a wider knowledge will help with clinical handovers and thinking of the bigger picture when looking at patient care. We treat the patient as a whole following a holistic approach and therefore require a multitude of skills ranging from nursing needs to therapy needs.

  • Tell us about the learning and development and career progression opportunities?

    There are many learning and development opportunities available within Rapid Response along with Bristol Community Health. Using the online booking system there is a range of clinical skills along with management and health and safety training. There is a lot of support and positive feedback regarding career progression. With regular 1:1s and performance reviews every six months it allows for a development pathway to be cultivated. There are external courses offered by UWE which again helps you progress to the next level within your career with support from the clinical teams. The main course available to the Rapid Response team is PACR (Physical Assessment and Clinical Reasoning) as this helps us with our advanced clinical assessment of the critically ill patient.

  • What’s the most rewarding thing about your role?

    The most rewarding thing about my role is being able to support patients to stay in their own home instead of being admitted to hospital. Within Rapid Response you cover a range of nursing skills such as providing IV care at home, or supplying palliative care needs for a patient who wishes to die at home. It is also allows for us to supply pieces of equipment to help allow a person to stay more independent within their environment or support people with infections or borderline admission who need close monitoring. It is the most rewarding job when you know you have made a difference to someone’s health and helped them get through a hard time in their life. It is also rewarding to be able to support a person who is near the end of their life by being able to make them comfortable.

  • What do you think patients would say about the service you provide?

    The feedback received by patients is often positive and they are grateful that our service has prevented the patient having been admitted. We normally see the patient within a 4 hour turnaround from referral and this is received well by patients and family. They feel we provide a thorough, efficient and effective service.

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