Day in the life of: Louise, anticoagulation nurse

It is National Thrombosis Week! (1st to 6th May 2017)

This annual event aims to raise awareness and to provide more information on Thrombosis. For the occasion, we are delighted to highlight one of our thrombosis experts and give you the opportunity to understand better what DVT is. Louise has just hosted her 1st Support Group for DVT patients, which was a resounding success so she will now run these every quarter.

Please meet our anticoagulation specialist nurse Louise!

Hi! I’m Louise, anticoagulation specialist nurse practitioner for GP Care. I have been married for 4 years and we have two sons aged 6 and 7. I have been a qualified nurse for 20 years (OMG! Really!). I have a background in Intensive Care Nursing, where I was in charge of a busy major trauma unit in an acute hospital trust. After 15 years in ICU, I felt that I needed a change from acute nursing and went onto surgical bed management within a very large hospital. To say it was a challenge is an understatement!

When I saw the role of Anticoagulation specialist nurse for GP Care advertised, it really interested me. I had never had a major role in anticoagulation before and I thought it would be a challenge as well as a fantastic opportunity to expand my nursing practice. I would be able to combine my acute nursing skills and my management abilities. But let’s go to the point - you must be wondering what my job consists of? I invite you to find it out by spending a day with me!

 

8 am: I just dropped my boys at school, on my way to work now. This morning, I am working at West Walk Surgery, Yate, Bristol, but during the week I also work in different clinic locations. GP Care delivers Community DVT services in 4 locations across North Bristol and South Gloucestershire.

8:30 am: I arrive at the surgery, ready to start the clinic. The first patient will arrive at 9am. I discuss today’s appointment list with the sonographer and HCA who are present with me. At the moment, I am learning how to scan people’s legs for a DVT using an ultrasound machine. In the room, we do our best to put the patient at ease and explain what is about to happen. We also ask his permission for me to scan his leg so that I can practice scanning. I hear a lot of “ooh, am I going to be your guinea pig?” Most patients are happy for me to scan their leg!

 

10:45 am: We have found a DVT in one of our patient’s leg. The patient is upset, scared, wondering what will happen to him and if he is going to die. I explain that it is very unlikely as he will start treatment today. I describe what a DVT is, the pathway and what is going to happen next and reassure him that he will be looked after properly. I talk to the surgery staff about the positive DVT. I have good relationships with all the staff in the 4 DVT centres that we work with. The patient has an appointment with a clinician that morning to start treatment immediately.

1 pm: It’s the end of clinic. There have been six DVT scans and two private scans today among which only one positive DVT patient. The patient has been seen, spoken to at length by the practice staff about the treatment, given all the relevant information and he has already left the practice. This makes me proud of my work with GP Care, proud to provide great patient care in the community without the need for patients to go to a busy hospital and wait for hours before they can receive a treatment.

2 pm: Back into GP Care’s main office at Christchurch Family Medical Centre in Downend. I catch up with my clinical lead (i.e. my boss!) Jackie Adams, Clinical Matron for GP Care. We talk about what’s going on that day in the clinics and in the office. We are currently updating GP Care’s infection control audit tracker. We need to ensure that all the clinics attended by our patients are maintained at a high standard. Jackie asks me to update the tracker and to book in some more audits for us to do.

Jackie (on the left) and Louise 

3 pm: I liaise with Debbie, the senior DVT co-ordinator. I make sure that she has received all the patient records from today’s clinic and that she is aware that we have found a DVT in a patient’s leg. Debbie keeps us all in DVT informed with what is going on and will sort most problems. Truth be told she knows the GP Care pathway better than anyone! We are a great team and keep the DVT service running smoothly so the patients have an excellent experience.

3:30 pm: I have received an email from Sue Bacon, lead anticoagulation nurse at Southmead Hospital, about developments within the world of anticoagulation. As part of my contract with GP Care, I work once a week at Southmead Hospital with the anticoagulant team, learn about what they do and train within the warfarin clinic that they provide. The warfarin clinic in total has about 2,500 patients, including about 250 patients having their blood done every day. The team including myself look at the blood results and inform the patients how much warfarin to take and when to have their next blood test done.

4 pm: I check my emails one last time to make sure there is no emergency. I then look at my diary to recall what is planned on the next day. (I actually do this a lot throughout the day because my memory isn’t as good as it used to be, I blame my boys!) On the menu tomorrow: a one-to-one catch up with Jackie to discuss in a confidential setting, a set aside time slot to work on my DVT scanning coursework (OMG! 1,500 word essay!) And Beavers! I need to put my family commitments in my diary so I know where I am, what I am doing and what time I need to be there!

4.30 pm: Another work day is completed! I am tired but happy because I know that we are providing gold standard care in the community, within easier reach for patients. It’s time for me to pack up my messy desk and pick my boys from after school club and hear stories about their day. They like telling me what they had for lunch, especially pudding and who they played with at playtimes.

If you would like to know more about my work or about DVT, please send me an email: louise.hill@gpcare.org.uk

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