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Finnbarr McCloskey

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  • Finnbarr McCloskey
  • Emergency Nurse Practitioner, Altnagelvin Hospital, WHSCT

I have been working as a nurse in the emergency department in Altnagelvin Area Hospital for six and a half years. I qualified with a first class honours degree in adult nursing at the University of Ulster’s Magee campus as a mature student in 2009. I had a placement within the emergency department as a student nurse and when I was offered a job there six months later as a newly qualified staff nurse I was excited at the learning prospects I would have.

The first year as a newly qualified staff nurse in emergency care I found to be stressful. I found that by going on the appropriate courses at the appropriate time gave me confidence in dealing with the patients I looked after.

During the first six weeks I attended ALERT. This gave me the tools and basic knowledge I would require in recognising the sick patient without overwhelming me with information.

I attended intermediate life support between month two and three. During this time the department held two minor injury days for the new nurses. During these two days the emergency nurse practitioners taught us how to apply slings, hand and ankle strapping, splints, basic x-ray interpretation and the anatomy and physiology of limbs. In addition the emergency department consultants gave us talks on fluid resuscitation and management of the various conditions that are dealt with within the department such as COUP, COPD, MI, STROKE, Sepsis.

Between months seven and eight I attended Paediatric intermediate life support. It was during these months that I was taught POP theory and application.

At the end of year one I completed advanced life support.

During year two I was taught the Manchester Triage System. At the end of year two I completed Advanced Paediatrics Life Support.

Year three for me involved beginning to “think outside the box” in relation to the direction in which I wanted my career to go and further advancing my skills in relation to patient care. I applied for a minor injuries course which I completed with the University of Ulster.

At the being of year four I decided that I wanted to become an emergency nurse practitioner. I applied to do the two year specialist practice course in emergency nursing with the University of Ulster and was successful in obtaining a place.

During this two year course I completed 84 days of clinical practice working with the various specialist nurses involved in emergency care. It was during these last two years that I feel my role has changed, I have become a leader, and my duties now included being in charge of the emergency department and promoting patient flow through the department. I am now also a sign off mentor for pre-registration nursing students. I have gained confidence and experience from completing my specialist practice course and I now find that, junior nurses and doctors seek my advice on caring for patients.

During my first year in emergency care I was frightened if anyone even made eye contact with me. I avoided answering the phone and was terrified if I was asked questions by patients or their relatives. The resuscitation phone and room was something I would run from. However, I quickly realised that knowledge and experience would help alleviate these fears. It was at that stage after completing ALS that I volunteered for resuscitation and any courses which I felt would assist my practice.

Now six and a half years since starting my job in the emergency department I now feel that I have a wealth of knowledge and skills which help me in the care of sick patients and manage various situations. I now look to national guidelines and through audits this helps to influence the care I provide. Emergency care is a stressful environment but I cannot now imagine myself working in any other department.

Reading list which helped me:

Minor Injuries. A Clinical Guide. 2nd ed. Dennis Purcell
Accident and Emergency. Theory into Practice. 3rd ed. Brial Dolan and Lynda Holt.

I also found useful various websites such as the Department of Health and Royal College of Nursing.

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