In December 2019, the first ever QNIS Academic Prize was awarded within the Open University. You can read about the ceremony here. The winner was Raphael Kombe Mwarandu, who works as a Practice Nurse in the General Practice in which he had volunteered, shortly after moving to Scotland. This is his story:
My journey into nursing started in March 2006 after leaving Kenya to join my wife in Scotland. With no references from a UK employer finding employment was difficult when I first arrived in the country. I applied for unpaid voluntary work experience in a GP Practice in Girvan as a way of gaining a reference, to aid my integration into the wider society and hopefully aid my future employment search. Initially my Practice role was as a Receptionist, due to previous reception experience while working in a holiday resort in Kenya. This allowed me to enhance existing skills, gain new skills, to pick up the local dialect and improve my communication skills. After 2 months at the GP Practice, I obtained a seasonal Receptionist post at a local hotel, but continued to work on a voluntary basis at the surgery because I enjoyed being part of a positive supportive team and enjoyed the patient interaction. This interaction with patients and staff enabled me to enhance my communication and people skills which have been vital prior to, during and post my nurse education.
After five months of volunteering at the Practice, a Receptionist post became available which I successfully secured and marked the official beginning of my exciting career in healthcare. For the next four years, the Practice provided various training sessions such as the RCGP Scotland Practice Receptionist course and a NHS Ayrshire and Arran Medical Receptionist Development course.
During my 2010 annual appraisal I was asked what my PDP (Personal Development Plan) for the following year was. I had noticed an increasing demand for phlebotomy appointments which was impacting on the Practice Nurses appointments and therefore asked if I could undertake phlebotomy training to relieve the pressure on the Practice Nurses. This training was organised through the local Health Board and followed up with in house Practice Nurses mentoring. In 2011 an initiative through the Podiatry Department for Diabetic Foot screening enabled me to undertake low risk diabetic foot screening. Through annual appraisal over the next 3 years I was able to obtain training for ear care, spirometry, wound care, urinalysis, ECG and vital signs. Acquiring these skills paved the way for my transition from Receptionist to Healthcare Assistant.
In 2012 my employer asked if I was interested in pursuing a nursing career because I had shown myself to be a competent Healthcare Assistant and patients were giving positive feedback on my clinical skills and temperament. I knew pursuing a nursing career was something I would like to do, but because of financial and family commitments full time study was impossible. It was made clear that the Practice was prepared to support me through the training if it was something I wished to pursue.
After my appraisal it came to my knowledge that the Open University (OU) offered a distance learning Pre-Registration Nursing Programme which would allow me to work while pursuing nursing education. I contacted the University and their representative visited the Practice. They advised that the Programme was a partnership between the Scottish Government and Health Boards to promote career progression for auxiliary nursing staff in an attempt to increase the nursing workforce. The application requirements were explained. I needed Maths and English grades that met NMC requirement for Nursing Education and employer support throughout the programme. The representative covered how the practice placements were organised and funding arrangements should I secure a place on the Pre-Registration Nursing Programme.
My grades were not sufficient, so I enrolled in Maths and English evening classes at the local college, two nights a week for a year. Once achieving the desired grades I secured a place on the four year Open University Pre-Registration Nursing Programme. I was the first student to enrol from a GP Practice and therefore required an honorary Health Board contract to ensure indemnity cover whilst on student placements. My base placement for the four years training was the Community Hospital attached to my GP Practice, but I had the opportunity to have placements in clinical areas out with my base. My placements varied from a Surgical Receiving Ward, Community Nursing, A&E, Day Surgery and ITU. These clinical placements helped me acquire new skills, gave me the ability to plan and prioritise care, promoted team working, enhanced pre-existing skills, and ensured I provide safe, individualised and evidence based patient care. After four exciting and challenging years I qualified with a Bsc (Honours) in Adult Nursing.
After qualifying in October 2018, like most new registrants I wondered which nursing career path I would follow. I have enjoyed and gained so much through my involvement with the staff, patients, their families and carers in all the practice placements. This made deciding which nursing career path to follow an increasingly difficult decision, i.e. Secondary or Primary Care. Working in a Primary Care setting offers opportunities to gain experience and expertise in various areas of practice, e.g. COPD, Diabetes and Counselling to name but a few. I have been extremely fortunate to have worked with a supportive GP Practice and this helped me make the decision to apply for a job in the same GP practice I joined 13yrs ago as a receptionist/administrator.
My role within the Practice now involves assessment and evaluation of patient care, providing advice and managing care for those with long term condition and delivering care following referral from the GP for various treatments such as: Venepucture, Ear Irrigation, Wound Care including suture and clips removal, Injection Administration (Hydroxocobalamin, Flu, Pneumococcal, Tetanus, Testosterone, Hep C and Fragmin), Blood Pressure Monitoring, Low Risk Diabetic Foot Checks, Diagnostic Spirometry, ECG, assisting GP with Minor Surgeries, running a Smoking Cessation clinic and assisting a GP run Respiratory Clinic. Over the years my employers have shown themselves to be committed and enthusiastic in encouraging their staff to advance their roles within the Practice and I have found that this has continued since joining them as a Practice Nurse. I have also found that NES is invaluable as it provides a wealth of training opportunities for nurses. Within 4 months of joining the Practice as a qualified nurse I completed Telephone Triage, Long Term Conditions Training, Introduction to COPD and Management of Minor Illness including Triage provided through NES. September 2019 I was successful in gaining a place on the 13 months NES run General Practice Nurse Programme. All of these training courses will increase my knowledge, clinical skills and competence enabling me to offer safe evidence–based care.
Being nominated for and the successful recipient of the QNIS award for my work in the community during and after my training so soon after becoming a registered nurse in Primary Care has brought a great sense of pride and achievement and has motivated me to continue to work hard in delivering safe and person centred care to patients in my community. Receiving the QNIS award has also motivated me to continue to seek/gain knowledge and clinical skills through post graduate training as I have started to look at the programmes offered by QNIS. I will be striving to join the QNIS Programme as this will not only allow me to acquire new skills and enhance existing ones but will enable me to progress to doing a Masters, Non-Medical prescribing and eventually becoming an Advanced Nurse Practitioner. This will allow me to provide patients/service users, their families and carers a safe and high quality of person centre care, improving their health outcome within community.
One of the things I like about my new role as a Practice Nurse is the interaction with patients and their families as it puts me in a unique position to build a rapport with them and provide continuity of care. This can help patients feel at ease and enable them to discuss their worries and anxieties about their health, which offers me the opportunity to provide the patient with appropriate individualised care, improving not only their health outcome but empowering them to manage their own health.
Last but not least I would definitely encourage anyone thinking of progressing their career from an Auxiliary Nursing/Healthcare Assistant to a registered nurse to grasp the opportunity when they can as it is possible. If I can do it everyone can! Pursuing nursing education as a mature student and gaining my qualification was very rewarding and gave me a huge sense of achievement. However, challenges such as time pressures, being out of your comfort zone whilst in new clinical areas and competing priorities can have a negative impact on the overall experience of being a mature student, but having the right support from family and friends, employers, work colleagues, mentors and the Open University helped me overcome these challenges.