Keara Farrell
Charge Nurse
Thornhill Community Hospital, Dumfries and Galloway
From an early age, I looked after my grandparents when their health got worse and then my neighbour asked me to help look after her father. My first summer job as a teenager was looking after an older person in their home. My friends couldn’t understand why I would want to do that at such a young age, but I loved it. I feel really strongly about providing care in someone’s own home wherever that’s possible and appropriate.
Thornhill is a cottage hospital for rehabilitation and end of life care. There is more continuity in care as there is less staff. Sometimes we care for people after they’ve been in hospital and before they are ready to go home and it’s good to see someone who has been very unwell getting back to how they were. I have worked as a community nurse over the last six years. I love the opportunity you have to build rapport. Building relationships becomes even more important for end-of-life care. We get to know the families and we go on to provide bereavement support.
Every day I hope not only to provide rehabilitation but to be mindful of each person’s mental and spiritual health. I make sure that all staff are aware of someone’s needs, adapting care plans to fit each person’s routine. Care with the least amount of disruption or to change to someone’s regular schedule makes for an easier transition between the community hospital and home. It’s rewarding to see a person’s mood lift as they work through the carefully curated care plan, knowing that my preparation has improved their wellbeing.
Throughout the academic year, we are extremely fortunate to support nursing students who are just starting out in nursing. Playing a part in their education is an honour, it’s encouraging to see student journeys from the beginning to the end of their placement. I want them to see the reality of the situation and the role they could play once they qualify. The Scottish government’s Nursing 2030 vision is a long-term strategy to shape the future of the nursing workforce. With our ageing population, more care will be in the community and so community nursing is evolving in a big way. When I am facilitating student placements, I ask for their honest feedback on my mentoring by using envision cards. Students on placement often tell me they had underestimated what community nursing involves. There is a bit of a stigma, some think that nurses become deskilled in the community but there are so many opportunities to develop and specialise.
I bring my confidence and knowledge to every new opportunity. I have been in post as charge nurse for over three years now and have developed my leadership skills. Although it was a huge learning curve, I have the drive, motivation and passion to be the best practitioner I can, that enthusiasm has helped mould me into the person I am today. The Kouzes and Posner exemplary leadership practices include encouraging heart. That’s a message I relate to. I love sunflowers and everyone now associates me with them. They grow to face the sun but, when they have no sun they face each other. To me, sunflowers express the importance of good leadership and effective teamwork. When staff feel as though they “have no sun” but can rely on the warmth of colleagues and comfort of collaborative working it creates a better, healthier working environment. Last May I sowed my own sunflowers for the first time, and their growth turned out to be the perfect metaphor for my reflective journey. Sometimes they faced setbacks, were bothered by rabbits or bad weather, but ultimately, they bounced back and flourished. Resilience in the face of challenge doesn’t just create healthy sunflowers, it creates stronger nurses.
Although I’m in a senior role I’m not afraid to share with the team and seek assistance from other staff. When days aren’t good, we should not be afraid to speak to one another. When I started, I didn’t think I could ask for help without looking weak. Knowing it’s okay not to know something and that we all grow when we share has been freeing.
Rewind to April 2020, Thornhill Hospital was required to close as a response to the COVID outbreak due to social distancing measures. Therefore, all staff were required to be deployed to alternative areas. My initial deployment was in post as acting senior charge nurse. During this time, I was part of a project team preparing a step-down ward from our acute hospital that would be located in our old maternity hospital. Despite getting this ward ready promptly we thankfully did not have to open during the first wave of COVID-19. Setting up a ward and being involved in management projects were things I hadn’t previously been exposed to so, although stressful, it was great learning for me.
Since then, I have been deployed to other roles many times – into COVID assessment roles, community nursing posts and rapid response team. Adapting to new ways of working and meeting new teams in a temporary set-up has been challenging and I remain open-minded which helps me cope with these unpredictable times. I have learned to prepare for anything, knowing I could be moved any time. I participate in mindfulness exercises; group Zoom sessions and nature walks. I recently read an article I found by Michael West about having a safe space offload, a place where I can be kind to myself whilst being kind to others. The quote I remember is: “The kinder we are to each other, the kinder we are to our patients” and I am comforted by the thought that they might pass that on too.
In January 2021, the project team were brought back together, and the step-down ward had to be opened within ten days as a response to the COVID outbreak in Dumfries & Galloway. Acting up as senior charge nurse again, I was responsible for supporting the team during this time. There was a reduced pool of core staff and most of the team was made up of deployed nurses from a variety of backgrounds. Despite the circumstances, it was a positive learning experience for me, a new ward, a different set of skills and a brand-new team made up of staff who had never worked together before. This has been my biggest achievement to date.
