Madeline Wilson works as a Clinical Team Lead for District Nursing and is committed to ensuring that the people of Renfrewshire receive the highest quality and standard of community nursing care and treatment.
As far as I can remember, I had always wanted to be a nurse. My parents used to say I had my life plotted out from the age of about five or six – I never wavered from nursing. My grandmother had lived with us when I was young, and from the age of 13, I cared for her.
When I was a student nurse, I went out with the district nurses in Paisley for a short period and I just remember loving the chat and the banter of being with the patients in their own home. I loved how real it felt. I don’t know whether it was because of the experience of caring for my gran at home, but something struck a chord and I knew it was the role for me.
After qualifying, I worked for a while on the wards before completing a diploma in district nursing. I worked as District Nursing Sister for 24 years in various areas before taking up the position of Clinical Team Leader for District Nursing in West Renfrewshire.
District nursing has changed dramatically since I started as a student in the early 90s. The role is as important today as it was then, but recognition must be given to the diversity and complexity in the care provided and the new technologies available.
When I was appointed as Clinical Team Leader, I quickly realised I was on a steep learning curve – I was a very experienced district nursing practitioner but was ready for a new challenge and I believed I could be a positive role model within Renfrewshire Health and Social Care Partnership.
I am directly responsible for the line management and supervision of nursing staff. I advise senior mangers on matters relating to service delivery and effectiveness, I take responsibility for the performance review within the team, and I lead on professional and practice development.
I am responsible for the operational management of the service and I work alongside the staff by going out into Clinical Practice and working with them in the delivering of care to patients and their families. I am visible to the teams and I believe it gives me credibility that I am seen to “do the job.”
As a leader, I try to be enthusiastic, a good listener and to see things from other people’s perspective. These are qualities that I have tried to adopt and use throughout my career as a district nurse and in my current role.
For the service to work effectively, we need staff who are out there on the ground doing the job to feel supported – and I see that as my role.
District nursing is a wonderful job, and I hope by sharing my clinical expertise I’m encouraging staff to be the best nurses they can be. A good district nurse will have compassion and empathy at their core, but they’ll also have a very high level of technical skill and able to work independently. When you open that door and you go into somebody’s house, you don’t know what you are going into, and I think a really good district nurse is somebody who is intuitive, who can quite quickly grasp a situation and those skills are very complex and highly developed. It’s about being open and friendly for people to want you to be in their home – that’s not always easy, enabling people to feel truly safe with you as a stranger in their home requires significant skills of listening and communication. You also have to be pretty resilient, you never know what you will encounter and you need to be self-reliant, thinking quickly and making good decisions. But most of all, you’ve got to be respectful of other people and how people live and not impose your views on to others.
We are in a very privileged position visiting people at home and so you need to really seek to understand that person and their preferences. A lot of patients on your caseload will be on that caseload for a number of years and working with them and their carers within their own homes or a homely environment brings the greatest of rewards, a sense of pride and achievement.
I continually strive to ensure that teams are supported to deliver the most effective, efficient and highest standards of care. A high level of professionalism ensures patients within our communities receive dignified care that improves and or maintains their health and wellbeing.
Having been a Practice Teacher for 21 years, I have mentored and supported district nursing students and trainee practice teachers during this time. Nurturing and supporting the District Nurses and practice teachers of the future has been an important part of my career. Since 2014 I have mentored seven SpQ DN Students and two practice teacher students, across Greater Glasgow and Clyde and hope that these District Nurses will be the visionaries of the future, setting the standards and having the confidence to help people achieve better health outcomes.
In my role as a clinical leader, I want to ensure a service that is strong and robust – I want there to be a district nursing service that people are proud of. The improvement I am developing as part of my Queen’s Nurse award is the further integration of working between the overnight out of hours district nurses and the care at home services.
The purpose is to deliver an effective and high quality Out of Hours Service that maximises resources and improves experience and outcomes. If someone’s health deteriorates at night, there are often fewer options available. On occasion this can result in people being taken to hospital unnecessarily.
Building on the learning from a previous pilot looking at the evening and overnight service, –we hope that by co-locating the services and identifying areas of improvement we can improve patient outcomes and experience.
Some of the goals of the service redesign include an increase in the overall overnight capacity, an
increase in the number of planned care at home activities, and a reduction on travel time and enhanced response times for unscheduled care. Feeling alone when something happens in the middle of the night can be very frightening. By ensuring that we have excellent community nursing and care staff available, we hope to enable more people in Renfrewshire to be well cared for at home 24 hours a day.