Blaising a Trail

Blaising a Trail: Practising Nurse-Led Floor Progression

After more than 15 years in vet nursing, Helen Binge is used to picking up any tools of the trade that help get the job done.

With a focus on anaesthesia, she has lectured around the country and been at the cutting edge of improvements she has seen could make a difference.

Now, the first thing Helen does each morning is get hold of an iPad. She accesses a programme that, added to tight teamwork, constant communication, skilled personnel and state-of-the-art facilities, helps with the smooth running of IVC Evidensia’s purpose-built Blaise Referral Hospital in Birmingham.

And, six months after its launch, the nurse-led floor operation is making the team’s working life better and, critically, ensuring the best possible experience for clients and their animals.

Helen qualified in 2008 at a first opinion and referral hospital, took on a head theatre nurse role there and quickly realised anaesthesia was her real passion.

She then moved to Bristol Vet School at Langford Campus, working as an anaesthesia nurse for several years before suggesting the introduction of a clinical workflow coordinator to improve efficiency.

“I soon took on that role full-time and really loved it,” said Helen.

“When the chance came up to join Blaise in a similar role last November, as part of the management team, I jumped at it. We have a nurse-led clinical floor here, which results in a very holistic approach to taking care of our patients.”

There’s an open plan set-up at the clinically designed hospital, with a corridor of consulting rooms leading into a large central ECC and prep area. There are four wards, eight consult rooms and four theatres, all equipped for mobile radiography and Fluoroscopy.

The hospital has an ICU with separate treatment area, two imaging rooms, oncology with two separate treatment rooms, a dispensary and much else besides.

Having everything easily accessible maximises the ability to deliver patient-focused care by making clinical decisions as close to the patient as possible.

And from first thing until last, ensuring everyone is on the same page is central to the nurse-led philosophy.

“We’re paperless here, so I’ll grab an iPad when I arrive, log onto SmartFlow and see what cases have come in overnight.,” said Helen.

“At 8.30am we’ll all get together for rounds; discuss every patient and what procedures they may need. Then I’ll plan what we’ll be doing before spending the day around the hospital floor, keeping a track of how everything is going and accommodating emergencies."

“First opinion vets can refer an emergency case here to be stabilised at any time of the day and the team can then decide what’s best for the pet’s ongoing treatment. It's all about maintaining efficiencies, getting to see as many patients as we can in a safe manner and providing the best possible treatment for them.”

Setting up her previous role at Langford was a career turning point for Helen.

“I learned how to hold myself and articulate things without being rude,” said Helen. “I had to find how to communicate in a polite but assertive way. If you get people’s backs up, then that doesn’t help in achieving what you want.”

Those communication skills have come to the fore at Blaise, where everyone is consulted and kept informed.

Having an overview of everything as part of the leadership team means that issues that could be experienced elsewhere, with one discipline having more say in what happens when, can be avoided.

“The nurse-led floor model means I’m not biased to any discipline or service, it’s all about the patient."

“We have a holistic approach to the overall capacity of the hospital and the welfare of our colleagues. You need to look after people. If the team feel they can’t do their job well because they are pulled in too many directions and aren’t appreciated, they just won’t enjoy it and will leave. So, it’s all about looking after them and making them feel empowered.”

A large part of the nurse empowerment comes through knowing they are being heard, again a key tenet of Blaise’s nurse-led philosophy.

It’s something that’s not universal within the profession.

“You can get that hierarchy of the vet and the nurse, with a feeling of a big gap between them,” said Helen.

“Here we are all equals. We may have different job roles, but we can’t work without each other. Everyone’s opinions need to be aired and they need to be listened to. They are all valuable.”

While intense preparation and detailed planning went on in the run-up to Blaise’s opening last autumn, seeing how things have worked in practice has led to many accommodations.

“We’ve been very flexible and fluid in trying different things,” said Helen. 

“You can’t be unwilling to adapt and change in this role. So, I’m already looking at the big picture and thinking about how we’ll work in the months and years to come as we grow and get busier. I’m always listening to our colleagues, too, hearing what they feel will help improve what we do.”

Being a part of the management team at Blaise, as well as the chance to be in at the start of something new and exciting, made the move irresistible for Helen.

But it meant relocating from a little village near Weston-Super-Mare to the outskirts of Worcestershire.

“I had long conversations with my partner who was very supportive in us selling the house, giving it a go and not always thinking about what might have been,” said Helen.

“We’re lucky to have found somewhere rural with lovely walks nearby, but the main thing has been leaving family and friends behind and moving to somewhere we literally know no one. Having to build a new social circle from scratch is probably the main compromise.”

It’s a move, though, she doesn’t regret for a second, and she is always conscious that at the heart of Blaise are the clients and the patients.

And everything that happens is with them in mind.

“My work ethic is patient safety and welfare first, followed by colleagues and then business,” added Helen.

“If you look after the first two, the business does well. When we look after the safety and welfare and have colleagues that are happy and able to do their jobs well, the patients get the care they deserve. Getting diagnosis and treatments quickly for their pets means clients are happy and that’s the service we’re here to provide.”