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Rebecca, Older People's Medicine

Rebecca, Older People’s Medicine

Norfolk and Norwich University Hospital NHS Foundation Trust

How did you begin your career working in Health and Social Care?

I graduated Medical School and began working in the NHS as a Junior Doctor based at the Royal Victoria Infirmary in Newcastle. I’d never been to Newcastle before I was interviewed for this job, indeed I probably hadn’t been further ‘North of Watford Gap’! I was struck by the friendliness of the Northerners and portion sizes of food given to me in restaurants!

I completed 6 months of Medical jobs there and then moved to Glasgow Royal Infirmary to complete my surgical attachment.
I returned to Newcastle to train as an Older People’s Medicine (OPM) Specialist and once my training was complete I spent 12 years as a Consultant at South Tyneside Hospital. I returned to Norfolk, the county of my birth, in April of 2019 and now work as a Consultant in OPM at the Norfolk and Norwich University Hospital (NNUH).

What are your day-to-day responsibilities in your job role?

A typical day starts with attending the daily ‘Red2Green’ meeting on my base ward at the hospital. As a multidisciplinary team we discuss all the patients and try to reduce internal and external delays to the patient’s journey by using the SAFER flow bundle.
I then review any new patients to my team and supervise Junior doctors in the daily management of patients. During this time we can often make use of impromptu teaching and learning opportunities – we can learn so much from each other.
I also have days where I am on-call and have the responsibility of seeing patients newly admitted to hospital and making plans for their investigation, treatment, management and discharge.
We have Departmental meetings where we discuss important developments and try to improve patient care, quality of care and deliver safe care.

What skills have you developed during your career? E.g. further training, personal development, secondment opportunities?

I was an Undergraduate Tutor in Medicine in the North East – a role I held for just over 10 years. It was exciting to play a small part in the education of Medical Students and to share some of the joy of medicine with them.

I was also Training Programme Director for Geriatric Medicine in the North East of England. This was a role I shared with a colleague whereby we were responsible for overseeing the delivery of teaching and training to the Geriatric Medicine trainees in the North East of England. This was a very diverse role including planning rotational opportunities for trainees, monitoring their progress and providing pastoral support to trainees. It was an enjoyable role.

Since coming to Norwich I have taken on the role of Clinical Governance Lead for our Department. This is a systematic approach to maintaining and improving the quality of patient care within a health system. This role has allowed me to develop my skills in leading a group of clinicians involved in daily patient care with the aims of encouraging high standards of care, transparent responsibility and accountability for those standards, and a constant dynamic of improvement.

What do you most enjoy about your current job role?

The patients – Norfolk has the highest percentage of patients of pensionable age or above in the UK. This figure is particularly high in North Norfolk. I enjoy working with these patients – trying to improve their health and social welfare and making appropriate plans for their future care.

My colleagues – I’m quite new here but have been welcomed into the department and made to feel at home. This has been a particular challenge during the time of Covid. I consider myself as very lucky that I have been able to come to work over this time and continue to do the job I love.

Watching more junior members of staff grow and develop during their time spent with us. Seeing people share knowledge, empower others to grow and watching people become confident.

What has been the biggest learning opportunity / challenge during your Health / Social Care career?

The biggest learning opportunity/challenge during my career has undoubtedly been the COVID-19 pandemic. I worked on a Yellow (Testing) ward during the first wave and had the opportunity to work with a new group of doctors. I watched the transformation of our OPM ward to essentially a short-stay medical ward. Our nursing staff were amazing – they were keen to learn, worked exceptionally hard and supported us through some difficult times.
I learnt a lot about COVID and how it presents in different patient groups.
I used alternative methods of communication when relatives couldn’t visit: virtual visiting via iPAD.
I learnt a lot about myself and my own resilience. I started new activities to help with my wellbeing when I was on off days – jigsaws, Origami, line drawing, spending time outside and talking with friends.

I was in receipt of lots of public generosity which was very gratefully received: bags of vegetables, cakes, hand-cream, plants and Thai meals.

We showed collectively that even in a time of great distress we could still provide excellent care and support each other.

What support have you been given throughout your career?

I am responsible for the care of up to 20 inpatients on a daily basis. These are all older people (usually more than 80 years old). I manage the Junior Doctor team who are critical in the delivery of high quality care to these patients.

I am also Clinical Governance Lead for my Department – this is the system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence will flourish. I take a great pride in the care I deliver and constantly want to improve on this. This is a new role for me in my career and is a valuable addition to my portfolio since I joined the NNUH.

I also deliver teaching and training to Junior Doctors which helps us all to share knowledge and ideas allowing development. Knowledge sharing is very important to me and I always try to learn something new every day – learning is a ‘two way street’ and I am happy to learn from anyone.

What excites you about the role that you do?

That everyday is unpredictable – there is never a dull day on our OPM ward. I learn something new every day and we usually manage to share a laugh with each other.

What advice would you give to people applying for a course / job within Health and Social Care?

1. Never give up – if one door closes then find another and knock a bit louder!

2. Make sure you spend time developing a friendship and support group and invest in your family. Health and Social Care can be challenging and a life outside of the ‘day job’ is recommended.

3. Make the most of new and challenging times – they can often teach you more and lots of our new developments during COVID-19 are here to stay e.g. telephone consultations.