Caps and capes with pride

Karen Addis, trauma and orthopaedic theatre sister The Prince of Wales Orthopaedic Hospital in Rhydlafar, just outside Cardiff, was Karen’s first NHS stomping ground at the age of 17.

She said: “When I turned up it was very scary. It was a very small hospital and the intake of students was very small too. There were only about six or seven of us.

“But the camaraderie – straightaway – was excellent.

“We lived in the student block for six weeks learning how to bed-bath people and doing the basics like taking blood pressures and temperatures.

“Once we went onto the wards it was pretty terrifying. Because it was orthopaedics some of the patients had been in hospital for a long time.

“As well as looking after the patient you had to take pride in the ward and making sure it was clean.

“All the beds had to be in a straight line and all the wheels needed to be turned in. It was that disciplined.

“I will always remember when a consultant came on a ward round, the patients had to be in their bed, with a modesty garment on and a draw sheet across.

“Nowadays the consultant asks where on earth the patients are half the time.

“I think there’s a lack of discipline now. The wards were run by ‘Sister’ and ‘Matron’ and you did exactly what you were told.

“I like the fact people are able to speak to sisters and have a disagreement, but maybe we need to grab back that discipline to a certain extent.”

The mother of two said while paperwork is required for legal reasons and patient handovers, there is too much of it.

“Sometimes I think we’re concentrating too much on the paperwork and not enough on the patient,” she admitted.

Karen, 53, who left school with no O-levels, is now a sister in trauma theatre.

“As much as I loved caring for patients I’d become too emotionally involved and I used to get attached to the patients,” she added.

“If they were to pass away I just found it very difficult to cope with that scenario.

“I spent a lot of time in theatres in my training and I really felt drawn to it for some reason or another.

“I think a nurse has an important role in theatre as you’re the advocate for the patient while they’re asleep.”

She said it is very exciting that UHW is set to become Wales’ first major trauma centre.

“I started in trauma theatre in 1986 – green behind the ears – and now I’m probably going to be finishing my career helping to set up a major trauma centre, which is just amazing.

“It’s going to be stressful but I’m really looking forward to it.

“I am still extremely proud to work for the NHS and I don’t want to see it be privatised. I don’t want to see that in my lifetime.”

Kirsten Mahoney, tissue viability nurse While her role is challenging and often exhausting, Kirsten says making a difference to patients’ lives makes it all worth while.

“My husband always says that if you cut me in half like a stick of rock you’d find the NHS in the middle,” she joked.

“I’m very proud to be a part of it. Sometimes we get criticised, but actually at the heart of the NHS is our passion to help our patients and improve their quality of life.

“That’s how it started – and those core values are still there.”

When she first qualified Kirsten worked in the intensive care unit at Swansea’s Morriston Hospital.

But she admits qualifying as a staff nurse came as a bit of a culture shock.

“Going from a student nurse to a staff nurse was a big transition. One minute you were just somebody on the ward and the next you were expected to know things and be very competent and confident.”

Following six to nine months in Morriston, she made the decision to move to intensive care in UHW, where she was put on an in-service training scheme for 18 months.

This involved working for six months in casualty, followed by a stint on a general ward to get some muchneeded experience.

“When I moved onto the general ward it posed greater challenges as we were always short-staffed, and even as a junior member I was expected to take charge of the ward quite frequently,” she said.

When she first started she was told it was the doctor’s job to diagnose, but as time has progressed nurses have become “advanced practitioners”, which has enhanced their roles within the NHS.

And now, in her key role as a tissue viability nurse in the community, she is responsible for ensuring pressure ulcers – also commonly known as bed sores – do not develop.

They can cause pain, odour and in severe cases life-threatening sepsis, in which the body’s own immune system attacks tissue and organs.

The Penarth resident, 53, added: “When I first started to work in Cardiff I was quite surprised at the number of pressure ulcers I was seeing and tried to instigate better practice in treatment in my patients.

“I think things have improved immensely. I can remember fighting very hard to get equipment in to patients on both the ward and community, whereas now we have a total bed management contract which I oversee, which means all patients have access to appropriate equipment to prevent pressure damage.

“We have invested a lot in prevention therapies, which include education for our nurses, and I think has been raised very high on Welsh Government agendas, so I think the raising awareness has helped to address and reduce the potential harms pressure ulcers create.”

She said the NHS is renowned worldwide and remains an institution many countries aspire to replicate.

“It is a privilege to be in a position where you can make a real impact on our patients in many different ways,” she said.

“In nursing it is so important to stay positive, enthusiastic and embrace all of the challenges that working within a large organisation such as the NHS brings.”

Lisa Williams, deputy ward sister Within two weeks of starting as a student nurse in Birmingham in 1998, Lisa Williams was on a ward looking after patients.

“It was handson straightaway, which I quite enjoyed and got me motivated,” said the 41-year-old.

“You always look back at your first day, your first patient, your first hospital. It was all quite scary and busy.

“I hadn’t really been a patient in the NHS before, and didn’t have many relatives who’d been patients or been involved in the NHS. I just knew what it was like on the news and didn’t know what I was letting myself in for, really.”

When she first came to live in Cardiff, the Scotland-born nurse worked in oncology care at Velindre Cancer Centre before moving to the University Hospital of Wales as a junior staff nurse in medicine.

She now works as a deputy ward sister and works alongside therapists and doctors to help mainly elderly patients.

“There’s a lot in the press at the moment about Alzheimer’s, dementia and lots of people living longer with cognitive impairments.

“Those can be challenging in itself, without even considering diabetes, respiratory problems, strokes.

“In medicine we’re not a speciality so we tend to cater for anything and everything.”

She said it was always wonderful to get positive feedback from patients, especially during a particularly tough shift.

“I think nowadays nurses are quite tough on themselves when it comes to standards. There’s a lot more monitoring and audits just to know how we’re doing,” said the Caerphilly resident.

“We are a bit more open to the public with regards to what we’re doing well and how we can improve, and when there have been mistakes putting our hands up.

“That has changed a lot even since I started 20 years ago.”

Even during the most difficult times in her job, such as the gruelling winter periods, she has never wanted to change career.

“It’s important for me to be a part of a team, and we’ve all got a voice in that team as well.”

Helen Bonello, ward manager Helen, who trained at Swansea University, qualified as a nurse in 2007.

She said there were some significant differences between the hospitals in Abertawe Bro Morgannwg University Health Board, where she underwent her student training, and Cardiff and Vale.

“The beds in Swansea were still all manually operated, so you’d get big calves from moving beds all day,” she said.

“A big part of my first placement [in Swansea] was being taught the fundamentals, such as the importance of bed making, keeping things clean and tidy, as well as infection prevention and control.

“But coming to Cardiff I had a bit of a shock to find the way in which the sheets came all bundled up. I actually had a bit of a telling off for putting what I thought were dirty sheets in with dirty, when in fact they were clean.”

She said it felt “overwhelming” to be given such responsibility as a qualified nurse on the medical assessment unit in UHW.

“Some of the patients were quite unwell and needed your immediate attention. Consolidating everything you learned was quite challenging to begin with.”

She now works as a ward manager, caring for frail and elderly patients who require rehabilitation.

“We try and have quite a quick turnaround. We try to keep our patients well, get them up, dressed and moving, keep them well-fed and nourished and send them home with the appropriate support as soon as possible.”

She said she’s had a “fair few” patients aged over 100 come into the wards.

“It’s nice to hear their stories and things that have gone on in their lives. Some people who are in their 90s and 100s have never been into hospital before. They can really make your day.”