International Nurses Day: Reflections by Effie Robinson RGN.

In the final of our series of articles for International Nurses Day or Clinical Quality Manager, Effie Robinson RN, reflects on her role, experiences in nursing, and shares a typical week at work.

Read the other reflections in this series from Joanna Burton RMN, Cyper Allan RGN, and Laura Carnall RGN.

Watch our International Nurses Day video here.

A typical week in my role as PCS Clinical Quality Manager…

Hi, hopefully you all know who I am, but for those who don’t my name is Effie Robinson and I have
been the Clinical Quality manager, bridging all PCS services for the last year. My background is vast
and varied but after a false start training to become a mental health nurse, I then trained as an adult
nurse. I have gone on to advance my career by undertaking additional studies in palliative care,
mentorship, prescribing, strategic management and human resource management (quite a mix I
know and there is more but that would make this article far too long) and I have a specialist
qualification in public health which is listed separately on the register. My work experiences prior to PCS are also quite varied but I have worked a community nurse, health visitor, safeguarding nurse (adults and children), clinical trainer, clinical 111 advisor, clinical team manager and as a clinician within a governance department.

My role within PCS I always find quite difficult to describe and define when ask in conversations but
somehow it is easier on paper, I see it as celebrating and sharing what PCS do well across all the
divisions and exploring and implementing processes to improve the things that may not be going
quite so well.

Okay so enough about me, lets talk about my week in review…

Monday: was quite relaxed for me this week, I am not on call, and it was a bank holiday, so
therefore I was on leave with no expectation to work. I did do something slightly work related and
that was to identify some reading materials for a new course I am undertaking in relation to
infection prevention and control. It was not exciting but it is essential, I want to pass my course
work and advise you my colleagues with the most accurate and up to date information. I also
checked in with a peer that is member of the RCN Yorkshire and Humber board, we a meeting
coming up soon that I am preparing for and I wanted to check I understood properly all the
abbreviations I was reading, we use so many in health care it can be confusing.

Tuesday: I had my one to one, I cannot lie slightly affected by my previous work experiences I
always feel a degree of apprehension prior to these meetings. It went fine. Myself and my line
manager discussed a report that I had drafted, it is published nationally on an NHS website but prior
to this is it scrutinised by the local ICB. The ICB deadline is this Friday and whilst it is okay to go to
them in a word format, our colleagues in the PCS communication team are going to us their skills
and knowledge to make the public version more accessible and inviting to read.

On a Tuesday I normally meet with the Primary Care at Scale team (PCAS), and we discuss any events
or calls from team members that have occurred during the out of hours times, this is in relation to
the Enhanced Access service. We discuss things such as IT issues and staffing mostly. It is not clinical
however I find it beneficial to attend from a quality perspective as I sometimes notice patterns or
reoccurring themes that are affecting our patients or causing unnecessary work for our teams. I
advise on whether events need an in-depth review such as a Significant Event Audit (SEA) or if we
should share the learning across other services.

I had a meeting planned Tuesday afternoon, it is the PCS Quality review meeting, PCAS meet with
the ICB to discuss the services that are commissioned by the ICB and if we are meeting our contract
commitments in relation to quality, but also are there any improvements that we could consider or
areas for review? At this meeting we discuss things such as complaints received and how these have
been addressed, any Significant incidents or Significant Event Audits and the progress of the
investigations and outcomes and the learning. We confirm if these concerns have been reported
nationally on the Learning from Patient Safety Events (LFPSE) service. Just as I was preparing for this
meeting I got a call from a colleague, the meeting had been stood down, she asked me do I have
anything to update or ask of the ICB in an email, because she will send which I am grateful for.
Whilst this meeting was important I was pleased it had been stood down as I needed the time to do
some tweaks to the data in the quality account and this allows me time to do so, but I also had
received a call from a practice feeding back about the care of some patients registered with their
practice that they feel was not completed in the way it should be. There are 10 records to review,
and I need the time to review the records for immediate actions, I will draft a response later.

Wednesday: I started the day on Systmone, I receive alerts in relation to patients who have
sadly passed away after accessing the Enhanced Access service. I review the patient records in
relation to when was our contact and what was our contact about, what happened next? I am
reviewing to see how close our contact was to their passing, and could we have done anything
differently, do we need to conduct any investigations?

My next job was to review some alerts that I have received in my inbox from the MHRA about
medications, I review and consider how these updates will impact on patients registered with the
practices and any patients that use PCAS services. I save these to a shared drive and inform GP leads
of the update. Sometimes I will write a small piece to go in team talk or the Enhanced Access
newsletter if needed. Once completed I moved on to reviewing the pcs. PCAS feedback email inbox,
I am awaiting response from a complainant who I am trying to arrange a phone call with, but also
looking for anything new from patients and practices. I have three working days to acknowledge new
complaints. HCPF do not have a response period, but I endeavour to review in case any urgent
actions that are needed but the rest I will complete when my diary capacity allows.

In the afternoon we met with a commissioner for PCAS, we discussed what was happening in the
wider city in relation to patients and the services available to them. What could be needed, how this
can be developed and what role PCAS can play.

I missed the Clinical Quality Lead meeting, one of my favourites things to attend. It is where I
normally get to catch up with the other lead nurses for the services and find out what is their
priorities for Practice, Primary Care Mental Health and Research. This meeting they discussed
nurses’ day and celebrating our teams and how we are progressing with our plans. They are not
grand plans but did want to acknowledge all the wonderful nurses and non-registered staff who are
delivering clinical care on behalf of PCS. We want to thank them and let them know they are
appreciated. I’ll do it early here too; thank you we know the services couldn’t run without you. Later
I took time to read the meeting chat and found out I have not escaped filming a video. I thought if I
left it long enough my they would forget, but alas not, I will film it Friday, please (do not) look out for
that soon.

Thursday: Today is the PCAS whole team catch up. We meet once a week to discuss all the
PCAS services. We update each other on what projects we are currently working on and what we
plan to work on next. My main current task ends tomorrow, so my next focuses are assurance
reports and other end of year jobs including audits that I want to get completed over the next week.
I am also starting to pull together/design some new audits in relation to our paramedic home visiting
service. I want to use this information to help evidence our successes but also identify areas for
change or improvement. I also want to spend a little bit of time researching what similar services
already exist to this and if there is someone I can link with to discuss there experience of designing
and implementing a similar service.

Senior managers Group meeting is next, I am in awe of this group of people whose experience and
knowledge of PCS and health care systems shine through. I sit, listen and learn from their experience
and gain insight into some plans regarding our future. My contribution is small this meeting, I have
learnt more than I have shared, but it is the things I need to know to be a success in my roll.
A couple of conversations later in relation to patients and their plans of care I am now moving on to
drafting a response letter to a complaint. I started the investigation last week when I went to one of
our hubs to speak to our team members it relates to, I can’t finish the letter because I am still
awaiting some further details and a statement, but I need to make a start if I am going to hit my
target response time of twenty working days. Once I have all the information and the draft is
completed, I send my response to the PCS medical director who reviews the response and are
satisfied that it has been investigated thoroughly. They make the changes that they deem
appropriate, and I then send the response to the complainant.

After drafting the letter, I plan actions for next week, as I mention above, I have lots of end of year
tasks and audits to do and I want to be ahead of my submission deadlines (which is not always the
case, but I do try). I know it is work but I can’t ignore I also have a lot of things happening at home
currently, with all of us supposed to be in different places at once and me also wanting to slip some
hub site visits in the evenings next week I thought if I plan my work now then my family may have
time to arrange alternative transport to fields, matches and classes or at least they’ll recognise how
much I have to juggle next week and pack their own lunches and wash their own sports kits…
anyway I digress, I’ll get back to writing about my week as a Clinical Quality Manager……

Friday: well, I am cheating with this week in review because it is not here yet but tomorrow my
diary is bare, on a Friday I like to do admin jobs like work my way through some of the health care
professional feedbacks (HCPF), I complete a situation reports and update protocols. I have a couple
of policies I am updating ready for presentation at our next policy group, and I am researching a new
staff role that we are going to use in the EA. I have a sense check to do. I also have a recruit I want
to chat with so I may try to call them. Typically, on a Friday I will try to review my progress against
my appraisal objectives/ things discussed in my One to One, but most times whilst the day starts off
‘Q’ (I am a nurse and I do not say the word that rhymes with riot) but it does not end that way.
I hope this has helped you learn a little bit more about my role and if anyone would like to shadow
me or ask me anything please get in touch.