Shetland has something for everybody, with the northern lights, amazing scenery, wild weather and low crime, and stunning wildlife. Working as an Advanced Nurse Practitioner across these islands offers a new dimension to nursing. I currently work on an island called Bressay.
Bressay is classed as a non-doctor island, thus the role of the nurse is key in the delivery of primary health care. Shetland has 5 non doctor islands – Bressay, Fair Isle, Foula, Fetlar, and Skerries. Each island has a resident nurse who provides a 24 hour service, thus providing all first contact, chronic health management and emergencies. Each island has a varied population ranging from the very young to the elderly, thus nursing practice has to be up-to-date and transverse across age ranges. Each island is only accessible vie ether boat or plane. These island nurses are supported by a General Practitioner who visits, but this can easily be hampered by the weather. Each island, apart from Bressay, has a nurse’s clinic where all up-to-date resources are at the disposal of the resident nurses; this allows for health care delivery to be tailored to meet the needs of individual patients.
This role of the non-doctor island nurse is unique to Scotland. There is very little known about these unique nursing roles. In 2012 I commenced a Clinical Doctorate in nursing with the University of Stirling; this has enabled me to explore the role of non-doctor islands and its uniqueness to nursing practice. The Doctorate has enabled me to reflect on my own practice and allowed me to critically analyse my own clinical areas and the importance that it plays across primary care delivery. I have commenced my final piece of work for the programme; the aim is to explore the role of nurses on these non-doctor islands. We know at this time that remote and rural healthcare practices have significant recruitment and retention difficulties; the aim is to explore what attracts and retains nurses across non-doctor islands. This will allow for strategic planning of service delivery as part of the 2020 vision.
I moved to Shetland in 2014. I trained in Liverpool at Edge Hill University and qualified as a nurse in 2004 and since then I have taken many pathways along the way. I started as a staff nurse in Accident and Emergency, I then took up a lecturer practitioner role with Edge Hill University, and then I specialised and became a Resuscitation Training Officer. I have always had an interest in remote and rural setting, with this goal in mind I started to look at options available. I first noticed a job in Shetland on one of its non-doctor islands, so I dedicated to join the nursing bank to see if I liked it. Over the following two summers I spend much time visiting Shetland’s more remote islands providing relief for the resident nurse. I was fortunate enough to get offered a job full time as the resident nurse for Bressay.
At the time this was a difficult decision to make, thus leaving family, friends and a career pathway that I enjoyed, but I needed something different. I have currently been in post for 4 years and I love the everyday challenges that remote and rural nursing brings. Shetland life takes a little getting used to. However I would struggle to return to an urban setting although I still have family in Liverpool and it’s a pleasure visiting friends and family.
Chris Rice, Advanced Nurse Practitioner, NHS Shetland
Clinical Doctorate Student, University of Stirling