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Nursing in Shetland – working as an Advanced Nurse Practitioner on a non-doctor island

ChrisShetland 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

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Queens Nursing Institute Scotland – supporting community nurses through education and practice – Guest Blogger

qnis logoWhen you see this blog, your first question might be “who is the QNIS, and why are they contributing to a blog on the Stirling University Health Sciences page?”  You may even need to google us. Go ahead, I’ll wait.  I’ll even help.

That is us, the Queen’s Nursing Institute Scotland. We’re a small community nursing charity, and we have been around since 1889.  We are based in Edinburgh, but cover the length and breadth of Scotland.

That explains the who, but what about the why?

Our mantra is promoting excellence in community nursing across Scotland.  This includes anything that helps get evidence into practice, and we do this by providing professional development opportunities, influencing key stakeholders, and providing funding for research, education and professional development.

What does this mean for you?

It means that we will be here to help and support you in a variety of different ways as you move through your community nursing career, sometimes, without you even knowing.  And this is how we’ll do it.

Photo of QNIS 2015 Conference

QNIS Conference, March 2015, Dunblane

Several of you may have attended our annual conference, held in March in Dunblane.  Next year, our conference is going to be held in Edinburgh, at Surgeon’s Hall.  We have already secured Jos de Blok as one of our speakers, and he will talk about the Buurtzorg model of care and realising a dream – the story of his entrepreneurial spirit, which built on the evidence to make high quality care a reality, which has revolutionised community health and social care provision in the Netherlands.  Our conferences are a wonderful way to develop within your profession, and an opportunity to build and grow your networks.  Further information on the conference will appear on our website later this year.

We encourage excellence by providing awards for the best undergraduate and post graduate community nursing student in each University across Scotland, ensuring that the very best are recognised and rewarded.

We also deliver funding for education and professional development by way of grants.  We have already provided seven grants this year, and the next group of education grants are available until 28th September.  For 2015 we have three funding streams: Individual Education Grants, to help nurses pursue their studies; Learning Visits, where we support a nurse to visit or shadow nurses across Scotland, the UK and Europe, and Team Headspace, protecting time for teams to identify ways to work more effectively together.

Photo of Rob Mackie of QNIS

Rob Mackie, QNIS

One of our core areas is funding research and development.  Each year we establish what key issues need attention, and provide a funding stream for innovation.  This year, our ‘Catalysts for Change’ programme looked at improving health inequalities, and six projects have been funded, covering everything from homeless transitional care to the health of those working in lap dancing clubs.

We are currently in the latter stages of developing a new set of voluntary standards for District Nursing Practice and Education.  These standards will enhance, not replace, the current NMC standards, and will ensure that nurses undertaking the SPQ are equipped for contemporary and future practice.

We offer Long Service Awards to nurses who have worked in the community for over 21 years, ensuring that loyalty and commitment are suitably rewarded.  This also ensures we are there at the beginning of your career, the middle, and at the end of it.

That should explain why we were asked to provide a blog, but if you need any further details, please visit our website.  You’ve already googled it once!

Rob Mackie, Research, Policy and Communications Officer, QNIS
29 July 2015