A day within the lifetime of a clinical advisor on 111 Wales

In our latest series, ‘A Day within the Life’, we showcase the variety of nursing roles inside the 111 telephone triage service. In the primary of three blogs on this series, Ms Rebecca Malin tells us about her role as a Clinical Nurse Advisor with NHS 111 Wales.

(1) What is your position and most important role/responsibilities?
I’m a clinical nurse advisor for NHS 111 Wales. The NHS 111 Wales service launched in 2016 as a totally free approach to access the NHS in Wales for health advice, information and access to urgent care. Clinical Advisor is an autonomous role supported by a team of senior clinical advisors and skilled practice educators. My most important role is to make use of my clinical assessment skills to advise people in Wales who’ve used the service a few big selection of ailments, injuries and conditions.

(2) How did you get into your current role/field of labor?
I began my role as a Clinical Nurse Advisor in November 2018. Since qualifying as a Nurse Practitioner in 2004, I actually have held previous positions and have worked in Renal, Stroke, Rehabilitation, District Nursing and the Brain Injury Unit. I used to be at a crossroads in my profession and was intrigued by the clinical advisor role since it will not be a task one encounters in nurse training. This will not be a task you experience as a registered nurse until you begin within the role or personally access this service. When I began as a clinical advisor, I used to be an experienced nurse, but my lack of prior exposure to telephone triage left me feeling a bit overwhelmed by the extent of responsibility. I remember clearly how I felt from expert to novice. However, my concern was short-lived as I used to be encouraged by the credibility of the support from skilled practice teachers and senior clinical advisors. This support, combined with collaboration with other healthcare professionals in clinical contact centers, encouraged me to advance on this position.

(3) Can you tell us what a typical day is like in your role/industry?
The biggest demand for our services occurs within the evenings and weekends, so a typical evening or weekend shift is fast-paced and in high demand. There isn’t any typical day on NHS 111 Wales, no two 111 hours are the identical, let alone two days. This is a task that covers a big selection of urgent healthcare needs. I can use my clinical assessment skills to advise on roughly 20 calls per day during a 7.5 hour shift. A fraction of my day might seem like this:

• A conversation that in the first place glance appears to be that of a health care skilled with a dermatitis-type rash exacerbated by the necessity to wash their hands – but few conversations are one-dimensional and related to at least one need – the caller’s rash caused such discomfort that it affected her sleep, her ability to work, her quality of life and, due to this fact, her mental health. Things can escalate and should be more deeply rooted than they initially seemed. In this case, the healthcare employee was suffering to such an extent that she was at a crisis point by way of her mental health needs.

• Then I receive a call from a vulnerable young mother who has no support network. It’s the nighttime and her baby has a fever. Through compassionate communication and the interlocutor’s participation, I can educate and empower the parent to cope with the issue in the current and future. You can start the conversation, sometimes talking to a frightened, caring parent, and end the conversation with a relieved, empowered parent who’s confident within the care plan. You feel like you’ve got reached through the phone into their home, reassuring them and imparting compassion and knowledge. You use your expert clinical knowledge to advise remotely over the phone, and your needs are diverse and multi-faceted.

(4) What parts of your role would you describe because the “best” or most satisfying?
Calls received on NHS 111 Wales can provide an insight or snapshot into the health of the general public at any given time. We are the primary to identify a pattern when a specific demographic is asking with symptoms of mumps, food poisoning or, as we’ve got seen recently, Covid symptoms – it’s a captivating role. Calling a clinical advisor on NHS 111 Wales stands out as the caller’s first step towards getting help or advice about their healthcare. Your assessment with the caller may lead to actions and advice that will result in a greater quality of life for the caller. Many callers find the initial face-to-face consultation too daunting or anxiety-provoking, or feel like they’re wasting other people’s time. By talking to them, we break down barriers for probably the most vulnerable in our society.

(5) What advice would you give to others who would really like to follow the same path?
My advice is to present it a try, even when it’s together with a face-to-face role. The listening skills you’ll acquire are invaluable in any situation, skilled or personal. The knowledge you’ll gain concerning the breadth of health and social issues is limitless. I’d also advise you to maintain yourself and reach out to colleagues who’ve experience in clinical triage. When you are recent to the job, the anxiety you hear over the phone might be overwhelming. When you are used to using body language and face-to-face contact to reassure one other person, listening and talking to them alone could also be unfamiliar, but it will pass as your skills improve and the team around you supports your development.

Rebecca works as a clinical nurse advisor for NHS 111 Wales (@NHS111Wales and @GIG111Cymru).

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