Advanced Practice Nurses transforming orthopaedic care in Fife
Published: Monday 04 Dec 2017
Surgery Team with Mr Whytock and visitors
NHS Fife has secured funding for two additional Advanced Nurse Practitioners (ANPs) to support its orthopaedic surgery team at the Victoria Hospital, Kirkcaldy.
In addition to assisting with hip and knee surgeries, the ANPs support elective orthopaedic services in a variety of ways, taking on many responsibilities previously performed by a doctor. There are currently two orthopaedic ANPs who are trained to carry out various duties including the prescription of medicines, post-operative care, request of further tests, such as bloods or x-rays, and patient discharge.
The two new ANPs will be funded by the Scottish Government following a successful application and are due to take up post over the coming weeks. Their presence will extend service provision from six to seven days and ensure greater flexibility, shift coverage and continuity of care for patients. The ANPs will also support the trauma wards, Junior Doctors and the Emergency Department. This will improve the patient experience, improve patient flow and reduce the length of stay.
The funding is a further boost for Fife’s orthopaedic surgery team, which has consistently been recognised as one of the most effective and efficient in Scotland. Last month, two visiting surgeons from England, Abdul Waheed and John Targett, made the trip north to learn more about their work and to gain firsthand experience of Fife’s successes around safety and pre-assessment procedures, theatre efficiency, productivity, and enhanced recovery.
Last year Director of Surgery and Consultant Orthopaedic Surgeon, Ed Dunstan, and his team became one of the first health boards in Scotland to successfully perform five hip replacements in one day – an achievement they have since gone on to replicate at regulate intervals. Mr Dunstan said the additional ANPs will build on an already strong service: “Our team prides itself upon making the most of its resources to give patients the best possible experience. There has been national interest in our success and the way we are doing things in Fife and this not only serves as a great source of pride for myself and the team, but also gives our patients confidence that they are in excellent hands.
“We are proud, in Fife, to have many members of nursing staff who have been appropriately trained and supported to take on extended roles that would have traditionally been carried out by doctors. In Orthopaedics, not only do we utilise Advanced Nurse Practitioners but also Surgical Assistants, Pre-assessment Nurses and Anaesthetic Assistants to mention but a few.”
Grant Whytock from Cupar is one of Mr Dunstan’s patients that has benefitted from the use of ANPs. The 58 year old had his second hip replacement at the end of September and was discharged from hospital within 23 hours. He said: “I went into hospital on the Monday and by 3:30PM on the Tuesday I had my bags packed and ready to go – when I told my wife she thought I was joking. After surgery I didn’t have much pain and I put that down to the skill of the surgeon and the team. It is a great feeling to come out of surgery and find that the pain you have suffered for months and months has gone away. I was in and out of hospital in a day, by the end of the week I was walking down the road with a stick and after four weeks I was able to walk without the stick. Nine weeks after my operation, I’ve completed a ten mile walk unaided and I feel as fit as anyone.”
Dorna Taylor has worked as an ANP in Fife for 12 years and is part of the orthopaedic surgery team. She says the role of the ANP brings considerable benefits for patients: “No one wants to be in hospital for longer than they need to be and ANPs help patients get in and out of hospital faster and with fewer delays. ANPs are registered nurses with extensive nursing experience and education that enables us to deliver care that has been historically provided by medical staff. Our medical grounding, communication skills, and extensive contacts across hospitals and other health boards mean patients get the best quality care, which enhances the likelihood of the best possible outcome for them.”