Careers
Driver for change After working with older individuals in Jersey and dealing with the challenges of a secure unit in London, Paula Thompson has returned to her native Northern Ireland to lead a team that is improving the lives of people with dementia. But instigating new ways of working has not always been easy, she tells Daniel Allen PAULA THOMPSON’S nursing career has taken her some way from her Northern Ireland roots. Her first stop as a newly qualified mental health nurse, when opportunities at home were scarce, was in Jersey and a job working with older people. Then, recognising that she needed to move on if she wanted more from her nursing career, she went to London and took up a position on a new secure unit. It would be eight years before she returned home and took up post in the role that has brought her a clutch of awards for the high quality care she and her team deliver to older people with dementia. Ms Thompson likes the challenges that nursing and management present. Her early move to the Channel Islands was a big step for an inexperienced nurse and, even though she loved the job and island life, she knew that she wanted more. ‘As a newly qualified nurse, it’s important to get wide experience and I just felt that, in Jersey, there was not a lot of room for development,’ she says. So she decided to move, which took her to a secure unit at the South London and Maudsley Trust. ‘I’d never worked in a secure unit before so it was a challenge, but a positive one. It was a new unit but we were all working together and there was a great team spirit. I was thrown in at the deep end but I gained so much experience,’ she says of her time in London. But by 2001, mainly for family reasons, it was time to return to Northern Ireland. Jobs were still scarce and, at first, she worked in the private sector, as a care manager in Belfast. NURSING MANAGEMENT
Other jobs followed, including managing a nursing home, and at one point she undertook a forensic nursing course before coming to realise that she wanted to take another direction. Then a post came up on an acute admission unit at Lagan Valley Hospital, where she had trained. She applied for the post and got it, but was soon asked to move to a dementia care ward. ‘I went, and it was the best thing I have ever done,’ she says. Surprising, perhaps, given that, at first, she was reluctant to move, having witnessed the institutionalised dementia care that was common in her student days. ‘I reflected on that care and I didn’t find it very rewarding or dynamic.’ Recognition But her willingness, once again, to embrace a challenge, led her eventually to her current role: ward sister on the 20-bed Downe Dementia Unit, sited in Downe Hospital, Downpatrick, and part of South Eastern Health and Social Care Trust. Four years on, her achievements on the unit have brought recognition. She was runner-up in the mental health category of the 2013 RCN Northern Ireland Nurse of the Year awards and joint winner of her trust’s nurse awards. This recognition has come for leading the transformation of dementia services and making care more person centred. Doing so has been a battle, though. Dementia care is renowned for high levels of staff burnout, and Ms Thompson had the extra challenge of having to
encourage staff who are used to delivering care in a particular way to embrace new working practices. ‘We held “culture” workshops with all the staff to determine our philosophy of care,’ she says. Bringing together established nurses and new recruits with fresh ideas was tricky to manage, and there was resistance, but she has succeeded. Referring to service users, she explains: ‘It used to be that everyone was up at seven; breakfast, lunch, bed at the same time every day. Now it’s about the person. We fit around their routine, not the other way round.’ Ms Thompson has also exercised her managerial muscle in changing the ward environment, as well as practice. ‘The ward got a total makeover,’ she says. The dementia unit, although part of a new hospital, was not purpose built. ‘All the walls were pure white, with lots of reflective surfaces, and patients got very agitated because they didn’t recognise themselves in the reflection.’ Bad acoustics caused an echo problem as well. But after refurbishment the ward is now fit for purpose and assistive technology, in the shape of alert systems fitted to beds, has helped reduce falls, previously a major risk factor for the unit’s patients. Ms Thompson deflects credit for the ward’s success to her nursing team. ‘The staff are brilliant,’ she says. ‘I’m lucky to have a very good team.’ But she also admits that she wants to bring substantial improvement to the people for whom she cares. ‘I want to be a driver for change.’ Daniel Allen is a freelance writer December 2013 | Volume 20 | Number 8 41
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Driver for change After working with older individuals in Jersey and dealing with the challenges of a secure unit in London, Paula Thompson has returned to her native Northern Ireland to lead a team that is improving the lives of people with dementia. But instigating new ways of working has not always been easy, she tells Daniel Allen PAULA THOMPSON’S nursing career has taken her some way from her Northern Ireland roots. Her first stop as a newly qualified mental health nurse, when opportunities at home were scarce, was in Jersey and a job working with older people. Then, recognising that she needed to move on if she wanted more from her nursing career, she went to London and took up a position on a new secure unit. It would be eight years before she returned home and took up post in the role that has brought her a clutch of awards for the high quality care she and her team deliver to older people with dementia. Ms Thompson likes the challenges that nursing and management present. Her early move to the Channel Islands was a big step for an inexperienced nurse and, even though she loved the job and island life, she knew that she wanted more. ‘As a newly qualified nurse, it’s important to get wide experience and I just felt that, in Jersey, there was not a lot of room for development,’ she says. So she decided to move, which took her to a secure unit at the South London and Maudsley Trust. ‘I’d never worked in a secure unit before so it was a challenge, but a positive one. It was a new unit but we were all working together and there was a great team spirit. I was thrown in at the deep end but I gained so much experience,’ she says of her time in London. But by 2001, mainly for family reasons, it was time to return to Northern Ireland. Jobs were still scarce and, at first, she worked in the private sector, as a care manager in Belfast. NURSING MANAGEMENT
Other jobs followed, including managing a nursing home, and at one point she undertook a forensic nursing course before coming to realise that she wanted to take another direction. Then a post came up on an acute admission unit at Lagan Valley Hospital, where she had trained. She applied for the post and got it, but was soon asked to move to a dementia care ward. ‘I went, and it was the best thing I have ever done,’ she says. Surprising, perhaps, given that, at first, she was reluctant to move, having witnessed the institutionalised dementia care that was common in her student days. ‘I reflected on that care and I didn’t find it very rewarding or dynamic.’ Recognition But her willingness, once again, to embrace a challenge, led her eventually to her current role: ward sister on the 20-bed Downe Dementia Unit, sited in Downe Hospital, Downpatrick, and part of South Eastern Health and Social Care Trust. Four years on, her achievements on the unit have brought recognition. She was runner-up in the mental health category of the 2013 RCN Northern Ireland Nurse of the Year awards and joint winner of her trust’s nurse awards. This recognition has come for leading the transformation of dementia services and making care more person centred. Doing so has been a battle, though. Dementia care is renowned for high levels of staff burnout, and Ms Thompson had the extra challenge of having to
encourage staff who are used to delivering care in a particular way to embrace new working practices. ‘We held “culture” workshops with all the staff to determine our philosophy of care,’ she says. Bringing together established nurses and new recruits with fresh ideas was tricky to manage, and there was resistance, but she has succeeded. Referring to service users, she explains: ‘It used to be that everyone was up at seven; breakfast, lunch, bed at the same time every day. Now it’s about the person. We fit around their routine, not the other way round.’ Ms Thompson has also exercised her managerial muscle in changing the ward environment, as well as practice. ‘The ward got a total makeover,’ she says. The dementia unit, although part of a new hospital, was not purpose built. ‘All the walls were pure white, with lots of reflective surfaces, and patients got very agitated because they didn’t recognise themselves in the reflection.’ Bad acoustics caused an echo problem as well. But after refurbishment the ward is now fit for purpose and assistive technology, in the shape of alert systems fitted to beds, has helped reduce falls, previously a major risk factor for the unit’s patients. Ms Thompson deflects credit for the ward’s success to her nursing team. ‘The staff are brilliant,’ she says. ‘I’m lucky to have a very good team.’ But she also admits that she wants to bring substantial improvement to the people for whom she cares. ‘I want to be a driver for change.’ Daniel Allen is a freelance writer December 2013 | Volume 20 | Number 8 41
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