Advanced Nurse Practitioners at Sheffield Children’s

Advanced nurse practitioners are changing the way teams work at Sheffield Children’s NHS Foundation Trust.

Sheffield Children’s has 13 advanced nurse practitioners (ANPs) working across the Trust, with at least five more in training. The largest number of ANPs work at Embrace, the Trust’s specialist critical care ambulance service which provides round-the-clock transport service for critically ill infants and children in Yorkshire and the Humber.

An advanced nurse practitioner (ANP) is educated at masters level and they have freedom and authority to make decisions in the assessment, diagnosis and treatment of patients. The role of an ANP is not to replace doctors, but to support them and assist in providing continuity of care for patients.

Nick Mills has been an ANP on the intensive care unit (ICU) for two years at Sheffield Children’s. He has more than 27 years of ICU experience and worked as a trainee at the hospital for three years prior to his accreditation.

Nick is a leader for ANPs and organised the first ANP paediatric intensive care service conference in 2016. This event allowed advanced nursing practitioners from paediatric intensive care units across the country to share learning, resources and to support one another. The event now happens each year and continues to provide opportunities for ANPs.

Nick describes his journey to becoming an ANP at Sheffield Children’s: “ANPs take a two to three year training course at university in order to prepare them for the role, with their time being split 20% audit/research/education and 80% clinical training. This further training allows them to take on many tasks not permitted in their former nursing roles, such as advanced airway management and resuscitation, prescribing medication, and ordering radiography. ANPs also specialise in long term ventilation, complex care, complex discharge or transition.

“Whilst doctors are on short placements during their training, often moving at six month intervals, some patients are in intensive care longer than the doctors are and so ANPs provide the element of continuity to their care. We have knowledge of complex problems, we know the patients. We can provide the specialised knowledge in order to support junior doctors. But we get to learn a great deal from them too!

“A typical shift at work will be 12 and a half hours, be it days, nights, or weekends. I’ll be given my own case load of three or four patients. I’ll be there for new admissions, discharges, crash calls, trauma calls and directing critical treatment.

“I’ve always worked on intensive care; it was the first job I got when I qualified. It’s a special area of healthcare because you get to focus on one patient and one family. Our patients can be very sick and the families can go through extremes of emotion; then we see them get better. It can be hugely satisfying work.

“As a job it’s tremendously challenging and very difficult sometimes, but it’s fantastic. I’m privileged to be involved in the care and make a difference to children’s lives.”

The Paediatric Critical Care Society has now accepted a new national job description, written by Nick, for Advanced Nurse Practitioners in Paediatric Critical Care. It is currently used and adapted by paediatric intensive care units across the country, who are seeking to standardise and validate much of the work that ANPs are already doing in critical care. The accreditation will enable further role development and progression of ANPs whilst also raising awareness of the role within hospitals.

Karen Spinks, Advanced Nurse Practitioner at Sheffield Children’s Embrace Transport Service, said: “Our team is made up of an ANP and a transport nurse or a registrar and a transport nurse. A consultant will join either team for certain clinical conditions but we do independently transfer some very sick neonatal and paediatric patients. ANPs have always been a part of Embrace. There were only two of us initially and now soon to be eight.

“It is a challenging role but it is probably these challenges and variety that attract me to the job. I have had shifts where I have transferred an extreme premature baby weighing a little over one pound in the morning, followed by a 68kg teenager later in the day. It certainly stretches an individuals ability to adapt management and decision making. I’ve had other shifts where I’m suddenly flying to Scarborough in a helicopter or flying in a fixed wing aircraft to Glasgow. Those days often feel a bit surreal.”

To find out more about working at Sheffield Children’s visit…. Why I work at Sheffield Children’s and Living and Working in Sheffield.