"Still caring for people" - What a 44 year career in nursing has taught Opto Health's Ros Carlile

What makes a good leader? What are the qualities that a nurse needs to work in EDs over multiple decades? And why are innovations such as Opto’s digital triage solution so needed to transform the practice of emergency medicine? To answer these questions, we sat down with Ros Carlile. Ros is a member of the clinical authoring team and is on the governance advisory board at Opto. Alongside that, she has over 40 years (44, to be precise) nursing experience, currently working as a Senior Sister/Emergency Nurse Practitioner in the ED at Royal University Hospital Bath also in a GP practice and OOH service in Wiltshire where she specialises in cardiac and respiratory problems.

During the COVID-19 pandemic, she played a key role in using and adapting remote triage and clinical consultations. Since 2018, she has been the deputy education lead for the Faculty of Emergency Nursing.

We began by discussing where Ros’ journey in nursing began. “I’ve always wanted to be a nurse. I knew that from when I was a child - my mother was a nurse.” Ros’ father was one of 17 children, and she says there were over 60 family members in her life; “and I think we learned to nurse each other as a family for many years.” She wonders if the decline of larger families has consequently eroded basic first-aid knowledge, citing many presentations at EDs that she sees as being a simple matter of better first aid and minor illness or injury knowledge. Perhaps that is why she has dedicated part of her career to Emergency Nursing and teaching, and in doing so, has empowered others in their own care.

Ros reached out to Opto because, simply put, “I felt that the waiting room in EDs was no longer a safe place. It’s always full now… I was concerned because we cannot carry on triaging in the way that we are. It’s not quick or safe enough”. Additionally, Ros referenced the fact that previously the sickest patients would arrive at an ED in an ambulance, but sustained pressure on that service means that she sees more and more people self-presenting at EDs with serious injuries or illness. Ultimately, these factors and more convinced her that emergency medicine in the modern era requires a digital platform to do its job properly.?

Ros recognises the challenges that digital adoption might entail, indeed she was the first to admit that “I’m not very digitally minded myself”. But her experience of the COVID-19 pandemic altered her perspective. “I think it brought us up to the 21st Century. I suddenly had to become a remote clinician, and I had to learn quickly. It taught me that you don’t have to bring everybody in - and although it might be more difficult for some of our elderly population, we can help them. Because this is what we need to do.” Ros is convinced that the flexibility and adaptability shown by the system in the face of an unprecedented global pandemic - and the rapid adoption of digital care-giving - demonstrates that integrating new technologies such as Opto’s does not have to be convoluted and difficult. Ros’ own work has backed this belief in the digital up. A recent project she ran in collaboration with MedVivo /111 OOH revealed that “we keep 80% of patients out of hospital by redirection, right person/skill, right place or simple first aid.”?

Ros reflected on the qualities that have kept her in nursing for over 40 years. “Still caring for people” was her concise but deeply moving answer. She sees clearly the enormous importance of what she does: “for a start, these days we live with diseases. We don’t die from them. We’re changing the way we think about looking after the elderly and children.” She’s passionate about education (she extolled the virtues of digital teaching, where missing a lecture doesn’t have to mean missing the opportunity to learn more) and gives up her time to teach at the Faculty of Emergency Nursing for free. She’s also always learning from her experiences. She has become an asthma expert, a decision that was prompted by the death of an 8 year old girl in her department. “She didn’t need to die. The signs were recognised, there wasn’t a management plan and her parents didn’t know how to use an inhaler.” Many would have marked this down as a deeply traumatic event to move on from, but Ros’ first thought was “I’ve got to promote this, we can educate and support clinicians and patients”.

“Someone gave me a gift to be a nurse,” Ros reflected. “ I remember my first day as if it was yesterday, and as I reminisce about my career - the opportunities I’ve had, juggling shift work and family life to complete my advanced practice and next chapters - I? will always encourage nurses to follow their dreams and their hearts to make a difference to every patient journey.”

The conversation concluded with a reference to leadership. What makes a good leader in intensely pressured contexts such as the EDs Ros has worked in for decades? “I think you have to be adaptable to change.” Additionally, she reflected on the need to be a role model and lead by example, as well as always putting herself in the shoes of those around her. “I suppose it is being kind and supportive to your team .”

To learn more about Opto Health, visit www.optohealth.co.uk