Delivering a children’s palliative care nurse rotation programme

Katie Stevens shares the highlights and challenges of project managing a children’s palliative care nurse rotation programme.

In January 2018 I commenced a post as Project Manager for Children’s Hospices across London (www.chal.org.uk). The project, funded by The Burdett Trust for Nursing, was to: set up, deliver and evaluate a children’s palliative care nurse rotation programme. I am a children’s nurse with 10 years’ experience working within a children’s hospice, and 5 years as a lecturer of pre-registration children’s nursing.

When I commenced this post I was delighted to take on the challenge of building nurse rotation posts across London with willing partners that include all 6 of London’s children’s hospices, PAN London neonatal nurse specialist, Great Ormond Street Hospital and Evelina London Children’s Hospital. When I left my hospice post I did so reluctantly as, at the time, it was the best way to expand my professional development. Had a rotation post been available I would have taken the opportunity. I always knew I would return to children’s palliative care, and so to do so in a role that would enable me to ensure that children’s palliative care nurses were offered development opportunities that support them to remain within the profession felt like destiny.

My return to the world of children’s palliative care quickly showed me just how much had changed in that 5 years. Children’s palliative care was more widely recognised as happening in all areas where children access healthcare. Everyone I spoke to could see the benefits of cross-organisational working, knowledge sharing and the need to offer nurses meaningful professional development.

As I travelled around hospices and hospital departments extremely busy, senior, professionals took the time to listen to the project objectives and welcomed opportunities for their nurses. At a time when staff shortage across the sector is greater than ever, these professionals recognised that they need to safeguard their employees. Managers want to offer their staff meaningful, flexible and attractive opportunities, not just to keep them in the post but also to enhance their job satisfaction and personal and professional development.

Likewise, the nurses I met who might consider a rotation opportunity were enthused by the opportunity. They were keen to enhance their knowledge, skills and networks. They were prepared to travel to new places and face new challenges in order to learn from each other and share their expertise.

20 months in, and as I prepare to hand over the project to a new project manager, here are a few of my highlights and challenges:

• September 2018 the first recruits to a secondment between Shooting Star Children’s Hospice and Great Ormond Street oncology wards commenced. To achieve this after just 9 months showed how, with willing partners, this initiative could work.
• It was quickly apparent that allowing the senior nurses to rotate in a similar way would not be possible. This was due to the nature of their role, and the need to safeguard service delivery. However, these nurses were clear that they also needed development opportunities, therefore:
  – An action learning set programme was developed, to be delivered alongside an existing Leadership Academy leadership programme. The first cohort of 4 nurses from across acute care and hospice care environments commenced in January 2019.
  – Facilitating this action learning set was incredible. The wealth of knowledge, passion and commitment these nurses have for children’s palliative care is outstanding. As a colleague from Hertfordshire University, who interviewed these nurses, said ‘If we could bottle their passion and commitment and sprinkle it across nursing we would be winning. If ever there was a recruitment advert for children’s palliative care it is that group of nurses.’
  – Cohort 2 commenced in August 2019.
• The second secondment, this time between Haven House Children’s Hospice and Acorn Ward, Whipps Cross Hospital commenced in March 2019. This was a highlight as it demonstrated the model was replicable elsewhere. Recruitment is underway for the next pairing.
• Supporting the nurses for monthly clinical supervision has allowed me insight into their experience. I have been impressed by their resilience and professionalism.
• The Project Manager role has not been without its difficulties. There are times when I have to repeatedly remind people that I need an answer, or a reply; the inevitable challenges facing services has sometimes meant that plans have had to be delayed; and the role itself can be isolating. However, at no point have I felt unsupported. Project partners have remained committed and with determination and perseverance I have successfully navigated these hindrances. As any professional within the sector would tell you – positive change doesn’t always come easy, but it is always worth the hard work.
• The greatest highlight for me has been anecdotal reports of the difference these secondment nurses are making for children, families and services. The reassurance felt by children and families when they see their acute care, ward based nurse, welcome them into the hospice is heart-warming. Likewise, the opportunity to discuss children’s hospice care with a hospice nurse working on the acute care ward before a family decides whether they want a referral is a great outcome. These nurses are increasing understanding, reassurance and choice for children and their families regarding the place and breadth of care options available to them.
• As plans develop for additional iterations of the secondment and action learning models, I am confident this project has had real benefits on many levels.

Investing in our children’s palliative care workforce is vital. As we acknowledge the increase in the need for children’s palliative care services, we need to value our current workforce as well as recruit new nurses into this profession who bring skills, knowledge and enthusiasm that will safeguard the future of children’s palliative care services. To attract these recruits we need to embrace opportunity, invest in our workforce and shout loudly about the fantastic work that is achieved across children’s palliative care services in the UK.