“The positive feedback we get from patients and carers is just lovely. You know they’re not giving it because they have to, but because they want to.”
Even as a little girl, our Chief Nurse Kate Bushell knew exactly what career she wanted to pursue. And this year she has celebrated 40 years as a nurse! During that time she has held many roles and supported patients across the age spectrum – from new-born babies to elderly people at the end of their lives. Here she reflects on a remarkable career that has been varied, enjoyable and so rewarding she says there is nothing about it she would have changed:
“I have always, always wanted to be a nurse. My great grandmothers were both nurses and I think that had an influence on me when I was a child. There was something about the importance of being sensitive and caring that really drew me to it.
“I went to a grammar school and it was very much geared to university, but I didn’t want to be a doctor – I was absolutely clear I wanted to be a nurse! I applied to my chosen schools of nursing after my A level and on 9th March 1983, I became a student nurse.
“I lived in a nurses’ home and in those days you were very protected. If you had a boyfriend they wouldn’t be admitted in the evening. We had a matron who would literally sit by the door all evening to check you weren’t bringing anyone in. What she didn’t seem to realise (or maybe she did but couldn’t do anything about it) was that there was an underground entrance people could be sneaked in through!
“It was a real old nurses’ home, with communal TV area, communal kitchen and bathrooms with baths in rows of cubicles. Needless to say, I moved out and into a flat with friends as soon as I could!
Affinity with elderly people
“I did my three-year training between the Royal Masonic Hospital in Hammersmith and Queen Mary’s Hospital in Roehampton, and once I’d qualified I moved into care of the elderly at a little community hospital. I absolutely loved it. I’ve always had an affinity with elderly people. They have given so much over their lives, and it’s about what you’re giving back to them.”
After a few “really enjoyable but quite emotionally challenging” years, Kate felt ready for a change. She trained and worked in midwifery. “I did enjoy being a midwife, but you’re not following things through with people – you just move on to the next.” She did a nurse practitioner course and moved into general practice, which brought longer-term relationships with patients. “It was great to follow the patient through, for example treating their wounds and seeing the improvements over time.”
Kate spent a decade in general practice, which allowed her to develop her interest in women’s health. She did a family planning course and ran a well woman clinic. She took further training in contraception and sexual health, extending her clinical skills – for example in non-medical prescribing – and strengthening her progress in autonomous practice.
Empowering youngsters
I left General Practice and took up a post as Lead nurse in Contraception and Sexual Health for a Community Trust which specialised in young people’s clinics. “It felt really good to be empowering youngsters through this work. You want them to be safe and need to approach the work in a non-judgemental but supportive way. You have to give them the information to empower them so that they gain confidence to make the decision that’s right for them.”
After five years Kate was appointed as service lead. “This was in Barnet, but then after three years, the sexual health side of the service was decommissioned by the CCG and I got another post as service lead for the district nursing service.
An increasing proportion of the workload was concerning mental capacity and safeguarding concerns, and an emphasis on the patient staying at home. That’s where my interest in safeguarding really developed. and II became the an adult safeguarding lead for the trust I was working in.”
Two years later Kate took up a post that moved her back to Kent, where she had grown up and her family still lived. She became Kent and Medway CCG’s Designated Nurse for Adult Safeguarding covering the Dartford, Gravesham and Swanley and Medway areas. “I really enjoyed the safeguarding aspect but didn’t like the loss of patient contact. I felt I was having no direct impact on patients.”
Patient at “the very centre” of DGS Health
And then in 2019 she came to DGS Health. “I love the job, I love developing and implementing the delivery of our services. In everything we do, the patient is at the very centre of it. It’s all about trying to make the patient journey safe and effective. Sometimes I think in a bigger organisation the patient can get a bit lost.”
Kate is proud of the “really low rate of clinical incidents” at DGS Health – an achievement she attributes primarily to the calibre of staff. “We seem to attract people who always want to do their best. They all give 100%. The positive feedback we get from patients and carers is just lovely. You know they’re not giving it because they have to, but because they want to.
“Last week, for example, one of our nurses received a message from a woman who had been really scared about looking after her mum as she reached the end of her life. The message said, ‘I can’t ever thank you enough for all the help you gave me not only to look after mum but also to give me the courage to believe I could do it. Your kindness to her and me will never be forgotten.’ When you receive feedback like that you know you have brilliant staff who give the best care!”
Meeting need effectively
What does Kate feel is her greatest achievement? “Every role has had achievements,” she said. “But the thing that keeps me going is starting off those new services, finding a need and implementing a service to meet that need effectively. For example, the COVID-19 pandemic brought social isolation to so many of the most frail and elderly people in our communities – and they have deteriorated as a result. Our Frailty Service is really helping to address their needs.”
What would be her advice to anyone thinking of going into nursing? “I’ve learned that some people have an aptitude for caring – and if you have that aptitude, just go for it! It’s such a rewarding career, helping people when they are at their most vulnerable and in need. The fact you can advocate for someone, even on your worst day, you can look back and know you’re doing a good thing. My career has been varied, interesting and very enjoyable. There have been some bad days along the way, but there isn’t anything about it I would have changed.”