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Home ventilation

Alison Armstrong, Senior Nurse Specialist for the North East Home Ventilation Service tells us about her role.

Alison Armstrong, Senior Nurse Specialist for the North East Home Ventilation Service tells us about her role. 

What is your professional background?
I qualified as a registered nurse in 1993. Initially I worked within neuro trauma intensive care, and for the 8 years that followed, I progressed from newly qualified staff nurse up to junior sister.

When did you begin working in the field of long-term ventilation?
On intensive care, I was part of a home ventilation ‘interest group’. I began my role formerly within the remit of home ventilation in 2001, when I was asked to cover a period of maternity leave. I remember being very reluctant to leave any of my critical care skills and colleagues behind, but reluctantly agreed. 16 years on, I’m still here! As part of a small specialist team, my position has been entirely within the North-East Assisted Ventilation Service, which is a regional service providing support to patients on assisted invasive and non-invasive ventilation in their own homes throughout the North of England.

What does your usual day look like?
Examples of my day-to-day clinical role include conducting respiratory assessments of patients with respiratory failure; establishing patients with respiratory failure onto ventilation, and those with impaired cough onto airway clearance or lung recruitment devices; teaching patients, relatives, carers and other staff members how to use this equipment; developing treatment plans with patients and explaining them to carers and relatives; hosting outpatient clinics; managing the withdrawal of mechanical ventilation at patients’ requests.

Do you work as part of an MDT?
Yes. I am only one part of a small but incredible team of specialist nurses, physio and health care assistants. I believe that one of the strengths of our team is that we share a common goal of ensuring good life quality for our patient group. As a multi-disciplinary team, we are involved with every aspect of the clinical delivery of our patient’s respiratory care. We also share the ongoing development of a safety culture, governance structure and service development initiatives. Everyone’s thoughts and opinions are valued. My role is very much around the nurturing, training and empowering the members of this multidisciplinary team. I am very privileged to work with such a passionate bunch of healthcare professionals. I firmly believe that you are only as good as the people around you!

What other initiatives have you been involved with?
I have been involved in developing the medical Home Mechanical Ventilation curriculum, and have subsequently been leading a smaller expert group of nurses and allied health professionals on the further development of this curriculum to provide a Long Term Ventilation Educational Framework for multi-professional use. Education is something I am passionate about; I am the nurse representative of the British Thoracic Society Education and Training committee. I am frequently asked to share my experience with others. I lecture at the local university, on courses and programmes specific to long-term ventilation and at conferences where I have been fortunate to be able to present work I have been involved with. Earlier this year, it was a huge honour to deliver a lecture tour in Singapore, where I was invited by the home ventilation respiratory support service at Tang Tock Seng Hospital as part of their Ministry of Health visiting expert scheme. I have also just completed my MSc in Practise Development. It has been a very busy year!!

Another role that I am very proud of is being the host of the Specialists in Long-term Ventilation at Home (SiLVaH) group. This is a non-medical group which complements the work of HMV-UK. My role is to co-ordinate a national network group of professionals, from both within the NHS and private sector, who are involved in the support and delivery of long term ventilation in the community setting. This group was established initially my one of my colleagues in Edinburgh. When she left in 2007, I offered to take on the role. There were around 10 members at the time; I could never have imagined that things would have grown to this degree!

I host an annual meeting in Newcastle which is attended by specialist nurses, physiotherapists and respiratory physiologists. The members work in collaboration throughout the year via email and our NHS Networks web site. The focus of this group is to share ideas around practise development, standardisation and service improvement, as we all learn from each other. This meeting itself allows networking opportunities with other health care professionals working within this specialist field of practice. It also provides a valuable insight into the service management and service delivery methods employed by other centres. The forum for group discussion promotes the sharing of ideas and assists with the creation of new innovations.

This year, SiLVaH celebrates its 10th anniversary. There are 100+ members on the group, representing many of the LTV centres throughout the UK and Europe. This gives this specialist field of practice a powerful voice, and a platform to represent the strength of MDT working and multi-professional collaboration. SiLVaH promotes networking, collaboration, friendship and healthcare delivery at its very best!!