Lindsay Reading has recently joined us as a rehabilitation case manager. A registered nurse with over 20 years' experience, Lindsay's expertise ranges from critical care to complex discharge and return to work. Read on to find out more:
What were you doing prior to joining HCML?
Immediately prior to joining HCML, I was a pre-op assessment nurse in a private hospital, helping patients prepare for surgeries. I assessed all surgical patients before their operations across a range of specialities, including orthopaedics, vascular surgery and ENT surgery. Although it was a private hospital, as the Covid-19 pandemic became increasingly widespread, the rise in hospital admissions meant that some critical NHS procedures were also carried out at the hospital too.
Prior to this I have over 20 years’ experience as a qualified nurse and have worked in various hospital and community settings.
Can you tell us more about your experience in critical care settings?
I’ve been qualified nurse for 21 years, with a large chunk of my career and expertise in cardiothoracic surgery. As a junior staff nurse, I worked in Acute Intensive Care, then I became sister on cardiac High Dependency Unit. A few years later I became a specialist cardiac liaison nurse where my role was to provide ongoing care for patients undergoing cardiothoracic surgery.
I would support them through their cardiac journey – from point of admission right through to discharge, providing advice and education, and promoting good heart health practices to help patients manage their heart conditions moving forwards. This involved pre-op assessments and making sure they were physically as well as mentally ready to undergo surgery.
A big part of the process was ensuring patients had all the information they needed beforehand and understood what to expect during and after surgery. Many surgeries were extremely intensive and it was important for patients to understand the critical nature of surgery and how that might impact them, for example, pre-empting the need for intensive care post-surgery. So as you can imagine, much of the preparation prior to surgery was about helping them prepare and build mental resilience – almost like counselling in certain circumstances. Educating patients on what they may face following their operation and how to access support was a massive part of this and fundamental to my role in critical care settings.
Consistency can be a challenge when it comes to acute settings – things are fast moving – so providing a constant support throughout the patient journey is vital. Being there at the beginning before surgery and then on the ward through their recovery and involvement in their discharge planning can often bring peace of mind to the patient.
You recently received the Nuffield ‘You Care’ award – can you tell us a bit more about that and what it was in aid of?
When the pandemic hit, the private hospital I worked at started taking on surgeries from the local hospital. This predominantly included surgery to treat cancer, as these operations were being cancelled and postponed as a result of needing bed space for Covid-19 patients and the risk of infection. The hospital really became a ‘safe haven’ for those needing to undergo all types of cancer surgeries.
My role there was specifically to carry out the pre-op assessments. There was one lady in particular who was referred to the hospital and had been waiting to undergo surgery for breast cancer through the NHS. The surgery was complicated and involved having a dye injection at another site prior to admission, and this coupled with the uncertainty brought about by the pandemic had understandably caused a lot of anxiety for this lady. I chatted to her over the phone and told her exactly what to expect before the operation, what would happen during surgery and what she could expect after surgery. She nominated me for the hospital awards on the basis of what she described as my “caring attitude.” I was then put forward at a national level and went onto win the award. But essentially I think when you’re having to go through something so hard and so emotional, it’s really just about having someone to listen.
Can you tell us about some of the community care you’ve been involved in? What are the synergies with case management?
Over the years I’ve had varying roles within community care working with patients who have extremely complex needs.
I’ve worked as a complex discharge manager where getting people home quickly with the correct support packages in place is paramount to their continued recovery. I’ve also been at the other end of the scale working as a District Nurse and practise nurse, where the focus is on supporting the health of people at home and making sure they don’t end up in hospital. All of these roles involve skills and experiences similar to that of a case manager.
There are other instances I’ve experienced where clinical recommendations and guidance is at odds with what the patient wants. Ultimately you have to respect people’s wishes. It may not always be what you believe is right, but if they have the capacity to make decisions then you need to make sure that their wishes are carried out in a safe and sustainable way. This means putting a plan in place and making sure everyone knows what to expect – educating the patient and their support network on likely outcomes (good and otherwise) as a result of their choices, and how to manage their ongoing healthcare in a way that they feel comfortable.
What made you decide to change from being a nurse to being a case manager?
A change of scenery and a change of how I can help people. It’s obviously quite challenging being in nursing at the moment with the rapid changes the profession has faced over the past couple of years. Nurses are obviously always determined to make a difference but it’s sometimes very challenging because of certain organisational processes and systems. With case management you’re in control – it's your responsibility to get the best outcomes for your clients and you have a range of treatments and stakeholders you can call upon to ensure the very best for your clients’ recovery.
Which three qualities do you think a case manager should have?
Organisation, time management…possibly a thick skin…and a sense of humour!
You’re experienced in complex discharge planning and working with clients who have complex social circumstances. Can you tell us about some of the kinds of challenges you’ve had to overcome to ensure the best outcomes for patients/clients?
Capacity and people’s own will! It’s the nature of humans that we don’t always want to be told what to do. People generally know what they want the outcome to be, but sometimes aren’t willing to listen to or follow the clinical advice and guidance that will get them there. Balancing the reality of situation while managing expectations can be difficult when people have high expectations – they don’t necessarily understand the processes that are needed to meet those expectations. When people are injured/poorly they sometimes - understandably - just want to know when they’ll be better. It’s about helping them to realise that to make progress, sometimes you have to take small steps to get there.
What attracted you to HCML?
Recommendations from people who work there! It’s a different area for me to go into and a new challenge. I’m away from that hospital setting and there isn’t that specific little team around me, but a wider team with a range of expertise, which makes it easier to make the change and still have that support.
What three words sum you up?
Organised, friendly, approachable.
As nurse with over 20 years of experience, you’ll be used to dealing with sensitive and demanding situations. What do you do inside or outside of work to manage stress and remain resilient?
I find it helpful to stop and take a deep breathe sometimes, and I know who I can go to for a chat! It’s really important having a team around you - some kind of support network – whether it’s colleagues or friends, or both! The occasional glass of wine doesn’t hurt either...
What keeps you motivated and inspired?
My kids, family, patients and clients. Being a nurse. I didn’t come into nursing to not make a difference. I’ve always wanted to be a nurse. I started training at 17, so my whole career has been nursing. Over the years I have worked with many inspirational and motivated people, be that patients or colleagues.