NURSING INNOVATORS

Jill Williams, 50, is associate clinical director for accident and emergency/ pre-hospital care (helicopter emergency medical services), Barts and the London trust, based at the Royal London Hospital, Whitechapel.

Salary: c£40,000

Describe your current job I have responsibility for running the A&E department based at the Royal London Hospital, the minor injuries unit at St Bartholomew's Hospital and the helicopter emergency medical service, which is a pan-London service based at the Royal London Hospital in Whitechapel.

I have responsibility for the consultant medical staff, operational management of the department, policy making, budget management, clinical governance and ensuring charter standards are met.

What was your career path?

My nursing career was mainly within the A&E service at St George's Hospital in Tooting and Whipps Cross Hospital, east London. I was also a medical ward sister at Queen Mary's in Roehampton. Following this I went into senior nursing officer roles and then into a variety of clinical managerial posts with responsibility for a number of different specialties, but also retaining A&E as part of my portfolio.

What attracted you to this job?

The main attraction in this job is the sheer diversity it offers. There are many challenges to be faced, both on a daily basis and in developing an innovative service for the future.

My major driving force is to improve the care of emergency patients - whether they are attending A&E with a very simple illness or injury, have suffered multiple trauma or been brought in by the helicopter emergency medical service.

How many staff do you manage?

We have over 80 nurses within the directorate, including senior nurses and emergency nurse practitioners. There are four whole-time equivalent consultant staff, although there are seven people in the posts. There are portering staff, reception staff, clerical staff, pilots, fire crew, data staff and paramedics.

How many hours a week do you work?

I work as many hours as it takes to do my job and this can vary considerably. I am often in about 8-8.30am and generally don't leave before 6.30pm. Once a fortnight I do a 12.5-hour shift in the A&E department acting as the senior nurse, taking an overview of the department on that day.

What is the most satisfying part of your work?

Undoubtedly working within a team. I believe that we are fairly unique in that there is a strong team element within all disciplines. We not only enjoy working together but we are all extremely supportive of each other and have very good professional and social relationships.

What is the most frustrating thing about your job?

Lack of resources. The reduced funding within the NHS means that we are looking for savings year on year, and it is very difficult to continue to be innovative and develop a service where money is not more forthcoming. When it comes to purchasing or replacing equipment there is no money.

What is the biggest challenge you face in the coming year?

In my job you never know what challenge you may face next. You can start the year thinking this could be your year to consolidate, and before you know it a major issue arises which diverts your attention totally.

The big challenge facing me this year is to convince my consultant colleagues of their need to have a strong clinical governance structure in place, as well as commissioning a new aircraft with Virgin. We are also continuing to establish medicine in the pre-hospital care environment and want to concentrate on working more closely with the London Ambulance Service to achieve this.

How do you relax?

I enjoy the company of my daughter and occasionally go riding with her at the weekends. I also have a large circle of friends I enjoy socialising with.

What has been the high point of your career?

Most people would expect me to say getting Richard Branson to buy the helicopter when we needed a new sponsor, but the thing that gives me most pleasure is seeing the way the A&E department at this hospital has developed into what I think is acknowledged as one of the best in the country. I hope that I've helped to achieve this in a small way, but it is the strong team spirit within all disciplines and their pride in the department that has been the greatest asset.

If you had chosen a career other than nursing, what would it have been?

I think if I'd been clever enough I would have liked to have been a vet.

What would you like to do in the future?

I would like to see doctors firmly established in the prehospital care environment. I have no real ambitions to become a general manager or anything higher as I want to be in a job where I can make a contribution that will benefit the emergency services.

Could you see yourself working in NHS Direct?

I don't think I've ever been able to see myself working anywhere other than a hospital.

Jill Williams: 'It is very difficult to be innovative where money is not forthcoming.'

Ian Govier, 39, senior nurse - professional development and training, NHS Direct Cymru Wales.

Salary: Whitley Scale: grade I

Describe your current job I started work with NHS Direct Wales at the beginning of the year and the past couple of months have probably been the busiest of my nursing career. I am currently completing the training programmes for the senior nurse advisers and nurse advisers who are taking up post. My role is also to assist in identifying and supporting professional development needs among the nursing team.

Additionally, I've been heavily involved in roadshows throughout Wales to recruit nursing staff to the service and I'm playing a key role in the selection of the nurse team. My work also involves establishing links with colleagues in clinical and educational settings throughout Wales and England.

What was your career path?

My clinical nursing experience has primarily been in trauma specialties, having spent some time working in A&E and burns trauma environments since qualifying as a nurse in the mid-1980s. I entered full-time nurse education in the early 1990s and completed my teacher training during this time.

However, the opportunity to lead a ward in a brand new burns unit in 1994 was one that I didn't want to miss and I spent the past five to six years working as a charge nurse/ward manager on an adult burns ward. I was seconded to the nursing division of a large district general hospital for most of last year, which allowed a greater insight into professional and operational matters within the NHS. I have been a commissioned officer in the Territorial Army Medical Services since 1991 and until recently undertook part-time teaching on an MSc nursing course at Swansea Institute of Higher Education.

What attracted you to this job?

I had been following the progress of NHS Direct for several months, and when the chance arose in December of last year to apply for this particular position I jumped at it.

How many staff do you manage?

By the end of this year there will be approximately 60 to 70 nurses for whom I'll have management responsibilities.

How many hours a week do you work?

I'm contracted to 37.5 hours a week, but in reality I'm putting in between 50 and 60. I'm looking forward to delegating some work to the senior nurse advisers, as being part of a small project team means that each member is putting in long hours.

What is the most satisfying part of your work?

Being involved at the early stages of NHS Direct Wales is particularly satisfying, especially as the planning comes to fruition.

What is the most frustrating thing about your job?

Listening to colleagues who know little about the service but nevertheless make uninformed comments.

What is the biggest challenge you face in the coming year?

Fitting in annual leave! Seriously though, there will be several challenges this year as NHS Direct establishes itself in Wales. One challenge will be to deliver a bilingual service and to positively influence some of the negative opinions that pervade healthcare colleagues - including nurses.

How do you relax?

After being on the wrong end of a hit-and-run car accident two years ago, my previous lively pursuits of surfing, rock climbing, racquet sports, running and the TA have taken a back seat. I particularly enjoy being with my family and playing the piano, guitar and singing. My most recent interest is birdwatching, which I find a welcome distraction from day-to-day work.

What has been the high point of your career?

If I were to identify just one, it would have been the opportunity to lead a team of nurses when the Welsh regional burns facility opened at Morriston Hospital, Swansea, in 1994. The ward quickly established a reputation for high standards of nursing care and was invited to apply for charter mark and health promotion awards in 1997.

If you had chosen a career other than nursing, what would it have been?

Music has always been my first love and I would have been very happy pursuing a career allied to this important aspect of my life.

What would you like to do in the future?

I'd like to see NHS Direct establish itself in Wales and the UK and be part of the service as it evolves into other aspects of primary care.

Could you see yourself working in a hospital again?

If the right opportunity arose, I would obviously consider it.

Ian Govier: 'I'd like to see NHS Direct establish itself in Wales and the UK.'