Enhanced nursing provision in Nenagh

Nenagh-based Advanced Nurse Practitioner Paula Ryan is part of UL Hospital Group's enhanced nursing service.

UL Hospitals Group is continuing its expansion of advanced nursing and midwifery practice with seven new posts secured in unscheduled care, rheumatology and care of the elderly. This is part of a national model that will see 120 Advanced Nursing Practitioners (ANPs) complete their education in the current academic year, and of a wider initiative announced in November 2017 by the Minister for Health Simon Harris that will see 700 ANPs and AMPs (Advanced Midwifery Practitioners) in post by 2021.

Paula Ryan is a Respiratory Registered Advanced Nurse Practitioner at Nenagh hospital since September 2015. “It was the first appointed Respiratory RANP post in the country so I had a blank canvas to work from,” she said.

“Currently, I see patients with symptoms suggestive of Asthma, Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Lung Disease (ILD). We are one of six expert centres in Ireland treating ILD patients and managing their complex needs with antifibrotic medications. I see patients in UHL and in Nenagh hospital with all of these conditions.
“Crucially, patients with symptoms suggestive of COPD and Asthma in particular are now referred to me directly from the GPs and from the current waiting list of the respiratory consultants. This means that we are capturing patients that we were not capturing before and patients are maximised on treatment early, thus preventing admission to hospital and acute exacerbations. Health promotion is key in my role, so managing patients from home through our outreach programmes is very important.”

Advanced nursing and midwifery practitioner roles are developed as a direct response to population health need and organisational requirements, as identified though local and national planning processes. The identification and confirmation of these specific role developments within HSE service areas is the responsibility of directors of Nursing and Midwifery across all disciplines of the professions.

ANPs and AMPs are already transforming services for patients in hospitals, in the community and in the home through an expanded scope of practice, greater clinical autonomy and decision-making. Ongoing education and research as well as mentoring of nursing colleagues are also key parts of the role.

Candidate ANPs/AMPs require a masters degree as well as a minimum of at least 500 clinical hours in their area of expertise. UL Hospitals Group has blazed a trail in certain specialties, having filled the first ANP posts in the country in dermatology (Sheila Ryan), respiratory (Paula Ryan) and orthopaedics (Audrey Butler). There are currently 13 registered ANPs/AMPs practising across UL Hospitals Group and a further eight candidate ANPs completing their education.

“It is a big commitment for a nurse or a midwife to go down this route and it heartening to see so many people doing just that with the full support of their colleagues in nursing and in medicine,” said Margaret Gleeson, Chief Director of Nursing and Midwifery, UL Hospitals Group. “Most importantly, the ANPs and AMPs and the extended scope of practice that entails are hugely valued by our patients. The ANPs are there throughout the patient journey and are very familiar with the patient. And that is very important for patients.”