How Aoife went from small GP clinic to running a university medicine team
Today I’m joined by Medical Nursing Academy member Aoife Behan. In this post, Aoife shares her career journey from working in a small general practice, to now running the internal medicine department at University College Dublin.
Today, Aoife shares with us her experience working in a large university centre, favourite cases, top tips and advice for any nurses wanting to advance their career.
Whether you’re working in GP or referral, training or qualified, or whether you have a love for medicine or are still figuring out your niche, I know Aoife’s experience will be so valuable for you.
Where it began
Aoife became a registered veterinary nurse in 2010, having studied at UCD and graduating with her Diploma in Veterinary Nursing. For the first two years of her studies, Aoife worked in a small GP clinic, before securing a position as an SVN at UCD itself. Once there, Aoife was able to work her way up to ultimately now running the medicine team.
Here’s how she did it:
“After graduating I remained in UCD as a rotating nurse. This role involved rotating through all the services including small animal surgery, small animal medicine, anaesthesia and large animal.
In 2014 I became a full time small animal medicine nurse. I then took on a role as an oncology nurse in 2018, as we were developing the service. I still dipped in and out of medicine occasionally before returning to my medicine role full time 18 months later. I am now the senior nurse in the small animal medicine department.”
Referral life
Aoife’s hospital is large - she works in a teaching hospital attached to the vet college. This means she not only has her patients and team to support, but final year vet and VN students rotating through the medicine service, too.
Aoife’s role is really varied, and she’s also managed to take specific interests and carve out extra responsibilities within her niche, like working on the blood donor clinic, and managing radioactive iodine patients:
“I supervise and direct the nurses working in my department. I process the new admissions for the vets which involves taking bloods, placing catheters, preparing them for their imaging, drawing up sedations etc.
I will help the other nurses in the department with patient care, procedures and interventions. My role is varied as I like to keep in touch with what is happening in wards, procedures, imaging etc to make sure everything is running smoothly.
I’m also part of the blood donor clinic - my role is mostly running bloods on the donors and then collecting the unit of blood from them.
I also look after the I131 cats after they have received their radioactive iodine. I spend a lot of time troubleshooting and ‘putting out fires’ too which is not my favourite part of the job but it is necessary.
I also have to keep on top of stock, orders, equipment maintenance and procurement and SOP’s. As it’s a teaching hospital there is also lots of that too!
It is a busy and varied role but I love it!”
Why medicine?
Aoife’s love for medicine began shortly after qualifying, when rotating through the medicine service. Why? Because she could see the opportunities for nurses to use their practical skills and deliver great care to medical patients.
“It was my favourite department to work in because I loved how much the nurses got to use their practical skills and I loved the emphasis on patient care. I found it to be a more dynamic and varied role compared to small animal surgery where there is a lot of time spent in theatre which I never enjoyed. When I was on a surgery rotation my favourite place to be was in the wards caring for the patients. So, for me there was never a question, it was always medicine!”
How to have a rewarding career as a medical nurse
Finding satisfaction within our roles is so important - nursing is a hugely rewarding career, and focusing on the good we do is easy to overlook.
The most rewarding aspect of medical nursing for Aoife is the patient care side of her role, and being able to use her skills and voice as a VN to stand up and advocate for her patients:
“Without a doubt the patient care aspect is the most rewarding thing about medical nursing. There is so much we as nurses can do to make our patients more comfortable and I believe our number one priority is advocating for them. Whether that be for more analgesia, assisted feeding, physiotherapy the list is endless. It is so rewarding to see the difference you can make for them.”
Favourite conditions
Speaking of rewarding aspects of the job, I asked Aoife about her favourite conditions to nurse - the ones that really light her up and allow her to use different skills. We chatted about her love for endocrine diseases, conditions needing intensive nursing care, and the ‘crispy old cats’ as well as her passion for feline nursing.
“My number one condition must be an Addisonian crisis. They present so critically ill but when you act fast, and they get the appropriate treatment it is just amazing how quickly they bounce back!
We also see lots of MUO (meningoencephalitis of unknown origin) too. I find them very rewarding to care for as they can be so ill on presentation, profoundly painful, sometimes recumbent. So, they require high intensity nursing care and there is so much we can do for them. They generally do very well once treated and then we see them back regularly for their cytarabine treatments, so we get to know them very well!
Also I have to mention the feline patients, particularly the geriatrics. Any condition, it doesn't matter. I love feline nursing. If I need to decompress or have a spare moment I will be in the cat ward cuddling the patients. They are so misunderstood by many and I just love caring for them. It is one of my missions in life to instil feline friendly techniques in the new generations of vets and vet nurses.”
How to give the best possible patient care
There are a lot of tools we can use as nurses to improve the wellbeing of our patients in the hospital. Some of these can seem ‘basic’ but, in reality, they have a huge impact on the care of our patients.
Aoife and I share some of the same favourites here - such as placing central lines or PICC lines in patients requiring multiple blood samples, and faecal catheters in diarrhoea patients to keep them clean.
Aoife’s other go-to nursing interventions include physiotherapy and pain assessments:
“Gentle physiotherapy for recumbent patients. Apart from the obvious benefits, our patients need mental stimulation and human interaction.
Also regular pain assessment. We use the Canine Short Form Glasgow Composite Measure Pain Scale (CMPS) and Feline Glasgow CMPS which includes the feline grimace scale. It means the level of pain is quantified and recorded regularly and there is no excuse not to escalate analgesia when required. It also prompts other staff members to assess pain thoroughly during busy periods or out of hours when it otherwise might go unnoticed that the patient is in pain.”
Lessons learned from medical nursing
I asked Aoife to share the most valuable lesson she has learned in her career as a medical nurse so far. For her, trusting her gut was the most important thing:
“Trust your gut. Nursing intuition is real, but you have to tune into it. That takes work and motivation.”
Advice for any nurse wanting to move into medicine
Medical nursing is such a fantastic area to get involved in - because, as Aoife has shared, there are so many opportunities to get hands on!
It can feel a little daunting at times, especially when our patients have such complicated diseases - and that can easily make nurses feel like they don’t know enough to work in medicine.
That’s far from the truth - as Aoife talks about here, patient care is vital and you don’t learn how to advocate for your patients from a textbook!
“Patient care is paramount so be prepared to advocate for your patients.
Also, the more you know about disease processes the more you can do to help your patients feel better and more comfortable - Read articles, do CPD, listen to podcasts! Veterinary medicine is ever evolving so you need to keep up with it and keep your knowledge base relevant.”
Working as equals with your vet team
Being able to work alongside our vets (not ‘underneath’ our vets) is vital. If you find yourself struggling to have your patient observations/opinions heard, Aoife suggests putting it across to them in an objective, evidence-based way wherever possible:
“Know what you are talking about. If you can present some objective data or evidence-based information to a vet, they are far more likely to really listen to you and act on whatever it is you are requesting for the patient.
This is important for forming a relationship of trust between nurses and vets. Once you have this solid base formed, they are more likely to trust you implicitly when there are those times when you say ‘I can’t put my finger on it but there is something not right.”
How to turn challenges into opportunities
We all know that we’ll encounter challenges in our careers - but with these, come lessons that we can learn from to improve our own wellbeing, and that of the patients we care for.
Aoife’s biggest challenge has been juggling work and life, especially trying to ‘do it all’ as a mum of 3 young children. But from this, she’s learned not just how to care for herself and her family, but how to use this in the care she gives her patients, too:
“For a long time, I thought it was impossible to be a highly valued and dedicated nurse and be a present and ‘good’ mother. I thought time outside work should be spent with my kids and felt guilty allocating time to further studies or education that could be spent with them.
But it definitely is possible. It’s hard work and I am exhausted all the time, but I love it. Since I made the realisation and decided to do something for myself, I have become a better nurse and have gained so much job satisfaction. The patients are receiving a more holistic approach and overall, a higher standard of care.”
You can learn more about Aoife’s clinic, and the type of cases she cares for here.
