“Nursing is a grand career”: A day in the life of Alice Markey, discharge nurse
Sister Alice Markey has been with Imperial College Healthcare NHS Trust for 25 years. As a discharge nurse, Alice ensures that patients are fit to leave hospital and that the right support is in place to help them continue their recovery, as you’ll see in Hospital on BBC Two. Here, Alice tells us about her role.
When I was four years of age and growing up in Ireland, I remember telling my Mammie: “When I grow up I want to be a nurse.” I come from a large family and helped to look after my siblings and I extended that care to my school life. I was always the one keeping an eye on the more delicate and vulnerable children. Nursing was the most natural choice for me, and it is my dream job.
Nursing is such a grand career as it allows you to learn so much. If you are trained well, it is knowledge you never forget. I took a career break of quite a few years to raise my own family of five daughters and a son, and on my first day back on the ward I was tasked with getting four patients ready for theatre. After the operations were completed the surgeon came onto the ward to ask which nurse had prepared his patients. Imagine my delight when he said, “I want to meet her, she is a rare find! Where have you been hiding her?”
In my current role I facilitate and manage the discharge of our patients, and I carry out health assessments and risk assessments. Is the patient fit to go home? And once home, is all the support they need going to be in place? To ensure it is, I work with external agencies like social care workers, Clinical Commissioning Groups and colleagues from multi-disciplinary teams (MDTs) made up of doctors, nurses and various healthcare workers like physiotherapists from around the Trust. And although this isn’t a nurse’s job, finding clean and suitable clothing and shoes for patients without these necessities of life brings me enormous satisfaction.
I love the unpredictability my work offers me; few careers are so varied. Each patient may have their own set of complex needs. Much of my day is spent working with the families of patients and managing their expectations. When the care of a loved one is at stake, emotions can run high. A key skill that I fall back on time and again is the ability to deal with a large range of people. I have to gain and then build their trust so they feel sure they are in the skilled, knowledgeable and experienced hands of the team.
I have calm days when the majority of my patients are totally straightforward – ready and fit to be discharged. On those days, I concentrate on completing health and risk assessments and holding family meetings.
Sometimes we are asked by a patient or their family to facilitate a quick discharge because it is their wish for them, or their loved one to die at home. However, even with the best will in the world if their condition means they aren’t suitable for transfer their wishes can’t be fulfilled – it is a hard task to break that news to them.
I’m still friends with the nurses I trained with 51 years ago. The system of nursing has changed and the training has also moved to higher education and university level, but we need to ensure that the basics of nursing are not forgotten. We are living in a society where things come quick and easy, but when it comes to nursing and health, it takes time to deliver great outcomes.
Nursing and caring for people is a life-long job. To my sheer delight, one of my children is a full time night sister which means I get to be a hands-on help for my three grandsons. I love getting their uniforms ready on a Sunday evening and checking their books and homework are packed and ready for Monday morning – it’s just like old times.