Elaine Keane, director of nursing at Peamount Hospital, Newcastle, Co Dublin, finds each day of work varied because of changes at the hospital
My first job of the day is to drop my daughter off at school. Then I try to get to the gym to start the day on the right foot. I live 10 minutes from Peamount Hospital so I usually get to my desk at 9.10am. After 15 years of working in Beaumont Hospital with a long commute, this is a welcome change.
Peamount Hospital is a 320-bed non-acute facility which caters for several care groups. It provides residential and day care for people with disabilities, older people and adults under 65 who have suffered brain injuries or neurological diseases.
My role of director of nursing means that I end up attending a lot of internal and external meetings. All the meetings can be a little frustrating but we are trying to marry our need to be clinically aware of what is happening on the ground as well as strategically looking forward.
I try to get on the wards as much as I can but don't get out as much as I would like to, so I rely on the assistant director of nursing and other support staff. It is important to get out and see staff and patients and get a feel for the challenges that face people on a day-to-day basis.
Staffing shortages and resources are always a big problem, but I try to look at innovative ways of overcoming them. The key I believe is for healthcare staff not to wrap themselves up in their professionalism too much and be willing to cross professional boundaries.
Every day at Peamount is varied at the moment because the hospital is going through significant changes since it was decided that it was a more appropriate setting for non-acute rather than acute services.
We are analysing the services we currently provide and trying to become more community-focused. We need to ensure the care we provide is what our patients need where they need it.
We want to become a facility that links the community to acute hospitals. The idea is to provide a facility to cater for another phase in a patient's illness once the acute phase is over. A setting like Peamount is ideal for people discharged from hospitals or patients suffering from serious chest infections who don't need acute hospital care but need elements of care such as physiotherapy.
We hope to provide a service that prevents acute hospital admission and promotes early discharge for patients from acute hospitals. For this we need to develop multidisciplinary teams to cater for patients.
We are also keen to promote independent living and community-based services. As part of this we are looking at challenging the way healthcare is delivered at the moment. Healthcare givers may need to go out to the community more. Residential care doesn't have to always be in an institution.
Take the case of patients with brain injuries. At the moment there is no half-way house for people to encourage them to live a more independent life. If you can't live at home, you have to live in residential care, even if you are only 30 years of age.