Orla O'Brien is assistant director of nursing in charge of the ICU and cardiology services at Our Lady's Hospital for Sick Children Crumlin
I started my nursing training in Our Lady's Hospital and have worked in various hospitals but always in cardiology and intensive care. My job is to manage intensive care cardiology and I am in a more HR role now than a hands-on nursing role. There are two ICU units with 21 beds in total and 180 nursing staff. Intensive care nursing is hands-on 24 hours a day and there are 5.5 nurses needed to keep a bed open.
Paediatrics is a challenging but rewarding area. There is a huge loyalty from staff here, a great allegiance to the children. As the national paediatric cardiology centre, my biggest challenge is the recruitment and retention of staff in order to deliver the service and standard of care that we do. Intensive care is a very specialised, very skilled area but with children it is even more so and it means the pool from which you draw staff from is small. We see children from birth right up to age 14 or 15 and to look after a one-kilo baby is very different from looking after a 40-kilo teenager as the equipment and drugs are very varied. Apart from cardiology, there are a number of other specialities in the hospital so the ICU nurses need to be highly skilled as they are dealing with various illnesses.
I work within a multi-disciplinary team and you need interpersonal skills, a strong personality and composure. Apart from having to be up to date on constantly evolving technology, you need to be a good communicator because it is such a highly emotive place. You are dealing with anxious parents and it can be very stressful.
Death is a feature of ICU - it is a constant - and with children, it is particularly difficult. As far as my working life goes, you could say I am the stereotypical working mother constantly juggling work and home. And, of course, the accompanying guilt and stress are part of the package. I have three children under the age of four - Ellie is three and a half and the twins, Rachel and Keelin, are 16 months old. I have a nanny who minds the children when I am working and my husband is great and pitches in.
I work three days a week, about 28 hours in total. I usually start at 7am and finish about 5pm although it can be later. You can't just walk out on people - hospitals don't work like that.
Childcare costs a fortune with no help from the Government so I am not working for the money. I am one of the few who have chosen to stay in the workforce but I feel that I have a lot to give. Crumlin is resourceful - my employers have been flexible with hours.
Since I now work three days a week, I am cramming everything into those days; my pace of work is very quick, I never sit down but I thrive on it.
Staffing levels are a huge challenge. The ICU is the centre of a hospital and if you haven't got that, then you haven't got a hospital. This year, we have had a massive recruitment drive and are very fast approaching full staffing levels. A lot of nurses are from overseas, particularly the Philippines and India. That presents its own challenges and diversity has been a huge challenge for the hospital, not just because of different languages but also because of the need to adapt to other cultures. Because Ireland has changed so much so quickly, it has been a very steep learning curve. But recruiting from overseas is not a long-term solution and I would like to see the introduction of a direct entry system, where school-leavers can come into paediatrics and train in the hospital in contrast to the seven years it takes at the moment.
Nursing has changed dramatically in the past decade, especially from what it was when I started off as a 17-year-old straight out of school. So I'm proud that I'm still here. And if you can make a difference to a child's life, that is immensely rewarding.
(Interview by Susan Calnan)