As part of International Nurses Day on Sunday 12 May, we talked to Caroline Woon - Clinical Nurse Specialist for Neurosurgery – to learn more about her role and what she enjoys most about it.
Tell us about your job/role?
I’ve been a Clinical Nurse Specialist for Neurosurgery since 2022 along with my colleague Rebecca Lissiman who shares the role.
Our work includes:
- caring for patients and whānau through their journey in neurosurgery and advocating for their needs
- providing advice and support to patients and their whānau
- supporting ward staff through education and advice advocating for high standards of care
- writing policies and guidelines
- carrying out research to improve patient care
- collaborating with other health professionals and teams worldwide to ensure the best care is provided for our neurosurgical population.
Why did you choose a job as Clinical Nurse Specialist in Neurosurgery?
I worked for many years as an educator in neuroscience nursing which supports patients with life changing conditions such as brain tumours and traumatic brain injuries - they require a lot of support, as do their whānau. I saw the need for a specialist nurse in this area and looked into what such a role would look like. My manager at the time, Amy Nel, really supported the development of this role and helped make it become a reality.
What do you like most about your job?
I love so many things about it. I can’t do anything without the amazing team around me - finding ways of overcoming seemingly impossible tasks together is so satisfying! I love being able to share my skills and knowledge with the nurses on the ward who care for neurosurgical patients and seeing the difference they make in their patients’ journey. I also love supporting highly agitated or aggressive patients and ensuring staff are kept safe. I have loved seeing a young patient who was critically unwell walk back into clinic, speak to me when she couldn’t before and ask me questions! Now that is a miracle.
What's your biggest work achievement?
Our biggest achievement as a team is improving staff safety. A number of years ago we had no training in the hospital for the safety of staff who deal with violent and/or aggressive people. We had a reactive, rather than preventative, culture which impacted on safety. There was no management plan staff could use to identify agitated patients’ needs, risks or the medication that could help. We now have that. In addition, we have an incredibly supportive security orderly team lead in Vanessa and I am hugely proud of the colleagial work we’ve done together.
Can you tell us more about the agitation project?
About six years ago, I became concerned for staff safety on our ward. With the support of my manager, we held an education day for our staff which included input from a psychologist and a safety trainer. We used role play to assist with learning and provided some tangible strategies to keep staff safe. Over time, this developed into the ‘My Safety’ training which we still have at our hospitals.
I was also worried that our culture was reactive rather than proactive when it came to agitated patients, so we worked to change this as a team. This led to a review of educational tools and strategies for staff safety, resulting in the development of an international research study looking at the safety of neuroscience nurses worldwide. There are now three articles exploring this subject!
We also launched an agitation plan which included a nursing assessment of what causes agitation such as pain, constipation, urinary retention, patient stress, worries at home or being unable to vape or smoke when in hospital. The plan also included a process for providing medication if a patient becomes agitated so doctors are aware of what to prescribe when faced with these decisions. I think these measures have helped improve staff safety, but there is still work to be done in this area and I continue to look for solutions. The collaborative approach between consult liaison (psychiatry), security and our ward has been a really great change. I would love to see an agitation strategy implemented across our hospitals to keep all our staff safe.
What does a typical day look like for you at work?
Our days vary a lot but generally we attend handover meetings, carry out ward rounds to identify patients who need additional support, advocate for their needs and support new staff to care for them. We also:
- attend multidisciplinary neurosurgery meetings advocating for patients and supporting them to come to terms with their diagnosis
- provide support for patients who have gone home but need advice
- provide teaching for staff or patients when needed
- support the neurosurgical clinics
Of course, coffee breaks are essential with some laughter along the way, as it can be a very emotionally challenging role.
What would you say to someone who wants to start a career as a Clinical Nurse Specialist?
I would say learn as much as you can as you care for patients, talk to members of the health care team, understand the decisions and ethical dilemmas everyone faces, have respect for all, and take the time to listen to what patients, whānau and staff have to say. I have learnt the value of silence, allowing people time to understand and respond. Believe in yourself because you can do awesome things. Ask the question why – this will lead to some interesting research opportunities and development projects!
Do you have a side hustle/ hobby/hidden talent?
I love to paddleboard – it helps me to escape the noise of life and feel at peace (as my children can only shout “mum come back” from the shore!). I’ve also published a school centenary book. In my spare time, I run conferences to support education for staff including NZ Neuro Nurses, Australasian Neuroscience Nurses Association and New Zealand Aotearoa Neuro Oncology Society. I’m also on the advisory board for Brain Tumour support NZ.
Do you have a favourite quote that’s inspired you?
“The sky is the limit” – I love to know anything is possible and help others understand this is true!
What's the best piece of advice you’ve ever been given - professional or personal?These pieces of advice have stuck with me:
- Never lose sight of the patient.
- Always ask the question “why?”.
- Don’t let the sun go down on your anger - tomorrow is a new day!
- Take care of yourself (I’m working on this!).
I try to follow these nuggets of advice every day.
Who is your biggest inspiration or has had the biggest impact on your life?
My family who are my rock - my husband and children Lucy and Henry, as well as my faith in God, get me through difficult times.
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