The staff nurse at Sligo Regional Hospital places great value on further education and is currently undertaking an ANP course

Mary McCaffrey, who works in the emergency department of Sligo Regional Hospital , recently commenced the advanced nurse practitioner (ANP) course, which isn’t surprising, considering her strong motivation to keep learning.

Mary – from Omagh in Co Tyrone – initially wanted to be a social worker, but after doing some modules in nursing as part of her degree in social administration, she decided to study nursing instead and has never looked back. She did her general nurse training in Craigavon Hospital, Armagh, and afterwards practiced for seven months in paediatrics before commencing her midwifery training in the Jubilee Maternity Hospital in Belfast.

After completing her midwifery training, Mary relocated to Sligo with her husband. She worked in St John’s Hospital before moving to Sligo Regional where she worked in a number of areas including medical, surgical and medical assessment. She is now a staff nurse in the emergency department.

Mary McCaffrey is a staff nurse in the emergency department of Sligo Regional Hospital

Mary has completed various clinicallybased courses, including one on NIPPV (non-invasive positive pressure ventilation) and another on care of the critically ill child, which she completed at Queen’s University, Belfast. She has a higher diploma in A&E and a masters in health sciences, for which she wrote a thesis on suicide and communicating with patients in the ED who may be suicidal. Mary found that non mental health trained ED nurses found it difficult to communicate effectively with suicidal patients.

Mary McCaffrey is a staff nurse in the emergency department of Sligo Regional Hospital

Mary has already done an x-ray prescribing course, but as a qualified ANP she will also be able to interpret x-rays and subsequently treat patients.

Other modules on the ANP course include pharmacology and examination of lower and upper limbs and shoulders. The course’s Advanced Physical Assessment module, incorporates OSCEs (objective structured clinical examinations). This involves the assessment of nurses while they are carrying out respiratory, cardiovascular, neurological and abdominal examinations on patients.

As part of the ANP course, participants are required to role play an initial patient assessment. This involves taking a report on patients’ family and medical history, medication, allergies and location of pain. As part of the role play, participants must also conduct a detailed examination of the patient based on their presenting problem.

Trainee ANPs work closely with the registrar and consultant who supervise their practice. After successful completion of the course, Mary will have the authority to assess, treat and discharge patients or refer them on. ANPs have their own caseload and this has proven to be very effective and patient friendly. Mary is enjoying the course and gaining confidence in her competence under the guidance of her medical colleagues.

“It is daunting to begin with because you are totally out of your realm, but it is worth it because at the end you get to work autonomously,” she said. “You have your own caseload, your own clinics and ambulatory clients, who can be treated by a nurse. Research has shown that patients are satisfied by the care given by ANPs.”

Mary continued: “I have excellent clinical teaching and mentorship from my medical colleagues which is an essential component of the ANP course. My clinical supervisor, Fergal Hickey, consultant in emergency medicine, has been so encouraging and so has Ann-Marie Loftus, director of nursing, who supports my continued professional development.”

An ANP has the authority to discharge patients with antibiotics and anti-inflammatory medication. They are audited every four years and are required to continually update their skills.

The responsibilities of an ANP offer an expanded role for nurses, allowing a wider scope of practice and providing good personal and professional satisfaction. Evaluations of the role have demonstrated that patients are satisfied with the care provided by ANPs.

The support of Mary’s husband gives her the space to further her education. She believes it is essential to have friends and hobbies outside the workplace and sings in the Sligo gospel choir every week, which she finds to be a great stress reliever and social outlet.

Day in the life - Mary McCaffrey: emergency dept nurse