As a child, Jackie Smith could often be found with her toy nurses’ kit and a bottle of Dettol, searching out patients she could treat.
Now, as lead nurse specialist for rheumatology at East Kent Hospitals there is no need to look for patients – they come to her in their droves.
Jackie leads a team of six nurses in looking after thousands of patients, from diagnosis to long-term management. And with most of the 200 conditions that come under the rheumatology umbrella life-long, the team care for their patients over the course of many years.
In collaboration with the rheumatology consultants, Jackie is able to run clinics, assess patients, evaluate blood tests, prescribe medication, carry out ultrasound scans and other investigations, inject joints, and educate patients on their disease and how to stay well.
She said: “I always say to student nurses that their placement with us won’t be like any other placement they’ve ever had.
“They won’t be taking blood pressure or any of the tasks they routinely do on the wards.
“Our roles are developing all the time, we have to keep on top of research so we know the best drugs to prescribe for our patients, and we manage our patients on behalf of the consultants so there is a lot of autonomy in what we do.”
Jackie has been with the service for 16 years and worked as lead nurse for two years.
But she started her medical career as a dental nurse, after a chance conversation with her own dentist led to him offering her a job.
She said: “I was a single mum at the time and it fitted around the childcare. I qualified as a dental nurse, because I wanted to be the best I could be, and then I took over as practice manager.
“My mum was a senior nurse and worked at a hospital in Herne Bay, and I signed up for some flexibank shifts there to develop my hospital experience.
“I worked alongside her and called her sister, which was a bit odd!”
Retirement meant Jackie’s mum was able to help with the childcare, allowing Jackie to train as a nurse. She qualified in 2000 and worked in day surgery for four years until the unit closed, leading to her move to rheumatology.
She said: “It’s a hugely interesting area to work in. There are 200 conditions, and some are so rare I will never see them.
“It’s about inflammation of the system, not just the joints, and we work with patients to control their disease and hopefully get it to a point where they are stable enough to be transferred to community teams.
“But they know we are always here for them and we have an advice line which is really popular, and has proved a godsend to a lot of people during the coronavirus pandemic.”
Jackie is passionate about staff development, and is proud of the rheumatology department’s commitment to ‘growing their own’, training nurses over time to prescribe drugs for their patients.
And she firmly believes part of the role is to advocate for patients and to be their voice, whether in the regular multi-disciplinary team meetings to discuss complex cases, or in helping to build a case for a more expensive drug to be used where others have failed.
She said: “I encourage all my nurses to have a voice and to use it – even if that means questioning me!
“We are a fantastic team and I’m proud of my nurses and the work we do.”