Rapid Access Neurology Unit (RANU)

The Rapid Access Neurology Unit (RANU or Starfish) is a nurse-led day unit at Great Ormond Street Hospital (GOSH) which provides rapid access to diagnosis and treatment for children with an acute neurological illness.

The unit is evolving and ultimately will become the neurosciences day care unit, encompassing RANU, neuromuscular, neurology and neurosurgical day cases.

One of a small team of nurses on the unit, Kay completed the children's nurse training programme at GOSH and has now been at the Trust for four years.

As a student I'd loved neurology, both in terms of the variety of patients and the opportunities for learning. I'd also found the staff to be so friendly and supportive. Although still a student, I was treated like a nurse from the very beginning.

Our patients are with us for very quick investigations, like MRI and CT scans, blood tests, and muscle biopsies. We have recently undergone training to treat botox patients with Entonox, which will be really interesting.

The pace on the unit can vary a lot, but as we're a very small team, it's often really busy. One of the plus points of working on Starfish is that it's Monday to Friday.

We often hear from parents that they've had a really good experience at GOSH, having had a difficult time in their local hospital where they weren't able to find answers.

Also, this might sound odd, but it's always really satisfying to get the right amount of blood from a patient, which can be tricky if the child's veins are very small. When the blood is required by the doctor for that patient's investigation, it's important to get it right.

With such a small team, it can be a juggling act to ensure everything runs smoothly. If one of us needs to attend an MRI, the other nurse needs to remain on the unit. Obviously we see a lot of stressed parents, for example, when their child is being prepared for a general anaesthetic for the first time. Then there are those families who receive bad news about a diagnosis, which has to be the hardest part for any nurse.

For me, patience and empathy are the two most important qualities for a nurse doing this job. It's also important to remember to have fun with the kids as well as the parents, which can make all the difference in a difficult situation.

My manager is great at coming to me with ideas about courses or study days I can attend, but there's never any pressure to do them if I'd rather not. Equally, if there's an opportunity that I really want to take, my ward manager will accommodate that.

The variety of work across our three areas of neurology, neurosurgery and day cases means that a nurse working in this field will never get bored. There is the option of rotating between wards too, so everyone has the opportunity to find out about a different aspect of neuroscience.

This is really important as we'll all be combined and working much closer together over the next 12 to 18 months once the new clinical building is up and running.

Laura qualified as a children's nurse eight years ago after completing the GOSH training programme and she has worked on Starfish for the last two years.

As a student, I enjoyed my placement within the unit, the variety of patients and that it's such a team-oriented specialty.

As well as day cases, we see urgent referrals from local hospitals. These are often patients who need to undergo MRI scans, blood tests or lumbar puncture tests. We see a lot of patients with new onset seizures. We see patients with regression of their skills, so they may have stopped talking or have some other unexplained developmental problem that needs investigating.

About 80 per cent of my job is clinical, so I play a key role in completing our investigations and carry out duties such as looking after patients who require general anaesthetic. I also manage staff, create the rosters and make sure that we're adhering to all the necessary policies and procedures.

When parents come here they invariably have a child with unexplained neurological symptoms, so understandably, they are often very stressed. If we're able to help them find out what's going on and to make them feel as comfortable as possible while they're here, that can be very rewarding.

You need to be able to build a relationship with a family very quickly because they are only going to be with us for one day. Having a good understanding of the specialty is key, as it's important to be able to answer any difficult questions from families.