Neurological and craniofacial team

Tiger ward

The neurological and craniofacial team specialise in the acute management of children with complex conditions, such as Crouzon and Apert syndrome, stroke, CNS infection and seizure control.

Tom, Band 6 Senior Staff Nurse and Team Leader

Tom came to GOSH six years ago having completed his children's nurse training in Bradford.

What attracted you to the profession?

I wanted to work with young people. Before I entered nursing I worked on kids' camps and with kids with learning disabilities. Many of my relatives are nurses so I resisted it as a career initially, but as I got older and gained more life experience it felt like the right career for me.

Why did you choose neurosciences?

As my background is in psychology, I already had an interest in neurology. There is still a lot we don't know about the brain, which makes it such a fascinating organ. It's a very dynamic area to work in and we're always learning new things. Any given condition presents itself differently from child to child so each case is unique.

What does a typical day look like?

I'll normally start the day by speaking to all the patients and families and by introducing myself to those who are new to me. If a patient is unwell, I'll do a brief head-to-toe assessment to get a sense of what's going on with them. I'll catch up with the doctors and review each patient's needs for that day.

Along with the Ward Manager and three other team leaders, I help to run the ward and support staff. If I'm in charge on any given day, my main responsibility will be bed management. I'll generally be trying to take as much pressure off staff as possible so that they are free to focus on the patients they've been assigned to.

As a team leader I'm responsible for managing a group of colleagues and carrying out their appraisals. However, I see this much more as a supportive than a management role.

What skills do you think nurses working on this team need?

Excellent communication, time management and organisation skills plus the ability to recognise one's limitations. I'm not great at multi-tasking - perhaps it's because I'm male! - so I know when to ask for help. Great nursing skills and a willingness to learn are essential too.

What are the most challenging aspects of being a neuroscience nurse?

If a child sustains some sort of neurological damage from an injury or infection, they can be left with long- term health problems. Because we're a specialist centre, often, by the time parents get to us they think we can find a cure for their child. We have to manage expectations.

Ensuring good communication between all the multi-disciplinary specialists - such as doctors, nursing staff, social workers, neuropsychologists and physiotherapists - can also be challenging. Communication can break down very easily, but we work together very well.

What do you find most rewarding about your job?

Working in the team itself. Everyone's encouraged to learn and progress.

I've just finished working night shifts and was looking after one little girl who had been quite unwell. She woke up one morning and smiled at me for the first time in four days, which meant that I went home on cloud nine.

Hanni, Band 4 Clinician's Assistant

Hanni has worked in the neurological and craniofacial team for two years. Prior to this, she worked in the outpatients department at GOSH. She completed her degree in Health and Social Care at Southampton University where she specialised in working with children and families.

Tell us about your job.

A major part of my role is taking bloods and putting in cannulas. I liaise with local hospitals to get patient results and deal with all the emergency admissions. I act as a general support to my colleagues on the ward, helping them with their workload where I can. I also go on ward rounds to ensure that I know what's going on with the patients.

What personal attributes do you need?

You need a lot of patience in this job. I think it's fair to say that I'm often the unpopular one - no child likes having their blood taken. It can be really hard seeing a child in distress, so learning to take some abuse and focus on getting the job done quickly is crucial.

Is there a particular situation that has inspired you?

Quite soon after I started working in this team, there was a little boy with us who had been diagnosed with encephalitis, which is when the brain becomes inflamed. He had been with us for about three weeks and just wasn't responding to anyone or anything.

A few months following his treatment he came back to the hospital for a visit and I was amazed to see him walking, talking and smiling. I found this totally inspiring and it made me feel really proud to be on the ward.

Would you encourage others to specialise in neurology?

I would. I think there's a misconception that our work is too difficult and depressing - that couldn't be further from the truth. Of course, there are challenges in neurology but when you're working with such an upbeat and supportive team, the positives will always outweigh the negatives.

Emma, Band 6 Senior Staff Nurse

Emma trained at GOSH and has been at GOSH for five and a half years.

Why did you choose neurology as a specialty?

It was a tough decision between neurology and oncology, but after a year working with cancer patients I decided to make the transition. It was important to me to have quality time with families and really get to know the patients, which isn't always possible in other specialties.

What kind of patients do you see on the ward?

The two main groups are epilepsy and craniofacial patients. Our focus is medical rather than surgical, but we do look after patients who need an embolisation, a pioneering procedure which involves the injection of glue into the vessel to stop the blood from overflowing. The procedure is often done as an emergency and can save lives.

Describe your role in a nutshell.

I have responsibility for every single patient on the ward, so ensuring that staff have a safe and manageable workload is a key part of the job.

What qualities do you need?

Good time management and organisation skills, a good sense of humour and the ability to stay calm when confronted with difficult scenarios are all essential.

What's the hardest part of your job?

Talking to stressed families. However, when we're able to offer a solution, it's hugely rewarding. In neurology, we can't always give the outcome families want, but it's so lovely to get positive feedback from parents who might once have been very distressed and angry when their child was admitted to the ward.

Would you encourage others to specialise in neurology?

Definitely. Neurology is so relevant to most specialties across different hospitals. It is a lovely specialty to work in and the patients are wonderful individuals. I'm thinking particularly of the teenagers who have craniofacial conditions. They've often been in and out of GOSH all their lives, so we've built a strong relationship with them by the time they reach adolescence.

Obviously I can only speak from my experience, but where I work is a fantastic, friendly ward. On the rare occasions that we get stressed, the team always offer help and support.

What's the training and career development like?

We're incredibly fortunate here at GOSH to have access to training which isn't so readily available at other hospitals. The scope for development is excellent. We're all encouraged to learn and often receive recommendations from our Practice Educator on which study options to take.