Island Medics

I worked in Theatre and Accident and Emergency for several years, before I decided to study to be an Emergency Nurse Practitioner (ENP) in Accident and Emergency. After working in Aberdeen for a few years I chose to come and work in Shetland because it was home, where I grew up and went to school.

Working in Shetland differs from other places I have worked in that it is remote and rural, so we see a lot of variety in our work. It can be very challenging at times as we can be the first port of call for some seriously injured trauma patients. We see patients brought in from the North Sea with either oil or fishing related injuries as well as other serious trauma/ medical conditions from the islands itself.

I guess the most challenging thing about the role is dealing with major trauma. Being an ENP and having the autonomy to see and treat patients with minor injuries, such as lacerations or fractured wrists/ankles is very satisfying though.

We see and treat approximately 7,000 new casualties a year.

The best thing about my job is being able to help people and make them feel better. Shetland is a very friendly place to live and work, it has a lot to offer with always something to do. It has a great community spirit, lots of outdoor pursuits, beautiful scenery not to mention the excellent wild life and is famous for its music and knitting. Working at the Gilbert Bain is a very varied and rewarding experience.

I worked in Theatre and Accident and Emergency for several years, before I decided to study to be an Emergency Nurse Practitioner (ENP) in Accident and Emergency. After working in Aberdeen for a few years I chose to come and work in Shetland because it was home, where I grew up and went to school.

Working in Shetland differs from other places I have worked in that it is remote and rural, so we see a lot of variety in our work. It can be very challenging at times as we can be the first port of call for some seriously injured trauma patients. We see patients brought in from the North Sea with either oil or fishing related injuries as well as other serious trauma/ medical conditions from the islands itself.

I guess the most challenging thing about the role is dealing with major trauma. Being an ENP and having the autonomy to see and treat patients with minor injuries, such as lacerations or fractured wrists/ankles is very satisfying though.

We see and treat approximately 7,000 new casualties a year.

The best thing about my job is being able to help people and make them feel better. Shetland is a very friendly place to live and work, it has a lot to offer with always something to do. It has a great community spirit, lots of outdoor pursuits, beautiful scenery not to mention the excellent wild life and is famous for its music and knitting. Working at the Gilbert Bain is a very varied and rewarding experience.

I came originally to do a locum contract and loved the place and people. Having worked elsewhere in the UK, I found Shetland much better. I met my wife whilst operating in theatre (she’s a theatre scrub nurse) and decided to stay.

The job varies from day to day and no two days are the same. I can be called on to see patients in A&E, the wards, theatre, outpatients. The day starts with a review of all patients seen the previous day in A&E and a discussion around admitted patients. This is followed by a ward round where all patients who have been admitted are seen and ongoing care planned. I then go to either theatre, the outpatient clinic or A&E. Following this we usually have a teaching session for junior doctors around 2pm. Then it’s back to A&E. I’m supposed to finish at 4pm but usually end the day around 6-7pm. Then it’s home to the family.

Yes, I think I would be able to work in a mainland hospital. However, I’d be frustrated dealing with only one area of medicine and for that reason I’d probably choose A&E where presentations are still varied.

Helping people who then say “thank you”.

Having enough time in my day to do all the paperwork associated with it! Just being left to do my job instead of having to fill in endless pieces of worthless paper would be nice.

Yes very!! It somehow makes things seem artificial. I am now aware how strange I sound on camera! The staff and patients varied in their opinions. Some were for it, others against.

This is one of the core activities we undertake. It not only teaches the next generation of doctors but we try to encourage them to come back and work on the island long term. Like most places in the UK we are desperately short of doctors. The island offers a great experience and working here is special. Current UK training seems to be falling short on a number of fronts and hopefully we are able to show what is possible.

Last year we looked after 278 pregnant women in Shetland with approximately two-thirds delivering here and one-third in Aberdeen due to need for consultant obstetric or neonatal facilities.

I feel that it is increasing, it certainly feels busier or at least the same from when I was here as a student midwife.

I feel for me I’ve been challenged a lot recently, moving midwifery posts whilst still being newly qualified has been hard, but I’m slowly gaining in confidence again. Getting to know a new area and having to consolidate my skills for all round midwifery, rather than just one area of practice as I had in my previous post. Getting to know the policies for the island and what changes this presents for rural midwifery compared to midwifery in an obstetric unit.

I think the best thing is really getting to know the women and being with them throughout their journey towards becoming a family. There’s something special about being with women throughout pregnancy, birth and in the early stages of parenthood.

I chose to work in Shetland because of how much I value the continuity seeing women and the amount of time I can spend with them. As a midwife on the mainland I felt that I gave the very best care I could in a busy environment, but I thought I could always give more but was restricted by the workload. For me as a midwife, it was important for me to be able to build relationships over time and to get to know the families you care for well.

I felt that it was an important and scary decision for me to make as a newly qualified midwife to uproot my life and move to Shetland alone, but it’s how I’d like to base my career and how I want to continue my path as a midwife.

I started as a Health Care Assistant in Theatre, and then trained with Open University and got a job as a Staff Nurse. The training took four years, (plus a fifth for my Honours Degree), and all of my placements were in Shetland, so that allowed me to study and work, as well as be at home with my family. After that I went on to be Senior Staff Nurse, and now I’m Senior Charge Nurse – working here has given me the opportunity to develop and rise fairly quickly.

I really enjoy my job, there can be days when you don't want to go to work like any job, but it is such a great team. Everyone helps everyone, from porters and domestics up to the most senior staff in the hospital, everyone chips in and does what's needed, even if it's just making someone a cup of tea, everyone really rallies together and gets on really well. There’s such a strong sense of community, in Shetland and in the hospital. You're all in it together and you're all so close and keep each other going on the tough days.

The most challenging thing is that this is a small community so you always have a connection to people or know something about them, nobody is really a stranger. So when there is any trauma or tragedy, that is a bit of a double edged thing. It can often be a comfort and a help that people in crisis know you and see you as a friendly face, but also you're living in the same community as that family so it affects you, and you always have that reminder.

I’m a committee member for the Simmer Dim Rally, and I love to get out and about around Shetland with the campervan, walking the dogs and taking photos. I’ve also recently started horse riding again. I’m expecting my first grandchild next year, so I’m currently knitting my first ever Shetland Shawl – the staff in the hospital have all been great at helping me with my knitting when we have a quiet moment!

The main challenge I face being a Paramedic is critically ill patients. In these situations I become very aware that my patient’s life is quite literally in my hands. Paramedics across the country meet critically ill patients every day however certain factors about living and working in Shetland make these patients a little bit more difficult to manage, including the geography of the island. For example, I can be an hour away from hospital along single track roads with no radio or mobile phone signal with a seriously ill patient which is a daunting experience and adds a little extra pressure.

Another factor is the amount of resources available in Shetland – having only two ambulances (four members of staff) on shift at any one time it can be more difficult to deal with serious incidents than the equivalent situation on the mainland. If we need any more than this luckily we can rely on the goodwill of our colleagues who don’t mind being called from home any time of day or night to attend a major incident. We can also get support flown up from the Mainland, but that obviously takes a while to happen.

The final challenge that comes with working in Shetland is I am very often called to somebody I know, or a relative of somebody I know. This without a doubt adds an extra level of pressure.

In Lerwick we have 10 Paramedics and five Technicians.

I studied Nursing at Glasgow Caledonian University and moved to Oxford and worked for 13 months as a staff nurse on a surgical urology ward after graduating.

In 2011 I left nursing to pursue my dream to become a Paramedic. I joined South Central Ambulance Service as an Emergency Care Assistant which I did for just over a year then joined the Scottish Ambulance Service to do my technician training. I moved home to Shetland to work at Lerwick Ambulance Station once this was completed.

In January 2017 I started my training to become a Specialist Paramedic. I should qualify as a Specialist in Jan 2018 (If I pass all my exams!! No pressure).

I think I am more nervous about seeing myself on the programme. I think it will be quite eye opening to see myself doing my job. Shetland being Shetland as well EVERYONE will be tuning in!!!

There’s not a straightforward answer! It was an opportunity to challenge myself in a subject area that I've always been interested in. But the unique thing about medicine is that it's so varied, and you have so many different options about what area to specialise in and the path to take to get there.

Definitely. At times the junior doctor is the only doctor on-site so our skill set has to be extremely varied. The exposure to clinical situations and the willingness of seniors to teach has meant that my practical skills have increased tenfold.

If you're sure, go for it. If you're not sure, do some work experience/shadowing to get a real insight into what doctors actually do.

Probably one of the many patients that have come in with injuries that require immediate treatment in A&E, e.g. joint dislocations that need relocating or lacerations that need stitching.

Spare time?! I did what I always do - relax and socialise with friends. But working in a new place meant that there were new friends to be made and new places to see.