First Registered Advanced Nurse Practitioner in Emergency Medicine for St. John’s Hospital Local Injury Unit (LIU)

Mairead O’Donoghue, a native of Co. Limerick, has become the first Registered Advanced Nurse Practitioner (RANP) in Emergency Medicine at the Local Injury Unit (LIU), St. John’s Hospital, Limerick.

RANPs are the highest level of clinical experts in the nursing profession in Ireland today.

Mairead qualified from UL as a nurse in 2003, having carried out her training in University Hospital Limerick. She has over 12 years’ nursing experience behind her and has worked in A&E abroad and in St. James’s Hospital in Dublin. She joined St. John’s in 2012 and from the outset wanted to train as an Advanced Nurse Practitioner.

Said Mairead, “I was very interested in studying to become an RANP because the role allows me to develop clinically as an independent, autonomous practitioner and strive for continuous improvement in practices for the benefit of patients.”

Mairead went on to complete her Advanced Practice year in Trinity College and then submitted her portfolio to the Nursing and Midwifery Board of Ireland, she was officially awarded RANP status in September.

LIUs are locally based services treating minor injuries and are a safe alternative to the Emergency Department (ED) for a number of injuries and conditions.

From the end of October and throughout Winter, ED presentations tend to be higher than the rest of the year. To alleviate the pressure on the ED, UL Hospitals is encouraging patients with minor injuries to present at their local LIU this Winter.

Said Mairead, “Patients coming to the LIU are generally seen within the hour after arriving, they can either self refer or get a GP referral.  Of course there are times when patients do need to go to the ED in UHL, such as when they are experiencing chest pain, abdominal pain or after a serious head injury. In those situations patients should always attend the ED. Now that there is an alternative for minor injuries, we would encourage patients to consider whether they could more appropriately travel to their nearest LIU where the supports are available.”

LIU activity across the UL Hospitals Group has been consistently growing throughout 2015, now accounting for 35% of all the groups Emergency presentations. The LIU in St. John’s saw an average of 175 patients per week in the first half of 2015.

Working in the LIU in St. John’s, Mairead specialises in non-complex, minor soft-tissue injuries, such as sprains, strains, suspected broken bones in arms or legs, minor scalds, burns or cuts and lacerations. Based in Limerick City, the catchment area for St. Johns is quite wide covering  Limerick, Clare and North Tipperary. She treats patients from 5 years up within an agreed scope of practice and thoroughly enjoys her role.

“Ultimately the patient will benefit from a more holistic approach. From the moment they arrive until they are discharged or referred, I can look after them as an RANP, assess their injury, request x-ray or other interventions, prescribe analgesia or tetanus, suture wounds and provide discharge advice, all under the clinical governance of a consultant in Emergency Medicine," said Mairead.

The LIUs come under the clinical governance of a consultant in emergency medicine and the Emergency Medicine RANPs rotate between the LIU and the ED at University Hospital Limerick (UHL) so they are an integral part of the Emergency Medicine team. The LIUs are at all times staffed by a senior clinical decision maker, qualified in emergency care. A wide range of diagnostic supports are available to staff in the LIUs and protocols are in place for the transfer  of patients to UHL, who clinical staff have decided are too unwell to be treated in the LIUs or whose condition falls outside the criteria for care in the LIU.

Dr. Gareth Quin, consultant in Emergency Medicine at UL Hospitals said, “The introduction of RANPs in emergency nursing is a new and exciting initiative for the nursing profession and for UL Hospitals, who now have six Emergency Medicine RANPs in total across the Group. The RANP, with the medical staff, can care for the majority of patients who attend the LIU and whose conditions are within the criteria of conditions that can be treated in the LIU. They are a very welcome addition to the team. “

All patients should, in the first instance, consider whether they can be more appropriately treated by their GP or out-of-hours GP service such as Shannondoc before presenting at either an LIU or the Emergency Department.

The LIU at St. John’s Hospital is open Monday to Friday from 8am to 6pm, and can be contacted on 061 462132.

LIUs are also open in Nenagh Hospital, 067 42311 and Ennis Hospital, 065 682 4464, 8am to 8pm 7 days a week.