Following the road less travelled from accountant to academic nurse

Sarah Goldberg is Professor in Older Persons Care, School of Health Sciences, University of Nottingham and is the Honorary Treasurer of the BGS.

Leaving university at 22, my only aim was to be paid well and I planned to achieve this by training as a Chartered Accountant. My aim was met, but over the years, I found the work as an auditor unsatisfying. A career break to care for my three young children resulted in me deciding to train as a nurse. My first staff nurse job was on a healthcare of the older person ward. The ward had a high proportion of patients with dementia. I had received no training on how to care for these patients’ complex needs during my nursing diploma and none was offered post-qualification. I found my lack of knowledge and skills uncomfortable, and a sharp contrast to the high level of training I’d received as an accountant. I left after seven months to become a diabetes research nurse and then a practice nurse.

I then met Professor Rowan Harwood, who had funding to develop and evaluate a medical and mental health unit (MMHU) which aimed to improve the hospital care of cognitively impaired older people. Inspired by Rowan’s vision of excellence in hospital dementia care, I joined his team as a research assistant. The trial of the MMHU demonstrated that patients cared for on the unit received a better care quality and had a better experience than those cared for on standard care wards^1,2. My project management expertise developed as an accountant resulted in me becoming the trial manager. I also completed my PhD while managing the trial and developed a passion for research.

I was then fortunate to be funded by Nottingham Hospitals Charity to develop the role of advanced nurse practitioner specialising in frailty. I used the Delphi method to gain expert consensus on competencies for this new role³. Many members of the BGS Nurses and AHP Council contributed to this research by being on the expert panel. I then secured a job at the University of Nottingham as an associate professor. Continuing to work with Rowan Harwood I was awarded funding as co-investigator on three large NIHR funded studies. PrAISED is a complex intervention to keep people with early dementia active and independent (results of the multisite randomised controlled trial are due in October 2022). VOICE1 used analysis of video recordings of conversations between healthcare practitioners and people with dementia to understand which communication practices are effective when delivering care. The findings were used to develop a dementia communication skills training course for healthcare practitioners⁴. We have recently started VOICE2 which aims to understand effective communication when healthcare practitioners are caring for a distressed patient with dementia.

In addition to research, I support undergraduate and post-graduate nursing students; clinical academic PhD students from a range of disciplines and have developed teaching and learning resources including the Foundations in Dementia MOOC https://www.futurelearn.com/courses/dementia-awareness-training and a series of online resources for hospital staff https://www.bgs.org.uk/blog/reusable-learning-objects-in-dementia-care. As Director of Research for my school, I am responsible for the strategic direction of research. I still use my accountancy experience as the Honorary Treasurer of the BGS.

When I changed career to become a nurse, I did not understand the diversity of the role I would end up doing. Research is always interesting and stimulating and makes a huge contribution to improving the healthcare of people with dementia and the skills and knowledge of those caring for them.

References

1. Goldberg SE, Whittamore KH, Pollock K, Harwood RH, Gladman JR. Caring for cognitively impaired older patients in the general hospital: a qualitative analysis of similarities and differences between a specialist Medical and Mental Health Unit and standard care wards. Int J Nurs Stud 2014; 51:1332-43.

2. Goldberg SE, Harwood RH et al. Comparison of a specialist Medical and Mental Health Unit with standard care for older people with cognitive impairment admitted to a general hospital: a randomised controlled trial (NIHR TEAM trial). BMJ 2013;347:f4132

3. Goldberg SE, Cooper J, Gordon A, Blundell A, Masud T and Moorchilot R. Development of a curriculum for Advanced Nurse Practitioners working with older people with frailty in the acute hospital through a modified Delphi process. Age & Ageing. 2016; 45 (1): 48-53.

4. O’Brien, R., Goldberg, S., Pilnick, A. et al (2018) The VOICE study- A before and after study of a dementia skills communication course. PLOS One: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198567