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SCTS NAHP Inspirational Star of the year 2022

Miss. Amy Millichope, ACP, Birmingham

04 November 2022 (Last updated: 4 Nov 2022 12:17) by Prof. Bhuvaneswari Krishnamoorthy, Mrs. Indu Deglurkar and Mr. Sridhar Rathinam

SCTS NAHP Inspirational Star of the year 2022

Editor: Prof. Bhuvaneswari Krishnamoorthy, Mrs. Indu Deglurkar and Mr. Sridhar Rathinam.

Nominated by: Miss. Kathryn Hewitt, ACP, Birmingham.

Nominee: Miss. Amy Millichope, ACP, Birmingham.

 

Kathryn, tell us a bit more about yourself and why did you nominate Miss. Amy Millichope for this Inspirational Star interview?

I’m Kathryn, the NAHP subcommittee lead for Cardiac Surgery and also sit on the Adult Cardiac Surgery Committee as the NAHP representative. I have worked the past 12 years in Cardiothoracic Surgery at the John Radcliff in Oxford, New Cross Hospital Wolverhampton. Currently, I work as a qualified ACP in Cardiac Surgery at University Hospitals Birmingham. During my time in Cardiothoracics I am fortunate to have worked with some extremely inspirational NAHP’s but I have chosen Amy specifically as my Inspirational Star for 2022 as her story will be inspirational to junior NAHP’s. Amy’s career path has been full of exciting journeys and plot twists all leading to her dream job as an ACP in Cardiac Surgery. I feel it highlights to us all that you really can live life to the full and still be working towards your dream job. She is a great example of work and life balance with her fill of adventures across the world.

 

  1. Amy, tell us bit about yourself (please include personal, career highlights, key moments in your life).

My name is Amy and I live in Birmingham with my partner and our daughter. I completed my Nursing BSc in 2009 and got my first job at Selly Oak Hospital on a military trauma ward, caring for patients with injuries sustained in the Afghanistan war. Whilst I loved my first job as a trauma nurse, I was inspired by the critical care outreach teams and advanced practice teams and this encouraged me to work hard so I could apply for a job in an Intensive Care Unit (ICU). I got my first ICU job in October 2010 on the Trauma and Burns Unit at Queen Elizabeth hospital Birmingham. At the time, intensive care was my dream job, but I had a real thirst to travel, and so I took a UK career break, and travelled to Australia where I worked and travelled around Asia on the way back to the UK. When I returned to my job in ICU in Birmingham I wanted to challenge myself. I loved the acuity of the patients, and the high level of nursing required to care for the Cardiac patient, and so I transferred to cardiac ICU and after working there for a year, I decided to take a research job with the Surgical Reconstruction and Microbiology Centre based at QEHB.

Although the experience I gained in research was invaluable, I missed direct patient care. I decided to complete a year within the role, and then go travelling one last time before really settling down. I took a 4-month sabbatical in early 2015, and travelled around North and Central America. On return my return to the UK, I wanted to advance my career to the next level so I applied for a job for a Trainee ACP role in cardiac surgery. Five years later, I had completed my MSc in Advanced Clinical Practice at the University of Birmingham.  After finishing my MSc, I had become involved in an “objection to large scale planning” application in my local area. This led me to me becoming more involved with both the community and the Town and City Councils. This then led me to stand for election for the Royal Sutton Coldfield Town Council, where I was elected in May 2022. I am now a local Councillor, and also sit on the Planning and Highways Committee.

 

  1. Why did you become a Cardiac ACP?

Since my third-year nursing student placement in 2008, I have been interested in advanced practice. I have always wanted to do more and learn more, but equally I looked up to them and thought “Wow, they must be so experienced in their area, and it will take me many years to be as skilled as them”. When the trainee job advert came out, I didn’t think I would be successful, but I thought, if I wasn’t successful the first time I could be in the future. I didn’t want to let the opportunity pass, I was ready to engage in master’s level education and use my existing and new knowledge and skills to perform in an autonomous role, to benefit the cardiac patients and the department. I was successful and I felt like I had won the lottery.

 

  1. What is the history of cardiac ACP in CT surgery?

Advanced Clinical Practice was founded in the USA and was well established by the 1960’s, prompted at the time by social issues and a lack of physicians. A degree of standardisation was established by the late 1990’s with licencing introduced in the early 2000’s allowing for utilisation of the role across the USA.

The introduction of Advanced Clinical Practice in the UK was slower, initially introduced into primary care in the late 1980’s. Various publications from key organisations attempted to lead the way for Advanced Clinical Practice over the next decade, but it has grown significantly in the UK over more recent years in response to a reduction in Junior Doctors working hours to a maximum of a 48-hour working week. Furthermore, the Deanery’s requirement for Cardiac Surgical Trainees to be allocated dedicated and protected time under direct surgical supervision in theatres has been a key driver for Advanced Clinical Practice roles within Cardiac Surgery. Recruiting ACPs to work over a 7-day service, allows Trainees to meet the requirements of their specialty training role without the added pressure of having ward patients to cover each day.

 

  1. What are the key moments that got you to where you are now?
  • Witnessing my father graduating at the age of 40, when I was 12 years old made me very proud to have a dad who is determined in life
  • Attending many job interviews for my first staff nurse job so I had options
  • Attending my first SCTS conference in 2018 and presenting an audit – attending the SCTS conference gave me a real buzz for the specialty
  • Graduating with my MSc in Advanced practice in 2020
  • Always taking an opportunity, even though it takes effort, it might just pay off

 

  1. A day in the life of a cardiac ACP………………
  • Arrive on shift at 0700 and take handover from the night medical team
  • Review each patient electronically using several systems, including observations, bloods, - imaging and medications
  • Review each patient with the SpR and make a plan for the day including the request and review of investigations such as CT scans
  • Clerk new admissions from other hospitals or ED, both elective or emergency admissions
  • Completing complex referrals to speciality teams such as Stroke or Microbiology
  • Ensure the timely and safe discharge of patient home
  • Prescribing and review of medications
  • MDT meetings for complex patients with physio, OT, Safeguarding, Learning Disability
  • Review all discharges from the ICU and make a plan for their recovery
  • Attend several meetings including cardiology and cardiac surgery MDT, Aortic MDT, Theatre scheduling, Morbidity and Mortality Meetings, Clinical Governance

 

  1. What challenges have you faced? How did you overcome them?

A big part of the ACP role is autonomous clinical assessment and diagnosis and prescribing where required. I initially was very dependent on protocols to guide my decision making, for example warfarin dosing. Other senior ACP’s and medical staff would often not follow a particular protocol, and used their clinical judgement to make decisions about certain medications and certain complex situations. It probably took me a year or so following my prescribing course to be comfortable in doing this, and of course, there are situations where I would still seek guidance regarding certain medications in certain situations, but that is the great thing about working in secondary care at a centre of excellence, the access to other speciality knowledge is available 24/7.

 

  1. How do you interface with trainees and surgical trainees?

I really enjoy meeting and working with the surgical trainees. The knowledge they bring to our ACP team is invaluable. As a team, we provide an ACP workforce with the aim to cover the ward patients so that the core surgical trainees can go to theatre as much as possible so that they can complete their surgical training. The ACP team is not an alternative or replacing the junior core surgical trainees, we enhance and support in their training to produce best trained surgeons.

 

  1. What are the other interests you have apart from your ACP job?

I love to eat with my partner, friends and family whether it’s in restaurants or home cooked food. I love cocktails too and my favourite would be an Amaretto Sours. I enjoy yoga and walking, especially with a good podcast. My favourites are “Table Manners” by Jessie and Lenny Ware, and “My Therapist Ghosted Me” by Joanne McNally and Vogue Williams. I have a little girl who is 17 months old, so also love to do things with her, whether it’s swimming, play groups or snuggling down on the sofa to watch Disney’s Moana or Frozen.

 

  1. What advice/top tips would you like to give it to current junior ACPs and those considering it?
  • Plan your time when undertaking your MSc, be organised and use GANTT charts
  • Spend as much time with other specialities as possible, even if you are starting an ACP job within cardiac surgery

Advanced Clinical practice is an amazing role and career. Health Education England currently fund the training in many parts of the UK. Being a clinical ACP could be your dream job. Or you could complete your ACP and then use it as a stepping stone to become a Nurse Consultant, or to teach future students at University. The career possibilities are endless.

 

  1. What has made you laugh?

A laugh out loud when listening to my favourite podcasts, or when my daughter says or does something funny. My partner Mitch makes me laugh too.

 

  1. What has made you cry?

The last thing that made me cry at work was a family whose relative was dying. It was in the height of the COVID pandemic and some of the relatives had to wait outside the hospital as it was only two relatives to a bed, and they weren’t allowed to change over. It was such an upsetting time for them, with the loss of their Wife, Mum and Grandma, and it really got to me that they had to say goodbye from outside without holding the hands or seeing the face of their loved ones. I couldn’t bear the thought to be in that situation with my family.

 

  1. How do you maintain a good work-life balance? Any advice for your juniors.

I find it quite easy to switch on and off, and try not to dwell on things. I find that this works for me as I really do “clock out” of work-mode when I leave the hospital. If there is something that is bothering me, I find it good to talk to people who understand the situation, and have previous experience with similar situations. I always arrange something nice to do on my days off, whether it’s chilling out with family, my little girl, or doing something adventurous. I also love to travel, and a pre-planned trip always keeps me excited, especially if it’s somewhere sunny and bright.

 

  1. If there was one thing you know now that you wish you knew at the start of the journey, what would it be?

Being an ACP is such a rewarding career, but it does take a lot of dedication, determination and hard work. You have to commit yourself 100%, not only to undertake an MSc in advanced studies whilst working full time, but also to become clinically competent within the role. You also have to love the specialty you work in, because you live and breathe it. Fortunately, I am lucky enough to have landed in an ACP job in a Cardiac speciality which I adore.

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