What interested you in becoming an Acute Medicine Matron?

It was not originally a path Tash had sought. She loved working as a Clinical Lead in Acute Medicine and had not previously considered moving into a Matron role.

When the existing Matron left, a secondment opportunity became available. After discussing it with colleagues, she decided to take the opportunity. She describes the transition as a steep learning curve, but one made easier by the teams around her.

How did you prepare for the role?

There was no single specific training pathway. Tash had completed a Leadership in Action course, which she found particularly useful. She also recommends the NHS Matron's Handbook as an important resource for both current and aspiring Matrons.

What were the biggest challenges?

The role was very different from anything she had previously undertaken, with a much greater emphasis on patient safety, quality standards and safe staffing.

She was also responsible for two Acute Medical Units on different sites which operated in different ways. A major part of the work has involved aligning practice as the services move towards being brought together.

What does a working week look like?

Meetings occupy a significant part of the week, alongside a number of operational roles. As staffing Matron of the day, Tash oversees safe staffing across the Trust and helps ensure areas requiring additional support receive it.

The operational role focuses on timely movement of patients from the Emergency Department and removing barriers across the directorate. She also spends time on the Acute Medical Units undertaking safety work, supporting Band 7 colleagues, advising teams and escalating concerns where necessary.

Matron walkabouts provide another opportunity to identify safety, infection-control and medicines-management issues, while also recognising excellent practice.

What experience would help before applying?

Tash recommends completing a leadership course before becoming a Matron. She also found shadow shifts with the Matron team invaluable before starting the role.

What sparked your interest in MSDEC?

Time working on the Acute Medical Unit created a particular interest in the waiting-room and acute medical clinic environments.

The fast pace, together with the opportunity to use initiative and triage skills, proved highly motivating. That interest grew further while coordinating shifts as a Band 6 nurse.

The continued expansion of MSDEC, quality improvement and development of nurse-led care remain important motivations in the role.

How did you progress to Ward Manager?

The move into ward management felt like a natural progression after spending substantial time within MSDEC. It was an environment that made full use of their skills and one in which they felt they thrived.

What does a working week look like?

The week typically includes two clinical shifts on the ward: one focused on navigation and another working as Nurse in Charge.

Two further days are dedicated to administrative responsibilities.

Recommended development

• Health Assessment
• Leadership courses, including programmes such as Dare to Lead
• Acute Medicine for Improvement

Why advanced clinical practice?

Cait loves working in Acute Medicine and wanted a career progression route that allowed her to remain primarily clinical.

How did you train?

She was supported by her Trust through a Master's degree at Warwick University, completed part-time over three years.

Training was split equally between clinical practice and university study and was funded by Health Education England. Her workplace clinical supervisor was an Acute Medicine consultant.

What was challenging?

The academic component of the degree was challenging, as was balancing the combined workload of clinical and academic practice.

What does your working week look like?

Cait works part-time, with around 85% of her time spent clinically across Acute Medicine, including AMU, SDEC and seeing medical patients in the Emergency Department.

The remainder is divided across the other pillars of advanced practice: leadership, research and education. She contributes to local simulation, service development and audit.

Useful experience before ACP training

Cait recommends gaining as much Acute Medicine experience as possible. Experience in other acute areas such as critical care, Emergency Medicine and respiratory medicine can also be helpful.

• Health Assessment
• Management of the acutely ill patient
• Advanced Life Support

What led you into Advanced Clinical Practice?

Changes to medical training through Modernising Medical Careers and the European Working Time Directive prompted substantial workforce redesign. This created new opportunities for other members of the multidisciplinary team to take on roles traditionally delivered by doctors.

How did you train?

Training combined work-based competency with a degree in Advanced Practice, followed by ongoing continuing professional development.

What does your working week look like?

The role combines work across SDEC, acute receiving and a venous thromboembolism service.

Training before applying

Look at the development opportunities and courses available locally and use them to build the knowledge and experience needed before applying for ACP training.

What interested you in education?

Nicola's first interest developed while supporting new starters and students. She enjoyed teaching and seeing how people could develop when given the right support.

Her experience in Acute Medicine enabled her to guide others through what can sometimes be a challenging clinical environment.

How did you develop as an educator?

The first step was becoming a student assessor, developing skills in feedback and development planning.

When a practice facilitator position became available, she applied and began her formal journey as an educator. The role provided opportunities to undertake train-the-trainer sessions, assess clinical skills and develop expertise in clinical supervision.

She then completed a Preparing to Teach award, developing skills such as lesson planning and course evaluation, and later completed a postgraduate certificate in healthcare education.

What challenges did you face?

Acute Medicine brings an unpredictable workload and a constantly changing environment. Teaching and supervising staff can therefore compete with immediate clinical demands.

Those challenges encouraged Nicola to develop different approaches to education and adapt her teaching to the situation and environment.

What does the working week look like?

The role is varied. Time may be divided between clinically supervising staff and classroom teaching.

Clinical supervision can include supervised medicines rounds, clinical competency assessment and supporting new starters. Other days may focus on professional development conversations and identifying courses that can help colleagues progress.

Much like an Acute Medical Unit itself, no two days are the same.

A good place to start

Nicola recommends becoming a student assessor. It provides valuable experience in feedback, supporting learners and, when needed, developing action plans. It can also provide useful evidence for an educator portfolio.

Why Acute Medicine leadership?

Hannah's interest in becoming a Senior Sister began during a management placement on an Acute Medical Unit. She was attracted by the fast-paced environment and the diversity of patients with complex, high-acuity needs.

Acute Medicine allows her to combine direct clinical care with leadership. Her role includes autonomous nurse-led activity such as DVT assessment, triage, mentoring junior staff and supporting change.

Service-improvement work, including Nurse SAMBA data reporting and work on nursing career pathways and education, has further developed her interest in the specialty.

How did you develop for the role?

Hannah's development has combined advanced education, clinical experience and leadership development.

She has completed postgraduate Level 7 courses including Health Assessment, Management of Acute Disease and Leadership in Healthcare, and is undertaking an MRes in Healthcare Research.

She is also Advanced Life Support trained and has completed GIC training. Alongside formal qualifications, she has deliberately developed autonomous practice, triage and leadership experience.

What challenges have you faced?

One challenge has been the limited availability of mentors who have successfully combined clinical work and research through a clear clinical academic pathway.

This has required Hannah to seek guidance proactively and build parts of her own path. Maintaining work-life balance while combining Acute Medicine, research and leadership has also been challenging.

What does your working week look like?

Hannah works full-time across three 11.5-hour shifts. Two are clinical: typically one involves triage and another is spent caring for patients in SDEC.

Her third shift is dedicated to MRes study through a Chief Nurse Fellowship programme within her Trust, which backfills one clinical day each week to support academic development.

Recommended development

Build broad clinical experience in acute settings, particularly triage, assessment, emergency care and managing high-acuity patients.

• Health Assessment
• Management of Acute Disease
• Postgraduate Acute Medicine study
• RAPID
• Advanced Life Support
• Leadership and management development
• Quality Improvement and service-change projects