This document summarizes Lee Berry's training and experience as an Acute Care Practitioner (ACP). It outlines their educational background and clinical rotations in intensive care, anesthesia, and outreach. It also describes the practical procedures Lee performed such as intubation, vascular access, and prescribing. Feedback was generally positive but some misunderstanding of the ACP role was encountered. Long term goals include increased responsibility and competency in the intensive care unit.

1. ACCP training
A
personal
perspec,ve

2. Lee Berry
• RN
qualified
1998
• Cri,cal
care
experience
2000-­‐2011
(university
teaching
hospital
SGH)
• ICU
• Medical
HDU
• Cri,cal
Care
Outreach
• Lead
for
resuscita,on
2011-­‐2013

3. Education
• Formal
-­‐
University
of
Southampton
MSc
pathway
• Key
components-­‐
• History
taking
and
physical
assessment
• Pharmacology
and
Independent
prescribing
• Modules
generic
not
tailored
to
ACCP
programme

4. Education
• Tutorial
programme
–
• List
of
core
topics
selected
by
ACCPs
• Formal
teaching
delivered
by
intensivits
and
anaesthe,c
consultants
• High
fidelity
simula,on
sessions-­‐
• Core
clinical
decision
making
and
airway
skill
prac,ce
• Non
,metabled
opportuni,es
(Theatre,
ICU,
Outreach)

5. Clinical rotations
• Rota,ons
at
RHCH
&
BNHH
• Intensive
care
unit
• Theatre
• Cri,cal
care
outreach
ICU
30
50%
Anaesthe,cs
13
22%
Outreach
17
28%
Clinical
Alloca*on
ICU
Anaesthe,cs
Outreach

6. Practical procedures
• Facilitated
by
ST3
and
above
during
clinical
alloca,on
• Intuba,on
&
Airway
skills
• Vascular
access,
CVC,
‘vas
cath’
• Arterial
line

7. Airway
Grade
1
Grade
2a
Grade
2b
Grade
3
Total
26
9
6
2
LMA
56
ETT
43
Total
99
60%
21%
14%
5%
Laryngoscopy
Grade
1
Grade
2a
Grade
2b
Grade
3
Airway
procedures
LMA
56
ETT
43
Total
99

8. Vascular access catheters
• Supervised
in
theatre
and
ICU
• No
Immediate
complica,ons
• Reduced
opportuni,es
in
ICU
for
line
placement
• Pseudomyxoma
surgery
3-­‐5
cases
a
week
and
line
changes.
10
3
11
Vascular
Access
CVC
Vas
Cath
Arterial
lines

9. Clinical role not just procedures
• Working
within
ICU
medical
team
• Responsible
for
pa,ent
daily
review
and
presenta,on
on
consultant
ward
round
• Undertaking
physical
assessment
and
interpreta,on
of
diagnos,c
informa,on
• Ordering
of
diagnos,c
tests
• Liaising
with
other
clinical
teams.
• Independent
prescribing

10. Feedback
• Regular
360
feedback
from-­‐
• Anaesthe,c
trainees
• Anaesthe,c
consultants
• ICU
Nursing
staff
• Cross
boundary
working
nature
of
role
has
led
to
misunderstanding
of
role
and
role
apprehension
among
a
small
number
of
medical
and
nursing
staff.
“Nurse
pretending
to
be
a
doctor?”

11. Second year goals and beyond
• To
become
involved
with
ICU
audit
• M
&
M
mee,ngs
&
case
presenta,ons
• Out
of
Hours
working
(weekends
/
nights)
Increased
learning
opportuni,es
but
maintaining
supervision
with
ICU
consultant
• Complete
competency
document
and
final
assessment.

12. FICM exit exam & National syllabus
• FICM
exit
exam
not
yet
in
place.
In
hospital
exam
and
competency
document
equivalent?
• Na,onal
syllabus
required
for
valida,on
and
role
consistency.