A career in nursing – and still not finished

Lesley Carruthers started her career as a teenage nursing cadet at the West Cumberland Hospital - then went on to become both one of its most senior nurses and one of the most well-known faces in the NHS in Cumbria.

As well as playing a key part in her career, she also became a patient at the hospital when she underwent treatment for breast cancer just over 10 years ago.

Now 60, she had planned to retire a year ago - but found herself accepting a new role, helping draw up plans for the hospital’s ongoing redevelopment.

Lesley, who lives in Whitehaven with husband Dave, is a strong supporter of the NHS and is urging more Cumbrians to think about nursing as a career.

And she believes the return of nursing cadets could be the solution to the area's long-standing recruitment problems.

Lesley remembers the day she decided, at the age of about 14, that she wanted to become a nurse.

“My grandfather had taken quite ill in Manchester, which is where my family were originally from, and we went down to visit him.

“I didn’t like the way he was being cared for. I decided I wanted to go into nursing so that I could make a difference,” she said.

Back then Lesley was a pupil at Workington Grammar School and remembers making a beeline for the nursing stand at a careers event.

She applied for the nursing cadet scheme at the West Cumberland Hospital and started there in 1974, aged just 16.

“It gave you a real grounding about nursing. You were working across all the departments, not just on wards. That gave you a really holistic picture of what nursing was about before you even started your career.”

Lesley qualified from the cadet scheme in 1976, then worked as a student nurse until she qualified in 1979. She went on to nurse at the hospital, in the community as a district nurse, then became a staff nurse and later senior nurse.

In 1995, Lesley completed further studies to become west Cumbria’s first clinical nurse practitioner, working in orthopedics to assess patients prior to surgery.

She said this helped to reduce the number of cancelled operations as she could identify those that weren’t physically fit enough for the surgery before the operation day.

“The first year it actually saved £365,000 in wasted theatre time,” she said. “That’s good, but most of all it’s far better for the patients. You do not want an anaesthetist having to cancel on the day of surgery. That's not good for the patient.”

In 2002, Lesley was made clinical manager for surgery, then later matron for surgery, at the West Cumberland Hospital.

In the mid 2000s, Lesley was diagnosed with breast cancer. But even then she refused to give up work. Instead she took on a different role away from the wards, working in business management, while she underwent treatment.

“I just needed something I could balance around my chemotherapy. I didn’t take any sick leave apart from the days of my chemo,” she said.

“I was treated at the West Cumberland Hospital and had fantastic care.”

From 2006, Lesley was back on the wards in various nursing leadership roles, becoming deputy director of nursing at North Cumbria University Hospitals, which runs the Whitehaven and Carlisle hospitals, from 2009 until 2016.

During this time she also helped reinstate the nursing cadet scheme that helped her find a way into the profession all those years earlier.

The scheme had stopped not long after Lesley qualified, with the route into nursing instead becoming more university based.

But with the NHS, both locally and nationally, facing nursing shortages, she felt it made sense to train up more local recruits.

“I was instrumental in bringing cadets back to the West Cumberland Hospital in 2014 and the Cumberland Infirmary the year after,” she said.

“It has grown from there and is working extremely well. It’s not just for younger ones. It’s opened the doors for a lot of mature students.

“Some of them probably didn’t have the education to go into the degree programme. They’ve had their own families and want to give something back to the community.

“This way they can go through college and get all the qualifications and experience they need. It’s an ideal opportunity for those people to get into nursing.”

“The cadet scheme is a fabulous route. It gives you a real insight into the profession, including the time you need to study and the shifts.

“If you want to go into nursing you will have to work days, night, bank holidays - it’s a 365-day-a-year service. You really want to have that understanding of what life will be like in the NHS before you take it further.”

Lesley is incredibly passionate about training and has studied continuously throughout her career, always looking to enhance and expand her skills.

Alongside her NHS career, she also worked for Hospice at Home between 1988 and 1999, providing care for those nearing the end of their lives.

In 2017, Lesley, who has four grandchildren, decided to retire before turning 60.

However she was asked to consider flexible working, becoming lead nurse for the West Cumberland Hospital redevelopment.

Having been involved in the first phase of the project, she felt it was a great opportunity to work on phases two and three - to finish the rebuild project and also establish a new medical campus on the Hensingham site.

Her role is to work between the clinical staff and managers, talking to nursing and medical staff regularly and translating their aspirations and vision for the building to those drawing up the business case.

“When we come to build phase two we have to make sure we get it right. It’s going to be here for the next 50 years,” she said.

“I do enjoy it. I still see patients and staff. It’s challenging and is also really exciting to be involved in the redevelopment.”

Lesley believes that the new hospital must become part of the wider healthcare system and expand to the modern-day NHS.

“It has to be about the whole health economy. It’s not just about the acute trust, but how we can best provide care across the whole of west Cumbria. That’s about integrating with community services, social care, children’s services, voluntary sector - it’s about what is best for the patient,” she explained.

Lesley said this joined up approach is not really new, as that’s how services used to operate when she first started in nursing.

“Back then we were a west Cumbria health economy. It didn’t matter if you worked in the hospital or the community. It was one system,” she said.

Looking at how much the NHS has changed during her career, she said there have been many restructures and changes to roles, but the core principles of nursing have never changed - and she hopes they never will.

“Seventy years is an unbelievable milestone. The NHS is facing an evolving situation. Life expectancy for example. At one time you’d die of a heart attack before you were 65. Now these people are living to their eighties and nineties, so the NHS has got to change and adapt,” explained Lesley.

“As nurses, we just want to do a good job and I just hope that will continue. I hope people will continue to have rewarding careers.”

Asked if she would still go into nursing, she added: “I don’t think I could do anything else. That’s where my passion is. You won’t ever take that passion away.

“I’ve thoroughly enjoyed all of my career. I’ve enjoyed the management and leadership, but have missed that hands on work with patients. I couldn’t say any one of the roles I’ve had has been best. I’ve enjoyed every single one.”

Lesley added that there are also a lot of new options for nurses nowadays that weren’t available when she first started out. That includes upskilling to be an advanced practitioner, taking on some of the duties traditionally carried out by doctors, and physicians’ associate posts that are new to west Cumbria.

“The career pathways nurses have now are fabulous. Within two to three years they can choose what route they want to go down and specialise.

“When I started you became a staff nurse and maybe a sister. If you wanted to go any further you had to go into management,” she explained.

One of the biggest challenges facing today's NHS is recruitment, with a national shortage of doctors and nurses hitting even some of the country's biggest cities.

In a largely-rural county like Cumbria, it is proving even more difficult to attract the staff we need.

However local hospital trusts are working hard to come up with new ways to attract staff, from innovative training schemes to high-profile recruitment campaigns.

In south Cumbria, the University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) was recently singled out for international acclaim after its six-week #BetterWithYou campaign.

An image from University Hospitals of Morecambe Bay's BetterWithYou campaign This focused on trust staff, using videos and a social media takeover, to highlight why they love living and working in the Morecambe Bay area, including at Furness General Hospital in Barrow.

It was so successful, the campaign led to 148 applications for hard-to-fill roles, from which bosses appointed seven midwives, 18 registered nurses, one theatre practitioner, 17 medical consultants, three radiographers and one mammographer.

Meanwhile, the North Cumbria University Hospitals NHS Trust (NCUH), which runs the Carlisle and Whitehaven hospitals, and Cumbria Partnership NHS Foundation Trust (CPFT) have been working together to attract and train future staff.

Last month they announced the recruitment of 20 trainee nursing associates and 20 nursing degree apprentices at NCUH, plus 10 trainee nursing associates and 10 nursing degree apprentices at CPFT.

The trainee nursing associate roles, offered on an internal secondment basis to existing health care assistants, will bridge the gap between clinical support workers and graduate nurses.

It is part of a two-year programme, leading to a foundation degree and a role as a nursing associate.