Consultants of the Lindsay Leg Club Foundation
Pam Kirby
Lead Nurse, Vascular/ Tissue Viability Team.
King's Mill Hospital, Sherwood Forest Hospitals
Since qualifying in 1977 I have worked in a variety of settings including A&E, general surgery, dermatology and urology including a role as Ward Leader until becoming vascular nurse specialist at this trust in 1995.
Having always had an interest in wound care I chose to focus on patients with leg ulcers, as this was where I felt I would make the most impact. Vascular patients require good pressure relief, which led to my interest in that subject. I soon became viewed as the "expert" and gradually assumed the role of Tissue Viability Nurse throughout the Trust. This involved more and more work combining my regular clinics and ward rounds with individual patient advice on wound care, pressure area care, and mattress audits.
I now lead a team comprising 2 tissue viability nurses and a vascular outreach nurse as well as me. My role involves running a nurse-led leg ulcer /wound care clinic, vascular ward rounds and clinic, diabetic foot clinic, writing guidelines and formularies, and teaching on these subjects on various post-graduate courses run by Nottingham University. I wonder how I ever managed to get home at night when I was a one-man band.
Working as I do in an acute setting, my patients consist of those referred for a vascular opinion, many of them with leg ulcers that require a variety of treatment options. Very few are strictly venous but include differing levels of arterial insufficiency with some being gangrenous, those awaiting autolytic amputation, or diabetic foot problems requiring careful observation. A variety of diagnostic assessment is undertaken to determine those needing revascularisation in order to preserve a limb. Amongst these are also amputees when reconstruction is too late or impossible, but are then able to move on to the next stage and out of the rut of constant suffering, attempts at re-plumbing, debridement and dressings. I have always felt very attached to these patients as they are with me for long periods of time.
Since becoming part of the "Leg Club" team I have met a professional set of nurses who are equally as enthusiastic and loyal to their patients as I feel. I admire their selfless determination to improve the lives of the members and to ensure they are at the heart of the aims of each club. My role, as educationalist on behalf of the Wound Care Society, is to share my experience, knowledge and skills to help support nurses extend their own abilities and confidence, and to develop pathways of care to ensure appropriate and timely referrals for a vascular opinion.
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