Virtual Ward matron, Anna Ryan has wanted to be a nurse since primary school. After working on the wards and training as a district nurse, time spent with Croydon’s rapid response service brought home to her the benefits of keeping older people out of hospital.
When she’s not taking referrals or setting people up with a virtual monitoring kit, this park lover likes nothing better than exploring London’s green spaces – followed by coffee and cake.
This interview is part of a series, going behind the scenes to get to know the people who keep NHS services working – in winter and beyond.
Meet Anna
Tell us about virtual wards
With virtual wards people are monitored from the comfort of their own home – to prevent them from being admitted to hospital or speed up discharge. If someone needs to be in hospital, they need to be there. But we know that sleep and peace and quiet aid recovery and when you’re ill you just want to be in your own bed. If we can support them to be monitored at home, then that’s absolutely what we should be doing.
How does it work?
We have two different types of kit. There’s continuous monitoring, where the patient has a wearable device that monitors their pulse, respiration rates, skin temperature, oxygen levels and movement – all the checks that would normally be done in hospital. We also have intermittent monitoring, where we issue the patient with a blood pressure machine and a pulse oximeter [to check their oxygen levels].
Everyone gets a tablet device so they can send and receive messages. If they tell us they don’t feel well, they’ll automatically get a phone call from a nurse who would organise a visit if needed.
What’s your typical day like?
First, we make sure that patients who went home yesterday are ok, then we review anyone referred for discharge today. At 9am we head to the wards where we support doctors to think of different avenues to get people home. I carry a pager, so anyone can contact me, and I get referrals throughout the day. We set patients up with the tech they need and go through the plan of what will happen when they go home, so they know they have full medical support.
How did you get here?
I’ve always wanted to be a nurse. My mum has photos of me dressed up as a nurse in primary school. I qualified 10 years ago and started out on an elderly care ward. As much as I loved working with this population, it was hard. People often came in walking but went home bedbound. A lot stayed a long time, getting over one infection after another. Had they gone home, they may not have had that reduced mobility.
I decided to go into district nursing and I started in Croydon in 2015. I was shadowing the rapid response team, working with them to develop skills. I felt we made a real difference. Every day we were going above and beyond to help patients remain at home. A job came up with that team in 2017, then, in 2020 we started using remote monitoring.
Is there a patient story that illustrates your role?
A young woman came into the Emergency Department with abdominal pain. The surgeons referred her to me. She was very keen to go home so we gave her two sorts of oral antibiotics and a strict fluid balance and had a plan to visit her to repeat blood tests.
We monitored her for seven days. The antibiotics were working and the pain was reduced to a manageable level. She was booked in for surgery on her gall bladder six weeks later. This way she avoided spending time in hospital away from her family.
What are the challenges of the job?
There are some old school ideas that if a patient is sick, they need to be in hospital but the world is changing. We have other ways of providing care. I need to make sure staff across the hospital trust me and the service. I’ll always try and give them feedback – ‘that patient you referred last week, they’re doing much better’ – so they know the outcome.
We care for anyone over 18 but our population is generally aged 50+. Some patients manage the tech, regardless of age – we had a 99-year-old who was hard of hearing who could do their own blood pressure. With older people the technology can be a challenge but we work round that. We work with friends, family or carers and offer phone calls or visits.
What do you get up to when not at work?
I spend most of my time in south London parks with my children aged two and four. Brockwell park is my favourite. I used to go swimming in the outdoor lido as a child and there’s a lovely playground.
If not this, what?
I would quite like to work in a bakery/cafe – that would be nice, though I might eat all the cakes. I do enjoy baking and I’m absolutely addicted to coffee.