Q&A with Gargi Ghosh, Lead Clinical Nurse Specialist

Hi Gargi! Thank you for taking the time to chat with us today, could I please ask for you to introduce yourself?

Hi! My current nursing status is part-time Clinical Nurse Specialist Nutrition for Policy and Service Development Lead and Clinical Lecturer. I’m also studying for my dream-PhD in Public Health at the University of West London with a UWL scholarship.

What did you do before you began studying for your PhD?

Prior to my PhD, I studied for my Master’s degree in Healthcare Education and Management; with a special interest in Nutrition and Public Health from Kingston University, London in 2012. I then went on to take up a Clinical Nurse Specialist in Nutrition role between 2015-2017, at Band 8.

I worked at Imperial College Healthcare NHS Trust, London and I specialised in the following fields: Patient Safety, Obesity, Human Nutrition, Artificial Nutrition, Public Health, Epidemiology, Metabolism, Nutritional and Metabolic Diseases, Nutritional Education, Nutrition Assessment, Insulin Resistance.

Do you have any publications you can share with us?

Yes! ‘The Next Between Obesity, Health and Social Care Needs for Older Adults: A Literature Review’(2019). As part of my Master’s, I wrote an academic paper that was published with the Nursing Standard… “The Safe Use of Oral Bowel-Cleansing Preparations” (2013).

Besides those, I have also written several Grey / Gray literature as part of my job commitment as a Policy Developer.

Where did you live before the UK and what was your experience of securing an NHS job?

I completed my Bachelor’s Degree in Nursing (Hons) from Calcutta (Kolkata) University, India in 2002. I never had the chance to work in India, other than part of my training where I actually worked in all hospital departments, including a placement in district general hospital and busy maternity unit.

In December 2002, I got married to my husband and we relocated to the UK as he had secured a job within the NHS. Once I reached the UK, I started to build up my CV, passed IELTS and I started to apply for NHS jobs.

I had to go through a number of interviews, before I secured a job at Glasgow Royal Infirmary Hospital NHS Trust. I joined the trust in June 2003 as a Band 5 pre-registered staff nurse under supervision. I worked at the trust for a year, before I could apply for my full-NMC Registration. In 2004, I received my NMC pin! I was fortunate enough to not need to sit the CBT exam, as the exam was only introduced in 2014.

Due to the nature of my husband’s job, (then, trainee Gastroenterologist) and our family commitments (caring for our two young children and running the house), I relocated to several different places within the UK, but I always managed to secure a new NHS permanent job within a few months.

How was the interview process? When it comes to NHS nursing interviews, what advice would you give to nursing students? And international nurses looking to join the NHS?

Delivering a good interview is always a challenging but fulfilling process. Over the years, I have given plenty of interviews and at the same time, I have been the one to interview prospective candidate for junior nursing posts.

In India, although English was always my second language during my school years, it was still very much one of my weak areas as nobody would speak it on a day-to-day basis. In addition, I was very much an introvert and so, when the two words “interview” and “English” were placed in the same sentence, it worried me. For this very reason, at one point I wanted to study maths so that I could talk and write with signs and symbols only. However, I eventually got admission to the biggest Nursing undergraduate college in Kolkata, and I started to pursue my career as a nurse.

I knew that nursing would be the career to hone my communication, interpersonal, relationship, networking, negotiating, delegating skills etc..! Not only that, but I always enjoyed challenging subjects at school and so, thanks to nursing – I now feel happy, stronger and more confident than ever!

Do you have any advice for nurses due to sit an interview?

In my opinion, in order to be successfully shortlisted for an NHS nursing interview, you need to have an effective CV (including your education, training, experience, commitment, academic writing, research, audits etc…).

You should always tailor your application to the job description and person specification. Once you’re shortlisted, it’s important to remember that every shortlisted interviewee has an equal opportunity to successfully obtain the job. So, to make sure you’re first choice, it’s all about how you present yourself as the ideal candidate for that role.

Even if you lack in experience, express yourself as confident, willing to learn with a desire to excel and you will go far. For example, in every role I made sure I implemented changes for the better to lead to service development and better patient care.

To exemplify, I identified the areas where nutritional product reviews could enhance patient care and delivery value for money, I updated new staff’s orientation packs, I started my own nutrition clinic for community patients to support them with feeding, reducing waste and giving them the essential resources to successfully manage their condition – the list is endless, but I truly believe that investing time on yourself is as important as investing time in your job.

Are you a healthcare professional looking for a new role, or simply needing some advice about careers with the NHS? Just hit the link below to chat to us on WhatsApp – our teams are on hand to help!

Do you remember your first few days and weeks within the NHS?

As I mentioned earlier, my 1^st job in the UK was in Glasgow, Scotland within a breast surgery ward and I was the youngest member in the team. As you will know, Scots have a strong accent and I wasn’t as confident with my English back then. I used to avoid taking phone calls because I couldn’t read peoples body language and I struggled to understand.

Nevertheless, I am grateful for my first job in Scotland. The people are wonderful, kind, cooperative, patient, good-hearted and they have a true passion for their work. Although there was definitely a cultural barrier with my language, my colleagues always used to teach me, involve me and treat me with patience and kindness.

I remember that my manager invited me to her birthday party and told me the theme was ‘cartoon’. Of course, I wanted to go to the party but I had no idea how to dress up as a cartoon character?! So, I eventually built up the confidence to ask her what this meant and she laughed and said she said ‘tartan’ not ‘cartoon!’ – so, it meant that I had to dress up in tartan clothing haha!

One message to all reading – barriers are not so hard to overcome after all with a determined mind.

What are your thoughts on living in the UK and working for the NHS, now you are here?

Before I relocated to the UK, I grew up in India but I had only trained there – I did not take up any formal work. One difference between India and the UK is that in India, there are not many laboratory facilities available and so, it was essential for us to rely on our clinical skills and history taking – the basics of medical science. Whereas, in the UK – the first port of call is to send a patient for an MRI or CT scan.

In addition, In India, there is a lack of standardisation across hospitals. In private hospitals, patients will receive excellent care with great facilities but if you go to a rural area, there is nothing and sadly, patients are dying without being seen by a doctor. To compare this to the UK, the NHS is standardised absolutely everywhere. The work environment is challenging but at the same time, it’s satisfying.

I love the NHS’ concept of building and utilising multidisciplinary teams all working together with the same objectives. I always feel like I have enough scope to contribute towards better patient care and towards an improved service development with my knowledge, skill and experience. I always felt valued working in the NHS. Also, every single NHS nurse and paramedic is highly skilled because it’s a requirement that their knowledge and skills are updated regularly.

Did you ever feel home sick?

Yes, I was homesick in my initial years in the UK as at that time, there was no WhatsApp or any form of an online call, let alone the video call. International calls were limited with minutes, as it was very costly. Although Glasgow is a tranquil and peaceful city, the initial few months were hard for me; I used to sit on the window ledge of my apartment all day long, so that I could see a few cars or if possible, a pedestrian passing by.

This made me more determined to find a job quickly so that I could see and talk to people, in order to protect my mental health. Gradually, I became busy with my job, study, family and friends and started having a normal life.

What made you specialise in Nutrition?

As my husband’s job involved working unsociable hours with plenty of on-call shifts, both day and night – I wanted my second job to guarantee a health work-life balance. At the time, I had two options: outpatients or radiology as both areas followed day shifts with no weekend commitments.

I got my second job in the Radiology Department as an Interventional Radiology Scrub Nurse; I then gradually progressed towards Junior sister and Senior sister. I worked in the Radiology Department for nine years.

The patients I looked after in Radiology ranged from not-so ill outpatients to the critically-ill inpatients for both adult and paediatric from different clinical specialities. This opportunity gave me a wide range of experience looking after patients with various needs. During this time, I gradually grew an interest in artificial nutrition while working with patients / critically ill patients with artificial nutrition. This stemmed from caring for patients with gastrointestinal issues undergoing a range of interventional procedures. Some of these procedures included an oesophageal and colonic stent, Percutaneous Transhepatic Cholangiogram, ERCP, barium studies with adults and paediatric patients.

For six months out of these nine years, I have worked as a corporate volunteer (as I was relocated to a new area and was looking for a job) in the Endoscopy department. I worked closely to the Consultant Gastroenterologists, IBD nurse, Nurse Endoscopists, Endoscopy lead and other Endoscopy staff. My job was to take necessary actions to update the online Global Rating System Score (a tool that enables endoscopy units to assess how well they provide a patient-centred service) to meet the deadline. It involved carrying out several audits to improve patient experience and quality of endoscopy service.

How long did it take you to get from a Staff Nurse to a Specialist Nurse? Do you have any advice for other nurses looking to pursue this career route?

It took nine years post-NMC registration starting a career as a specialist nurse.

To become a Nutrition Specialist Nurse, one needs experience looking after patients with artificial nutrition, dealing with critically-ill patients with artificial nutrition, experience with patients undergoing for endoscopy and colonoscopy procedures, and at the same time knowledge about the gastrointestinal system: the anatomy and physiology, experience/knowledge about the care pathway of a patient with artificial nutrition for both primary and secondary sector besides one’s leadership skill to manage workload, patients advocacy skill and teaching skill to educate multidisciplinary staff, patients and carers.

To become a Specialist Nurse, one piece of advice I always give is to always offer something unique (you should always have a passion for this skill) as you will then be distinguished from others. To demonstrate, I absolutely love doing difficult IV cannulations/channels and so, it was always satisfying whilst attempting a very challenging one. And so, for every difficult cannulation, I was always the nurse to be called – even whilst I was a junior! I was in a unique position and that took me far.

Also, my last piece of advice is to always go the extra mile in whatever you do. Even if you think that you might fail, go ahead and give everything you have because the experience will have so much value for you.

How did you obtain your scholarship for your PhD?

This was a lengthy process, but again with determination – I got there.

I booked and attended a (free of cost) post-graduate studentship open day via “Think Postgrad” to get some insight about the process.  I think it is a great beginning point for anyone who wants to pursue their higher study but doesn’t know where to start.

I was registered with few UK PhD funding organisations along with “Think Postgrad” and they would regularly send me different funded opportunities. I kept on applying with my CV and one day, I got a response from the University of West London asking for me to submit my research proposal. I was then invited to an interview and I was successful!

What stage of your career did you get made a Lead Policy and Service Developer? What did you enjoy the most about it? How much clinical work was involved?

Anyone holding a senior nursing position must be actively engaged to innovate and benchmark nursing practice. All “Nursing leaders must translate new research findings to the practice environment and into nursing education and from nursing education into practice and policy” (Institute of Medicine, 2011).

As a Lead Nutrition Nurse Specialist, I participated in assessing, planning, prioritising and evaluating the current nutrition service within the Trust.  I led and was actively involved in the development of protocols, guidelines, policies, integrated care pathways, clinical research trials and audit tools for the Nutrition and Dietetics Department to improve quality of service delivery guided by the nationally set evidence based practice. I was one of the key members of the Nutrition Steering Committee at the Imperial College NHS Trust. I am also a member of National Nutrition Nurses Group (NNNG).

While I started my fulltime PhD (40 hours/week), I wanted to do something that would give me a bit of flexibility and help me to manage my time effectively. After starting my PhD, I had to spend an enormous amount of time on researching facts or evidences as well as on academic writing. So, developing policy and benchmarking the nursing practice seemed to be an ideal area to contribute for me at that stage.

This post needs a senior level of clinical experience and expertise to develop a forward thinking strategy,  benchmark the best practice and developed a standardised service for management of patients admitted within the NHS Trust and for those patients who continued to require additional support following their discharge into the community.

Typically, I enjoy the flexibility that I can manage my own time according to my workload and set deadline.

The role doesn’t involve hands on clinical work, however, one holding this post should have updated knowledge about the current clinical practice and the standards set locally or nationally. It also involves monitoring the current practice, monitor and evaluate the effect of specialist nursing care, procedures and interventions and at the same time bring necessary changes to meet the standard.

What is your experience of working within the pandemic?

It was challenging especially with concerns involving safety of my colleagues and vulnerable staff, who faced continuous intense psychological pressure due to the staff shortage, the redeployment process and lack of PPE.

I was trained for PPE and I was about to take the training on ventilation to help and support the frontline workers, but unfortunately, I got infected with the virus and of course, I had to quarantine for two-weeks. However, I continued to support my colleagues closely and remotely on a regular basis. Although they gave patients hope and encouraged each other to keep going, of course, they had their frustrations and anxiety too.

Do you have any plans for the future?

I believe to be successful in any field or venture in life, you not only have to be very clear about your goal but also feel very strongly about it. After completion of my PhD in public Health, I believe I will be able to bring new ideas to the health system and contribute to it in my own way. In my vision, limited resources can be managed wisely, health personnel can be nurtured in a better learning and mutually respectful environment, ultimately leading to better patient care.

To run the health system of any country as smoothly as possible, it should be guided and led by individuals who have an in-depth knowledge about the hospitals and community health needs, are aware of its challenges, but at same time are equipped with management skills. The present problem is that most of the current managers across the NHS and other health services and institutions come from a pure management background with little hands-on experience of the health dynamics.

On the other hand, clinicians and other health professionals often fail at management tasks because they lack essential management skills. I hope to bridge this gap, as a senior health professional with 17 years of clinical experience, my Master’s in Healthcare management and through this Doctoral programme getting an opportunity to be directly involved with clinical issues, exploring the challenges that our community face in day to day life.

To conclude, I would like to share my inspiration that keeps me going in moments of frustration and despair… In India, I was singing at a fundraiser for a paediatric cancer hospital – and, a little six year old girl with acute myeloid leukaemia gave me a note that said “It’s not how hard you work, but how hard you try that makes a difference”.