Advanced Clinical Practitioner (ACP) Shailen Soobhug is the winner of the 2024 AfPP Novice Writer Award, for his paper on the design and implementation of a training programme on ultrasound-guided lower limb peripheral nerve blockade.
“I never thought I would write a paper, let alone win an award, but when I was training to perform ultrasound-guided lower-limb nerve blockade, I could not find a paper detailing the training process clinicians went through from start to finish. I wanted to capture my whole journey in one paper. Also, there was no paper written by non-medics actually performing the skill,” said Shailen, who has worked in the healthcare sector for 25 years, first as a nurse, then an educator, and now as an ACP working in recovery at the Royal Sussex County Hospital in Brighton.
He added: “The training process to perform ultrasound-guided lower limb nerve blockade is long and challenging, with so many different elements involved. I felt it was important to chart the intricacies of this learning process, the journey from novice to expert, and especially how we applied theories of learning into clinical training of complex procedural skills.
“Imperative we pursue clinical excellence”
“It’s imperative we pursue clinical excellence, fulfil our potentials and also share our knowledge in order to improve patient experience and outcomes.”
Having worked in a recovery setting for many years, Shailen knows what a challenging environment it can be. Following major surgery, which usually lasts for several hours, there are many common complications, and patients would sometimes wake up in recovery in excruciating pain. Some could have had a nerve block in theatre that had either failed or worn out due to extended surgical times, whereas others may not have had nerve blocks.
He said in recovery they would administer intravenous opioids to these patients to control their pain, but this came with side effects, including drowsiness, nausea, and depressed respiratory drive. This resulted in prolonged stay in recovery and affected bed flow in the department.
Complete analgesia within a few minutes
Shailen said performing a targeted nerve block in recovery provides complete analgesia within a few minutes, lasting hours without the need for any additional analgesia.
“However, an anaesthetist is not always available to perform the procedure in recovery due to conflicting demands,” he said.
“This was one of the main reasons I undertook my training in ultrasound-guided lower limb peripheral nerve blocks.”
Shailen said he was incredibly lucky to be mentored by Dr Chris Swaine, “a brilliant consultant anaesthetist”, and it took the good part of a year to train.
Now, several years on, Shailen has performed hundreds of all types of nerve blocks and is extremely enthusiastic about his learnings and sharing these with others.
“The technology surrounding ultrasound-guided nerve block makes life so much easier and safer for both practitioners and patients,” he said.
“In years gone by nerve blocks were performed though anatomical landmark injections, and one could not see the exact spot of the injections, but now ultrasound allows you to see the anatomy and target the injection precisely around the nerves.
“Dramatic difference nerve blocks have”
“Working in recovery and also being part of the acute pain nerve block service, I see the dramatic difference nerve blocks have on a patient’s experience and journey. The world of recovery, chest trauma and critical limb ischaemia is a world of pain. Being able to take away patients’ pain within minutes with an intervention, and without any of the side effects associated with intravenous opioids is a fulfilling experience. It’s wonderful to have the skills and I have many people who have supported my training over the years to thank for that.
“The perioperative environment is an extremely challenging one, but by supporting each other, and sharing our learning regardless of professional background, we can improve things for each other, and patients.”
The Novice Writer Award was launched by The Association for Perioperative Practice (AfPP) in 2004 in memory of David Pidduck, who served as the editor of the AfPP Newsletter from 2002 – 2004. David encouraged many novice writers to submit articles for the Newsletter and Journal of Perioperative Practice (JPP).
AfPP’s other awards and bursaries include a Volunteer Award, Perioperative Team of the Year Award, and the Education and Research Fellowship Fund Award.
Picture shows Shailen with his Novice Writer Award. He also received an all expenses paid place at the AfPP Annual Conference, and a copy of AfPP’s Standards and Recommendations for Safe Perioperative Practice.
Reference: Shoobhug S 2024 Design and implementation of a training programme on ultrasound-guided lower limb peripheral nerve blockade: An Advanced Clinical Practitioner’s personal journey Journal of Perioperative Practice 34 (4) 112-121 Available from: https://journals.sagepub.com/doi/10.1177/1750458923115920
