A day in the life of Helen, Aftercare Manager

As an Aftercare Manager for Thames Valley Air Ambulance, based in the John Radcliffe Hospital, I visit people at their bedside in the hours, days, and weeks after a life-changing event. I feel incredibly privileged to be the first face from our charity that a patient sees once they have regained consciousness, or after the effects of powerful drugs have worn off. I help them, and their loved ones, piece together what happened.

One of the most important parts of my job is that people thank me. Often with overwhelming gratitude. Sometimes, it doesn’t feel quite right, because I wasn’t the one holding their hand in that critical moment or making the call that saved a life. But what I can do is pass on their thanks to the people who were there.  

I get to be the bridge between someone’s worst day and those that helped them through it. That means everything to me. And it means the world to our crew, too. 

Although we have other fantastic hospitals in the region, the majority of our patients are taken to the John Radcliffe. It’s the largest hospital and the major trauma centre for our area, with neurosurgery specialists, plastics, cardiology specialists and paediatric critical care. Our crew are called out an average of nine times a day, and many of those patients come to this hospital for onward care. So no day here is ‘average’, because new people are arriving all the time. But join me on a walk-through of one day in my job to hear the kinds of things I get up to.  

My day starts early. I like to see as many people as possible when I’m here, normally between 12 and 20 in a day, so I’m parked up by 7am. I let the emergency dispatchers and crew know I’m in the hospital and check in with my colleagues in the Aftercare team, who are busy supporting our patients and relatives in the community.  

Today, the crew are bringing a patient into resus who has been involved in a serious road traffic collision. The patient has received a pre-hospital anesthetic, been intubated, and received blood on scene. I meet them in resus to observe the handover. Right now, he needs the specialist expert care of the emergency department. So, I assure the crew I will follow up with him later and update them.    

Often patients don’t remember the first time I meet them. That first visit is more about letting them, and their family, know that I’m here whenever they’re ready to chat. I need to judge when a patient will retain information and I’m not going to overwhelm them. 

I head off to visit another patient on the unit whose incident was five days ago. He’s so grateful to meet someone from Thames Valley Air Ambulance. He grasps my hand and asks me to thank the crew. The incredible care of the staff on the unit means he looks comfortable in what can be a distressing environment.  

Next, I want to check in with a woman who recently collapsed in a supermarket. She’s in the specialist heart centre, where cardiac arrest patients are cared for. Crews can use a direct line to refer patients directly into this centre. For this patient, the fog is beginning to lift from the immediate aftermath of her incident and I’m able to fill her in on a bit more detail, which she wouldn’t have been able to process last time I saw her.  

After a catch-up with Trauma Coordinators Frankie and Patricia, who fill me in on the trauma pathways and surgery dates for our mutual patients, I pop to the trauma centre to talk to the team there. The trauma team follows patients throughout their journey here at the hospital and we discuss a couple of ongoing cases, including a truck driver who was recently involved in a motorway collision and a man who fell off some scaffolding. Thanks to our data sharing agreement, I can also share details from scene that can be beneficial for the patient’s ongoing care. Discussions like these are so valuable and the support I receive from the staff in the John Radcliffe makes it feel like we’re all on the same team, with our patients at the heart of everything we do.  

Heading back up to my office, I quickly put my head around the door of the Specialist Nurse who deals with organ donation in the hospital. We’ve started a new scheme where our crews receive a letter informing them when a patient who sadly does not survive goes on to be an organ donor. Sadly, there are times when, despite our best efforts, we can’t prevent a loss. Being able to tell our critical care paramedics and doctors that a patient has gone on to save someone in need of a transplant really helps them. 

Then it’s back to my desk to eat a quick lunch while dialing into a seminar for a course I’m undertaking at Oxford Brookes, in Advanced Communication and Supportive Relationships. It’s valuable to share experiences with others on the course, who come from a range of clinical backgrounds. 

After that I head down to the hospital coffee shop, to have a cup of tea with the wife of a patient in a drug-induced coma. Meeting away from the unit can provide a more neutral space to meet relatives and coming here gives her a break from his bedside. It allows her the chance to talk about the effect of his incident on her mental wellbeing, as well as to ask for help on practical matters.  

We can provide access to free legal support after a recent partnership increased our ability to support patients and their families well beyond the time of their incident or illness. Knowing they have someone to ask about finances, for example, can lighten the incredibly heavy burden of worry in those early days.  

The tough conversations continue as I catch up with the mother of a patient who suffered acute psychosis leading to an attempt at taking their life. It’s never an easy thing to talk about, but I check in with how the mental health support from the psych team is going and I help to push forward a subject access request on her behalf. These requests for information can be essential when patients are going through tricky legal situations or administrative loopholes and it’s good to feel like I can help in a small but useful way. 

Then it’s back to the Trauma Ward for me, to visit a patient who is recovering after serious injury including an unstable pelvic fracture and acute kidney failure. It’s not the first time I’ve met him, but it’s my first time meeting his wife. We share a poignant moment where she passes on her thanks to our crew and I give her some Thames Valley Air Ambulance teddy bears for the couple’s young children. As a mum myself, it always hits home when children are involved and I’m thankful we can share this happy moment after so much worry for their family.  

As the day continues, I visit many different parts of the hospital. From the neuro-intensive care unit, to check on the patients we have who have had an intercranial bleed or suffered a traumatic brain injury, to the specialist surgery unit, where people go with injuries that may require reconstructive surgery and skin grafts, and the children’s hospital.  

Checking my notebook, I head back to my desk to update our system with my notes. Our crew are always keen to read updates on how patients are doing. It’s important for clinical updates, but also for their wellbeing to know how the people they care for are getting on. I make a final call to Adam, the Head of Aftercare. We discuss the patients I have visited today, and I hand over any patients who are being discharged and would like ongoing support in the community.  

As I think about heading home, my mind is full of everyone I’ve seen today, and I know I’ll be thinking about them overnight. But just knowing I’ve been able to help fill in gaps about what happened, and perhaps provide reassurance about the days ahead, is a great comfort. I think of the families of the patients we care for, and I know I will give my son a longer hug at bedtime tonight.  

I think of our crews still out in the region alongside the ambulance service, and I wonder what emergencies they will attend tonight. I take a minute to wish them safety and strength for their shift, and I feel incredibly proud to be part of the team.  

I head out into the Oxford evening, hoping that nobody needs our services tonight but knowing that, if they do, our crew will be there when the worst happens. And the Aftercare team will be there for whatever happens next.