Ronke Adejolu, RN
Ronke Adejolu is a senior healthcare professional, digital systems leader, a nurse, with a background in health services management, with a career spanning key strategic and operational leadership roles.
She brings years of credibility, overseeing, leading, and delivering successful change and transformation programmes across the private and the public sector. She is passionate about systems leadership in healthcare, and the importance of cultivating and fostering a psychologically safe, respectful, equitable culture of learning where all nurses are valued, succeed, and thrive regardless of who they are or where they sit within an organisation. Ronke is a Topol Digital Fellow and aDDoN Alumni, a Digital Health CCIO Advisory Panel member and an active member of the Shuri Network.
Previous nursing career
I trained as a registered nurse in the days of capes, hats, manual sphygmomanometers, glass thermometers, at my alma mater, the Whittington Health NHS Trust. Over the years, I have been fortunate to work in senior strategic and operational roles, across settings like the NHS, the Department of Health and Social Care, private healthcare, AHSN, telecommunications, and recruitment and management consultancy. This has helped me to build invaluable knowledge, experience, and skills.
Letting my Nursing and Midwifery Council (NMC) registration lapse was never part of my plan. But I spent a lot of time travelling and working across areas like South East Asia, Europe and the US which meant I was unable to continue the required clinical practice to maintain my NMC registration. During the time my registration was lapsed I felt something was missing; a disconnect with my nursing colleagues, patients, and practice on the frontline.
The application process
Towards the end of 2019, I decided to enrol on the Return to Practice (RtP) Nursing Programme. Going through the websites of universities near me, I was delighted to find a few with active applications. But my heart sank when I found out the number of clinical practice hours I had to undertake. With a hectic role in digital urgent and emergency care and a young child, I had no idea if my employer, NHS England, would support me. I turned to my then Director Dr Sam Shah, who just uttered four words: “of course you can” and yes, we will support you all the way. Feeling reassured and energised, he suggested I spoke to Jacqui Jedrzejewski, Deputy director and senior nurse to support me through the process, all the way through to organisation sign off. I remembered my discussion with Jacqui, her first response was: “We each have a duty to try to get nurses back on the register and to support them to do so, my answer is 100% yes! And I will be more than happy to support you through the process.”
The application process was straightforward, but I only had three days before the closing date. I had to negotiate with the university to send in my supporting information within a week. Flexibility at its best! Following a successful interview, I made it on to the return to nursing course. I was on my way! The first few weeks consisted of registration, a variety of presentations, workshops, hands-on sessions, and a one-off assessment to test our English and drug calculation competencies.
It was an amazing cohort, with mature students from diverse backgrounds, most of us averaging 20 years as RGNs. Now all I had to do was figure out how to complete my clinical practice in 6 months while holding down a very busy full-time job. While initially I decided I could do this by working 10 hour night shifts over the weekend, it quickly dawned on me that I would never get to interact, meet, speak, or work with the nursing staff during the day. This is where Jacqui came in again. We worked out a mutual and agreeable 4-day condensed week which afforded me the opportunity to work with clinical and nursing staff on Fridays for the duration of the programme. Where there’s a will, there’s always a way.
I was clear on my choice of clinical practice setting, was lucky to find an amazing hospice in my neck of the woods, approached the hospice directly, they said yes. Everyone at the hospice was very welcoming, supportive, and the icing on the cake was the hospice was within reasonable driving distance from and back to my home.
As someone who trained in an acute hospital setting in the early 90s, it would had been easier for me to choose a familiar territory, but I chose a community nursing hospice setting because I was curious. I wanted to gain first-hand understanding about hospices in general, reconnect with frontline nurses and clinicians, gain a better insight into areas like digital maturity levels and leadership across the digital and meet the clinical practice requirements of the RtP programme to enable re-registration with the NMC.
Having led multiple successful clinical system deployments across community and mental health settings, I found community nurses and their views were grossly underrepresented in the requirements gathering, use cases, scoping, implementation and the delivery process, and were seldomly at the table where they could positively influence decisions. From my experience, there was also very limited knowledge and understanding of who community nurses are, what they do, the complexity of the environment they work in and the extraordinary care they provide to patients and the population.
I was very excited at the prospect of being back in a nurse’s uniform, everyone including the nursing staff and my clinical lead was very friendly, kind and eased me back gently into practice. I enjoyed every bit of my time at the hospice (night/days shifts), with the invaluable opportunity to interact and deliver direct care to patients, something I had not been able to do for some time. I felt very supported by the entire nursing team in re-estabilising my core skills.
Working at the hospice, was an experience I would not forget in a hurry. I worked with extraordinary nurses, nursing associates, other clinicians and amazing support staff who provided exceptional, daily holistic care to patients with life-limiting illnesses and care that included pain control and symptom management, emotional, psychological, practical, spiritual, including social care support for patients and their family. I saw first-hand, some patients who I thought on admission looked like they only had a few days to live, walk out with a smile on their faces after 2-3 weeks, this speaks to the incredible work of hospice nurses. Sadly, this was not always the case for all patients, a number of patients died comfortably, nevertheless, the nursing staff and unit provided and maintained maximum, first class and personalised nursing care to patients until the end including support to the family where required.
RtP assessments and completion
Completing the Practice Assessment Document (PAD) throughout clinical place was straightforward, nothing too onerous. I personally, would had preferred the option to update the PAD document online with a QR code scanned after each completed shift as confirmation of clinical placement attendance. Overall, I enjoyed meeting other mature nurses from diverse nursing backgrounds, found the course content (face-to-face and self-directed material), tailored to suit your circumstances and pace of delivery appropriate. At the height of the 1st wave of the Covid-19 pandemic, the university sent out a formal notice to all RtP clinical practice areas to pause all clinical placements for safety reasons which meant a bit of a delay to my clinical practice completion date but I eventually did. I also had to submit a presentation on an area of interest. RtP results were published before the end of the year including my Registration re-entry back onto the Nursing and Midwifery Council register.
If you are contemplating about returning to nursing practice, this is probably the most exciting time in my view with so many routes e.g. nursing practice, administration, education, digital health technology and research. The world is your oyster. I continue to work in broader roles across systems but always with a wider nursing lens, leading with impact working in collaboration with credible system leaders from diverse backgrounds, professions and boundaries working together towards a unified vision to achieve the NHS Long Term Plan ambition, aligned with chief nursing officer’s key priorities towards a sustainable future for our nurses across provider organisations and integrated care systems.
Notable changes (not an exhaustive list)
The uniform - gone are the days of checked dresses, hats, navy cardigans, capes, and black Dr Marten’s shoes, It’s now tunics and trousers. RtP trousers provided by the university was way too big for me, so I had to invest in a good comfortable, stretchy navy pair for the RtP duration
Technology - In those days, we only had one PC on the ward, for those who remember the Compaq computers and floppy diskettes. There are now a few more desktop computers and monitors but in desperate need of a hardware upgrade.
Equipment – Old heavy chained hoists have been replaced with sophisticated portable motorised hoists with configurable carriers based to your size.
Manual white boards - still very much around, personally, I would like to see a move away from this to an electronic command centre style white board with back-end intelligence providing real time status updates, automatic notifications, or reminders
General atmosphere - Happy and kind staff, happy patients, overall, more ore relaxed, than regimental
Digitisation - converting analogue process to the digital e.g. storing manual patient records on computers instead of paper folders. It’s safe to say, this is still a blend of both paper and electronic processes. As an RtP student, you are not required to enter information on patient assessments electronically but it’s advisable to explore and familiarise yourself with electronic patient systems, especially if following your RtP, you want to remain in core clinical practice (please note; EPR systems differ across organisations)
Medication padlocked trolleys, long gone, with patient regular medication now stored in a small box permanently embedded in the wall near the patient’s bedside.
Portable mercury sphygmomanometers and glass thermometers, long gone and replaced with portable vital signs machines and disposable thermometer covers
Weekly resus trolley checks - One of my favourite tasks to do when I was a year 1 student nurse, is still very much around.
Medicine stock checks – usually done on nights, this was one of the hardest for me. I was not prepared for the volume of medicines and time it took to stock take. This from my perspective is one of those areas digital transformation and innovation programmes need to review as a priority to help free up time valuable time for nurses
Paper nursing assessments forms are still very much around, with an EPR currently in place, there are approx 15+ paper nursing assessment forms still per patient on admission. This was one of the reasons I applied to become a Topol Digital Fellow on cohort 2 last year, (I am now an Alumni). https://topol.hee.nhs.uk/digital-fellowships/ I sought to explore the scale and use of paper-based nursing assessments and the variation in nursing assessment terminology across hospices to inform a broader programme of work on standards to enable information sharing across organisational boundaries and care settings ensure nurses caring for patients, have standardised and accessible data at their fingertips to improve patient care, experience and outcomes.