Courage: Denise Stevens – Clinical Governance Nurse Manager, A&E, CDUs and Urgent care


Denise qualified in Leeds in 1982 and specialised in Accident & Emergency – or ‘Casualty’ as it was known back then. After completing a Masters degree at Leeds University, she went on to build a successful career as an award-winning emergency care nurse, eventually becoming an independent practitioner at a Minor Injury Unit and then Director of an Out-of-Hours service. She joined NHS Professionals in October 2017.

I remember…

…knowing at a very young age that I wanted to be a nurse. I felt it was a privilege to help others in need and I was always fascinated by people’s stories. 
Nursing back in the 80s was very different to a modern nursing career; patients stayed in hospital to recover from surgery very much longer and as they reached full recovery, they used to help out on the wards. There were scary times too because, as a newly qualified nurse, you had to take charge on wards on night shifts.

I worked for many years at Saint James Hospital in Leeds through lots of Government reforms and target setting. I made lifelong friends and even met my husband, who was a paramedic. We went on to have two daughters and one of them is now a staff nurse in A&E at St James. How history repeats itself!

Courage is…

…when you have to dig deep on many occasions, like breaking bad news to relatives about the death of loved ones who had suffered severe trauma or when dealing with families involved in cot death syndrome. 

You need to have courage in spades as a nurse and you must be able to challenge poor practice on behalf of your patients. You have to be able to advocate for them when they are vulnerable and need you to have courage on their behalf.

I showed courage when…

…I challenged old ways of practice and the way my A&E was managed, which on many occasions was a difficult task. We had an ever-growing number of patients attending the department and the system wasn’t coping. Patients were experiencing very long waits to see a doctor. I used my Masters dissertation to prove to management teams that nurses could be central to expediting patient care and that - using structured nurse assessment - patients could be referred to specialties without needing to see an A&E doctor. 

I was given the opportunity to rearrange the department with a nurse-led Emergency Assessment Unit, but after a year or two, with still more patients attending A&E, I made the case for change again to introduce a Clinical Decision Unit (CDU). It was a great success for patients and I was awarded a reforming emergency care award. I spoke at conferences and helped other hospitals set up their own CDU. This took heaps of courage! 

I’ve always developed my career by being courageous and taking the steps to challenge when things can be done better but, above all, to improve care for patients. It’s a skill I’ve never stopped developing.

What I know now that I wish I'd known then:

Courage in nursing is an enabler to doing the right thing. It prevents you from being coerced by colleagues and it makes you stand up to improve standards for patients and their families
To enable change for the better, you must be able to have the courage to advocate for staff too.