This winter, local NHS staff, particularly those on the front line, are working hard to make sure people receive the care they need. Among them is Marlon Reyes, frailty nurse in the emergency department at St Helier hospital.
Marlon Reyes has two great loves – caring for people and travel. His work as a nurse has enabled him to do both, bringing him from the Philippines to London, where he has worked for more than 20 years, specialising in emergency and senior health.
Two years ago, he took up a brand new role with community services provider Sutton Health and Care, which is proving vital to easing winter pressures and improving quality of life for older people.
This interview is part of a series, going behind the scenes to get to know the people who keep NHS services working – in winter and beyond.
Tell us what you do
I’m a frailty nurse, working for Sutton Health and Care, based in the emergency department at St Helier hospital. I see patients aged over 65, mostly they have become less mobile, some have had falls or are suffering from confusion.
With older people, the longer they stay in hospital there’s a chance they’ll develop a hospital-acquired infection or decline physically due to being inactive and lose their independence. Plus, the environment is very noisy, with a lot of people in and out. Patients with dementia become agitated because they don’t get enough sleep. These are the things we’re trying to prevent.
My role is a front door to community services for people who come to the emergency department. We assess patients, and if we can do so safely, we send them home making use of all the services we have in the community, such as district nurses, palliative care nurses, physiotherapists and virtual ward staff. We look at all the social, physical and emotional support they need. We have a direct line to social care in Sutton, as well as Age UK and Admiral [specialist dementia] nurses. If needed, they can put a care package in place within 24 hours and sometimes we ask family members to bridge the gap so people can go home.
What was the journey that brought you to this role?
Before I came to the UK, I was an emergency nurse in the Philippines. I’ve worked at St George’s hospital for 20 years. I worked in acute medical wards, then I moved to senior health – that’s where my interest lies. When this opportunity came up, I decided to use my expertise and knowledge to do a different role, which is very close to my experience at St George’s.
Why did you decide to work in healthcare?
I always wanted to work in the medical field and nursing has been my only career since leaving school. My two great loves are working with people and travel abroad, and nursing has been a way to travel and work at the same time, while fulfilling my passion for caring.
What’s a typical day like?
I usually get here at 7.30am to make sure I’m ready for an 8am start. I join the emergency department meetings and we identify patients who are appropriate for our assessments. Then I meet our frailty doctors and we start our morning. We normally see a minimum of four to five patients in a day and, in 90% of cases, we manage to send them home.
My role is mainly in the emergency department but I also see people in their own homes, as part of the urgent community response service. By sorting out issues – whether they need equipment or a package of care – we prevent them from being admitted to hospital.
Can you give us an example of a patient you’ve helped?
I had a lady with dementia. She was coming back to the hospital with the same issues – infections, falls at home. When we assessed her, she was very confused and frightened. We looked at her medical history and there was nothing significantly wrong. In the frailty team we look at the whole picture. We found she had chronic constipation, which was making her agitated, leading to falls. As soon as we treated it she was back as she was. We referred her to district nurses and her frequency in coming to the hospital has decreased.
How does your role help tackle winter pressures?
As soon as the patient steps into the emergency department, we plan for their discharge. We don’t wait, we’re assessing patients from 8am to 4pm, so we can start the process of getting them home. In that way we relieve the pressures in the emergency department and keep it for those patients who really need a hospital bed, while reducing the time frail people are waiting.
Tell us something we might not know about you?
I like travel, and photography too. I play a lot of sport, swimming, badminton basketball, I like to balance everything, workload, social life – but travel is my passion. I would say Jordan is my number one destination but I’ve just come back from Dubai where I have a twin brother. We spent our 50th birthdays there.
If you weren’t a nurse, what would you be doing?
I like to keep myself busy, so I’d probably have a small business, maybe my own coffee shop – either here or back home.
This article first appeared on the Soutth West London ICS website as part of a series of interviews with people providing care on the winter frontline.