The Journey and Impact of a Surgical Advanced Nurse Practitioner in North Wales

by: Arniel Bautista Hernando

A Career Dedicated to High-Level Patient Care

Healthcare has always been more than a profession for me — it is a calling that grew from my desire to help people and make a difference in their lives. My journey in nursing is shaped by years of learning, clinical experience, leadership, and continuous professional growth.

Working in healthcare allows me to translate my passion into action every day. Through my career, I have always aimed to provide high-quality patient care, make thoughtful clinical decisions, and support patients and their families during challenging times.

My Roles and Responsibilities

I am currently working as a Surgical Advanced Nurse Practitioner in Betsi Cadwaladr University Health Board in North Wales.

My main responsibility is to provide high level patient care, working autonomously and making complex clinical decisions. I receive referral from the General Practitioner for patients with surgical concerns such as Appendicitis, Gallstones, Bowel Obstruction, Bowel Perforation, abscesses and other abdominal issues. I also receive referrals from doctors, advanced nurse practitioners from Emergency Department and other specialties.

When patients arrive in our unit, which is the Same Day Emergency Care, a unit run by an Advanced Nurse practitioners from different specialties including medical, surgical and orthopaedics, I assess patients and arrange necessary investigations such as blood tests, x-rays, ultrasounds, or CT scans.

Part of my work also involves performing minor procedures such as catheterisation, nasogastric tube insertions, and incision and drainage of abscesses under local anaesthetics under the supervision of the senior surgeon. I also prescribe medications and provide tablets for patients to take home. Communication is an essential part of my role. I help maintain communication links between theatre teams, patients, and wards while providing leadership within the surgical team.

During weekends, I am part of the Surgical on-call team, working at a level similar to a senior house officer. I review surgical inpatients and respond to new referrals from the emergency department and GP surgery.

Aside from my clinical work, I am also very active in the Royal College of Nursing (RCN) Trade Union. I am currently an RCN Steward, supporting nurses who may face work-related issues including disciplinary concerns. I am also one of the RCN Wales Board Members.

At the same time, I serve as the Vice President elect of the Filipino Nurses Association UK (FNA-UK). I help organise and support events that ensure Filipino nurses are supported and prepared for new professional opportunities.

As an RCN Wales Board member, my main responsibility is to advise and support the Executive Director of Nursing in delivering priorities in Wales, aligning with RCN’s overall aims and objectives. I represent RCN members in Wales and make sure that their welfare are well looked after.

Building My Career Path in Advanced Practice

I have done different senior jobs in the Health Board where I am working. I was a Night Nurse Practitioner during the old days where we managed the hospital at night. We looked after the staffing, bed management and escalation as well as reviewing deterioration in patients. With the development of advanced practice, I was offered to do an MSC in Advanced Clinical Practice in University of Wales in Bangor School of Nursing. The course really helped me gained so much confidence and knowledge to do my job properly.

Joy and Fulfilment in My Nursing Career

When I was young, I wanted to be a doctor. This job gives me the satisfaction and feeling that I fulfilled my dreams. I basically work like a doctor and function like a doctor but with an advanced nurse qualification. The job is very rewarding when I see the patients getting better and going home with the problem sorted. I like it when patients appreciate what I have done for them and thank me for the care I provided. It is a very satisfying feeling that I have done something right for the patient. This job is probably my retirement job. I will retire on this job. This career is the collection of all my experiences since I qualified as a nurse in 2001 in the Philippines. My first job was as a nurse in the National Kidney and Transplant Institute as an Intensive Care Unit and Transplant Nurse.

Facing Challenges and Learning through Experience

I believe every job has challenges. In nursing, unfortunately the higher banding you go, the more responsibilities and accountabilities you carry. These challenges taught me valuable lessons and made me more competent and confident.

Majority of patients call me Doctor although I introduced myself as an advanced nurse practitioner and I am wearing an ANP uniform. Sometimes I correct them and tell them sorry I am only a nurse, or jokingly say that they have promoted me now to a doctor.

As a surgical advanced nurse practitioner, I fully support the doctors training. I personally assist and help the newly qualified doctors starting their training in our hospital. It is very nice to see them growing and gaining confidence so quickly.

My Advice for Career Progression

First of all, you need to know what you want to do in your nursing career. Once you decide, make sure you work towards it. If you want to be an advanced nurse practitioner, you need to develop your skills and slowly take courses that will help you secure an ANP post. I always encourage nurses to speak to their manager regarding career progression because a manager can help shape your future. If you have the right manager, he or she will support you and develop you to your potentials.

As a Filipino nurse, I am very happy with my career progression for over 25 years in Wales. In return, I am doing a lot for Filipino nurses to help and support them to the best of my ability. Whether it is career progression or any work issues that needs support and representation, I remain committed to helping.

This 25th Anniversary is more than a milestone—it is a tribute to the dedication, resilience, and lasting contribution of Filipino nurses who began their journey in Bangor in 2001. Over the years, they have not only served with excellence in the same hospital but have also embraced and enriched the Welsh community, building families, careers, and a legacy that continues to inspire future generations.