As a collective group, the nurses within the West Midlands Care Team (CARE), are clinical professionals with a wealth of experience who have a background in acute emergency or critical care. They have undertaken additional education and training in pre-hospital medicine. Amongst the nurses on the team there are MSc level advanced nurse practitioners and independent prescribers. As with the doctors, a period of mentoring and experience under the supervision of an experienced team nurse is mandatory before undertaking unsupervised practice.

Many of the team nurses are empowered to make high-level clinical decisions and will often assess, manage and facilitate transfer patients to a level in keeping with their professional scope of practice as reflected in their mainstream NHS role.

The CARE team's unique approach to pre hospital care is one of cohesive multidisciplinary working focusing on skill sets rather than job titles and encourages nurses to be proactive and dynamic in advancing there contribution to immediate pre hospital care.

As many of the team nurses undertake advanced practice roles in their mainstream NHS job this autonomous patient care is reflected in the carrying out of physical patient assessment and examination in order to achieve a differential diagnosis and in the prescribing of treatments including independent non medical prescribing often identically mirroring their medical colleagues with the added ability to use their nursing experience and post graduate education to focus on the broader holistic health care issues and human factors.

The nurses positive contribution is highlighted by the ability to not become “clinically case focused" in relation to the patients need for medical care but to address the broader management issues and the human factors, focusing on emotional, social and cultural concerns, utilising effective communication skills to deal with intense emotional situations.

Within the team it is recognised that a considerable amount of work has been undertaken by some of nurses in achieving the Diploma in Immediate Medical Care of the Royal College of Surgeons of Edinburgh (DIMC RCSEd) this is a prestigious inter-professional examination that is both rigorous and challenging, designed for practitioners wishing to work independently in the unpredictable and dynamic setting of pre hospital emergency and immediate care.

The DIMC RCSEd examination ensures that clinicians are safe to practice and have up-to-date knowledge, skills and understanding of emergency pre hospital care in all its facets, focusing on the management on the full range of conditions that they might be presented with across all specialities.

CARE Team nurses and innovation

The CARE team has been a leader in innovation. Andy Thurgood, deputy clinical director for the CARE Team is able to clinically lead a shift during operational activity. In addition to this he also provides 'topside' medical advice to non-consultant clincians who are out on the team.

There is no other immediate care scheme within UK that does this.

Nurses and IBTPHEM

The Intercollegiate Board for Training in Pre-hospital Emergency Medicine is responsible for training and assessment in Pre-Hospital Emergency Medicine (PHEM) on behalf of its parent medical Colleges. PHEM is a new sub-specialty area of medical practice focusing on the specialist provision of on-scene and in-transit critical care. Work is in progress to enable appropriately skilled and trained nurses to access the PHEM training.