Speaker 0 | 00:11.603
You walk in to a hospital, what do you notice? The lighting, the waiting room, the beeping of machines. Most patients say the same thing. It's the people. Today, we sit down with Bernadette Carroll, director of nursing at Bon Secours Hospital, Limerick, to explore what exceptional care really feels like. From the patient's point of view and how, the new Bon Secours Hospital in Limerick has been designed with patient experience in mind. Bernadette, we are delighted to welcome you to the podcast.

Speaker 1 | 00:39.993
Thank you very much. I'm delighted to be here.

Speaker 0 | 00:42.876
Bernadette, can we start with a bit about your role and your journey leading up to your current position at the Bon Secours Hospital in Limerick?

Speaker 1 | 00:50.454
Yes, so my name is Bernadette Carl and I'm the director of nursing here in the Bon Secours Hospital in Limerick. I joined the Bon Secours five and a half years ago now. And I trained in Dublin. I immigrated to Australia for five years. I came back to work in Limerick. And I worked in the HSE in the public sector for an awful long time. So I joined the Bon Secours in Limerick five and a half years ago. And I must say, it is the best thing I ever did. And I'm delighted to be part of this whole venture now and the new hospital. So, yes, so that's my role at the moment.

Speaker 0 | 01:26.584
That's fantastic. Okay, so let's get straight into it. Exceptional care is a term closely associated with the hospital system. As a director of nursing, what does that term mean to you?

Speaker 1 | 01:38.524
Exceptional care is really important for us in the hospital. It's high quality, evidence-based, compassionate patient care. And, you know, weekly or monthly in the hospital, when I do induction, I tell people that, that that is the most important thing is exceptional patient care. If we didn't want to provide exceptional patient care, we wouldn't work in a hospital or we wouldn't work in healthcare. And that's what we're all about. All that's important at the end of the day is the patient is at the centre of everything that we do. We pride ourselves in Bon Secours hospital in Limerick at present in providing that high standard of care and feedback from patients is exceptional. And that's how we measure what we do. We pick up that exceptional care on a Friday evening in Barrington's Hospital. And we'll take it with us to the new hospital on a Monday morning. So, but really, that is what it's about. Reputation is so important. And for all of those patients that have been to Barrington's and received that care, I don't want them to worry and not think that it won't happen in the new hospital. Of course it will. And beyond, you know, so it will be wonderful. And we'll take that with us.

Speaker 0 | 02:49.255
That's fantastic. And, you know, the new hospital isn't just bricks and mortar, I think. The patient journey sounds like it's been integrated from the start. What are some of the ways it's been designed, with that patient journey first?

Speaker 1 | 03:03.004
So, from the very moment that the patient will receive their appointment letter, with a date and time for their procedure, their journey has begun. So that's their first interaction with us. So I'm sure for people who are passed on the road now, they'll look at the hospital. Or they've seen the videos on social media and they see the hospital progressing at a wonderful pace. We're on target to open September for phase 1 and October for phase 2. So I'm sure patients have their own opinions already of the wonderful building as they pass by it on the entrance to Limerick City. We're very proud of the design and we have been involved in creating the building behind the scenes from before the sod was turned. So patients and their families will park at the front of the hospital. They'll come in through the main entrance and into the main reception of the hospital. There'll be a set-down area also for those that might require it. Main reception is inside the front entrance. And I hope that the first impression that people will get will be influenced by the wonderful two-storey glass concourse that we have inside the front door. It's flooded with natural light. Hopefully, they'll have a feeling of being embraced within a welcoming space which drowns out all the hustle and bustle of the outside world. So patients should feel secure when they step inside the front door of a hospital. They shouldn't feel rushed or lost and not know what direction they're going in. So in the present hospital, actually, I think it happened during Covid times, where we have a healthcare assistant who meets everybody on arrival and helps them in their journey through the complicated building that was the Barrington's. And so now we will also have somebody to meet and greet as you arrive into the hospital. So patients shouldn't ever feel that they'll be lost and they'll be embraced from the moment they arrive in the front door. The interior design concept is something that we're very proud of. And the design concept that is being proposed is a biophilic design. And like lots of our listeners, we'd never have heard of biophilic design until we went down this road. And we've learned so many new things. So biophilic design, it purposefully incorporates nature into interior spaces and attempts to connect us with the outdoors. The features used to benefit patients and families and staff as this design creates an environment which aims to reduce stress, promotes healing and improves mood and general well-being. This is achieved with the use of soft pastel colours, which mimic nature. There's a gentle curve of the building, I'm sure that everybody's seen it from the outside, so just imagine what it's going to be like from the inside. The pillars and the concourse and all that are very soft curves and shapes to reduce those hard, rigid corners that you have often in buildings. So, through the extensive use of glass, there is an opportunity to view the landscaping and we've beautiful landscaping in the gardens. And we also have a healing garden. We're very proud of this and it will be a wonderful feature of the hospital. So from the waiting areas and from the restaurant, you'll be able to view the landscape and the healing garden. And it helps us to promote an air of peace and tranquility in the hospital. And that's what it should be like when you go into a hospital. There should be an air of peace and tranquility. We've used natural products such as wood and stone. It helps reduce our carbon footprint, but it also creates an ambience, which is carried through the hospital and into the hospital chapel and the ground floor, and we have a multi-faith room there. The chapel is a sacred space for prayer and reflection, and it's a very important aspect of the Bon Secours mission and our Catholic ethos. We hope that it will be a quiet space for anybody who would like to avail of the calm, restful and sheltered environment in their hour of need. Our aim is to reduce patients' anxiety as they wait for their procedure. Or the stress for a relative who may be waiting for a patient who is having investigations or a procedure on the day. There will be ample seating, areas clustered outside each portal of care, which will help enhance the patient experience and provide them with a comfortable space to relax and wait. It's difficult for people coming into hospital. Nobody wants to be in hospital. It's not something anybody looks forward to. So it's important for us now to do everything that we can to reduce that anxiety and fear for patients and relatives, and to ensure that they feel that embrace when they arrive into the hospital.

Speaker 0 | 07:39.874
Anytime I'm in one of the Bon Secours hospitals, it seems like it's everyone's responsibility to look after a patient's journey. If you see someone that looks a little bit lost, you know, you see. The staff immediately come up to them and make sure they're OK, make sure they know where they're going. Is that something that is discussed with the staff, or is that just part of the kind of culture of the Bon Secours?

Speaker 1 | 08:01.922
Yes. So we've learned that from Barrington's Hospital. It's been difficult to navigate that old building and we always seem to be giving instructions to people despite good signage. So everybody, whether it's a nurse, a doctor, hygiene, catering staff. Anybody who meets a patient looking a bit bewildered, they'll always stop and say, where are you off to? Or, you know, can I help you? And take them along on their journey. In the new hospital, now that you mentioned that, a huge aspect of it is signage and wayfinding. So everything, we have looked at this in great detail and in depth. And how the signage, and even what the signs are made from. So that they fit in with that biophilic environment. So the size of the signs, the colour of the signs, the font, everything has been carefully considered. So that that pathway should be very streamlined and easy for patients.

Speaker 0 | 08:54.092
It's really interesting because it seems like there's one part of it that's kind of structural in regards to the building and the pathways. But there's another part of it that's just more on the compassion, empathy side. And it seems like that's really part of the culture in Bon Secours Limerick.

Speaker 1 | 09:08.842
Yeah, the human side of it. So nothing can ever replace that, really. So all the signage in the world and people will still ask you, won't they, for directions. So we pride ourselves really on providing that care to people when they arrive and making them feel at ease and comfortable and not lost.

Speaker 0 | 09:26.916
And do you think that's downstream from Bon Secours being so mission based and so associated with that mission? Do you think that's how that's permeated into it?

Speaker 1 | 09:35.783
Yes, that's true. And I guess, like I said earlier, I suppose everybody goes into health care to provide good care. But yes, our mission and values, that's what we're about. We want to show dignity to patients. We show integrity and honesty, and we treat people compassionately. Like Bon Secours, the phrase, it stands for good help. And that's a simple phrase, but that's what we provide, is good help to those in need. And whatever your journey is, you know, we'll go with you on that journey. And so we will provide you with that good help.

Speaker 0 | 10:15.926
Subjectively, you know, that's fantastic. But objectively, Bon Secours seems like it does really well in things like feedback, NPS, scores. Are you often surprised when you see that fantastic feedback coming through?

Speaker 1 | 10:26.379
Yes, and we are. We ask people for their feedback. And actually, it's interesting. People, everybody gives feedback. And likewise, sometimes you will have negative feedback and we will learn from that. And we'll contact that patient the very next day and say, what could we have done differently? Could we learn from your experience? And so that's rare. But we always address that with each individual patient. Because there's no point in getting feedback unless you're going to act on it and do something and learn from that. So, yes, we really welcome patient feedback. And it's interesting, they talk about, you might think that they would always talk about their procedure or the consultant that looked after them. Interestingly, they talk about who they met at reception and how they were smiling with them and chatting about the weather or whatever and making them feel welcome. And they talk about the nurses and the doctors they met, the food that they had, how clean the place was. All of those seem like very basic things, but people will always comment on that. And we would pride ourselves on the very high standard that we provide.

Speaker 0 | 11:30.575
That's fantastic. And it seems like the new Limerick Hospital is going to allow you to do that to an even higher degree. And I know things like noise level, natural light, all these kind of structural things have been built in as part of the new Limerick Hospital. Are you excited to see how they're going to feed back into the patient experience?

Speaker 1 | 11:46.591
Yes. And so I touched on it earlier. So the, we created portals of care. Instead of calling them departments, we call them portals of care. And that came from the design period. So we thought, OK, well, we build a hospital and try and fit everything into it. But we looked at it differently and we thought, OK, these are the patients that we have coming for elective procedures or for admission. Let's look at their journey and then build a hospital around that journey. So we didn't just build it first. We actually did the reverse. We looked at the pathway the patients would have. It's interesting, you learn a lot, we learned a lot from Covid. And every hospital in the country had the same situation, where patients had to walk through lots of different departments to get to where they needed to be. And we thought, Okay, let's keep all of our outpatients and all of our day cases on the ground floor, so the patients don't have to. And visitors walk endlessly through the hospital and risk spreading infection and so on. So anybody that needed to be on the ground floor, we've kept them on the ground floor. Inpatient wards then are on higher floors, so because there's less traffic and less movement of patients, so on the ground floor. We have like, a day procedure unit, and first to the left, and then beside that with the hospital access unit. Or, as some people would traditionally call it, a medical assessment unit. But it'll have a broader scope than medicine. We have a large ophthalmology suite, it started out as an ophthalmology department, and we ended up bringing our ophthalmology theatre there, and we've built a purpose-built ophthalmology suite. So for people who are coming for their eye operation or their eye diagnostics, it's on the ground floor. Those people are already visually impaired and challenged visually. So why would you want them to bring them through complicated lifts and stairs and pathways? So we kept all of those patients and they're on the right at the ground floor. So all of those things were considered and the portals of care are laid out in that fashion. So that was really, really good agood example of how you can do something and build a hospital that's purpose-built to meet the needs of the patient, rather than the reverse.

Speaker 0 | 13:57.225
I think patients and visitors are going to get really excited about it. I think everyone has that experience of walking around the hospital, not knowing where they need to go, being lost, asking questions. So it's great to see that the new Limerick Hospital has been built with that in mind.

Speaker 1 | 14:12.186
Yes. And it is interesting when you, when you design something, all of the bedrooms, for example, s we have two medical wards and we have a surgical ward and an orthopedic surgical ward. And we decided to go with all single room accommodation and that gives comfort and privacy to the patient. And like you said, it's very quiet and peaceful and restful. When you're in hospital and you're sick, you want to rest and have sleep and not have a lot of noise and traffic around you. So every room 25 bed wards, all single rooms with en suite. Everything was carefully designed in the bedroom, the position the bed should be at, the journey from the bed to the en-suite for the patient. We considered several options with the architects and designers, and we came up with the best option. So it's the shortest journey for the patient from the bed to the en-suite. Traditionally, and through quality and improvement, we noticed that any time, if you look up the research, patients fall on their journey from the bed to the bathroom, to the en-suite. And therefore, we wanted to design it in such a way to reduce those risks and keep the hospital safe. And there's also ergonomically that design, it lends itself to good patient care for the nursing and medical staff. If you approach the patient from the one side in every room. So that your repetitive action that you carry out is safer because you do the same task at the same side all of the time, and that makes that task safer. So all of those options were considered, and the ergonomics of the room was designed in that way. I suppose I've spoken about patients all through this journey, and those patients wouldn't be there without all of our staff. And we're doubling our workforce now. I'm sure people have seen our advertisements out there. But for staff, it's really important to have a really good workplace. We spend half of our lives at work, really. So it's important that where we work, we feel happy. And so ergonomics are very important, and nursing and healthcare staff are lifting patients and moving patients. So anything that aids in making that safer for staff, more comfortable for the patient should be considered. So we considered all of those aspects when we were designing the rooms.

Speaker 0 | 16:35.672
Fantastic. And you mentioned there about the staff, and obviously there's a cohort at Barrington's that are moving across. What's the excitement level? What's the feelings there?

Speaker 1 | 16:45.203
There's great excitement, really. So we're doubling our workforce. Of course, there's a nervousness and there's an excitement, all mixed together. At Christmas time, I think that transition period kind of started, and we had our last Christmas in Barrington's. And that was a very poignant time for us. There are staff in Barrington's who have been there since pre-Bon Secours healthcare system time. And staff were there 15 and 20 years. And we've given them their staff awards to celebrate those milestones. And we've staffed that are here since Bon Secours joined acquired Barrington's in 2017. So we've staffed from that time. And now we have a whole new family of people who are going to join us. And they're going to join that Bons family that we have here in Limerick. And even though our workforce will double, we still have all of the staff that we have now. And they will look after the new staff that come and bring them along and teach them how we in Bon Secours do things. And you what our ethos is about, and share the compassionate care that we provide and the expectations that we have. And so for all of the new staff that join, we meet them at induction and we talk to them and tell them how we in Bon Secours in Barrington's like to do things. And we will share all that information with everybody, and there'll be several days of induction for new staff. And that'll be really nice and teach them how we do things. And new staff will come, and they'll bring new expertise and new skills and new relationships. And it will be wonderful. And so we really look forward to that. And for the last two weeks, we've been interviewing staff and the journey now is continuing for more staff. But it's really heartwarming to see the people that we've met so far. And all of the expertise that they will bring with them. And the knowledge and their passion for health care. And so they'll bring that with them and join us. We'll have a wonderful new Bons family together.

Speaker 0 | 18:44.528
Is there anything in the new hospital that you think is really going to empower the current staff and anything that you're really excited about? You know, they're obviously going to be in this new, beautiful building with lots of natural light.

Speaker 1 | 18:56.141
Yes. So at the moment, staff are being brought out to visit the site. So, up to now, you know, only those that are required on site. And Sisk are very concerned about the health and safety of all of us. So now staff are out there to visit their own individual departments and that makes it seem real and they get to see what their department is going to look like. But a lot of us have worked in healthcare and have visited hospitals throughout the country over the years. And often you're in narrow corridors and tight spaces, and it's very difficult to provide good quality patient care in those environments. Now we will have very spacious corridors, spacious rooms. When you're transporting patients between departments, that's really important that you have good wide corridors and so on. Staff facilities have been really important. And as Jason, our CEO, would say, when, he loves to talk about food and the restaurant, And we're putting a lot of work at the moment into the food for patients and the quality of food. Times that patients receive their food. I know it's very difficult when you're in a hospital setting, you have to have a certain regime around when the food is served, but we want to make that more flexible. And that if it doesn't suit a patient at a particular time to have their lunch or their supper, that that time might be able to be extended. And there's a bit of flexibility. So that's really good. But like Jason said, the other half that have to have meals are all of the staff. So we have a wonderful restaurant. We have a theatre tea room upstairs so that the food can be transported up, staff can order food and it can come to the tea room. The tea room is fabulous up in the theatre. There's a big window that looks out onto the healing garden. And we're all jealous now of all the people working in theatre. So they have this, you know, exclusive theatre tea room up there. So there are changing rooms, shower facilities, parking for staff. So all of those facilities are there and we've all worked and grown in hospitals that didn't have all those facilities before for the staff. But now, because this is purpose-built, we had the opportunity to do all of that. Locker rooms And there's a room beside, between the locker rooms and the restaurant, where staff, There will be cupboards and fridges if people want to bring their own food. And so we thought of everything, you know, so everything to make the staff happy and to facilitate their work life, because that's really important.

Speaker 0 | 21:27.882
And it's fantastic, Bernadette, that you talk so closely between the staff experience and the patient experience and patient outcomes. And, you know, looking into the research, I was blown away by the correlation there. I saw in the British Medical Journal in 2025 that a systematic review of 66 research articles and found consistently positive associations with staff experience and patient outcomes. Like, the research here seems really clear to me and strong. But what do you see at ground level? Do you see that investment in the staff and the culture permeates, and you see results and better patient outcomes?

Speaker 1 | 22:04.853
Yes, definitely. And that is really interesting research, because if you have a happy workforce, that permeates through into the environment that we create. And we have a happy environment. And patients are cared for and the patients feel that. And there's, if you ever went somewhere and there was an ambience around the place of a certain tension. or, you know, that does affect you. So we would pride ourselves actually in Barrington's, in spite of the challenges around the building that we've had. And we've done really well with that and made the best of those circumstances. Now we'll be in the new hospital. We will have a much different ambience and a restful, calm environment. And that is really good for staff. Staff feel happy in their workplace. And it's interesting now, through the interview process, the number of people that have approached us for a new job. Because they see this wonderful building and it does attract people. So if you have a happy workforce, you will have happy patient care. And that's what it's all about, really, isn't it? 

Speaker 0 | 23:11.889
Yeah, it is. It is all about that. And you mentioned before about the feedback and the positive feedback that you've got from the patients. What do you hope patients say to people like their family and friends after they've had an experience at Bons? What do you want them to say?

Speaker 1 | 23:26.157
So it's interesting. There's a, we want people to come back. And if you've had a good experience, you'll always come back. And so patients, unfortunately, I should say, if they need to return to us, But they know that they can come back to us and that we will follow up on their care and look after them. And we do hear that all of the time. People say oh, I had a friend who went to the Bon Secours and for that reason. I've seen one of the consultants and I'm going to come for treatment there. And that's really important. And that speaks for itself if patients and relatives and family tell other people about their experience and that's why they come and see us. So reputation is really important and we want people to have a very positive experience and to share that with other people. Um, I'm sure lots of people in healthcare have heard the phrase or the quote previously from Maya Angelou. And she talks about, you know, people will forget what you told them. They'll forget your name, but they'll never forget how you made them feel. And that's what it's all about, really. It's how you make people feel. We want to provide holistic patient care. We want people to feel good when they're walking out that door.

Speaker 0 | 24:41.606
Bernadette, I know there's been a huge emphasis on detailed and structured scheduling, designed to support smoother patient flows and reduce pressure points. Why is this so important from a patient experience perspective?

Speaker 1 | 24:55.472
In Barrington's hospital, for those people that have attended already and are familiar with the hospital, we've always had elective surgical care. The only medicine that we had in the hospital really was endoscopy. So now we're changing and we're growing and developing new services. So we will have more elective surgery. However, we're expanding all of the orthopaedics, urology, ENT, all of the specialities that we do at the moment. So that's all being expanded. So this is a very detailed schedule happening so that every consultant has a theatre list. But also, like you said, that's really important for the patients. Our theatres will probably extend from seven in the morning to seven in the evening. Initially, they will start five days a week and probably run into six days. And all of that enhances the patient experience because they can come at a time that suits them. And their consultant may be able to facilitate that. So scheduling is really important. It also is important that our facilities are opened and are utilised to the best that we can utilise them.

Speaker 0 | 25:58.444
Fantastic. Anytime I'm in a Bon Secours hospital, I always noticed a nice, calm air about the place in terms of the nurses, the staff. What's the magic there? Is there a specific nurse ratio that's happening? You know, why does everyone seem like they're in control?

Speaker 1 | 26:14.343
I'm glad that that's the phrase that you use, in control, and that's what we always aim for. In Ireland, the safe staffing framework was commissioned by the Department of Health and it was to review how hospitals are staffed in Ireland. It was intended for the public hospital system, however, the Bon Secours have embraced that, and we also base our staffing and our nurse-patient ratio on the safe staffing Framework. So in a medical or a surgical ward, the nurse would have a ratio of one to six patients, and that is really good patient care. And also, it gives a nurse opportunity to spend time with those patients. It's very difficult if you have a ratio of 1 to 12. How do you divide all your time between those patients? On night duty, the recommendation is 1 to 8, and that's the staffing framework that we will have. So it gives the patient time with that nurse, and it also gives that nurse time to provide the highest quality care. So I'm glad that you feel that. That's the impression that you get when you go into the hospital, because that's what you should feel.

Speaker 0 | 27:13.543
Bernadette, I am so impressed by you, it seems like you've taken on such a huge challenge, but you seem like you're really relishing it. 

Speaker 1 | 27:15.252
Yes, um, I when I came to the Bonds course five years ago. And when I met with Jason, he told me that there was a plan to buy a site and the field was bought. And so I knew that exciting times were ahead and that there was a big challenge, however, that brings wonderful opportunity within this very exciting time. I have a wonderful team and we have nursing healthcare assistants, ODPs and administrative staff in our team and we work really well together. And we work with the multidisciplinary team in the hospital. I think every team is very aware of that, none of us can do it without the others. So that's really important that we work together, but it's a privilege really to lead this wonderful team of nurses and now double that workforce. So people who come maybe work in one department and look for an opportunity to move to a different department and learn new skills, I'm always open to that. There's further education available to people and we are linked with the University of Limerick and all the universities throughout the country. So if people want to engage in postgraduate education, Bon Secours are always open to that and we encourage that. So a very exciting time ahead.

Speaker 0 | 28:29.831
Bernadette, I think that is a lovely way to end the podcast. Thank you so much for talking to us today.

Speaker 1 | 28:34.738
Thank you very much. I enjoyed it. Thank you.

Speaker 0 | 28:37.175
That was Bernadette Carroll, director of nursing for the Bon Secours Hospital, Limerick. Join us next time as we further explore the hospital of the future.