International #hellomynameis Day

July 23rd marks International #hellomynameis day. The #hellomynameis campaign was started by Dr Kate Granger MBE, a lady who set up a campaign in August 2013 using social media after receiving treatment in hospital for terminal cancer and realising that not all of the staff helping to support her introduced themselves. The campaign has raised awareness about the importance of healthcare professionals telling service users their name and role to help improve communication and increase the quality of patient care. The 23rd of July sadly marks the anniversary of Kate’s passing, though her husband Chris Pointon continues to travel the world delivering talks about Kate’s story and how we as healthcare professionals can improve people’s experiences of being cared for.

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Hello, my name is Abbie and I am a student mental health nurse. As I am a couple of weeks away from the end of my first year I have had lots of contact with service users on practice placements so I’ve been able to get a flavour of how much of a difference introductions can make from a professional perspective. From a personal perspective when I’ve been treated myself and accompanying loved ones to the hospital or the doctors I’ve witnessed professionals assessing not just the physical health but also the personal thoughts and feelings (mental health assessments are very thorough – see here) of people without telling them their name. Not doing so can put up a barrier to communication as the service user may feel awkward and uncomfortable with disclosing very sensitive information that they may previously have never shared with anybody before to a nameless stranger. A simple introduction can make the service user feel more valued and willing to talk about things like what they’ve been experiencing and what they wish to gain from treatment, which helps professionals deliver person-centred care that is tailored to each individual’s needs. Kate’s #hellomynameis campaign strives to improve patient experiences and aligns with the 6 Cs, values underpinning effective nursing practice that were set out in Compassion in Practice: Evidencing the Impact (2016).

6csSome University of Manchester students find themselves on placement within the Tameside and Glossop Integrated Care NHS Foundation Trust, which is where a number of nurses dubbed ‘Kate Granger nurses’ are the first in the UK to have been appointed. Kate Granger nurses will wear special identifiable badges and aim to encourage staff members in the trust to demonstrate effective communication and uphold the standards of compassionate care that Kate and her husband Chris have spent years campaigning for.

Searching #hellomynameis online brings up a wealth of posts showing healthcare professionals and service users pledging their support for the campaign. Visit the campaign’s website to see what events Kate’s husband is attending and find out more about how you can get involved.

 

Collaboration: the future of our NHS- #nurswivesunite

13151090_226356241076122_2131036156_nI write this not to highlight the negatives of our current NHS in crisis, but to address how we can collaboratively work together to save our glorious institution.

I don’t need to talk about our failing health service, I don’t need to talk about the millions of pounds needed from the money tree to keep our beloved institution a float. I don’t need to talk about what the NHS means to Britain and its people, I don’t need to talk about the pressures, the constraints we as healthcare professionals all face.

What we need to talk about is how we can change the future.  I don’t think I’m wrong in saying this is without question the hardest time ever to train to be a nurse or midwife.

We’ve lost our bursary, some of us have lost our passion, our dreams of delivering the care we want to.  Who do we thank for this? Is it a question of politics? Or has our health service just reached a tremendous plateau of increased life expectancy, a rise in population, increased complex care which have become a potent mix given the current economic climate.

How do we adapt?

Collaboration that’s how!

Collaboration– “A purposeful relationship in which all parties strategically choose to cooperate in order to achieve shared or overlapping objectives.”

I love this definition, it epitomises what I believe is at the heart of what we all signed up for; whether you are a student midwife or student nurse we all have overlapping goals, we all CARE.

 We all want to deliver the best care possible whereby it be to a baby on neonatal unit, an Alzheimer’s patient, a child, a patient on a high dependency unit, a labouring woman, they all deserve the same amount of care and compassion.

 We are governed by the code (NMC 2015), we all follow the code, are regulated by the code, we all follow the same overlapping objectives -care, compassion and empathy.

As a whole we are truely invincible.  We have the power to stand up and fight. We have the power to change OUR NHS !!!

Let’s get to know one another, the roles we represent, the care we provide and how we can support each other.  Once we are fully united then I believe we have the power to transform and adapt to the future of our glorious glorious service.

 

Mysterious midwife? Vs obstetric nurse

So at the end of this week I will have finished my nine week community placement and I am absolutely gutted! 😩

Community to me IS midwifery- community encompasses the entire midwifery continuum. From booking to postpartum the community midwife is highly skilled in all areas of midwifery. For those who are unaware of what a community midwife does an average day from personal experience is a full antenatal clinic dealing with a wide range of medical, social issues, recognising safeguarding problems- including domestic violence, mental health problems, poverty amongst many many more.

Postnatal home visits, parent education, meetings with multidisciplinary agencies, phone calls from colleagues, anxious women, the hospital…. the list goes on!!!!!!!

One of the most beautiful amazing things we get to advocate in community is homebirth. Indeed research tells us that giving birth in the comfort of your own home with your family, partner, home comforts round you increases oxytocin- the hormone of love, childbirth, bonding and feeding which will therefore lead to positive outcomes. Of course some women are not suitable and we throughly risk assess all women in our care at booking to determine plan of care for delivery, providing the woman with the most upto date evidence based practice.

Of late, being an avid tweeter I have become increasingly alarmed by a small but growing consensus of people who believe midwifery has no place in contemporary society. These people believe it to be an ideology, a fantasy, a dream concept. I was very disturbed to read one post attacking midwives for our quest to promote normal birth as being for our own selfish gains. Believing that promotion of normal birth, home delivery to be nothing more than a ridiculous ideology that no longer features in a medicalised world.

This is the very reason why I feel midwifery is not just underrepresented but STILL in 2017 the average joes’ knowledge of childbirth and maternity is so poor that it is very easy to whip up so much negative hype- particularly on the back of terrible tragedies such as morecombe bay.

Why is childbirth seen as such a mysterious entity??? Why compared to most industrialised countries do we have abysmal breastfeeding rates?

Who do we blame for the increasing trend towards the medicalisation of child birth and the entire maternity care package?

Its somewhat of a wicked problem but all I know is the role of the midwife is to show care and compassion, to recognise deviations from the norm and REFER!!, promote normal pregnancy and labour. To be a midwife you need to care, care about the woman you are looking after, the baby in utero. Our strive for normality in childbirth proves how much we care! We want the very best outcome for the gorgeous ladies and babies we look after.

So please help spread the word-……..Midwifery is a vocation not a cult!!!!

Top Tips for Your First Placement

 

There is only two weeks until the first year placements start!!! Not only has this made me super nostalgic (and panicky because I’m halfway through my degree now), but it gave me the idea to write down some top tips.

Be YOU. This may sound like the cheesiest advice ever, but it’s true. With every placement, I’ve started this year, I’ve been quiet and not myself at all for the first few weeks because I’m so nervous. But what I’ve (finally) learnt is that once I started acting like me, I felt so much more relaxed. Make jokes, smile, talk to your colleagues. The secret to making it through any shift, even when you’re not having a great day, is with the people you work with! PLUS, the more you act naturally on placement, the easier it will be to feel more and more like a proper nurse, not just some clown in a uniform.

Throw yourself into every opportunity (if you’re comfortable****). I made a habit of not saying no to any task that was handed to me, just so I could experience everything. Sure, I didn’t always want to walk down to the Pharmacy and ask (for the 8th time that day) where our medication was , but it helped! I got to know the hospital, understand the breadth of the role that the pharmacy has, and take a little breather from the business of the ward. Even boring tasks help you learn something, even if all you’ve learnt is I’m not a mad fan of this!

****Sometimes, you aren’t ready. There are times when you will be asked to do something (like giving an injection) and you might not feel ready. That is OKAY! Talk to your mentor, learn the methods and take some baby steps. You get to decide when you’re ready!

Don’t beat yourself up for making mistakes. They happen all the time. We are learning and working! You’ll do things wrong sometimes and that is okay. Whoever is teaching you should walk you through it anyway.

Talk about your day! One of my favorite times of day whilst on placement is going home and getting it all off my chest. Since I live with non-nurses, I often filter out the gory bits (bless them) but it really helps to process the day and reflect.

Get your paperwork sorted out on time! Both of my first-year placements involved me panicking because I didn’t talk to my mentor about paperwork. I thought it would make me look pushy. It doesn’t. 99.99% of the time, your mentor might have just forgotten or they might have a plan of their own. Just talk to them! If issues arise from there, talk to your PEF and AA.

And finally- GOOD LUCK! This journey is hard and can be frustrating, but there will be so many days when it’s so so worth it.

If anyone fancies trying their hand at blogging their experiences with placement, why not give us an email, a Facebook message or a tweet? We’re always on the lookout for more student nurse’s and midwives!

Tools of the Trade – Mental Health Nursing

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Assessment or screening tools are key to gathering a whole wealth of information from a client and they can often lead to them opening up about other or underlying issues that may be impacting on their health. How and what they answer can give you insight into their current feelings about things as well as provide a baseline of presentation to record any future changes and used to point towards treatment required. Being able to monitor someone’s recovery progress can help staff encourage and motivate a person, just as being able to monitor someone’s deterioration can help staff adapt treatment and interventions appropriately.

Tools are not always perfect and we have to work with them openly and carefully using them as a guideline to help support the treatment or diagnosis we provide. Below is a short list of the some of the assessment tools you might come across on placement;

The Hospital Anxiety and Depression Scale (HADS) – Used for Anxiety & Depression can be used in community as well as hospital. It is a 14 question Psychological screening tool assessing the severity of symptoms.

Generalised Anxiety Disorder Questionnaire (GAD-7) – Screening tool used to measure the severity of Generalised Anxiety Disorder. 7 questions that can be administrated by a health care professional or self-administrated by the client themselves.

The Mini Mental State Examination (MMSE) – Commonly used short assessment used for screening for any dementia or cognitive impairment concerns are suspected. It measures cognitive functioning, and can be used to monitor change. 11 item tool taking around 10 minutes to administer making it a quick and useful tool to use.

The Addenbrooke’s Cognitive Examination (ACE) –  Well validated assessment tool for clinic setting assessment of cognitive functioning. This measures cognitive domains including language, visuospatial, memory and attention.  Usage is usually in part with other screening tests such as blood test, ECG and MRI scan to inform a diagnosis.

The Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS) – Is a self-assessment tool for measuring the side-effects of antipsychotic medications. Red herrings are included to check the accuracy of the results. The 51 questions are based on true side effects with 10 being false  ones aim to help patients Identify, understand and gain awareness of side effects they could be experiencing.

The Alcohol Use Disorders Identification Test (AUDIT) – A basic screening tool used to pick up the early signs of hazardous and harmful drinking and identify mild dependence and highlight if a need for assisted withdrawal is required.

There are many varied tools assessing risk used by health care professionals in all fields and in  a wide variety of settings. It is important practitioners should take care to always explain what is involved,  how long it will last and how they can help a patient and their treatment.

Using an assessment tool can help uncover more information about a patients situation and help to encourage conversation that could provide valuable information to inform their care is more personalised and help reduce risk.

Keep your assessment tool box handy and help patients access all areas in health care support.smile

An Interview with Ian Wilson – Mental Health Lecturer

word-cloud-ianIan Wilson, Honourary Teaching Fellow in the Mental Health Field has given us an early christmas present in the form of this amazing, honest interview about his specialist field – Mental Health, specifically discussing his work in the community with dually diagnosed service users (those with mental health and substance misuse diagnoses). This is a truly insightful piece with some wonderful tips and advice for all fields of Nursing.

ENJOY!!…

 

What do you enjoy most about working in the community?

I enjoy the autonomy of community work. I enjoy being truly collaborative with my service users and colleagues. I enjoy the flexibility and responsiveness that community work offers workers and their clients. I enjoy the equalization of the ‘power balance’ between professionals and service users that community work offers.

What do you enjoy most about working with the university?

Regular contact with students is undoubtedly the most rewarding part of my university job. I welcome the enthusiasm, creativity, professionalism and dedication to mental health nursing that I see students frequently displaying. Because of this student contact I am reassured about the future of my profession and reassured about the future of mental health services.

What do you think is the biggest challenge facing Mental Health Nurses today?

I believe that we MUST maintain and nurture our own professional identity as mental health nurses. We have a unique perspective and a unique therapeutic trust. Both of these things are a huge privilege. We must ensure that this is not diluted.

Even as Student Nurses we can sometimes neglect our own mental health, especially with dissertations looming, what advice would you give students struggling with university stress?

I manage my own stress through regular exercise. I also have a group of friends who I can trust. Some of them are nurses, most of them aren’t. I have different groups of friends for different aspects of my life; my ‘football’ friends; my ‘music’ friends; my ‘work’ friends; friends I’ve known for 40 years or more, friends who have only recently entered my life. I rely on them all for support and encouragement.

How has your role as a Mental health Nurse changed since you registered?

I commenced my career as an inpatient staff nurse (two years). I then moved into community mental health nursing and I’ve done that for 20 + years. During that time my roles have changed and my responsibilities have increased. However, my core values have changed surprisingly little. I would still recognize myself from 25 years ago!

What qualities make a great Mental Health Nurse?

Empathy, unconditional positive regard, honesty, therapeutic optimism, positivity, self-reflection, a genuine interest in other people’s lives, open mindedness, a sense of humour, resilience, resourcefulness, self-reliance.

What made you choose to work with those suffering from drug and alcohol misuse?

I have both personal and professional reasons for working with dually-diagnosed (both mental health & substance misuse) service users. Additionally, I find service users with ‘dual’ problems resourceful, resilient, insightful and challenging. This keeps me going!

f3766f876d143ea85bd35fb7b63cabaf731c5493-3-1.jpgWhat piece of advice would you give Mental Health Student Nurses today?

Take every opportunity that comes your way to promote non-stigmatising attitudes towards mental health service users. Promote acceptance and respect among your colleagues. Use evidence based practice wherever possible. Have confidence to stand up against poor practice whenever you encounter it. Always push to improve services and your own skills and knowledge as a nurse.

From your experience working with service users who smoke cannabis, have you seen a therapeutic effect from taking it as a method of self-medicating and not just for recreational use?

Yes. For instance, a man with bi-polar illness has been using cannabis to regulate his mood. He has been actively attempting to reduce his cannabis use but as soon as he starts to reduce, he experiences a relapse into distressing elevated mood. His answer to this currently is to attempt to grow his own cannabis, which, he hopes, will be high in cannabidiols (anti-psychotic and sedating) rather than high in THC (very psychosis inducing). He is proving to be partially successful. However, in my experience this is unusual. Most of the service users I’ve worked with for many years do not get a good therapeutic effect from cannabis. Quite the opposite in fact. For almost all service users with psychotic illnesses cannabis can be a disaster for their mental health prognosis.

What impact do you think there would be on mental health services if cannabis was to be decriminalised or legalised in the UK?

Taking cannabis misuse out of the legal system and into the healthcare system would enable those people who have problems with cannabis misuse to seek appropriate help and treatment. It would also remove it from the control of organized crime.

From your experience what role does excessive alcohol consumption play in the development of mental health disorders?

This is a complex and multi-dimensional issue. Demographically, 50% of people entering alcohol treatment services have a severe depressive illness. 20% of people have a psychotic disorder (Weaver et al 2003). Whether this is a consequence of drinking excessively, or whether drinking excessively is a causative factor in the development of illnesses is, of course, usually too complex to fully determine.

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Legal Highs come in all sorts of forms and can be bought on the high street

With the rise of “legal highs” and previously uncommon substances of abuse (such as ketamine) in Greater Manchester, has their been a notable shift in conditions patients suffer with as the popular drugs of choice have changed?

I believe that there is now no doubt that many of the newer substances, such as synthetic cannabinoids and highly potent stimulants such as PMA and methadrone are potentially far more dangerous to both physical and mental health. Synthetic cannabinoids, especially, appear to be very dangerous and unpredictable. However, their use, among mental health service users and people in general seems to be increasing year by year.

If you could give child/adult field nurses a few key points to convey to patients they may encounter that they believe might be struggling with drug or alcohol abuse what would they be?

  • Be honest but non-judgmental about peoples’ lifestyle choices
  • Encourage service users to discuss issues of substance misuse in an open and honest manner
  • Listen to what they tell you and find ways of reflecting back what they’ve said
  • Express empathy about their situation in relation to substance misuse. Be especially empathic about the difficulty their substance misuse is causing them and how it may be preventing them to achieve their goals
  • Seek permission to offer information which is neutral, up-to-date, and presented in an accessible form. Check out carefully what they make of this information
  • If they don’t want to change their current patterns of substance misuse, carry on discussing the issue in an open and honest manner, avoid arguing or persuading; offer harm reduction tips
  • Keep the door open to possible intervention in the future

A moment of CALM: de-stress with new wellbeing workshops for student nurses and midwives

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It’s well known that in order to properly care for others, we must first take care of ourselves. I’m sure many of us have shared that advice with our friends, family, patients or their carers, yet how good are we at following it ourselves?

As the term progresses and the list of assignments builds up, it is tempting to put our health and wellbeing on the back burner. There are so many competing demands, especially as many of us juggle uni work with part-time jobs, family commitments or other personal issues. It can be overwhelming at times: every student nurse I have spoken to has felt the pressure at one time or another, yet you can often end up feeling quite isolated, thinking ‘is it just me?’ Believe me, it’s not.

Don’t fear – help is at hand! After feedback from previous students, a brand new project has been set up to support students throughout the year. CALM has been designed been designed specifically for student nurses and midwives, aimed at tackling some of the regular issues we might face during the course.

On offer is a four week Mindfulness course starting this afternoon which will give an introduction to mindfulness and share techniques to cope with anxiety and stress. Mindfulness is about being present in the moment, switching off from the endless distractions and learning to calmly accept the emotions and thoughts that fill our minds. Over the four weeks you will be given an introduction to acceptance and be taught some simple stress-busting tips including how to carry out a body scan and breathing exercises. You will also learn how to recognise stress cycle and ways to build mindfulness into your everyday routine.

On top of that are drop-in sessions on money management, for practical tips on how to make your bursary and student loan go further, and a session on housing for anyone who wants advice on finding accommodation that fits our hectic schedules. A series of free sport and fitness classes are also in the works, so watch this space!

meditation-1000062_960_720Starting this afternoon, the Mindfulness course will run every Wednesday for the next four weeks between 1-2pm and there are a couple of one-off money management and housing sessions planned for the rest of this semester. You can book a place on any of the sessions here or contact Eve Foster at sso.intern@manchester.ac.uk – and if you’re interested in the Mindfulness course, it’s fine if you can’t make the first session today.

Don’t forget that the university also offer a fantastic counselling service and a massive range of wellbeing and relaxation courses, from daily meditation sessions to longer courses on low mood and self esteem. There are also plenty of online resources and apps like Headspace that can help you unwind and de-stress.

You don’t have to become a incense-burning zen master to build mindfulness into your everyday life. Mindfulness expert Andy Puddicombe says in this TED talk that we only need to spend 10 minutes doing absolutely nothing to feel the transformative effects of mindfulness.

So kick back, switch off and just breath.