#hellomynameis Kate

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Kate Granger, the founder of the amazing campaign ‘#hellomynameis’, wonderful doctor and cancer patient, died this week. Throughout her treatment, she spoke up and informed healthcare professionals how they could improve their practice by doing something simple; introducing themselves. A simple introduction, she believed, could go a long way. The patient needs to feel like a person, not just a list of symptoms. This is the exactly what patient-centered care is all about; Kate hit the nail on the head, we need to change our behaviour.

When I first came into contact with this campaign, I thought “gosh how could anybody forget to introduce themselves?” but it happens, and I’ll put my hands up and say there has been a moment when the patient has had to ask me! But it does make all the difference because it is the beginning of a professional-therapeutic relationship, and the patient needs to be able to trust their caregiver. It makes me smile when patients are happy to say “Kate, can I just ask you a question?” Or “Kate can you just do this?”.  It makes the situation a little bit more normal, less formal and that helps people relax.

What we need to learn from Kate’s work is that speaking up is the best way to kickstart change. If you see something, or think that something could work better- do not be afraid to speak up. Even if you just mention it to your mentor, write it in a reflection to show to your academic adviser, maybe even a blog post…. it can do a world of good. It might not turn into a nationwide social media campaign, but the smallest changes can make the biggest difference. For example, Natasha (one of our lovely bloggers) has been using her knowledge, and spreading it amongst the staff in the Sri Lankan hospital where she completed her DILP placement. You can read that blog post here as it’s a good example of what I’m trying to get across.

The #hellomynameis campaign is still going strong, and I don’t think it will be slowing down anytime soon! Kate’s family and supporters are keen to keep her amazing work going, and I for one will happily get more involved. You can get involved on Twitter or just through the website.

Rest in peace Kate, thank-you for inspiring us.

High risk women and the importance of continuity of midwifery care

  So this week I’ve enjoyed working within the birth centre at my trust. The birth centre is midwifery led care for low risk women.  This unit only has midwives, there are no doctors, no CTG monitoring,  no medical equipment just relaxing rooms with lava lamps, pools, tea and coffee making facilities, a calm safe place to give birth. The women who are able to use these facilities ’ will have had the pleasure of MLC- midwifery led care throughout their pregnancy, enjoying the continuity of midwifery.  Whilst enjoying my first day me and my mentor got called to go to a heart and lungs ward to see a woman who was extremely anxious about her baby. At 36 weeks she was to have a C- Section at the advice of her  medical team and Consultant Obstetrician. The woman had cystic fibrosis and due to the long term use of steroids to treat her condition she had also developed gestational diabetes.  Once we got to the ward the nurses informed us of how anxious she was about birth, attachment and bonding, feeding, all the anxieties a low risk woman would have. They had been unable to calm her worries.  Throughout her entire pregnancy the woman had not seen one MW apart from the booking appointment at 12 weeks. This was because she was “high risk”. Being high risk she automatically qualified for Consultant led care .  All she had seen were her CF doctors and a Consultant Obstetrician. All the woman wanted and craved was midwifery care, she wanted to discuss her pregnancy, her pending motherhood, her feelings and thoughts of what was to come. Seeing a midwife made her pregnancy seem real putting her anxieties to rest. As midwives we are in a unique position, our role ultimately is to listen to the women we care for. Doctors obviously have to listen but from a medicalised point of view. Anatomy and physiology is always at the forefront of their mind.  It was rewarding to see how our chat had helped the woman, the relief on her face was plain to see, she opened up to us, spoke about her greatest fears, I found the whole experience so hugely rewarding. This is why I came into midwifery- to make a difference, to listen to women, to support them at their most vulnerable, to make them believe they can do it, they can birth, they can get through pregnancy, they are amazing! listening This experience got me thinking- High risk women need continuity of midwifery just as much as low risk women do, in fact in many ways potentially they are in greater need.  This woman had been medicalised her entire life and craved for the normality of pregnancy.  It is so important these women are not forgotten about. Yes absolutely high risk conditions must be monitored by obstetric means during pregnancy, intrapartum and post natal but midwifery offers a unique form of care that is just as important. why  

From fear to maternity……..

So, before I embarked on this student midwife jaunt I was a counsellor for 15 years (I did ALL sorts of counselling-general, bereavement, play therapy with children and adults, couples, mindfulness groups, Neuro Linguistic Programming, anxiety, depression, eating disorders, chronic pain management groups……no therapy stone was left unturned I was the CPD queen!) and when I started to think about retraining in a completely different profession I could not IMAGINE myself ever doing certain…..ahem….invasive procedures! I could not visualise myself (not matter how much I meditated!) as anything other than a counsellor; could not picture myself in a uniform doing medical type things!shocked face

Some may argue that rooting around in peoples subconscious’ for 15 years is pretty invasive but I was so confident and comfortable as a counsellor I was at that joyful stage of awareness/learning known as ‘unconscious competence’ so I didn’t even need to think when I was with clients anymore I  just was!

So, how did I get to thinking about how being a student midwife is not obscure anymore? How did my concerns about carrying out physically invasive procedures (not just vaginal examinations but palpating women’s abdomens, venepuncture, being physically present at such a life changing event etc) suddenly pop into my consciousness again? Because, as I was clipping my name badge on my uniform on Thursday night to go on a night shift just FOUR MONTHS after starting placement the thought went through my head of “off I go to work again….” in a kind of same old same old/blasé way! WHATTTTTTTT?! HOW did this happen?! Don’t get me wrong I wasn’t thinking about it in a boring way-I was excited and apprehensive but it was NORMAL! ME putting on a uniform and heading out to ‘work’ to do all kinds of things I could not even imagine myself doing in September has become…..

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This makes me wonder about how adaptable we are as human beings-is it a survival mechanism in us as social creatures that we have to create normality so we can fit in to our new surroundings? Do we/I crave normality and therefore make the abnormal/obscure fit into our frames of reference so we can feel comfortable again?

I can remember whispering to my fellow new student midwives over a pint or 2 on a ‘meet & greet’ night out before the course started “how do you feel about taking blood and doing VE’s?”; some were apprehensive like me but others were worried about other things that hadn’t crossed my mind like talking to women and holding a baby….it made me realise we all have our own hang ups but we push our boundaries, expand our comfort zone, feel the fear and do it anyway and all the other cliché’s I can think of to get us through challenging experiences! As my mentors have got to know me they’ve realised giving me a choice is not an option as I will always find an excuse to not do something I am uncomfortable with mainly for fear of hurting the woman! I tell new mentors “don’t give me a get-out clause just tell me to do it” which so far has worked well! It is likely self reflection will remain a huge part of my learning and at times, standing outside of myself and observing the student midwife stood clipping her badge on her uniform getting ready for another night shift allows me the space to remember how fortunate I am to be given the opportunity of another amazing career at this time in my life and to not take for granted any shift or any experience-whilst orange is the new black so venepuncture is the new CBT…..I may not love it but its a necessary procedure;-) Self awareness is a gift and I feel a necessity in professions such as midwifery as how can we be resilient if we aren’t self aware? I guess that is for another blog though!

Prostate Cancer Awareness Month

If you had asked me a month ago what I knew about prostate cancer, I would have said “didn’t that fictional character Adrian Mole have it?”, and then quickly add that it was mentioned in an A&P lecture- so I’m not an expert. If a patient or relative had asked me, it would have been an awkward moment for everyone. So as March is prostate cancer awareness month, maybe its time to spread the knowledge! As the most common cancer for men, its key for any budding student nurse to know their stuff.

My pathway of prostate cancer knowledge began with an afternoon shadowing a specialist Urology nurse. I sat and watched the patients come and go, lapping up the constant information that was being thrown at me.

Firstly, you have to identify the cancer through a PSA (prostate specific antigen) blood test (which should be performed regularly for men over 50!). PSA is a protein produced by cancer cells, so can help early detection. There’s loads more information about the tests available here, the same information from the leaflet I was given on placement!

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The next step is treatment. I had no idea that the usual first action to prevent the cancer from spreading is steroid injections. These prevent the production of Testosterone, which would otherwise fuel the cancerous cell growth. With this treatment, you can carry on a relatively normal life! I met a patient who was diagnosed quite young and carried on working.

The last, and most important step, is support. Cancer does change your life, so its super important to be able to talk to people in similar situations. Talking is some of the best treatment you can get. The nurse I was shadowing was a keen champion of support groups, and made sure that every patient knew where there closest one was.

So that’s your whistlestop tour of prostate cancer! For more information, Prostate Cancer UK and Macmillan are amazing and very informative.

 

 

Nutrition and Hydration Awareness

Nutrition and Hydration Week is on March 14th-20th 2016

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From their website:

—————Maintaining Nutrition and Hydration in Patients—————

Our mission is to create a global movement that will reinforce and focus, energy, activity and engagement on nutrition and hydration as an important part of quality care, experience and safety improvement in health and social care settings.

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This is truly an awareness week. Being mindful of our patients’ diet and fluid intake is crucial to their recovery whilst in hospital and keeping an eye on your patients in the community can mean you catch nutritional problems before they progress.

Take for example hydration on a hospital ward:

We all know the water jug system of three different coloured lids signifying water being changed three times a day. Which is lovely if your unit has enough of each colour lid left. But the system still leaves a great deal to be desired.

Who changes the water jugs? Is it you, maybe a healthcare support worker, maybe domestic staff? Did anyone take note of whether the patient actually drank any of the water?

Did the patient have an appropriate cup that they could grab a hold of? Could they pick up the jug to refill their own cup themselves? Could they reach the jug on their table? Do they need a straw or lidded cup so they don’t spill water everywhere?

How many times have we taken a patient’s blood pressure, noticed it is slightly low and recommended they drink some more water? If they are dehydrated, why is that the case? Are they feeling nauseous? Would they really prefer some juice or a hot drink? I know I personally prefer very cold water and struggle with room temperature water. Could you go and refill their jug with fresh cold water – would it really take that long that you can’t fit it onto your to-do list? If it would, then can you delegate to someone else?

The same goes for diet on a ward. Have you cleared away a food tray that is nearly full? Why? Are they feeling nauseous? Did they get the wrong meal? Was it cold when it finally arrived? Did they need support with eating? What are you now going to do to ensure they get something to eat because just waiting till the next meal time isn’t appropriate?

We need to ask ourselves how well we actually monitor nutrition and hydration. Are there systems in place to help us do this, or is it all left up to how well we remember to monitor it ourselves? Be honest with yourself – is it something you forget? If so, why not talk to other members of the team. Think up a way to support each other in making certain things like this don’t get lost in the hustle and bustle of every shift.

Remember to stop for a moment and empathise with the patient – then talk to them about what you can do to make it better.

I personally believe that sometimes we, as nurses/student nurses, don’t ask patients their preferences for fear that we can’t accommodate their wishes. And yes, this may be true some of the time – but we should do what we can and we won’t know what will help until we ask!

beat eating disorders

 

February 22-28 is Eating Disorder Awareness Week

 

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From their website:

———————BEAT – Beating Eating Disorders———————

We are pleased to announce that in 2016, Beat will be focussing on the topic of ‘Eating disorders in the workplace’ during Eating Disorders Awareness Week.

A really important issue, we will be highlighting why it is important that individuals affected by eating disorders are supported at work and how this can best be facilitated by employers.

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Why not consider coupling BEAT Week with Student Volunteering Week?

You might want to go to a local school and talk to students about eating disorders.

Or maybe you could arrange a food drive to donate to a local Food Bank (on Oxford Road)?

I personally think eating and dietary health is a huge concern for nurses/student nurses.

Our work schedules and long shifts can make it very difficult to eat regular, well balanced meals. Many of us resort to less healthy processed and pre-packaged foods which come with a raft of preservatives, hidden calories and poorly balanced macronutrients. That lack of balance leads to hunger and snacking and I know I make terribly unhealthy food choices when I’m hungry. Also, the last thing I want to do at the end of a 12 hour shift is cook a balanced meal from fresh ingredients before I start my next shift at 7.30am the next day!

Add to that the fact that we work in a profession that requires us to promote health and healthy eating – something that could make us feel like hypocrites when talking to patients.

I’ve stopped counting the number of diet conversations that happen every break time in the staff room. One person is going carb-free, another is doing a 5:2 fasting diet and then someone will enter and share how they were trying to diet but it all collapsed after a week.

Weight and eating healthy is something we all struggle with as a society and it brings with it challenging self-esteem and emotional struggles that can drain your energy without you realising it. Pile messages from the media on top of my already shaky body-confidence and suddenly those biscuits someone brought into the staff room look like just the answer to all my stress and anxiety.

Support each other – consider starting a drive at work to encourage everyone to bring in healthy snacks. Maybe share recipe and food preparation tips such as healthy slow-cooker recipes that can make enough for a few meals at a time.

Remember to keep in mind the fact that eating disorders cover a wide range of any concerns surrounding diet and the emotional and physical results of our choices.

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British Heart Foundation Awareness Day

Hot on the heels of World Cancer Day is the British Heart Foundation’s Wear it. Beat it. fundraising campaign on February 5th!

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From their website:

————————Get reddy to join the fun!————————

Wear red and host an event on Friday 5 February 2016, to help beat heart disease. The money you raise will support the BHF’s life saving research.

Why it matters? Heart and circulatory disease takes the lives of more than 400 people in the UK each day. So let’s get red everywhere and help raise money for the British Heart Foundation’s life saving research.

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Why not think about arranging a bake sale and get creative with some red food dye!

Or get some friends to sponsor you to dye your hair red?

Instead of raising money, maybe you want to do something to promote cardiovascular health? Try encouraging friends to join you at the gym!

Just don’t forget to remind people why you’re doing all this – heart health is so very important to our bodies and it’s definitely something we take for granted until it starts to cause us problems when we’re older.

Whatever you decide to do, have fun!