Sunderland Royal Hospital. Welcome to. Ward B25 THE GI UNIT

Transcription

1 Sunderland Royal Hospital Welcome to Ward B25 THE GI UNIT Portfolio of Learning Opportunities Student. Mentor. Date.. 1

2 INTRODUCTION Welcome to the GI Unit The GI Unit is planned to be on C31 and will be under the combined management of the General Surgeons and the Gastroenterologists. 12 beds are allocated to these and the remainder will be allocated to the Bariatric consultants. At present the unit specialises in Bariatric Surgery and General Surgery. The ward is a mixed sex ward. At present consisting of 4 bays, with 4 beds to a bay. No side wards. This will change when we move to our allocated ward. Date as yet to be given. We receive our patients either as direct admission from home (elective), from clinic or from ESAU (Emergency Surgical Assessment Unit). The elective surgery which is undertaken on the Unit at present is as follows : Bariatric Surgery - Gastric Balloon insertion, Gastric Banding, Gastric Bypasses. General Surgery - Laparoscopic Cholecystectomy, various hernia repairs, preparations for other procedures e.g. colonoscopies. To name a few. Sunderland Royal Hospital has a restricted visiting policy. Daily visiting hours are:- 2pm-5pm 6pm-8pm 2

3 The hospital promotes protective mealtimes for all patients, which enables the patient to enjoy their meals free from interruptions and distractions. Visitors will be asked to leave at these times unless it has been agreed with the ward manager that they are aloud to stay, e.g. to assist to feed a relative. A mentor and associate mentor will be assigned to you before you start on the ward. They will guide you through your stay with us, providing support, advice and expert knowledge. They will also go through the Induction Checklist with you. There is also an evaluation form to be completed upon completion of your placement. 3

4 LEARNING OPPORTUNITIES PRACTICAL NURSING SKILLS Recording Physiological Observations Temperature Pulse Blood Pressure Oxygen saturation Blood Glucose Weight Urine output Fluid Intake Administration of Medicines Oral Medication Intravenous Medication Controlled Drugs Intra Muscular Injections Subcutaneous Injections Care of IV infusions Medical Devices Venflons Central Lines Line Surveillance Administration of Blood Blood Products Aseptic Technique Wound care Dressings Nutritional Assessment / support MUST Tool Weight NJ/NG feeding 4

5 Total Parental nutrition Moving & Handling Use of Aids, e.g. hoist, slide sheets Piling & Handling Assessment Tool Catheters Insertion of catheters Care of catheter Surveillance of catheter Mouth/ Skin/Pressure Area Care Oral Hygiene Braden Assessment Tool Pressure Care Prevention Risk Assessment Fall Risk Assessment Equipment Crash Trolley, checks Ordering of equipment from library Infection Control Hand Hygiene Aseptic Technique Infections, e.g. MRSA NG Tube Insertion of Care of Preparation for Investigations OGD Colonoscopy Sigmoidoscopy ERCP 5

6 MRCP MRI CT Scan Ultra Sound Scan Gastro graphing Barium meal Barium follow through Preparation for Theatre Pre Op Care Post Op Care Consent/Information for Investigations and Procedures Communication Use of HISS Patient Information, e.g. results Single Assessment Process (SAP) Care Plans Evaluation Patient Assessments Nursing Policies Standards Protocols Documentation Telephone manner Health Education and Promotion Managerial & Organisation Skills Prioritising Delegation Time Management Leadership Off Duty Management of a Team Policies Standards of Practice Clinical Audits Handling Complaints Resource Management Stock Control/Ordering Drug ordering Non-Stock Materials 6

7 Handling Emergency Situations Fire Cardiac Arrest Violent Incident Accident/Near Miss Patient Falls Self Discharges Religious Needs Arranging Priest Referrals to Other Agencies Medical Social Worker Occupational Health Physiotherapist Specialist Nurse, e.g. Pain Team SALT Dietician including Bariatric Dietician Macmillan Nurses Palliative Discharge Liaison Team Bed Managers Admission of Elective Patient Transferring of Patient from ESAU Discharge Planning Remember it is your responsibility to approach your mentor to arrange to observe any of these procedures. It is also your responsibility to fulfill your objectives to gain your competencies. 7

8 THE DIRECTORATE Surgical and Urology Matron Business Manager Practice Development Nurse ICP Matron Denise Simpson Michelle Ferguson Julie Porter Jackie Mains Consultants Bariatric Mr Small Mr Balupuri Mr Schroeder General Surgeons Mr Surtees Mr Corson Mr Boobis Mr Farook Mr Holtham Mr O Dair Mr Iwuchukwu There is also a Registrar, Senior House Officer and Junior House Officer assigned to each team. All have there own bleep numbers. There numbers are found on the notice board in the office which is allocated as nurses station at present. 8

9 Nursing Staff Ward manager Junior Charge Nurse Band 7 Sarah Jobling Band 6 Arun Sekhar Staff Nurses Band 5 Health Care Assistants Band 2 Specialist Nurses Band 7 Kim Common & Jane Rodger OFF DUTY/MENTOR As previously mentioned, your mentor will be allocated to you prior to commencement of your placement. Your mentor will help co-ordinate your experience during your stay, enabling you to gain the knowledge you require for your competencies. All members have been prepared for their role as a mentor and are familiar with your training requirements. Your mentor and other members of the team will help to orientate you to the ward and its layout. As a student you are welcome to visit the ward before you start your placement. All of our team are approachable and are available to give you support and advice. REMEMBER we can learn from you as well. Should you have any problems regarding your placement please speak to the ward manger or any senior members of staff as soon as possible. 9

10 OFF DUTY TIMES Early Early half Late Long day Night shift TEAM NURSING As a Unit we promote team nursing. Staff are divided into 2 teams, Team 1 and Team 2. Where possible staff keep to their allocated team, this is to encourage continuity of care for our patients. Within your team you will be allocated a patient or patients (depending which year you are in) whose care you will be responsible for, under the supervision of your mentor. An important feature of team nursing is communication between mentor and student. The student needs to inform of any problems or changes in patients which may compromise their care, so enabling the nurse to act on straight away. WARD ROUNDS All consultants have daily ward rounds. The ward has a co-ordinator allocated each shift, this team member goes on the ward round unless there is more than one ward round going at the same time. Consultants will turn up 10

11 on the ward any time from hours. There is an on call team after and on weekends and Bank Holidays there are separate bleep numbers for these, which again are found on the notice board. INFORMATION AND RESEARCH We encourage research and evidence based practice. At present organising regular teaching sessions on the Unit. We have link nurses. With which you are welcome to approach for advice. All information files are kept in the managers office. Students are welcome to read but must not be removed from the office. As previously mentioned, the aim of the unit is to be a combined G.I. Unit. Below is a brief out line of the unit. Conditions to be admitted Gastrointestinal haemorrhage a. Upper G.I bleeding b. Lower G.I bleeding Inflammatory bowel disease Gall stone pancreatitis Obstructive jaundice Patients with entero-cutaneous fistulas Patients on TPN (Not ICCU/HDU patients) Conditions NOT to be admitted Bowel obstructions 11

12 Bowel cancer (unless presenting as acute haemorrhage) Liver disease, including jaundice Non-gall stone pancreatitis ( including chronic, alcoholic and idiopathic) Admissions Admission rights All general surgeons All gastroenterologists Sources of admissions Direct Indirect Nutritional Unit It is intended to have a nutritional team attached to the unit. This will be under the delegtation of Dr Painter and Dr Hobday. They will advise on the nutritional requirements of patients within the Unit and any patients on other wards within the hospital 12

13 THE G.I. UNIT NURSING PHILOSOPHY It is the aim of the ward staff to provide a warm, friendly and clean environment in which to care for patients and relatives during their stay in hospital. On arrival you will be introduced to your named nurse who will plan, implement and evaluate care in partnership with the patient / carer. Your named nurse will also efficiently and promptly plan your discharge aided by members of the multi-disciplinary team. To treat patients with respect at all times and help maintain their privacy, dignity and individuality, taking into account any cultural or religious beliefs they may have. We strive to maintain good lines of communication, relaying information promptly to patients and their relatives. We also aim to promote and encourage self care. To promote Health Education for patients and relatives by providing help, advice and information on how to prevent illness and disease, we will play an 13

14 active role in the education of patients and relatives with regard to individual conditions. To work as part of a multi-disciplinary team promoting effective communication channels and developing good working relationships. We have an ongoing responsibility for enhancing our knowledge, skills and expertise and to share this knowledge with our colleagues and patients. The staff of The G.I. Unit play an active part in the training of the students and the development of the new staff members by providing learning opportunities and mentorship. We have a commitment to quality and monitor this alongside our nursing practice by listening to patients, carrying out audits, collating information and altering practice in line with finding new research. 14

15 Student Induction Checklist The G.I. Unit 15

16 Date Mentors Signature Students Signature Introduction & Orientation Discuss the Ward s Philosophy of Care Discuss the roles Of the MDT 16

17 Discuss the Roles of the Nursing team Orientate to Location of Emergency Equipment Explain the Bleep System The Role of the Mentor 17

18 Locations of Policies and Procedures Discuss and Ensure, student Is aware of Complaints policy Level of education e.g. Control of Infection CPR Hours of duty 18

19 Discuss cleanliness of ward Discuss learning opportunities Discuss what the G.I. Unit Is about Informal interview Including Students responsibilities 19

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21 Student Evaluation Form Were you allocated a mentor and associate mentor? Were you introduced to staff on the ward on your 1 st day?.... Were you orientated to the ward on your 1 st day? Have you worked alongside your mentor through out your placement?..... Have you gained the competencies you set out to achieve?. 21

22 ... If not, can you explain the reasons why? Have you enjoyed your stay with us? If not can you tell us why? What do we do best as a Unit for students coming into our area?... What do we do worse as a Unit for students coming into our area? 22

23 ... Were you made welcome throughout your placement? Did you gain enough learning opportunities? Is there anything we could do to improve learning opportunities?.....were you made aware of the POLO file and learning zones?... What year student are you?

24 Were you given a student pack at the commencement of your placement?.... Are there any suggestions you could give us to improve the learning for student who come to our Unit? Thank you for taking the time to complete this evaluation form. 24