Student Nurse Orientation Booklet Claire Evanson/ T Flanagan St Giles Walsall Hospice Student Orientation Booklet November 2011 Updated: November 2013
Welcome Welcome to St Giles Walsall Hospice. This booklet has been designed with the aim of supporting you through your first weeks with us and providing a framework for your induction to the unit. There are many learning opportunities for you whilst you are with us, even if you feel that palliative care is not the area you wish to pursue on qualification, the skills you learn here will stand you in good stead wherever you go. Prior to starting your placement on the ward you will be allocated 2 mentors. These will be drawn from our mentoring team of 10 staff nurses who hold the Supporting Learning & Assessment in Practice mentorship qualification and who are on the hospice s live mentorship register. We aim to ensure that informal discussion and communication of your progress on the unit is ongoing throughout your placement with us. This allows identification of any problems that may occur or any new learning opportunities identified. In addition to this there will be 3 formal meetings; an initial meeting during your first week to identify & discuss learning objectives; a mid-way, intermediate interview for discussion and reflection; and your final interview will be held during the last week of your clinical placement with us. Working in an area where our patients psychosocial needs are as important as their physical needs, it would be easy to become overly involved with our patients. It is important to remember that professional boundaries should be maintained at all times and if you feel that you are finding it difficult to cope with what can be a very emotive placement then discuss with your mentor as soon as possible and we can provide additional clinical supervision. Student Name: Mentors Names Placement start date Placement finish date St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 1
Nursing Philosophy of Unit "You matter because you are you. You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but also to live until you die." ~ Dame Cicely Saunders The hospice adopts a holistic approach to caring for our patients, which takes into account their physical, psychological, social and spiritual needs. Our patients and their families should be treated with the utmost respect. We recognise that our patients are individuals and that are treated as the person they are at the time of caring, regardless of personal history. All our care is based on these fundamental principles: of encouraging the fullness of living, hope and independence by being realistic and honest; and of recognising and respecting the uniqueness of every individual. For Your Information: The ward telephone number is 01922 602542. Our address is: St Giles Walsall Hospice Walsall Palliative Care Centre Goscote Lane Goscote Walsall WS3 1SJ (We are on the site of the old Goscote hospital.) St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 2
What is Palliative Care? Hospices care for and admit patients with a life limiting illness. Whilst the majority of our patients have cancer, we also care for those with other conditions such as end stage COPD, end stage Heart Failure, end stage Renal Failure and Motor Neurone Disease. Hospices are not hospitals; they have different aims and objectives. The aim of the hospice team is not to cure but to enhance the quality of time left whilst maintaining a high level of care. Treatments and interventions are for symptom control- the prevention & relief of suffering by means of early identification, impeccable assessment and treatment of symptoms- physical, psychological, social and spiritual. Admissions tend to fall into 3 categories: Symptom control; examples being for pain management, nausea and vomiting, opioid induced constipation, and anxiety. Respite; these patients are being well managed in the community but come into the hospice for various reasons including to give carers a break. End of life care; for those who are actively dying and have chosen the hospice as their preferred place of death. It is not just for the patient that care at end of life is provided, the needs of family are also important. As Dame Cicely Saunders, the founder of the modern hospice movement is quoted as saying: How people die remains in the memory of those who live on. Recommended reading (there are further texts available at the onsite library): Introducing Palliative Care: Robert Twycross ABC of Palliative Care: Marie Fallon, Geoffrey Hanks Government policies, papers and documents to be aware of: Cancer Reform Strategy (2007) Healthcare Commission Complaints Report (2007) NHS Next Stage Review- Darzi (2008) End of Life Care Strategy (2008) Liverpool Care Pathway Gold Standard Framework Preferred Priorities of Care White Paper on standards & norms for Palliative care in Europe (2009) Essence of Care (DOH 2010) St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 3
Who s who? Nursing Team Helen Reeves - Clinical Nurse Manager Jade Reberio - Sister Each shift you will be allocated to either the blue or green team. Whilst teams are ultimately responsible for their own patients, where necessary staff work across the ward and answer all call bells. Staff education & continuing skills training is an integral part of our unit s philosophy. As well as the formal learning offered, we also have a ground level culture of informal sharing of knowledge & skills which is extended to students who express interest. Medical Team Consists of a team of Consultants and Medical Officers Ward Team Margaret Bott & Kim Clarke - Ward Receptionists Toni Flanagan Nurse Practitioner Practice Development (based at Whittington) Sonia- Ward Pharmacist (based at Manor Hospital) Sally- Head of Cleaning Services Urban Thompson - head of kitchen Volunteers organised by Margaret Bott, roles are receptionists & ward helpers Multi-disciplinary team Physiotherapists Occupational health Complimentary therapist Chaplaincy team Day Hospice Nurses Katie Burbridge - Nurse Consultant Macmillan Nurses Pre-bereavement councillors Helen Guy, psychologist Citizen s Advice St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 4
Orientation Shift Pattern Nursing staff work 12.5 hour shifts, of which you are entitled to a complimentary 20 minute break & 2 x 30 mins unpaid breaks. Handover takes place during the first 30 minutes of each shift. Day Shift 0700-1930 Night Shift 1900-0730 There is a fridge & microwave in the staff room and, during the day, meals can be ordered from the main kitchen. There is no facility for smokers. There is an off unit changing room located upstairs in the building, however the majority of staff travel in uniform or change in ward staff toilet. There are no lockers so please do not bring valuables to work. First Day Meet mentors. Introduce staff & their roles within the unit Ward routine Checklist: Buzzer system- call bell & emergency bell Telephone system Location of resus trolley (trick question-we don t have one) Off duty & request book Sickness/ absence procedures Car parking Ordering staff meals from kitchen Mobile phones on ward Smoking Manual handling introduction Fire procedure Visitors Open visiting times. Facilities: - visitors room with tea & coffee making facilities - overnight stay room - reclining armchairs & put-up beds for relatives to stay in patient rooms Telephone calls - maintain confidentiality & an awareness of family dynamics St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 5
Geographic Layout Ward Layout Patients rooms & ensuites Visitors room Quiet Room Toilets (visitors & staff) Nursing Office Treatment Room & drug trolleys Drugs Room Sluice (x2) Ward Kitchen Staff room Smoking room (FOR PATIENTS ONLY) Patient notes current & stored Where to locate supplies & equipment Where to locate manual handling equipment Resources available to student on ward Layout of Building All Walsall palliative care services are now housed under one roof. The actual building is NHS owned and houses the Macmillan nurses, community support teams, chemotherapy suite, complimentary therapists, day hospice, and information support. There is also a library that students can access whilst on placement. Organisation Structure The hospice is run by and comes under the direction of St Giles Hospice, Whittington, Lichfield. All internal services are based there including HR, education services and salaries. Funding- we are part funded by the NHS and part funded by the public. Our fundraising department needs to raise 2.4 million each year in order to maintain services. We also rely on and value our team of volunteers who in terms of experience, life skills and personalities add to our unit. We value each contribution however great or small. St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 6
Learning Aims & Objectives These are negotiated with your mentor during your first initial interview, these are individual to you and are dependent on your stage of training, length of placement with us and interests. Here are some suggestions that you may wish to consider when planning what you would like to get out of this placement Hospice - Demonstrate a clear understanding of the basic roles & functions of hospice, debunking myths & providing a general introduction to the working of hospices. - Identify members of the hospice palliative care team & their roles - Discuss the origins, development & principles of palliative care. - Critically analyse the provision of palliative care and the respective roles of providers. - Demonstrate an understanding of the factors influencing the extension of palliative care to different groups; young adults, older people, those with malignant & nonmalignant conditions. Symptom Control - Demonstrate a broad knowledge of the existential needs of the person with a life limiting illness. - Discuss symptoms seen in terminal illness & methods of dealing with them. - Discuss aspects of analgesic ladder for pain relief in palliative care - Understanding of principles of integrated management to a range of symptomsphysical, psychosocial & spiritual - Critically evaluate the role of supportive interventions in palliative care, eg complementary therapies. - Demonstrate an understanding of practice in the control of symptoms and the provision of psychosocial & spiritual support for people with non-malignant conditions. Communication - Demonstrate an awareness of communication in difficult situations & breaking bad news, (inc body language, listening skills, emotional charged situations, positive verbal communication skills) - Discuss how effective communication improves the quality of palliative care provision. Death & bereavement - Introduction to concept that death is a part of life s journey (and not a medical failure) and to be comfortable, competent & confident regarding end of life - Critically evaluate the impact of effective ethical decision making at the end of life. - Evaluate the nature of loss and response to relating dying and death from the perspective of the ill person and carers including the bereaved. - Assess the quality of dying & critically examine the notions of a good death. - Understanding of own role and an awareness of relevance of EOLC to future roles & settings. - Critically analyse societal & professional attitudes to death & dying and how these impact on clinical practice. St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 7
Policies, Procedures & Expectations Emergency Procedure Ensure the student can recognise the features and types of clinical emergencies. Locate emergency equipment and ensure the student is familiar with all equipment. Ensure the student is aware of the appropriate actions to summon help in an emergency. Fire Policy Locate & describe the Hospice fire policy. Describe the procedure for reporting fire and evacuation. Locate fire alarms, fire exits and fire extinguishers. Policies, Protocols & Procedures Locate & discuss policies procedures and guidelines In brief: Clinical procedures based on Royal Marsden. Documentation NMC record keeping guidelines IT policy- Wifi is available for patients & relatives. Incident reporting Whistle blowing Security policies Dress code Confidentiality Acceptance of gifts Policies read Signed by student Signed by mentor Date Date Completion of orientation Signed by student Signed by mentor Date Date St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 8
Our Expectations of Our Students On time for shift In correct uniform. Motivated, enthusiastic, willing to learn & to be part of the team. Undertake role as learner in accordance with competency level. Courteous & respectful towards patients, relatives, volunteers & staff Will ask if feels need for additional support. Adheres to NMC code of conduct & conducts self in professional manner What Our Students can expect from us Welcoming environment. To be treated with courtesy & respect, and as a valued member of the multidisciplinary team. Equity of treatment & opportunity for all students. Work regularly with appropriately prepared mentors. Mentors to offer regular contact time to reflect together on practice, identify areas for development & complete assessment documentation. Flexible collaborative approach that acknowledges &, wherever possible, responds to the individual learning needs of the student. To have no more than the optimum number of students on placement on unit. Flexibility regarding off duty, as negotiated & agreed by student, mentor & unit. Respect supernumerary status whilst ensuring involved in range of care given. Learning resources, appropriate to clinical area, to be available to student whilst on placement. The opportunity to evaluate the placement, with appropriate & transparent action being taken in response to feedback. Finally You matter because you are you We hope you have a worthwhile placement with us. We recognise that palliative care can be an emotional placement and rekindle buried emotions. If you have any concerns, require support, or just want to chat, Helen is always available to talk to you in confidence and can negotiate as required with the university. St Giles Walsall Hospice - Student Orientation Booklet reviewed November 2013 9