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Profile of learning opportunities


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Profile of learning opportunities

  1. 1. Profile of learning opportunities
  2. 2. CONTENTS Guidance for learners and mentors. Page : 3. Medical Directorate. Page : 4. Medical wards / Day Units. Page : 5 – 8. Learning Zones. Page : 9. Key Elements. Page : 10 – 26. Who’s Who Page : 27. 2
  3. 3. GUIDENCE FOR LEARNERS AND MENTORS. This document, (POLO) has been produced to detail all the learning opportunities available in the medical directorate. The learning opportunities are fairly generic to all the medical wards, however there are specific learning opportunities unique to the individual areas. It is intended that learners and mentors work together to help the individuals, to select the appropriate opportunities to meet their specific competencies for the placement. Learners should not expect to access all of these opportunities while on the placement. However think of this POLO as a window of learning opportunities available, and select those that are relevant to them. JUNE GORDON 2005. 3
  4. 4. The Medical Directorate is……. a diverse, innovative collaborative and friendly environment to work, that embraces and encourages learning. The Medical Directorate consists of……. 10 in–patients wards covering a number of specialties. Plus the Diabetes Centre, Rheumatology day unit, Cardiac Diagnostic Services and the Procedure Investigation Unit (PIU). The Medical Directorate Structure……. Clinical Director Consultants Service Manager Personal Assistant Junior Medical Staff Clinical Leaders Assistant Service Manager 4 Modern Matrons Wards Departments Medical Secretaries Sisters & Charge Nurses 4
  5. 5. MEDICAL WARDS. WARD 1. A 19-bedded ward whose specialty is acute medicine for older people. The occupational Therapists are based on the ward. There is a purpose built activities daily living (ADL) kitchen for patient’s assessments on the ward. WARD 2. A 25-bedded ward that also specializes in acute medicine for older people. The occupational therapy facilities are shared with ward 1. The staff work closely with the older persons liaison team and the community resource team. Both these wards offer a vast and varied experience of medical problems in the older patient, such as Parkinson’s disease, Stroke, Heart failure, Diabetes and unstable blood pressure. Learners will also be given the opportunity to spend time with the individual specialist nurses. WARD 3. A 20-bedded ward that is primarily an acute Stroke unit, but also takes general medical patients, so there is the opportunity to gain a fast variety of experiences. The ward staff works closely with the stroke research team, and assist with clinical trials. The unit has close links with the community stroke team and the rehabilitation ward, 22 on the Jubilee wing. Learners are encouraged to visit and work with the Stroke Research Nurse, Occupational Therapist, (OT), Community Liaison, Secondary Prevention Nurse, (CLASPN), and the Stroke Assessment Nurse (SAN). All learners are given every opportunity to gain knowledge in all aspects of Stroke, as well as general medicine. 5
  6. 6. WARD 4. A 25-bedded ward that is primarily a respiratory unit, but also takes some general medical patients, so there is the opportunity to gain a wide range of experiences. Many of the qualified staff are trained to use the Bipap machine, this is used for patients who need none invasive ventilation. The ward staff also have some responsibility for the twice weekly pulmonary rehabilitation clinic. The unit has close links with the Respiratory nurse specialist; the Lung Cancer Nurse specialist and the Chronic Obstructive Pulmonary Disease (COPD) assisted discharge team. All learners will have the opportunity to spend time and work with the individual nurse specialists, and learn all aspects of respiratory care. WARD 5. A 26-bedded Cardiology / medical ward. The ward works with, the Coronary Care Unit, Cardiac Catheterisation lab, (CATH LAB), Heart Failure Nurses specialist, Cardiac Rehabilitation Team, Chest Pain Clinic, and the Cardiology Nurse Practitioners. Some of the staff rotate onto Coronary care and cat lab. Learners will be given the opportunity to visit the various cardiac areas, spend time and work with the individual nurse specialists, enhancing their learning opportunities in all aspects of cardiology as well as general medicine. CORONARY CARE UNIT. (CCU) An 8-bedded unit. There are a number of nurse practitioners that work alongside the team dealing with all aspects of cardiology, such as rehabilitation; thrombolysis, chest pain assessment and myocardial infarction (MI) follow up clinics. All learners will be able to spend time and work with the individual specialists. WARD 6. A 24-bedded acute medical ward, that specializes in Rheumatology and Endocrinology disorders. The ward has close links with the Physiotherapy team, Pain team and the Rheumatology nurse specialist. All learners will be able to spend time and work with the individual nurse specialists and gain knowledge in Rheumatology and Endocrinology as well as general medicine. 6
  7. 7. MEDICAL ASSESSMENT UNIT (MAU). A 24-bedded medical ward, which receives all medical admissions from accident and emergency (A&E) or direct from general practitioners (GPs). A nurse sees all patients to assess them within fifteen minutes of arrival, they are seen by a doctor in order of priority. The patients can have a length of stay on the unit of less than 24hrs. There are 4 nurse practitioners that work along side the nursing and medical teams to assist in the triage and assessment and clerking of patients. Learners will be able to gain a vast and varied experience of patients admitted with medical problems, as well as observing/assisting with a variety of procedures such as lumber punctures. WARD 16. A 21-bedded medical ward, that specializes in diabetes and endocrinology, but also takes other medical admissions. The ward also caters for accident and emergency (A&E) inpatients, such as self harm, drug overdoses, alcohol intoxication, soft tissue injuries, head injuries or falls. The ward has developed close links with the drug / alcohol and the self harm team for early intervention. Learners will be able to gain a very varied experience of medical patients, A/E patients, as well as spending time with the individual specialist nurses. WARD 17. A24-bedded ward that is primarily a hematology and gastroenterology ward but also takes general medical and oncology patients. The ward has developed close links with the Endoscopy department and the Chemotherapy day unit,(CDU). Ward 17 trained staff supports the Hematology Nurse Practitioner in running the weekly Hematology Procedure clinic held on (CDU). Learners will have the opportunity to visit these day units, and gain experience in hematology and chemotherapy The ward offers all learners the opportunity to gain a variety of experiences, and spend time and work with the individual specialist nurses. 7
  8. 8. DAY UNITS. PROCEDURE INVESTIGATION UNIT (PIU). This unit provides a service to the medical outpatients taking a lead in a number of clinical procedures such as angiography, endopscopic retrograde colangiopancreatography (ERCP), blood pressure monitoring (BP) and investigations into endocrine disorders. DIABETIC CENTRE, This department has a number of diabetic specialist nurses and research staff, who provide advice and support for inpatients, ward staff and outpatients, running a number of different clinics. RHEUMATOLOGY DAY UNIT, This day unit runs a number of clinics to provide specialist treatment for patients with rheumatology conditions. The specialist nurse runs nurse led clinics providing treatments, advice and support for patients. CARDIAC DIAGNOSTIC SERVICES. This unit is an integral part of the cardiology service providing in and out patient diagnostic services which include Electro cardio graph (ECG), ECHO, Transoephageal echo, exercise testing and has links with nuclear medicine. Learners can access all these day units from their base ward by utilizing the learning zones on the ward. 8
  10. 10. KEY ELEMENTS Anatomy, Physiology and Pathology. Clinical Nursing Skills. Communication Skills. Health Education and Promotion. Management and Managerial Issues. Management of Patient Care. Staff development. Quality Issues. 10
  11. 11. ANATOMY AND PHSIOLOGY AND PATHOLOGY. Learning Opportunity. Relevant Resource. Normal anatomy, physiology and Mentor, nursing staff, doctors, pathology. education and resource files, books, posters, x-rays. CADIOV CARDIOVASCULAR. Mentor, nursing staff, education Angina. resource files, coronary care staff, Myocardial infarction. specialist nurses, doctors, books, Heart failure, LVF. ECG technicians, pharmacy. ECG. / Pacing. In house training days. Cardiac arrhythmia’s. Cardiac arrest. Cardiomyopathy. Medication. Angiogram. Angioplasty. Coronary Artery bypass grafts. DISTURBANCES ELECTROLYTE BALANCE. Mentor, nursing staff, doctors. Normal fluid balance. Books, education resource files. Dehydration. Recording and understanding fluid balance charts. Fluid retention, / Oedema. Acidosis. Reading and understanding blood results 11
  12. 12. ENDOCRINE SYSTEM. Diabetes. Mentor, nursing staff, Doctors, Thyroid problems. education and resource files books, Pituitary problems. Diabetic nurse specialist, dietician Pancreatitis. and pharmacy. Medication. In house training days. Learning Opportunity. Re Relevant Resource GASTROINTESTINAL SYSTEM. Nausea and vomiting. Mentor, nursing staff, doctors, Diarrhoea. education and resource files books. Constipation. Nutritional nurse specialist, Haematemesis / Maleana. endoscopy staff. Dysphagia nurse Dysphagia. specialist, Macmillan and cancer Ulceration and cancers – upper specialist nurses, Dietician. and lower GI tract. MANAGEMENT OF: Nasogastric feeding. Peg feeding. Preparation for GI investigations. Post procedure care. Bowel preparation. HAEMATOLOGY. Mentor, nursing staff, doctors resource files Blood formation and bone marrow function. and books. Red cells. White cells. Blood transfusion literature, nurse Platelets. specialist, hospital and infection Collecting blood specimens. control policies. Hematology and Blood transfusion. phlebotomy staff Haemorrhage. Thrombosis. 12
  13. 13. INFECTION CAUSES. Spread. Mentor, nursing staff, doctors Infection screening. infection control team and policies, Specimen collection. as well as hospital policies. Prevention. Barrier nursing. Reverse barrier nursing. Learning Opportunity. Relevant Resource. Liver and Biliary system. Jaundice. Mentor nursing staff and doctors. Tumours. Books education resource files. Clotting disorder. Nurse specialist. Liver failure. Alcohol liver disease. Cirrhosis. ERCP. Ascitis. Hepatorenal syndrome. Hyponatraemia. Liver biopsy. Muscular System. Sub Lux shoulder. Mentor, nursing staff, resource files Shoulder protocol. and books. Physiotherapy team, Muscle tone- tightening / loss. doctors and occupational therapy Bot tox. team. Drop foot. Posture. Contractures of limbs and fingers. 13
  14. 14. Nervous System. Brain tumours. Mentor, nursing staff. C.V.A. Stroke team, and doctors. Books, T.I.A. Educational and resource files. Epilepsy. The various nurse specialists. Parkinsons. M.S. Guyllain Barrie Syndrome. Headaches. Infections. C.T. scans. M.R.I. scan. Learning Opportunity. Relevant Resource. Renal and urinary system. Acute/chronic renal failure. Urinary tract infections. Mentor, nursing staff, Urine testing. infection Specimen collection. Control team, specialist nurse. Catheter insertion / removal. Books and education resource file. Fluid balance. Respiratory System. Chest infections. Mentor, nursing staff, doctors. Aspiration. Respiratory nurse specialists team. C.O.P.D. Books and education resource file. Asthma. Pharmacy team. Drugs, inhalers, nebulisers. Lung cancer nurse specialist. Oxygen therapy. Tumours / lung cancer. Skeletal System. Rheumatoid / Osteo arthritis. Mentor, nursing staff and doctors. Infections. Books, education resource files. Osteoporosis. Nurse specialist. 14
  15. 15. CLINICAL NURSING SKILLS. Learning Opportunity. Relevant resource. Administration Of medication. Using drug / IV / S/C charts. Oral medication. Mentor, nursing staff, Pharmacy. Nasal gastric / peg medication. Education resource file, leaflets, Intravenous medication. Medical staff. Subcutaneous medication. Rectal medication. S/C and I/V Infusions. Controlled drugs. Aseptic technique. Dressings. Mentor, nursing staff, tissue Wound management. viability Catheterisation. Nurse, infection control team. Site IV/ S/C Venflons. Mentor, nursing staff, and doctors. Obtaining blood specimens. O.D. training department. Canulatio Clinical Devices. Using and checking : : : Infusion pumps. Mentor, nursing staff. Syringe drivers. O.D. training department. Space lab monitors. E.C.G. department, E.C.G machine. Resuscitation officer, cascade trainer. Crash trolley / defibrillator. Policy files. B.M. machine. 15
  16. 16. Urine testing machine. Learning Opportunity. Relevant Resource. Moving and handling. Risk assessing patient. Mentor, nursing staff, Use of equipment : Physiotherapy Hoist. Team, ergonomics department. Slings. Risk assessment and policy file. Glide sheets. Education resource file Sam hall turner Banana slide. Pat slide. Physiological observations. Blood pressure. Mentor, nursing staff. Temperature, pulse, respiration. Respiratory team. Oxygen saturation’s. Education resource files. Blood glucose. Books and leaflets. Urinalysis. Urine volumes. Weight. Maintaining accurate charts. Snobs. Neurological observations. 16
  17. 17. Preparation for investigations. Obtaining consent Information Mentor, nursing staff doctors. for each investigation. Endoscopy, ultrasound, sonar and Administering the preparation. All departments C.T. scan of head. ultrasound. Books, literature, C.T. scan chest / abdomen. Leaflets procedure and policy files. Ultrasound scan. M.R.I. scan. Endoscopy. Barium studies. Sigmoidoscopy. Colonoscopy. 17
  18. 18. Learning Opportunity. Relevant Resource. Risk assessment of a patient and The appropriate action. Falls. Mentor, nursing staff. Policy files. Mouth care. Dietician tissue viability nurse. Nutrition. Falls clinic. Risk of pressure damage. Documentation. Setting up equipment. Catheter insertion. Mentor, nursing staff, doctors. Lumbar puncture. Procedure file. Nurse specialists. C.V.P. line insertion / removal. Education resource file. Wound dressing. Fine bore feeding tube insertion. Abdominal Paracentesis. Using specialist beds and chairs. Assessing patient for bed. Mentor, nursing staff, policy Ordering beds. file Types of beds and how to use them. Tissue viability nurse. Assessing patient for type of chair. Chairs available such as, Physiotherapy team, occupational • upright therapy team. • Parker knoll • Suffolk. 18
  19. 19. COMMUNICATION SKILLS. Learning Opportunity. Relevant Resource. Verbal communication. Using the telephone. Mentor, nursing staff, ward clerk. Receiving / giving information. Switch board. Bleep system. Nurse handovers. Doctors ward rounds. Patient / relative enquiries. Patient transfers within the trust. None verbal communication. White boards. Mentor, nursing staff, ward clerk. Referral forms. M.D.T. staff. Multidisciplinary team notes. Discharge liaison nurse. Ward diary. Discharge medication sheets. Discharge letter for D/N or Nursing home. Patient transfers to other trusts. Computer Skills. Understanding confidentiality. Mentor, nursing staff, ward clerk. Access nursing documentation. IT department. Access patient information. Access patient’s results. Policy / procedure file. Use the trust internet / E-mail. Ordering equipment i.e. beds. Booking ambulances. 19
  20. 20. HEALTH EDUCATION AND PROMOTION. Learning Opportunities. Relevant Resource. Healthy lifestyle changes in relation to :- Obesity. Mentor, nursing staff, doctors. Smoking. Dietician, smoking sensation nurse. Alcoholic liver disease. Gastroenterology team, Drug / alcohol abuse. Drug and alcohol team. Bowel disorders. Heart disease. Cardiac rehab team. Diabetes. Diabetic team, dietician. Raised cholesterol. Hypertention. Stroke team, SALT, OT Stroke rehabilitation. Specialist nurse. Health education / promotion. Leaflets, health promotion Models of health. Team, library. Promotion of regular exercise. Mentor, nursing staff, dietician. Diet / healthy eating. Physiotherapy, rehab teams. Pain assessment / management. Leaflets education resource file. Doctors, pain control team. Counselling. Chapliancy, Macmillan nurses, And clinical psychologist. Drug and alcohol addiction team. 20
  21. 21. Interface between hospital and Discharge liaison nurse, CROP, Community care. ICIS, community stroke team. All the MDT. Primary care team. MANAGEMENT and MANAGEERIAL ISSUES. Learning Opportunity. Relevant Resource. Emergency situations. Cardiac arrest. Mentor, nursing staff, CCU staff, Resuscitation officer, OD training, Cascade trainers. Patient falls. Fast bleep. Procedure / policy file falls clinic. Fire. Switch board. Violent incidents. Fire officer. Security alarm systems. Security / hospital policeman. Managing a team. Mentorship / Preceptorship – Mentor, education leads. Supervision of new staff. Ward managers. Audit tools. Organisational skills. Books, research articles. Delegation. Prioritising. Time management. Leadership. Off duty / bank staff. Standards of care. Implementing change. 21
  22. 22. Resource management. Budget control. Ward manager, budget sheets. Stock control. Stores. None stock. Drugs. Pharmacy Stationary. Skill mix. Learning Opportunity. Relevant resource. Risk management. Policies and procedures. Mentor, ward manager, Moving and handling. policies Staff training updates. Procedure files, health/safety team. OD training. Ergonomics team, Moving handling facilitator. Equipment safety checks / audits. Medical devices. Electronics, health/safety team. Procedure file. Ward manager. Environment assessment / audit. Quality control. Domestic team, estates department Infection control. Ward manager. Health and safety. Infection control team. Waste disposal. Health/safety team. Policy / procedure files. Porters. Waste management. 22
  23. 23. MANAGEMENT OF PATIENT CARE. Learning Opportunities. Relevant Resource. Use of :- Nursing model. Mentor, nursing staff. Essence of care. Essence of care files. Documentation used. Policy / procedure files, intranet Standards / protocols/ policies. Care plans/ pathways. Named nurse. Assessment. What is assessed? Mentor, qualified staff. Who is assessed? Policies / procedure files. How is assessment carried out? Patients / carers, medical notes. When is assessment carried out? Education resource file. Planning. Risk assessment tools. Mentor, qualified nurses. Care plans. Specialists nurses. Care pathways, i.e. stroke, or the Research literature. dying patient. MDT involvement, i.e. physio, OT MDT team members, individual Specialists nurses community Specialist nurses and community based services. services. Discharge planning. Discharge liaison nurse. 23
  24. 24. Implementing / evaluation and documentation. Mentor, qualified nurses, Ward rounds. doctors MDT meetings. MDT team members. Patient and Care plans / document evaluate relatives. document interventions. Learning Opportunity. Relevant Resource. Patients hygiene. Mouth care. Mentor, nursing staff, Skin care. assessment Pressure area care. tools. Education resource files. Tissue viability nurse. Research. Continence. Washing / dressing. Continence adviser. Bathing. OT, physiotherapy. Nutrition. Nutritional assessment. Mentor, nursing staff, dietician. Food charts. Research articles. Supplements. Swallow assessment. Altered texture/ thickened fluids. SALT team, dysphasia trained staff on the ward, specialist nurse. 24
  25. 25. Feeding problems, i.e. positional, OT, staff. use of lap trays, straws, beakers. Nasal gastric feeding tubes and Dietician, nurse specialist. Peg tubes / insertion/ care. Procedure / policy file. Feeding regimes pumps. Communication. With patients, verbally and flash Mentor, nursing staff, SALT. cards. Relatives, verbally, leaflets and Health education staff, stroke Pamphlets. Research and stroke association. Medical staff, ward rounds. Medical staff. MDT team, meetings, white boards MDT pathway, ward clerk and Individual MDT members. Referrals to other agencies. Protocols, information file. Learning Opportunity. Relevant resource. Difficult situations : Self discharge. Mentor, qualified staff, policy Missing patient. file. Patient/staff/visitors incident/accident. Modern matron. Missing property. Security/ hospital policeman. Deceased patients. Chaplains. Religious needs. Special diets. Dietician catering staff. Mentor Access to patients own particular Nursing staff. Switch board. religious representative. Religious and cultural file. Time and place to prayer. Hospital chaplain service. Communion. Drug administration policy. Controlled drugs. Mentor, qualified nurses. Oral drugs. Policy file, pharmacy staff. Intravenous drugs. 25
  26. 26. Subcutaneous drugs Anti embolic stocking. When / why to use. Mentor, nursing staff, doctors, How to measure correctly. Research articles. How to apply. STAFF DEVELOPMENT. Learning Opportunities. Relevant r Relevant Resource. Staff development : Mentor, qualified staff. Clinical supervision. Modern matron. Reflective practice. Development programmes. Contacts. OD training department. Personal development plans. Staff development prospectus. UNN. 26
  27. 27. QUALITY ISSUES. Learning Opportunities. Relevant Resource. Quality issues. Mentor, qualified nursing staff. Policies. Modern matron / medical Procedures. directive team. Standards of practice. Research articles, library internet. Research. Research / audit departments. Clinical audits. Practice development nurses. Changing practice. Handling complaints. Clinical incident reporting ( IRI ) 27
  28. 28. Who’s Who Bright purple with white piping Modern Matron Navy with white piping Sister Burgundy with white piping Nurse Practitioner/ Specialists Navy Junior Sister Blue Staff Nurse 28
  29. 29. Lilac Auxiliary Nurse White with University logo Student Nurses White with red piping Cadet Nurses 29