Katrina Potter Lesley Catterall UKMSSNA Committee members

1. MS NURSES
SKILLS DEVELOPMENT WORKSHOP
Katrina Potter
Lesley Catterall
UKMSSNA Committee members

2. Aims of the session
• To identify the potential challenges for MS nurses
• To provide tips on managing and improving consultations
• To share ideas on managing time and admin
• To explore ways of balancing DMT monitoring and symptom
management
• To identify ways to develop and maintain your expertise
• To share sources of support

3. MS
Clinical
Specialists
Educator
Co-ordinator
Advice
Evidence based
Practice
delivery
Support
Link between
Neurologist/GP
and
People with MS

4. What are the challenges for MS
nurses?
Group exercise

5. What MS nurses tell us
Overwhelming
Pulled in to many
directions
Exhausting
DistressingToo much to
learn
Juggling
actDifficult to
manage
personalities
with MDT’s

6. Diagnosis is
not always
straight
forward
Help
patients face
fear for the
future
Deal with
the
uncertainty
of MS
New
treatments
available
No cure
Managing
side effects
and relapses
Managing
transition into
secondary
progressive MSBlood
monitoring

7. How can we manage these problems?

8. Right patient, right person, right time
Location –
clinic or
home?
Joint clinics
eg.
continence
Group/self
management
sessions
Could
someone
else help?

9. Managing consultations: the
challenges
Group exercise

10. Things to think about
Set the scene:
•Let the patient know how long you have with them
•Agenda setting - what’s their priority
•We have 5 minutes left…
•Bring a list?
•Be realistic- can you do a full assessment?
•New patients, Home care paperwork, baseline
assessments ? Double slot ? Home visit
•Separate monitoring and symptom management
appointments

11. Things to think about
•Ask specific questions.
•Stop consultation at relevant points?
•Can I just take us back to your point about …?
•Being more specific … Type of pain …Frequency …
Duration … How much of a problem?
•Feeding back to the patient - Have I understood
correctly…?
•Agreed course of action, care plan, management plan,

12. Communication skills
Communication
skills
Open
questions
Information and
advice giving
Summarising
Reflective
listening
Affirmations

13. Managing patient
Dependence
How do pts contact you?
Can we become “too” available?
Do we create dependence?
How can we reduce dependency?

14. How can we reduce
dependence?
Promoting Self Management at onset
Realistic expectations
Consider putting on phone message ‘may
not be able to return your call on the
same day’

15. Managing Expectations
Building the Relationship
Gaining Trust
Honesty
Education
Dispelling Myths
Appropriate Support
Shared Decision Making
Sometimes saying “No”
Consistency

16. End of Consultation
Shared Decision Making
Agreement
Care plan or Management Plan
MS Society (2016)-83% of people living with MS
didn’t have a care plan.

17. KEYPOINTS
• Can we be too available?
• Can we promote self
management?
• Shared Decision Making
• Prioritize appropriately
• Manage our time effectively
• Plan treatment in agreement
with patient
• Get pts to be specific
• Get them back on track
• Work within our own roles and
know when to refer on and to
whom
• End the consultation on a
positive note
• Build the relationship
• Be reflective practitioners
• Know when to ask for
help/advice
• Say “NO”
• Know which consultation slot is
most appropriate
• Balance between building trust
and not creating dependence

18. Managing the Admin

20. “Organisation is like exercise, its
not very effective if you do it only
once. You have to keep at it”
(Jill Pollack 2011)

21. Tips to becoming an organised Specialist
• Remember you cannot add hours to the day
• Set your goals
• Prioritise
• ? Benefits of multi-tasking
• Delegate where possible
• Don’t suffer from inbox congestion
• Treat phone calls like meetings
• Know yourself
• Review of your day

22. Audit
Florence Nightingale undertook one of the first
nursing audits during the Crimean War

23. Audit
NHS England states that:
• Clinical audit is a way to find out if healthcare is being provided in line with
standards and lets care providers and patients know where their service is
doing well, and where there could be improvements.
Different types of audit: - standards-based
audit - patient surveys
Liaise with audit department for support and help
Utilise existing tools, don’t reinvent the wheel

25. What to Audit and why?
• Identifies good practice and
demonstrates effective service
• Lead to service improvements
• Improve working relationships
• Patient satisfaction
• Service standards e.g.
response times
• Service against national
guidelines or standards
• MS patient admissions

27. Changing Landscape
• Increase in demand for our time
• Treatment monitoring v holistic MS care
• Reducing cost but improving quality
• Need to work smarter
• Need for expertise in other disease areas:
haematology, endocrinology, dermatology
• Increase need for knowledge of current and
emerging therapies

28. How do we achieve this?

29. Personal and Professional
Development
MS Trust / MS Society Study Days
Journals
Competencies
Pharma Sponsored courses
Neuro skills assessment course Manchester
Non medical prescribing
MS Nurse International Certification Exam
MS Pro http://www.msnursepro.org/
MS Trust map of services
Preceptorship

30. Using modern technology
• Apps for smart phones
• Twitter/Facebook/social media
• RSS feeds
• Managing social media
appropriately

31. Sources of Support
UKMSSNA
MS
Trust
MS Society
Regional
meetings
Work
colleagues
Line manager
Clinical
supervision
NMC
guidance

32. Some Useful websites
www.ukmssna.org.uk
www.mstrust.org.uk
www.mssociety.org.uk
www.nice.org.uk
www.dh.gov.uk/en/index.htm
www.msif.org/en/
www.msactivesource.co.uk/
www.atlasofms.org

33. Networking!
Leave contact details at UKMSSNA stand and
we will try and match you with someone with
expertise in the area you need support in

34. Any questions?