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MS Nurses Skills Development Workshop
This document summarizes a skills development workshop for MS nurses that aimed to help them manage challenges in their roles. The workshop covered: identifying challenges MS nurses face in consultations and managing time/admin duties; tips for effective consultations including communication skills, managing patient dependence, and ending consultations; ways to manage time including organization, delegation, and auditing services; and sources of ongoing learning, development, and support for MS nurses.
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MS Nurses Skills Development Workshop
- 1. MS NURSES SKILLS DEVELOPMENTWORKSHOP Katrina Potter Lesley Catterall UKMSSNA Committee members
- 2. Aims of thesession • 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
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- 4. What are thechallenges for MS nurses? Group exercise
- 5. What MS nursestell 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 patientsface 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 wemanage these problems?
- 8. Right patient, rightperson, right time Location – clinic or home? Joint clinics eg. continence Group/self management sessions Could someone else help?
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- 10. Things to thinkabout 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 thinkabout •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 advicegiving Summarising Reflective listening Affirmations
- 13. Managing patient Dependence How dopts contact you? Can we become “too” available? Do we create dependence? How can we reduce dependency?
- 14. How can wereduce 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 theRelationship Gaining Trust Honesty Education Dispelling Myths Appropriate Support Shared Decision Making Sometimes saying “No” Consistency
- 16. End of Consultation SharedDecision 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 webe 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
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- 20. “Organisation is likeexercise, its not very effective if you do it only once. You have to keep at it” (Jill Pollack 2011)
- 21. Tips to becomingan 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 undertookone of the first nursing audits during the Crimean War
- 23. Audit NHS England statesthat: • 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 Auditand 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 • Increasein 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 weachieve this?
- 29. Personal and Professional Development MSTrust / 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 MSSociety Regional meetings Work colleagues Line manager Clinical supervision NMC guidance
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- 33. Networking! Leave contact detailsat UKMSSNA stand and we will try and match you with someone with expertise in the area you need support in
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Editor's Notes
- #2 Introduce self and Emma Other members of UKMSSNA make yourselves known Introduce themselves name where they work community/acute, specialist centre length of time in post
- #3 Liz tips and admin Emma audit, being a specialist and support Please be interactive, we may not have the answers you may
- #8 Each service will be unique, not one answer will fit all
- #11 Length of time slot in letter Some patients you know will take longer book double slots or I put them at the end of clinic New patients have double slots Some services run sessions to discuss DMDs to a group of patients rather than seeing people on a one to one basis Be clever with your limited time HV for those unable to get to clinic, although have transport issues
- #12 Think of ways you can end your consultation in a professional and thoughtful way ‘I realise we have not addressed everything today shall we book another appointment to cover your other concerns?’ Summing up can be a useful tool Sometimes you just have to get up and open the door, standing up is helpful, closing the file, putting pen down Sometimes closed questions are good, yes/no answers
- #14 Use motivational interviewing techniques shared decision making, advise attending local course, good for goal orientated client centred care We all have patients that contact us all the time but in my experience most patients don’t contact you unless it is really important to them or you have asked them. Getting to know your case load really helps Usually patients have a unique selling point to help you remember you they are Flexible Email, phone, drop in clinics
- #15 Plus care plan so patients know when to contact you and when to contact others
- #22 I now have 1 day a month where I work form home and do all the tedious admin/paperwork projects e.g. teaching sessions, online training, write policy etc. this way when projects come in I know I have set time to complete them I work best one by completing one task at a time
- #25 Can be auditing a standard or about a problem you are facing and planning a change Great idea to audit your service before setting up the service as then will have comparison of effectiveness of the service Keep audit small and doable Ensure you complete the circle and implement change then audit the change Liaise with audit departments for support and help Utilise existing tolls, don’t reinvent the wheel
- #26 Use of GEMMS survey tool, compares your service against national MS services NICE guidelines 2014 have audit on line for you to complete to see how your service is doing against this guideline, what improvements need to be made
- #27 ?remove
- #30 UKMSSNA care manual working on competencies with MS trust Identify own gaps in knowledge may be IT skills, presentation skills, motivational interviewingetc