Uganda blog 30 January 2015 - second entry

Medication cupboard

Day 3 Paediatric Ward
 
When we arrived we were shown around the ward and were immediately struck by the extremely poor conditions the doctors and nurses were working in. Although the walls were painted in bright colourful murals the lack of resources, beds and facilities were painfully obvious to see. Drips hung from windows medication cupboards poorly stocked

Queues to see admissions were so long they spilled onto the grass outside in the blazing sun no shade to for them to escape. 

We split up and one was sent to the acute ward the other to admissions:

Jayne - Acute Ward 
I cannot put into words the sadness I feel after today. Children desperately ill with malnutrition, AIDs and malaria to name but a few. Parents shared beds with there children those not so fortunate to have a bed on mattresses on the floor. The piercing cry of many as procedures were carried out without any pain relief, will stay with me forever. Nurses stretched to the limit with no time to stop and talk to the patients. However among the sadness were glimmers of hope as children were being discharged, premature babies thriving despite the lack of resources. With a world so full of riches should innocent children really have to suffer? 

Our intrepid students

Nicola - Admissions 
Whilst I sat in the admissions department I noticed on the examination bed was a bundle of quilts and covers. I could not believe my eyes as part of the cover began to move 'is there someone under there?' I asked. Yes!! Three premature babies delivered during the night and they were perfectly content and seemed healthy being given a course of antibiotics to prevent infection. This staff were so busy and overworked yet managed so well with the resources and situation at hand. 

Next stop maternity....

Uganda blog 30 January 2015 entry 1

Day 2 Psychiatric Ward (Nicola and Jayne)

Our day in the psychiatric ward didn't turn out as expected. We spent the day with a doctor in his out patient clinic held in a small cramped room no place for safe storage of files or books. There was no list of patients who would attend nor did we know if anyone would actually attend. However there was a steady flow of patients all morning. Between the steady flow of patients the Doctor was keen and enthusiastic to know what our role as a Learning Disability Nurse entailed in the UK. He listened attentively asking many questions about conditions and medication writing down things of interest to himself. He asked many questions, from how we managed individuals with a learning disability to was there social exclusion and stigmatisation to name but a few.

The doctor's office

Based on some of the heart-rending stories we heard from people visiting the clinic, stories of abuse, exploitation and having to hide away children with learning disabilites,the Doctor confirmed that unfortunately in many cases this was true, being  the stark reality due to differences in culture of having a child with 'mental retardation' in Uganda. Families hid away their child to avoid social exclusion which was reflected in the records as in all the statistics shown to us there was only 1 recording of mental retardation. Epilepsy, bipolar and depression being the main reason for visiting the clinic. Next stop paediatrics....

Uganda blog 29 January 2015

Day 7

Sophie and Alice

Today we spent time on the surgical ward. We first went to the hospital handover where a lot of information was given about the number of patients on the various wards, their conditions and equipment such as lack of oxygen. It was refreshing to see staff nurses being open and honest about the challenges they are facing. A prayer was said before and after the meeting showing a high reliance on their faiths.

How do we describe the Surgical ward? Words cannot explain the experience, not only was this out of our comfort zone but it challenged us emotionally and physically. We were introduced to the doctor in charge and then went onto the ward which caters for female and children under 12. 

What we first noticed was the overwhelming number of people, with beds lining the walls and patients even lying on the floor with flys buzzing around them. We went on the ward round with the doctor. There were several babies and young children with horrific burns with no pain relief available because the families could not afford it and they were screaming and crying as dressings were changed. Conditions included spina bifida, road traffic accidents, breast and stomach cancer and juvenile arthritis. The nurse changing the dressings was robotic in her actions with little empathy for the children and their families. However, after spending only a few hours on this ward we can see why the nurses may need to distance themselves emotionally as there were no alternative methods and even for us to observe was distressing. 

Infection control was better than anticipated as sterile gloves were worn and sharps disposed of properly and wounds appeared clean. We were made aware that a lot of the conditions were advanced due to not accessing healthcare sooner and the cost of treatment. 

The doctor was very knowledgeable and communicated well with both the patients and us effectively. At one point during our time on this ward we became so distressed by hearing children screaming in pain - a noise that will stay with us for ever - we felt there was no alternative but to take some time outside. On returning we continued the ward round it was made apparent throughout that patients were not being treated due to lack of resources such as operations being cancelled on a daily basis and the treatment that the families could just not afford.  We felt frustrated and helpless at this. 

After leaving we felt extremely guilty because we could just walk away knowing that they had to stay. We will never forget our time on this ward. 

Uganda blog 27 January 2015 - entry 2

Alice and Sophie's first day in Mbarara university hospital

Today was out first day of clinical placement and we spent time on the psychiatric ward where they looked after children from the age of 2, with mental health problems ranging from schizophrenia, bipolar and depression. One of the biggest shocks was the fact that ADHD and epilepsy were classed as mental illness and both carried social stigmatisation. We were orientated to the ward and we saw seclusion rooms used as storage; large mixed aged dorms with no privacy and if you wanted to stay in your own room you have to pay 36,000 shillings a night which doesn't happen in the UK. There was no evidence of any locks on the doors including the nurses office and medication storage. Patients were free to walk around as they pleased. Their filing system was chaotic to say the least compared with the UK; they did have files that dated back as far as 1991; however, a nurse stated that it was hard to locate individual files based on when the client was last seen and with limited storage availability.

We got to attend an outpatient clinic with a senior psychiatrist who engaged well with patients and families and seemed knowledgable on the area of mental health and even questioned the status of epilepsy as a mental illness. We saw a range of clients and there were a lot of patients reviewing their medication, mainly antidepressants. The antipsychotics used were all first generation drugs which the UK no longer recommend due to extra-pyramidal side effects. The psychiatrist really made time for each patient regardless of time available and really seemed to want to help, however there was little regard to patient consent in regard to our presence. Confidentiality also did not seem to exist as patients were being discussed in front of other patients and professionals that we're not involved in their care.

After the out patient clinic we got to spend time on the ward, interacting with patients who seemed happy to have someone to engage with. Some of them tried to teach us the Ankole language, dancing and showing signs of respect for nurses. The patients stated they get bored as there are no ward activities except for a small television.

We observed a nurse starting a medication round with many patients sharing the same medication pot. No regard for infection control was witnessed as the nurse wore no gloves and handled the tablets. Medication charts were used and seemed similar to the UK. Some of the patients seemed happy and stated they thought they were getting better; however, some appeared to have extra-pyramidal side effects with slow movements and delayed reactions.

Overall our time on the psychiatric ward was a positive one, it opened our eyes to the fact that, although there are similarities to the UK, the Ugandan society still has some improvements to psychiatric care and the stigmatisation surrounding it. Tomorrow we will be on the surgical ward which is completely out of our comfort zone and should be interesting. 

Uganda blog 27 January 2015 - entry 1

Jayne Fleming, Nicola Froud, Sophie Park and Alice Lee are 3rd year Learning Disability Nursing students who have have elected to spend time in Uganda at Mbarara University Hospital as part of their clinical placement.

Day 6 in Uganda
Up until now we have been enjoying the magical sights and unspoiled landscapes the country had to offer. The journey to Mbarara did not go without a few hitches...delayed flights...problems boarding transfer flight...lost luggage and sickness to name but a few!

However today saw the start of our clinical placement in Mbarara hospital. Our (Nicola and Jayne) first day began on the surgical ward and opened our eyes to the sobering reality of the inequalities in healthcare. Lack of resources, beds, doctors and nurses are but a few of the challenges faced on a daily basis. The pain and suffering was on a grand scale. With no pain relief to offer, medical staff were forced to carry out procedures in overcrowded wards with no privacy while families looked on helplessly. We observed one nurse working frantically to care for the more than 30 patients on the ward; families cared for the patients while the nurse dressed wounds, cleaned burns having no time to stop and talk or comfort the patient. 

Dr Fred who kindly allowed us to follow his ward round showed a great deal of empathy with nothing too much trouble. He explained in depth the frustrations they faced with patients often left untreated unable to pay for treatment and medication. He highlighted the extraordinarily high cases of breast and stomach cancer with most being advanced and untreatable by the time they reached hospital.

Infection control - although not to UK standards - was carried out very well considering resources were so limited. Sterile gloves were used for each patient and care was taken when disposing of clinical waste. This seemed like a positive step in the right direction. Most wounds we saw were clean and free of infection with the nurse taking pride in the job she had done so well. Tomorrow's stop....the psychiatric ward.

Editorial by Mark Hayter

Professor Mark Hayter, recently appointed an Editor of the prestigious USA publication Nursing Outlook, the journal of the American Academy of Nursing, of which Mark is a Fellow, has published:

Professor Mark Hayter

Hayter M (2015) Ebola - the best and worst within nursing...and maybe us all Nursing Outlook doi: 10.1016/j.outlook.2014.11.009

Faculty colleague interviewed on local radio

Helen Sissons was interviewed on local radio on 19 January 2015 about proposals to flouridate the water supply.  Helen's views are included in the following piece:

Fluoride is already in drinking water, but adding extra could help the city's poor dental health. 

Hull City Council say they're considering the possibility of putting fluoride into Hull's drinking water to improve our dental health.

The city is one of the worst places in the country for tooth decay, especially amongst children.

Helen Sisson, a public health lecturer at Hull University, says under normal circumstances fluoride doesn't cause side effects:

"Provided the level of fluoride that's added to water is safe, you know within the recommended levels, no there aren't. And Public Health England monitorsthis every four years in areas where fluoridisation occurs." 

She says the move could spark opposition, because people can't choose to opt out of fluoridation once it's happened:

"The argument against tend to be ethical. You can't have a choice about whether or not the water in your area is fluoridated or not. Once it's happened, you will actually get fluoridated water coming out of your tap." 

But Helen says it's a cost-effective option that could reduce the strain on the health service:

"When you look at the amount that it costs for a child to be admitted under general anaesthetic to have dental work done, because of decay, that's a significant offset for the initial costs." 

In a statement, Julia Weldon, Director of Public Health, says:

"We are working alongside Public Health England, our local dentists, schools and our community dental health providers, to ensure that we make a difference to this important area of public health.

"An oral health plan will be presented to the Health and Wellbeing Board in March and this will consider fluoridation, alongside a number of other approaches including promoting good dental hygiene and the importance of a healthy diet low in sugar." 

New report calls for LD competency framework for all nursing students

The Council of Deans for Health have issued the following press release, quoting our colleague Sue Beacock:

For immediate release: 21 January 2015

 

Education experts have recommended the introduction of a competency framework to strengthen learning disability education for all nursing students, in a new report published today.

 

Based on existing good practice, Learning Disabilities - Meeting the Educational Needs of Nursing Students, co-authored by the Learning and Disabilities Nursing Academic Network(LIDNAN) and the Council of Deans of Health (CoDH) also includes recommendations forall universities who deliver nurse education to have a link lecturer for learning disabilities and involve people with learning disabilities and their carers across their programmes.

 

Sue Beacock, Senior Lecturer, Learning Disabilities at the University of Hull said: 

 

‘This report will support colleagues and policy makers to better understand current challengesand to meet the growing need for all health and social care staff to know how to work with and care for people with a learning disability.’

Professor Dame Jessica Corner, Chair of the Council of Deans of Health, said: 

‘Our members play a crucial role in educating students to work with people with learning disabilities across all health settings and this report highlights ways in which universities can ensure learning disabilities is reflected in all nursing courses. 

Although this report is focused on the fields of nursing, this is an issue for all health and social care professionals. Our hope is that this will be a first step in a wider debate about education across the professions’.

 

 

-ENDS-

 

RCN Older People’s forum and BGS joint conference

Making integrated care a reality

This inaugural joint conference celebrates how older people’s experiences of services can be improved through multi-professional, multi-agency collaboration. It builds on the success of previous conferences hosted by the RCN and BGS to share experiences of how working together can make integrated care a reality.

Themes for the conference include:
• care closer to home
• partnership in care for people with dementia
• frailty
• developing older people’s nursing.

Monday 30 – Tuesday 31 March 2015

Renaissance Manchester Hotel, Blackfriars Street, Manchester M3 2EQ

Day 1
2pm registration
2.45pm conference begins
5pm conference closes
5–6pm welcome reception and exhibition viewing

Day 2
8.45am registration
9.30am conference begins
4.30pm conference closes

Online booking is now available.

Prestigious studentship award

Henning Holle,  Department of Psychology, and Fiona Cowdell have been successful in our application for a prestigious British Skin Foundation PhD studentship. 

Henning Holle

Fiona Cowdell

Julie Santy-Tomlison - PhD

The Faculty is happy to announce that Julie Santy-Tomlison has completed all the requirements of her PhD entitled:

Julie Santy-Tomlinson

An Exploration of the Patient’s Experiences of the symptoms of Pin Site Infection and Irritation during External Fixation