Ask, Listen & Do by Lindsay Sim and Jennifer Cranmer

Carers Support within

Dumfries & Galloway Royal Infirmary

There are three 8 hour shifts in every day, when you’ve finished yours, Carers still have another 2 to do – or at least be on call for!

Who is looking after your patient once they leave your clinic or are discharged from your ward? Most of these people are going home to continued care from a family member. In some circumstances, the Carer is thrown in to a completely new situation, for example a husband discharged home from hospital after a stroke, a wifes cancer diagnosis or a young person going home to his parents after a serious car crash. Many issues are thrown into the pot –– ‘we live in a second floor flat’ – ‘how are we going to manage financially’? – ‘one of us will need to give up work and care for him’ and the list goes on. As we all settle into our new wards, departments and offices within the new build – ask yourself how you have coped with the change. You may have found the change exciting or even difficult to deal with but one thing remains the same for all of us………we all knew it was coming and had the time to prepare ourselves – unlike a Carer whose life can be changed forever after a chat with a Nurse or Consultant or a phone call from the Police.

A Project such as ours is designed to meet the needs of Carers who require up to date information, advice and support in order to continue to carry on caring in good health, fully informed and knowing where to go when the road gets a little bumpier and that we are there to support them throughout their whole caring journey.

As Carers Support Coordinators we ASK the Carer what matters to them, LISTEN to what matters to them and try our best to DO what matters to them. In order to carry this out we need referrals for Carers from hospital workers. Supporting Carers within the hospital should start from the cared for’s admission – a referral at discharge can mean vital support is missed during the hospital stay. ‘We define a Carer as anyone who provides support to a member of their family or a friend who is affected by a long term illness, disability, age related condition or addiction who couldn’t otherwise manage without their help’.

As all illnesses and disabilities are different, the Carers that are providing the care are different too. They can be young, middle aged or elderly, working as well as caring, retired and caring and all have their own story to tell which in some cases can affect their ability to care for a person. They can be husbands, wives, a daughter, a son, a grandchild, Mothers, Fathers, Aunts and Uncles and all have to juggle their lives whilst fitting in a caring role that they never anticipated. Every caring role is different, no two Carers are the same and no two caring situations are the same. It is everyone’s responsibility to recognise Carers – please do not assume that someone else has already referred them to our Project, we would rather receive two referrals than none at all.

The issues we are presented with as Carers Support Coordinators may seem unimportant to some, but to a Carer they are vitally important. Here are a few scenarios’ that come to us during a typical day………….

• An NHS staff member, Mr White approached us whose daughter with special needs required extra support during her morning routine. He asked us how he should go about asking his line manager for flexibility at work in order to meet both his and his daughter’s needs. We gave him Carers in employment information and offered support at any meetings with his line manager or HR should they arise. We referred to Community Social Work and registered Mr White as a Carer with our Carers Centre service. He then accessed an Adult Carers Support Plan which identified how he was coping with is caring role for his daughter and the areas in which he needed support with.

 

• Mr Brown was signposted to us from a nurse in a ward as his son was having difficulties due to housing issues because of his paralysis and wheelchair use. His grandson was also identified as a Young Carer and referred to our Young Carers Project. We identified funding for travel to and from hospital for him to bring his grandson to visit his Father as he did not drive. We referred on to the Advocacy Service, FIAT, Capability Scotland and liaised with his son’s Community Social Worker. Mr Brown continues to be supported in the community by a Carers Support Worker and has had an Adult Carer Support Plan carried out.

 

• Mr Green is already registered with the Carers Centre as a Carer for his wife, he got in touch because he had asked a ward staff member to contact the Spiritual Lead – Dawn Allan and this had not been done. Mr Green was understandably anxious as he had been diagnosed with a terminal illness and being a minister himself he wanted to speak with a likeminded person. We got in touch with Dawn and Mr Green was delighted to have spent some time with her as was Dawn.

 

• Spent an hour with a male Carer whose wife had been diagnosed 2 years previously with a brain tumour and was nearing the end of her life. He appreciated having someone to ‘vent’ to and said that someone taking the time to listen to him was worth its weight in gold.

 

• We went up to a ward to visit a registered Carer with our service who has been in hospital for most of the year and back and forward to Edinburgh for further treatment. The Carer lives some distance from DGRI and doesn’t have many visitors. His wife has mental health problems and his community Carers Support Worker has been checking that she is ok so that we can relay this information back to the Carer and alleviate any worries that he may have about being away from her for so long.

 

• A member of NHS staff emailed us to ask what benefits they would be entitled to should they give up work to care for their elderly Father. They were finding the working/caring role too demanding and felt that something had to give. They registered with our service and we referred them to the FIAT team to discuss their financial situation further. The NHS member of staff gave up work but prior to this applied for a short break away through our ‘Time to Live’ fund as they hadn’t had a break from caring for over 3 years.

 

• Senior member of NHS staff approached us to ask what support someone they line manage could receive from our service if they registered with us. They were worried about their staff member coping with such a heavy caring role and they had noticed how tired and withdrawn they had become. The staff member agreed to a referral to us and now there is support from community care services going into her family members house hold which has alleviated a huge amount of stress and guilt from the staff member and her work performance has risen due to feeling more supported from her Manager and the Carers Centre.

 

• A Carer came to us in distress due to their elderly Mother not accepting support upon discharge. We liaised with staff on the ward to support them in discussions with the family and advised around other local support which can be accessed. The staff were appreciative of our input in a difficult situation and the Carer continued to receive support from the Carers Centre after her Mothers discharge home.

We are happy to be invited to attend huddles or MDT meetings. This has proven beneficial in the past in identifying Carer referrals. The Communications Team has/ will be sent out our newest referral form, please save this to your desk top computers and if any of the above sound familiar to you or you come across someone who you feel would benefit from accessing our service; you can refer them to us.

For further information, please visit our Carers Centre website here

Please like  our Facebook page here

Find our referral form here please save it to your desk top for future use.

 

Lindsay

 

 

 

 

 

 

 

Jennifer

 

 

 

 

 

 

 

 

Lindsay Sim & Jennifer Cranmer

 

Carers Support Coordinators

Hospital Carers Support Project

Support & Advice Centre

(behind ‘Cashiers Office’ in main atrium)

t: 01387 241384

#33384

e: dgcarers@nhs.net

 

Tuesday & Wednesday 11am-4pm

Thursday 4pm-8pm

Friday 9am-3pm

 

 

 

 

 

 

 

 

 

 

What effect is porn having on your service users? by Laura Gibson

Blogs are usually written from the perspective of an individual voicing their views, experience or message. However, for today’s blog that approach isn’t really appropriate. Instead, with the purpose of igniting thinking and conversations around a contentious topic, the following has been drafted by a small group of multi-agency staff with subject knowledge…

 Dumfries and Galloway’s Sexual Health Awareness Week 2018

Let’s Talk About Sex – Pornography

22^nd – 28^th January 2018

Each year Dumfries and Galloway’s Sexual Health Awareness Week aims to encourage discussion about Sexual Health and Wellbeing with a particular focus on an emerging theme or issue of interest to the public and partner organisations.

Due to the advances of the internet and mobile technology, pornography (the display of nudity or sexual activity intended for sexual arousal) has never been so accessible. There is an emerging body of evidence around the effects of pornography on a variety of health and wellbeing outcomes. The aim of this year’s Sexual Health Awareness Week is to encourage discussions about the effects of pornography on health and wellbeing. Seven key themes (one for each day of the campaign) are identified and links to further reading are included for anyone who wishes to find out more.

We ask that you share this information, along with the other resources available here, with your colleagues, patients/service users and friends to facilitate discussions around the effects of pornography.

You can also tell us your thoughts by completing our short survey or attending our FREE roundtable event on Thursday 25^th January 2018, 2pm-4pm at the Garroch Training Centre near Dumfries. Email dgsexualhealth@nhs.net if you’d like to book a place.

1. Porn and relationships

A report by Relate and Relationships Scotland found that almost half (47%) of relationship counsellors and therapists report seeing an increasing number of clients where pornography is causing a problem in their relationship.

The same survey found that some people viewed watching pornography alone without your partner as being unfaithful and posed the theory that increasingly unrealistic expectations fuelled by portrayals of sex in pornography might be leading to dissatisfaction with sexual relationships. Experts recently claimed that pornography is blamed for up to 70% of rocky marriages (up from 10% in the 90s).

2. Learning about sex through porn

Many people say that they use pornography to learn about sexual relationships. But pornography isn’t reality – the relationships portrayed in porn blur the lines between fantasy and reality. This results in many people thinking that sexual relationships should be conducted in the way they are in porn films.

Young people want to learn about pornography through sex and relationships education at school, and 87% of parents also want lessons to address porn. However, pornography is not currently covered in many schools. Building the knowledge, skills and confidence of school staff to deliver effective Relationships, Sexual Health and Parenthood Education is a priority locally, and this includes encouraging discussions about pornography at an appropriate stage.

3. Porn and violence

Violence is commonplace in porn. Research on best-selling pornographic videos where 302 scenes were analysed showed that 88% of them had physical aggression (e.g. spanking, gagging, slapping) and in 48% of these name-calling took place. The aggressors were mainly men and the people who suffered the violence were female, usually portrayed to enjoy or accept this violence.

Research has also shown that women who experience domestic abuse are at more risk of sexual violence if their abusive husbands use pornography. Pornography is also part of the commercial sexual exploitation industry and is linked to the trafficking of women and girls for sexual exploitation; so sometimes the women who appear in porn videos are not just “actresses”.

4. Porn and body image

In porn films, men have large penises, minimal body hair and toned bodies. Women have little or no body hair, large, pert breasts, are pretty and tanned. This often results in viewers feeling that the people they are watching are normal, which in turn impacts on their own body image. You can find out more here about women’s and men’s bodies in pornography.

5. Porn and the brain

Pornography use can have a similar effect on the brain to some substances including drugs. Studies have shown that porn stimulates the same areas of the brain as addictive drugs, making the brain release the same chemicals. As a result people can get trapped into a vicious circle where the brain is hijacked by porn.

Many neurological studies show evidence that the brain changes from internet pornography use. Scans have shown that even moderate use can cause grey matter to shrink in key areas needed for thinking and learning.

6. Revenge porn

So called ‘Revenge Porn’ refers to the uploading of sexually explicit material to humiliate or intimidate a partner who has broken off a relationship (Citron & Franks 2014). The Abusive Behaviour and Sexual Harm (Scotland) Act 2016 came into force in Scotland 3^rd July 2017 and provides guidance on the issues and implications if found guilty of sharing photographs and films without consent. There have been two recent campaigns around revenge porn, one in Scotland ‘Not yours to share’  and one in England & Wales ‘Be Aware Before You Share’. Both campaigns have information and resources suitable for use with clients/service users.

7. Young people and porn

Every day children and young people are accessing mainstream pornography on the internet, including the most hardcore, violent and abusive images. The average age of first accessing pornography (accidently or deliberately) is 11 years and 1 in 3 children have viewed sexualised images online before the age of 10. The single largest group of internet pornography consumers is children aged 12-17.

Evidence clearly shows pornography has a detrimental impact on children and young people including premature sexualisation, negative body image and unhealthy notions about relationships which include a tendency to view women as objects and the acceptance of aggressive attitudes and behaviours as the norm.

For further information and support around the impacts of pornography, please click on the links above or visit www.womenssupportproject.co.uk/content/pornography/206,172/ .

 Author:

Laura Gibson (on behalf of a multi-agency planning group)

Health and Wellbeing Specialist

DG Health and Wellbeing

Directorate of Public Health

NHS Dumfries & Galloway

 

January 2018

 

 

Cant Thank Everyone Enough

You don’t have to look very far these days to realise that the NHS is under significant pressure; the local bulletins, national news and local papers are all talking about ‘Winter Pressures’ and ‘Flu Outbreaks.’ This, along with staff shortages and capacity issues, would make many of us dread going in to hospital or having a loved one admitted however I recently had to witness my husband spend the festive period in the new DGRI and I was so impressed by his, and my, care that I wanted to write about it.

On the 19th of December my husband was referred up to X-Ray for a CXR. This rapidly became a CT scan and then direct admission to the Combined Assessment Unit. This itself was a massive shock for all of us and a very scary time. However the staff in X-ray were amazing and made a frightening experience a tiny bit more acceptable by their kindness and attention. Thank you to all of them.

When we arrived on CAU it was obvious that it was a very busy place. For the staff to be working under this pressure in a new environment beggars belief but they did so with equanimity and charm. The care my husband got was excellent and I wish to thank Moira and all the other nurses who were fantastic as well as the Health Care Support Workers (many cups of tea which were never too much bother) and also Drs Ali and Oates. Dr Oates your visit on Christmas Day meant a great deal to us.

After CAU we moved up to Ward B2 and the outstanding care continued. I came in at 8.30am and left at 9pm and having a single room and open visiting meant I was able to stay with my Husband at all times which meant so much to us especially during this time of uncertainty. We could cry in private and talk in a way we could never have in a 4 bedded bay. Once again the staff were amazing – all the staff nurses, HCSWs and Domestics got used to seeing me around and, despite being extremely busy over Christmas and New Year, catered to our needs. They brought blankets and cups of tea – the small things which can mean so much – without us having to ask, in fact they were so busy we would not have asked for anything. Dr Gysin listened to our moans with patience and kindness and ensured that my husband got home as soon as possible, just after New Year.

We have just started a journey which will now mean trips to Edinburgh for more tests and possible treatment. This was always going to be a hard time but the caring and compassion we experienced whilst in DGRI over the festive period has made it that little more bearable.

Thank you

Love Wins by Euan McLeod

Having returned to clinical practice after a number of years away from the NHS (not saying what number) but nonetheless a significant period I attended the corporate inductions week to prepare me for my role in the organisation.

I had thought that much would have changed but although there were a lot of things different it seemed to me that the very essence of what we did as nurses, and indeed as anyone, employed in the NHS had not changed significantly in that we were all part of an organisation there to provide help and support to those in their time of need,

One thing that had developed was the formation of a set of values. The NHS Dumfries and Galloway CORE values

You may recall that the workshop to develop the CORE values was in response to the publication of the Francis enquiry into the Mid Staffs hospital, and that the aim like most health boards up and down the country was to try and create something that would help deliver higher standards of care and stop situations like Mid Staffs happening again.

What was it that went wrong? Did they not love (care/respect) the people they were looking after? Did nobody love their work enough to want to do things well? Were peoples regard for each other such that they became indifferent to their needs?

Love may apply to various kinds of regard towards other people or objects, and this aspect seemed to reflect what had happened at Mid Staffs, a lack of respect or due regard for the people entrusted to their care.

Love – it’s not a word we use often in healthcare but perhaps it’s central and underpins a lot of the other words or values we use to describe how we should be or act in the pursuit of caring for others.  In that sense I wanted to think about that word LOVE and what it might mean in the context of our main activity as deliverers of healthcare.

The title sat in my notes and in my mind for some weeks, I read the board paper on the development of the CORE values and wondered if it might mention love anywhere. Lots of care, compassion, empathy respect, dignity, etc in the body of the document, and hey right at the back in the summary of responses on positive experiences / feelings, there it was the word LOVE-maybe only 1 person had mentioned it but there it was.

Now all this talk of love may be getting some of you kinda twitched as if this was all some soppy, half baked romantic drivel, the kinda thing that people don’t talk openly about, but think just for a moment about how often you might use the word in the context of things, objects and places and not people

What do you mean when you say oh I just love going on holiday to France, Spain, The Bahamas etc or I just love Jaguar cars, or some designer shoes or handbags.

If someone asked you if you loved your job what would you say-Do you love making a difference to people’s lives?

I don’t think anyone would say no to that

I looked up the Francis report and here’s what it said was the MAIN message

The Francis report is a powerful reminder that we need a renewed focus on hearing and understanding what patients are saying Ruth Thorlby, Senior Fellow, Nuffield Trust

From <https://www.nuffieldtrust.org.uk/resource/the-francis-public-inquiry-report-a-response>

Hearing and understanding what patients say -no problem there then easy and straightforward

The importance of that hearing and understanding aspect was highlighted in the recently published kings fund report

https://www.kingsfund.org.uk/sites/default/files/2017-11/Embedding-culture-QI-Kings-Fund-November-2017.pdf

“Finally, participants noted that a focus on improving patient outcomes and experience was a way to further engage staff in improvement activities:

You have to build that coalition of people who want to make a difference and who want to change and at the centre of it all keep the focus absolutely on patients and never have a conversation that doesn’t involve a patient, because if you do you’re in the wrong place because that’s the only currency, the language, that staff understand. (NHS provider chief executive)”

How can we firstly HEAR what patients say and secondly how can we UNDERSTAND what they are telling us.

Into my in box comes an email from Gaping Void- Everbody’s a patient because evervbody’s a person

Here’s a link if you want to check further https://www.gapingvoid.com/

Gaping void exist to develop the use of culture and art in healthcare settings and the topic that caught my eye was entitled “Everybody’s a patient because everybody’s a person”

There are two underlying truths in patient care:

All patients are, foremost, humans, and one day, we will all be patients.

When designing healthcare experiences, from waiting rooms to waiting times, we have to remember that we’re building for humans — people in pain, people grieving, and people suffering who need to feel loved.

We have to create the experiences that we, as patients, would want to go through. Because, one day, we will.

From <http://mailchi.mp/gapingvoid/we-are-all-patients>

If we are able to love people we care for and hold them in a position of high regard then we will be able to hear what they say and perhaps understand, in turn Love may win over the tensions, frustrations and myriad difficulties that are part of delivering health care  and we can be part of creating experiences that are for  people knowing that perhaps one day we may be the patient

Euan McLeod is a Mental Health Staff Nurse for NHS Dumfries and Galloway