Inspirational by Eddie Docherty

As the new Nursing, Midwifery and Allied Health Professions Executive Director I’ve now been in post since February 1st. As I write this blog almost exactly 4 months since starting, Id like to use this opportunity to introduce myself to as many staff as possible, and share some of my initial thoughts.

Prior to starting in NHS Dumfries and Galloway I’d worked in a number of health boards. Initially working in NHS Lanarkshire, in critical care and advanced practice, I moved to NHS Ayrshire and Arran in 2007, initially as nurse consultant for the acutely unwell adult, moving on to senior nurse consultant then associate nurse director. During this period I also worked in NHS Orkney as associate nurse director for 8 months, learning about the challenges and rewards of working in a remote and rural setting. For the year prior to commencing in D&G I worked as the lead nurse for East Ayrshire Integrated Joint Board and Associate Nurse Director for Primary care and Community Nursing. I’ve been incredibly lucky in my career, supported and developed by truly inspirational staff throughout the years, and have maintained roles which have allowed for direct patient contact through most of my time in nursing. Working with patients and staff has always been a key priority for me- its why I started nursing.

This link to inspirational staff continues as I’ve moved to NHS Dumfries and Galloway. At the last Twitter conversation held by the Chief Nursing Officer, Professor Fiona McQueen, one of the questions posed was: – What are you most proud of in your current role? I didn’t hesitate in my answer. I spoke of the compassion I see and hear about everyday from the staff in NHS D&G. The value of compassion is clearly embedded throughout our teams, from the Board to the staff directly delivering care to our patients. The key attitude of compassion in our delivery of care is reflected in the shared behaviours and attitudes I’ve seen in the last 4 months and is the springboard for the excellence in care we all strive for. Of course we aren’t perfect, but on the whole, compassion is being displayed. What I would ask everyone is this- are we compassionate to each other? Are you compassionate to yourself? The organisation is in a period of unprecedented change as we join an integrated world and build a new hospital. D&G couldn’t do just one major change at a time! The financial challenge is more acute than ever as we try to do the same, or even more, with less. If we are not compassionate towards ourselves and each other we may find ourselves overwhelmed and begin to lose touch with the reasons we all came into health care? Something to think about.

We often speak of our challenges, but clearly this period brings significant opportunities. I believe that each team hold the answers to most problems within their areas. The ability to adapt and innovate, to find solutions to complex problems, lie within the gift of all of our teams. If empowerment of staff is to truly have meaning then the staff have to feel empowered to enact change. The application of quality improvement methodology and an understanding of the theories of profound knowledge are the survival tools of the 21st century health care team. I have spoken to staff around our areas about the need for innovation and commonly say “The answer is in the room” It usually is. Someone within the area has the exact answer to the problem. If all staff members can see that improvement is something they do rather than have done to them, combined with the skills and understanding of the science of improvement, we can absolutely change the landscape we all work in.

Speaking to senior nursing, midwifery and AHP staff I have been incredibly impressed with the projects and ideas being developed, and in many areas there is great work being done in one key area: patient experience and satisfaction. For many years patient experience and satisfaction have been placed in the ‘nice to do’ category of work. As we move forward it is clear that the patient experiences of our systems are key to understanding how effective we are. There are many great local examples of this, from such areas as mental health, critical care, occupational therapy and medicine, but we haven’t yet shown our ability to do this at scale and share our learning across the entire organisation. I’m confident we will, following the discussions I’ve had with various teams, but it’s not something we can do without anymore. We look at, and report on, complaints as they come in and use them to look at individual areas of improvement, however, working in Scotland, we don’t spend any time looking at compliments and positive feedback. If we can capture the learning points from the good and bad episodes of the patient experience we can gain a better understanding of the impact we have in a balanced way.

I feel honoured to be Executive Director for Nursing, Midwifery and Allied Health Professions within NHS Dumfries and Galloway. Everywhere I look I see staff members that are committed to the care and well being of their patients and who place the person at the heart of everything they do. We have challenges and opportunities ahead of us and I’m absolutely convinced we can shape the future of our services together to meet the needs of our patients and improve the health of our communities.

Eddie Docherty is Director of Nursing at NHS Dumfries and Galloway

 

Stressed about Stress by Amanda Taka

Stress is one of those words that has become intrinsic in our everyday vocabulary: we’ve all heard ourselves moaning “I’m so stressed!” What is it and how can we manage it?

Stress is defined in different ways by different organisations, but the common thread seems to be that stress is “feeling under pressure”. A small amount of stress is good for us: it keeps us motivated and helps us to do our best. However, when we are living with stress all the time, it can lead to a myriad of unpleasant feelings and physical symptoms can follow.

A Taka 1

Often we are quick to identify stress in others, but would we recognise it in ourselves? Symptoms associated with stress are wide ranging and initially we might not associate the physical symptoms as related to our mental wellbeing. There has been a tradition to separate mental and physical health, but evidence shows the link is greater than we previously may have understood. The jury is still out as to whether stress itself causes disease, but there’s lots of evidence to show that the unhealthy habits we rely on when we’re stressed contribute to many conditions.

Physical symptoms can include:

  • Sleep problems
  • Dizziness
  • Chest pain, palpitations
  • Dry mouth, lump in the throat, shaky hands
  • Lack of appetite, or conversely, comfort eating
  • Repetitive tic
  • Headaches
  • Diarrhoea or constipation
  • Loss of libido
  • Tearfulness/depression/anxiety
  • Worsening symptoms of long term conditions

Additionally:

  • Poor concentration
  • Difficulty making decisions
  • Irritability
  • A feeling that things are hanging over you
  • Excessive intake of caffeine, cigarettes or alcohol
  • Low self esteem/lack of confidence

This list is not exhaustive!

A Taka 2

What causes stress?

Here’s the tricky bit. We’re all different, so we all have different triggers. For example, one nurse would struggle to cope with the incessant physical and emotional demands of working in the Emergency Department, whereas that environment is perfect for a different nurse.

Acknowledged triggers of stress are as follows:

  • Work pressures, job instability, fear of redundancy
  • Parenting, family and relationship difficulties
  • Financial pressures
  • Bullying and discrimination
  • Loneliness and isolation
  • Living with a long term condition
  • Caring responsibilities

And one more for us workaholics:

  • Taking on too much responsibility and feeling you don’t have enough time to do everything!

OK, so it looks like life itself is stressful.

If you’re feeling like stress is starting to impact on the quality of your life then the first thing would be to get it down on paper. Spotting stress in its early stages can help prevent things from getting worse. Things to include in your “stress diary”:

  • Date, time and place of the incident
  • What you were doing, before, during and after
  • Who you were with
  • What were your feelings, before, during and after
  • Any physical sensations
  • Give the event a “stress rating” e.g 0 = no stress, 10 = the most stressed you could possibly feel.

Making a stress diary is helpful because it aids our ability to make connections between the context and the symptoms. Ideally, a stress diary should be continued for at least 2 weeks. This helps us to see things in perspective. Additionally, this is a vital piece of evidence to discuss with your GP if you’re feeling overwhelmed and unable to cope.

A Taka 3

Quick Fix

When I searched ‘wellbeing’ in Amazon at the beginning of the year, I was astounded at the number of different products that claim to enhance one’s wellbeing: necklaces, crystals and orthotic sandals sat alongside the list of ‘new age’ literature that was available. I’m not sure it’s something that can be bought. There’s certainly no single ‘cure all’ solution. Therefore it’s worth trying, or combining, a number of different approaches until you succeed. Most research shows the following are a good place to start:

  • Physical activity – doesn’t need to be a gym membership, incorporating 30 minutes of activity can help boost mood and clear the mind (remember it can be in blocks of 10 minutes)

 

 

  • Relaxation techniques such as mindfulness and breathing exercises are evidence based ways of reducing stress. Courses are available across the region, check the local press or http://www.uws.ac.uk/wellnessandrecoverycollege for details.

Nursing is acknowledged to be a stressful profession. In our profession, we tend to put everyone before ourselves, but who looks after the caring professions? I passionately believe that we need to give ourselves the time and effort to look after our own mental wellbeing, and being aware of our stress levels is intrinsic to this.

Further self help resources to try:

  • Living Life telephone self help service and online programme for people with mild to moderate feelings of anxiety and depression using Cognitive Based Therapy. See http://www.llttf.com/ for more info

 

  • Breathing space – confidential helpline that describes itself as a ‘first stop’ service which aims to listen and provide emotional support. http://breathingspace.scot

 

 

  • Steps to Deal with Stress – you may have noticed the little square booklets floating around NHS D&G, pick one up, they have great common sense tips to help with stress busting. More info at http://www.stepsforstress.org/

A last word

If you or someone you know is struggling and self help techniques haven’t worked, you may need to seek expert help. For some people a combination of medication, talking therapy alongside some of the techniques outlined above are appropriate. Also, it’s worth remembering that the Samaritans have changed their number to 116 123. Further helplines can be found at http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/mental-health-helplines.aspx

And remember… “taking on too many commitments” may lead to feelings of stress!

Amanda Taka is a Keep Well Nurse at NHS Dumfries and Galloway

Thank you to Ward 18 and DGRI by Kevin Irving

Dear Mr Ace,

I am writing to you to express my sincere gratitude and thanks to the staff in Ward 18 (Elderly Care) of the Dumfries and Galloway Royal Infirmary. Whilst I was visiting the UK my Mother took critically ill and was admitted to the hospital where she received excellent care from the doctors and staff on this particular ward. I spent nearly 4 to 5 hours a day in the hospital for over 15 days attending my mother’s bedside and could observe the highest quality of care. Having worked in health and safety in my career as a mining engineer, at the most senior executive level, for over 35 years I can honestly comment that the leadership and team work on Ward 18 was some of the best I have seen and is a credit to the staff.

The doctors on the ward, from the lead consultant caring for my mother to the rest of the team, showed enormous care and compassion to my mother’s needs and requests. My mother made what I think we all would agree was a remarkable recovery. During the difficult time of when my mother was very ill the doctors ensured that both my sister and I were well informed and we were able to have very open and honest discussions regarding my mother’s care. They also showed compassion towards my sister and my own feelings through what was a very stressful period.

Ward 18

I would like to give special thanks to Snr Charge Nurse Janice Cluckie who demonstrates incredible leadership to her staff and also discussed my mother’s needs with empathy and thoughtfulness. It was clear to see that she took time to see that all patients on her ward were well cared for. Janice is certainly a role model that your organisation should be proud of.

I have nothing but praise for the ward staff who showed consideration and care for all the patients. From a visitors point of view I saw total dedication to their duty for the well-being of their patients with humbleness and sincere kind heartedness.

Whilst spending time in the area I had the opportunity to look around the premises and surf the internet about the hospital. I see from your Board papers and Inspectors reports that you have some areas for improvement. I can only say from my observations that you certainly appear to be on a positive trend. I noted in your most recent Board papers that complaints about the hospital service are on the increase. I would recommend making a KPI of some of the positive comments you may be receiving, such as this letter, as they may show another side of the story or use information from the website www.patientopinion.org.uk or NHS Choices website.

As an aside I used the dining room daily at lunch times and the food served was of good healthy quality, a good price and presented by excellent welcoming staff. I feel the NHS food is sometimes often viewed negatively. I can only say that Dumfries and Galloway seem to be improving this aspect of patient and staff care.

I would be very grateful if you could ensure that the leadership team of Dumfries and Galloway Royal Infirmary give some recognition and positive feedback on my behalf to the doctors and staff on Ward 18.

With many thanks, yours sincerely

Kevin Irving

Kevin, who lives in Australia, added a handwritten post script which read “Wishing you all a Merry Christmas and a Happy New Year from the sunny side of Down Under.”

Sometimes you can’t see the wood for the trees… by Laura White

In September 2015 when my team and I were at the glittering Excellence in Care Awards ceremony at Easterbrook Hall after being nominated for not one, but two awards, I found myself pondering what it took for us to get from our lowest low to our highest high…

In early 2014 the Healthcare Environment Inspectorate walked into ICU unannounced and unearthed a catalogue of issues that turned our world upside down. In an instant our team went from a well-oiled machine to a rusty old tractor not knowing how to function.

The title of the blog sums up what we thought, as an organisation none of us could see what the Healthcare Inspectorate saw, we were in fact too close, too involved. For all our nursing care was never in question, we still doubted our abilities as nurses and wondered whether we were failing at the job we worked so hard at and got so much satisfaction from. The shame and embarrassment of having our place of work discussed in the newspapers and throughout the hospital, whilst trying to ‘keep it together’ still caring for critically ill patients and their families, was an overwhelmingly stressful time for all of us. The whole time we seemed to only have one question for each other…”How did this happen?” We put all our time and effort in to caring for our patients, did it matter that there wasn’t a record of the shelves being wiped down? Yes it did.

Laura 1

We listened to feedback, sought advice and did extensive research around the way we did things. We really dug deep and relearned our roles to include a vast new array of cleaning and infection control measures. It took months of liaising with the Infection Control Team, Domestic Services, Medics, Management, and Estates to name a few. There was clarification sought for EVERYTHING, from everyday things like bed bathing a patient to the fear of the effects of excessive Actichlor on our health.

The transition period between the inspection and the refurbishment of ICU put strain on everyone involved, however during this time it became apparent how well we pulled together, worked as a team and were committed to putting the broken pieces back together in order to be the best we could be. Staff came in to help in their own time, worked extra shifts and there was actually a lot of excitement about working in the newly refurbished unit, it was like a blank canvas. Don’t get me wrong, it wasn’t all plain sailing, the months following the inspection included periods of extremely low staff morale, increased sickness absence and an emotionally fragile workforce who at times found it difficult to talk about what happened to us. We eventually found that discussing the experience with colleagues and other professionals did help to rid us of some of the mixed emotions we were struggling with. Thankfully there did come a time when we realised we had to stop looking back and start looking forward and take the good from a bad situation.

We slowly began to regain confidence in ourselves and became very proud of our ‘new’ unit. During this time it became clear just how many of us had ‘a touch of OCD’! There were times when you could probably have eaten your dinner off the floor in ICU, and we just stopped short of putting Actichlor in our cereal! We now work relentlessly keeping our very extensive cleaning schedule up to date and everyone is involved in adhering to our philosophy of cleanliness, God help anyone who tries to put their gloves and aprons in a domestic stream waste bin! We really are acutely aware of everything now.

We knew that changing habits would be the hardest part but also that these changes had to be sustainable and over time these changes have become the new norm for us. These are the changes which are now the norm to the new staff that have joined us since the inspection and will undoubtedly evolve and develop in the future, as everything does in nursing.  The HEI inspectors have since returned to the unit and saw a drastic improvement in all aspects of cleanliness, which we knew they would.

Laura 2

Winning the Excellence in Care award for Infection Prevention in a way closed the chapter on the hard times we faced in 2014 and reinforced to us how we took the best from it and got to where we are today. We are dedicated, committed and knowledgeable in Infection Prevention and have regained the confidence we lost when our unit was put under the microscope.

As the saying goes “what doesn’t kill you makes you stronger”.

Laura White is the Senior Charge Nurse for ICU and Surgical HDU at DGRI

 

Let’s Get Physical by Amanda Taka

With the festive season looming towards us, the last thing you want to be told is to get physical right? However with 8 weeks to Christmas, we still have plenty of time before we carve the turkey. The Physical Activity Guidelines for adults recommend that we build up to 30 minutes of moderate intensity activity 5 days out of 7. But how do we fit this in to our busy working lives? And is it worth the effort?

We’ve all heard of the benefits of exercising, but here’s a recap:

Regular exercise:

  • reduces the risk of many diseases such as type 2 diabetes, coronary heart disease and stroke
  • helps us to maintain a healthy weight
  • improves our self esteem
  • promotes a sense of wellbeing
  • reduces symptoms of depression and anxiety

Working in the NHS we can’t fail to be reminded of what we should be doing and why. However, being ready, willing and able to make those lifestyle changes can be another matter.

Amanda 1And before you write me off as one of those typical fitness fanatics, let me tell you a bit of my story. At school I was always the last to be picked for team games, I didn’t learn to swim until I was 16 because I was frightened to put my head under water, I hated PE and used to hide in the Geography block toilets to avoid detection. My Mum and Dad told me to stay as I was because playing squash and golf gave you a heart attack. My Dad’s motto was ‘built for comfort not for speed’. They were both overweight and although I wasn’t, I always knew I would be too because that’s what happened to us in our family. And so it would have gone on if I hadn’t returned to Uni and trained to be a nurse.

Anyone who has trained to be a nurse knows that it changes you. It changes the way you look at people, the way to speak to people and the way you react to people. Furthermore, it challenges hard held beliefs and preconceptions. Studying at UWS under the influence of Julie Orr and her colleagues, I began to see that getting older doesn’t need to mean that we inevitably get bigger and slower. I realised that the ability to change was within me and additionally I had the power to influence my young daughters’ long term health.

This Eureka moment happened to me in the middle of one lecture towards the end of my training. Julie was telling us about when she was doing her Masters and how she fitted it into family life “and I still went to the gym three times a week” was the phrase that hit home for me. Like a bolt of lightning I realised that I needed to make physical activity a priority for me. I started to take up yoga again – something that I hadn’t done regularly since I’d had my children. Slowly I began to build physical activity into my day, feeling very smug about it too thank-you very much.

After qualifying, I got a job on a fast paced 22 bedded respiratory ward. Working full time was enough to achieve my 30 minutes a day. Life doesn’t stay static though, and I moved to a 6 bedded Coronary Care Unit. My daily steps dropped, my waistband started to feel a bit tighter and I put half a stone on. I realised that I had to change tactics. I began to walk into town on my days off, I got myself a Fitbit and tried to do 10,000 steps a day, challenging nurses on other wards inspired my competitive streak. Obviously when you put physical activity first, other things slide. I won’t be winning any Good Housekeeping awards imminently and I don’t have time to watch TV. But as I see it, the benefits outweigh the costs.

Then earlier this year I left Coronary Care and moved to the Keep Well project here in Dumfries and Galloway. Keep Well is an anticipatory person-centred service that aims to reduce health inequalities. Part of this role involves delivering brief interventions for physical activity. I started to see that the guidelines weren’t going to be achievable for everyone – like the 64 year old lady who had to use a wheelchair because of her COPD. In that case, the message is do what you can, keep doing it and try and build on what you can do. Most of my clients with long term conditions are very aware of their limitations and they know better than I do, what is achievable for them.

Amanda 2Changing from a shift based work life to a ‘normal’ 8.30 to 4.30 job required further readjustment to my physical activity routine. Covering the whole of D&G has found me spending large amounts of time in the car. But the advantage is that I now have my weekends free and I make sure I do something active with my children. But I was struggling to do something on week days. So I started a 90 day Yoga challenge – 30 minutes of aerobic yoga for 90 days. The only time of the day I could fit this in was before everyone else got up. I found that I was so used to getting up at 5am to go to Carlisle that doing yoga at 6.30am was achievable for me. In all honesty, I haven’t made it onto my yoga mat every single day because sometimes life gets in the way, but I didn’t beat myself up because I knew that tomorrow was another day.

Now I realise that getting up at 6am to exercise isn’t going to work for everyone. So, I suppose the main message I’m trying to share is

  • Find an activity that you enjoy
  • Small changes really make the difference if you do them often enough
  • Give yourself permission to exercise – no one else can do it for you
  • Don’t give up if you miss a few days/weeks/months. Life gets busy and big events sometimes engulf us.
  • Set a SMART goal, running the London marathon next April is not appropriate for everyone. Parking the car as far away from the office 3 days a week could be more achievable.

As the largest occupational group in Scotland, we nurses are in an incredible position to reach a huge number of people. If we start with ourselves, this will ripple out to our families, our communities and ultimately to the Scottish population.

Lesley Fightmaster Yoga Fix 90 – 90 day to build a healthy habit https://www.youtube.com/watch?v=ArZDT5zXSR0

Amanda Taka is a Keep Well Nurse based in Public Health, Crichton Royal Hospital and a Coronary Care Nurse with North Cumbria University Hospitals NHS Trust.

Amanda 3

To the World you Might be One Person, but to One Person You Might be the World by @FionaCMcQueen

Over the years, I’ve heard about truly exquisite experiences people have had when they’ve experienced good nursing. Whether it’s been supporting someone to a peaceful death, holding a frightened hand before an operation, or supporting a young person through difficulties, there’s no doubt that good nursing is recognised when you see it. So why don’t we see it all the time? Should we see it all the time? From my perspective- absolutely; excellence in care from every nurse, for every patient, every time. ‘But Fiona, I hear people think, that’s just not possible, you just don’t understand………’

Fiona 1If the profession believes that it’s not possible to deliver excellence in care all of the time, then we will never do it. I’m not saying it’s easy, but I honestly believe it can be done. But we can’t do it alone. When thinking about what gets in the way of that excellence, it could be any one from a long list; not enough staff, staff not appropriately trained, pharmacy not available, doctor not available, equipment not available, staff too busy…….. the list could be endless. But what of the above is impossible to change? What of the above is an acceptable reason for poor care? I would argue none. At times we can be too understanding of the pressures we face when trying to deliver care. It really is a whole system issue, and one that the Scottish Government and NHS Boards are working to improve.

Fiona 2We’ve seen huge leaps and bounds in patient safety with the Scottish Patient Safety Programme, significant increases in the number of nurses employed by Boards when they apply the nursing workforce tools, significant numbers of extra student nurses, and a strategic focus on staff health and wellbeing thorough the national programme, Everyone Matters. So what’s stopping us?

From a national perspective, it’s clear that Boards are under considerable strain; financial pressures are making balancing the budget more essential than ever before. The changing demography is beginning to bite. Whilst the recession has perhaps delayed some of the workforce challenges that we are bound to meet with the reduction in working age population, vacancies across NHS Scotland and the Care Home sector are increasing and becoming more difficult to fill. Our older population, whilst in many ways are a real asset to our communities – you only have to look at what they deliver in providing care as carers or as volunteers in our local communities – are also being admitted for care in much larger numbers.

So what is to be done; in Boards like Dumfries and Galloway who have a relatively small population, spread out over many square kilometres, it can be a real challenge. But with challenge often comes opportunities. The many areas of outstanding practice that come out of D&G are testament to that. Whether it’s in responding to patient needs from a person centred care perspective or creating innovative solutions to responding to local needs – you only have to look and it’s there. Most of us like to cling on to what we know, but if we look at the health service since its inception, although many aspects are very similar, many aspects of service delivery have changed hugely and we wouldn’t want to go back. The list is endless; infusion pumps to keep people pain free and support a peaceful death, stroke care where people who would have been grossly disabled can literally walk out of hospital within a matter of days, the improved treatment of MIs in specialist areas have transformed the way we now treat coronary heart disease. And of course nursing becoming an all graduate profession is continuing to contribute to improved outcomes for our patients.

Fiona 3So if we are to truly protect our public services and make sure we continue to maintain local services we must embrace change, whilst holding on to what we hold dear; providing truly person centred compassionate care to everybody we care for. Because, although our care may seem routine to us, we never know when that one person we are caring for is at the end of their tether and we are truly the world to them.

I’m confident that we can really have a world class health service but only if we anchor ourselves in what’s important to people, and are creative and bold in our solutions for finding sustainable locally based services.

Fiona 4

Fiona McQueen is the Chief Nursing Officer for Scotland

Flexible Visiting – Who is really the visitor? by @KeriVannuil

As a staff nurse in ward 12 acute stroke/ respiratory, my day is governed by time- medication rounds, breakfast time, personal care, observations etc the list can be endless. There is one time of the day that can strike fear into the hearts of many medical professionals and that is VISITING time!

Why is it seen as such an inconvenience on our day?

Why do we feel we don’t have sufficient time to spend with the patients and their loved ones giving accurate information about their current treatment plan?

And why do we feel we won’t be able to get on with the other tasks requiring our attention if the visitors are present?

Last year a member of my family was admitted to DGRI and this is when I became a visitor for the first time. At the time the trust was operating an open visiting policy from 2pm to 8pm. As a nurse I thought that was ample time for anyone to fit a visit in to their loved one. However I soon discovered that if I was on a late shift from 1.30pm until 9.30pm I was not going to be able to spend as time with my relative as I would like.

How do people on shifts fit everything in? Surely there is a friendlier approach to visiting?

Following the recent person centred care collaborative I have been thinking a lot about DGRI’s previous trial of “open visiting”. Having listened to experiences of other colleagues within NHS Scotland I was embarrassed to say we do not have open visiting.

During a trial of open visiting the wards were open from 11am which meant we did not have an influx of visitors at 2pm which was usually our busiest time. The early visiting also meant we could catch up with relatives and discuss care plans and discharge planning.   Since having our new open visiting times we have unfortunately gone back to the influx at 2pm.

As a ward we are very good with palliative/ dementia patients at saying visitors can come any time if it’s what they want or need. But this surely must happen for every patient every time by every nurse to be truly person centred?

In our area we did a 3 month pilot of flexible visiting. The aim of the pilot was to allow patients to have their visitors come in at a time of their choosing and allowed the visitors to come at a time which fitted in with them, even to just say a quick “Hello” before or after work. 

Goal-All patients should be able to see their loved ones/ visitors at any time of their choosing.

The aim of this trial is to assess the impact of unrestricted visiting on the following areas of patient experience

                                   – Patient Centred Care

                                   – Reduction in complaints

                                   – Patient experience

                                   – Staff experience.

                                   – enhanced access to MDT

                                  – enhances professional behaviours.

                                   – Creates a transparent working environment

 Keri 1

 

I know that many people will have their reservations about this trial but I would hope those people would put themselves in that patient or family member’s position. As members of a profession that work shifts we should also be able to understand the need for flexibility for each patient and their loved ones.

Getting the information right for patients and staff is crucial to the success of this trial and if the information uses a common sense approach I would hope this will give staff the confidence to get on board, take ownership and make this a success for everyone involved.

As a nursing team we decided to begin the trial on the 1st of November 2014 until the 5th of January 2015.

Keri 2The most challenging aspect of the flexible visiting was actually the amount of time it took explaining it to the patients and visitors. As this was a small scale trail the only information available was the posters and booklets produced by our team.

 

The flexible visiting was very well received by patients, visitors and staff.

Staff commented that it reduced the influx of visitors at 2 pm and meant the staff could then spend more time updating relatives and answering any questions they had throughout the day.

During the trial there was no incidence of confrontation when relatives were asked to step out while personal care was carried out or when privacy was required by the doctors.

After the trail a discussion was held with staff regarding their experience and also patients and relatives. It was felt flexible visiting did not have any detrimental effect on the daily running of the ward and it enhanced patient and relative experience. It also reduced the workload at peak times on nurses as they were able to speak to visitors throughout the day

As a team we made the decision to make flexible visiting standard practice within ward 12. I would encourage all wards to approach this with an open mind and give it a try. With the new build in a few years it will be even more important to be flexible with visiting.

As a medical team we are just with the patient a relatively short time so I guess it’s really us that are visiting.

 Keri 5

Keri 4Keri Van-Nuil is a Staff Nurse on Ward 12 and a Capacity Manager at Dumfries and Galloway Royal Infirmary