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PROSEN UNIT Dementia Assessment
Whitehills Health and Community Care Centre Forfar
Student Nurse Welcome/Induction Pack
Students Name 1 Mentors Name Associate/Team Mentor(s)
Introduction
The aim of this booklet is to give you, the student insight into this placement. Providing you with a flavour of the learning opportunities, and range of expertise and experience you can tap into.
We hope your placement is both an enjoyable and educationally enriching experience. We will welcome new, fresh and challenging ideas and observations.
Team Vision
2 Prosen Unit is a specialist inpatient unit providing intermediate care for people with Dementia, who for various reasons cannot live independently or in mainstream care settings. The nurses of Prosen Unit are committed to ensuring that they keep abreast of current thinking and have the knowledge and skills to provide specialist care for people with Dementia. In order to facilitate this we continually update our knowledge using current published materials such as the material published by the Dementia Services Development Centre at Stirling University. The DSDC provides carers handbooks and publications by experts working in the field of dementia care. We also use materials provided by NHS Education for Scotland and the Scottish Recovery Network in order to ensure that our practice is Recovery Focused. And follow the guidelines developed by The Scottish Intercollegiate Guidelines Network (SIGN 86) for the most effective treatments for various symptoms associated with dementia. The nursing documentation we use in Prosen is an Integrated Care Pathway, focusing on recovery orientated, person centred, multidisciplinary assessment involving service users and their guardians in all aspects of the process. We are also beginning to move healthcare records to electronic versions and address information sharing across disciplines and organisations.
In Prosen we work within the guidelines of the Mental Welfare Commission, an independent organisation working to safeguard the rights of everyone with mental illness. The Mental Welfare Commission believe that everyone with a mental illness should;- be treated with dignity and respect have the right to treatment that’s allowed by law and fully meets professional standards have the right to live free from abuse and neglect or discrimination get the care and treatment that best suits his or her needs; and be enabled to lead as fulfilling a life as possible (Mental Welfare Commission for Scotland)
We in Prosen fully endorse these principles and act upon them in all that we do. The Mental Welfare Commission is available as a resource for advice and guidance by staff, carers and patients. A representative from the commission visits Prosen Unit on an annual basis to meet with patients, carers and staff and to ensure that their principles are upheld.
3 The patients in Prosen Unit are cared for within the legal framework of mental health law. We abide by the requirements of the Adults With Incapacity Act (2000) and of the Mental Health (Care and Treatment) (Scotland) Act (2003)
In Prosen Unit, the nurses are governed by the principles of the Nursing and Midwifery Council code of professional conduct. The NMC provides standards for conduct, performance and ethics for all registered nurses and stipulates that we as nurses are personally accountable for our practice. That we must;- Make the care of people your first concern, treating them as individuals and respecting their dignity Work with others to protect and promote the health and wellbeing of those in your care, their families and carers, and the wider community Provide a high standard of practice and care at all times Be open and honest , act with integrity and uphold the reputation of your profession You must always act lawfully, whether those laws relate to your professional practice or personal life (Nursing and Midwifery Council)
We also work within the NHS Clinical Governance agenda. Striving for excellence in the fields of clinical effectiveness, risk management and fitness to practice. In Prosen Unit we are committed to focusing on patients, their needs and aspirations and to involving patients and their carers in decision-making and the provision of their care.
Local Information Prosen Unit Whitehills Health and Community Care Centre Station Road Forfar DD8 3DY Phone Number 01307 475217 Or via Ninewells Switchboard on ext. 61217
Forfar is linked to most towns locally via bus services, and there is a regular bus service from Forfar town centre to Whitehills. Local timetables are available on site.
4 Forfar is not linked to the rail network, but is situated close to the main A90 trunk road. There is an extensive car park at the front of the building. This can frequently become congested and result in parking on street.
Whitehills Health and Community Care Centre. Whitehills Health and Community Care Centre was opened in Spring 2005 as a community care centre providing older peoples’ in patient services, as well as outpatients, minor illness and injury services and a variety of social work and voluntary services. The Hospital has a small dining room, which is open to visitors and staff throughout the week, however this closes at 4pm so if you require an evening meal this should be ordered when you come on duty. Alternatively, there is provision within Prosen to store and heat food brought in for your meal break. There is a small shop run by the WRVS which stocks confectionery, magazines and newspapers and a small supply of toiletries. At weekends there are vending machines situated in the dining area. We will endeavour to provide locker facilities within the Whitehills staff changing area during your placement, but remind you to keep any valuables stored on site to a minimum.
Prosen Unit Prosen Unit is part of Older People Services, Psychiatry of Old Age In-Patient services in Angus. We are situated on the lower ground floor of Whitehills Health and Community Care Centre, which we share with Isla Unit (Medicine for the Elderly) and Clova Ward (GP led and Hospice Accommodation). Access to the ward from the main entrance is along the main corridor and down via the stairs or lift. For access to the building for an early shift please ensure that you arrange to meet with a member of ward staff, as entry is via a swipe access system at this time. For the safety of our client group, the entrance to Prosen is also secured by way of a swipe card access, we ask that all visitors ring the doorbell and can subsequently be admitted by ward staff. The Prosen Unit and NHS Tayside discourage the use of mobile phones within its premises. The Prosen Unit and NHS Tayside must comply with the Smoking Health and Social care Act (2005).
5 Overview of Prosen Unit Prosen Unit offers Dementia Assessment and Intermediate Care to the population of Angus. For people suffering with dementia the need for specialist care is sometimes required because of the complexities of their condition and behaviour and identified care needs that, at that time could not be met in any community setting including care homes. This behaviour can include; agitation, hyperactivity or sensitivity, care compliance problems, anger and frustration resulting from and in loss of control, aggression or distress. It may be that we undertake further assessment to identify possible coping strategies, which might be supported by medication regimes, behavioural strategies and social interventions. Prosen Unit is divided in to two sections Lour and Airlie. Each section has its own team of nursing staff. All Patients are allocated a named nurse, associate nurse and carer from their team. We believe that this enhances individual care, as each team can concentrate on getting to know their residents, family and significant others very well. Each team has a sitting and dining area and bedroom accommodation along their corridor. Bedrooms are single rooms with en suit washroom facilities. In this way we are able to maximise person centred, recovery focussed care. You will be allocated a mentor for the duration of your placement. You will work predominantly within one or other of the two teams, and in the same team as your mentor. In this way you will be able to quickly become familiar with the patients within this team, and become involved in planning and reviewing care for at least one of your mentor’s patients.
Staff Shifts are as follows Early Shift 7am to 2.30pm Late Shift 1.30pm to 9pm Night duty 8.45pm to 7.15 Staff breaks are generally 10am for early shift and 6pm for the late shift. During your time at the Prosen Unit you will be expected to do a mixture of late and early shifts. Ideally this will mirror your preceptors shift pattern to maximise your time on duty with them. This will involve working some weekends during your placement. Please discuss your shift allocation with your mentor prior to commencing your placement and together you can work out how best to maximise your support and accommodate your needs. You should be aware how to report any absence from duty to your University or College, but you also need to keep the ward informed, even if supernumerary. Regular attendance is
6 obviously important if you are to achieve your OAR booklet outcomes. Any special needs or requests regarding off duty should be discusses with mentor as well as any other relevant special needs.
The multidisciplinary team Our patients are all under the care of a team of Psychiatrists based at Sunnyside Royal Hospital. The Consultant who oversees care within Prosen is Dr. Susan Logie, who is generally assisted by a Specialist Registrar. Patients are also usually on the caseload of a local community case manager, affiliated to one of the Community Mental Health teams for older people. Patients may also be referred to other members of the care team and Allied Health Professionals, as required. Our day to day medical cover is provided by local General Practitioner surgeries, who attend the ward twice weekly on a regular basis and we have direct access to NHS 24 for out of hours medical cover. Our patients are continually assessed regarding their need to be in such a unit. When patients no longer need this type of specialist inpatient service, the multi-disciplinary team, along with the patient and family, will plan future care needs. During your placement you will be given the opportunity to become involved in liaison with medical staff during their visits. Your degree of involvement will depend on your stage of study. You should be given opportunity to become involved in liaison with Social Work Staff, Community Mental Health Teams, and AHPs. The nursing team consists of a Senior Charge Nurse, a Charge Nurse, Senior Staff Nurses, Staff Nurses, Enrolled Nurses, Health Care Assistants, Nursing Assistants and we also welcome Nursing Students and Angus College Students.
Practice Education Facilitators There are 9 Practice Education Facilitators (PEFs) across NHS Tayside, with responsibilities for all NHS clinical placements. Your local PEF is Nancy Galloway, (see useful websites). Their role includes supporting the Mentor, facilitating communication and improving links between the clinical areas and the HEI’s and FEI’s. They also aim to ensure that the students’ experience in the clinical placement is of the highest quality and greatest benefit.
7 The PEFs can be contacted about issues regarding the clinical placement, however we suggest you follow protocol as per your student handbook.
Prosen Unit Educational Philosophy Statement of Values In Relation to the Education of Students
Prosen unit provides a rich and varied placement experience for all levels of student nurse. We also welcome AHP and medical students who may visit the ward as part of their placement experiences. Whilst on placement within Prosen we aim to make the students’ experience rewarding and valuable to them, we have therefore compiled this statement of values which the student should expect to experience whilst with us on placement.
We encourage students to ask questions and will always try to answer them. We expect students to assist with their own learning by developing a questioning approach. We look forward to hearing their views and suggestions about how we can improve the learning experience for our students.
We will:- Treat students as individuals acknowledging their needs and encouraging their participation in formulating healthcare records.
Encourage students to feel part of the multidisciplinary team by involving them in assisting and directing healthcare professionals in providing patient care, as is appropriate to the stage in their training.
Recognise and value the contribution of all students in the process of planning and carrying out patient care and assist them to achieve and maintain knowledge and skills in order to provide safe and effective care.
Ann Morrison CN/ Rhoda Angus SCN
Date 28/11/2011
Useful Websites: -
University of Dundee; Clinical Placement Support Unit (CPPSU): [email protected] NHS Education Scotland: nes.scot.nhs.uk NMC: nmc-uk.org Literature search facility, free with Athens log on details, full articles available: www.elib.scot.nhs.uk
Local PEF; Nancy Galloway: [email protected] 01382 740074 07778 791619 Date Started………….……. Length of Placement………….……. 8 Midway Assessment: Date…..…..…….. Final Assessment: Date……….……..
Orientation Plan Specific Areas Discussed Date & Sign Introduce to Mentor Discuss Philosophy of Care Discuss Hours of Working Identify Off Duty folder (If applicable) Discuss Dress Code Identify procedures for reporting sickness/absence (community ensure that appropriate mobile phone numbers are known) Identify:- Practice Education Facilitator Link Lecturer
Orientation to Placement:- Layout Emergency Equipment Emergency telephone procedures Fire procedures Placement phone numbers Page system Introduce to staff
Identify location of local and national policies/procedures/guideline s & NMC documentation
Identify procedures for reporting accidents and near misses Orientation to Placement:- Tayside PEFs 2005
9 Assessment and the OAR Booklet
Your OAR Booklet is your responsibility, but we ask that it be made readily available for your mentor and/or staff to review when required. There are great many opportunities for you to gain the experience and practical skills towards completing the required competencies for this placement. As a student nurse you will be guided in many areas, but you will also be expected to show enthusiasm, initiative and interest. We expect to be asked questions and will endeavour to answer them appropriately. However, as an adult learner, we may nudge you in the right direction and get you to discover the answers for yourself. Throughout your time with us your mentor will provide ongoing constructive feedback as to your progress. It will also be their responsibility to carry out your midway and final assessments. This will involve their liaising with all members of the team whom you have come into contact with.
Learning Opportunities You should take time to look at these learning opportunities and tie them in with the Competencies headings in your OAR Booklet. 1. Communication Oral, telephone and written communication with relatives, nursing/care staff and the multidisciplinary team, as well as various forms of verbal and non-verbal communication with patients. You will encounter communication difficulties and barriers related to the aging process and to dementia. You will be given the opportunity to become involved in nursing handover reports and also in recording nursing observations in healthcare records. 2. Health Promotion Health promotion re lifestyle, health education, multi-disciplinary team, cultural sensitivity, developing health promotion practice. 3. Nursing assessment and care planning Utilising a systematic approach to nursing care, you will have an opportunity to become involved in assessing a patients strengths and weaknesses and formulating strategies to address issues highlighted at assessment, in line with the nursing process. Where appropriate you will be able to identify specific assessment tools and become involved in
10 selecting and modifying such tools for use with the client group. You will be involved in reporting on findings of assessment, planning interventions and goal setting. Where appropriate you will be involved in planning admission and discharge care. You will be involved in maintaining accurate and appropriate nursing records, required to prioritise, delegate and generally manage workload along with your mentor. 4. Essential Nursing Care You will be given the opportunity to observe and be closely involved with all members of the nursing team as they undertake all aspects of basic nursing care, attending to and assisting patients in aspects of daily life. You will be involved in providing; patient comfort, collaborative care with patients and family, aspects of moving and handling and administration of medication, its uses and side effects. You will be given the opportunity to observe and participate in core nursing skills, such as wound care, observation of vital signs, and illness management, as well as specialist skills in working with people with dementia and aspects of managing behaviours which challenge others. 5. Safety You will be involved in discussing how to deal with emergency situations, recognise personal limitations and environmental risk strategies, under-go patient risk assessment and risk management. You will be given the opportunity to discuss infection control issues, de-escalation and management of aggression. 6. Professional/Ethical Practice You will be given the opportunity to explore ethical issues around caring for people with Dementia, with your preceptor, as issues arise. You will be required to practice within the NMC Codes of Professional Regulation, and be given the opportunity to discuss its requirements and implications. You should have knowledge of patient rights to confidentiality, respect and dignity and be aware of your own accountability and responsibility. You will be given the opportunity to discuss the Mental Health (Care and Treatment) (Scotland) Act 2003, and to discuss the implications of caring for adults with incapacity.
11 Your Placement During your time in the Prosen Unit you should expect:
A named Mentor (and in some cases Associate or Team Mentor).
Initial discussion regarding your learning needs, outcomes and competencies.
Regular and constructive feedback on your performance including Mid-way & Final Assessment.
A supportive learning environment.
Provision of learning opportunities including clinical skills and visiting related areas. Remember to bring your OAR Booklet with you. Aims during Placement During your time within Prosen Unit you, the student, will (further) develop both clinical and managerial skills, both personal and professional. You will research relevant theory and utilise and/or explain how it can be used to enhance nursing practice, and improve patient care. Objectives A Learning Contract will be employed to document agreed objectives with a view to you achieving the competencies required from this placement.
Learning Outcomes
At the end of the placement you will have met the required competencies.
You will have demonstrated that you can effectively manage your time and prioritise your workload.
You will have had the opportunity to plan and assess care with your Mentor and other members of the team.
You will reflect on the care that you have provided during your placement.
You will have liaised and worked (if applicable) with other members of the multidisciplinary team.
You will have a clear understanding of the issues relevant to this area, what and how care is provided.
Signature of Learner:-……………………………………..
Signature of Mentor:-…………………………………….
Date:-………………………………………………………
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