STUDENT EXPERIENCES IN THE REAL WORLD OF NURSING
to corporate tax evasion these days, why not start there? Scott Justice is a staff nurse from Edinburgh currently on a career break in Tokyo
This is a blatant move towards ‘victim blaming’ As a practice nurse working with people living with diabetes, I am acutely aware of the shortage of interventions to support people who long to change their lifestyle or behaviours. The waiting list for access to psychological therapies is long, places on rehabilitation programmes for substance misusers are like gold dust and there is a shortage of evidence-based weight loss initiatives to help people living with obesity. The suggestion that benefits should depend on a person’s willingness to engage in medical treatments is deeply insulting to all those trapped in a cycle of poor health, and is a blatant move towards ‘victim blaming’. Linda Drake is a practice nurse in south London
Cut in income is more likely to exacerbate the problem Most people living with obesity, or drug or alcohol addiction, are well aware they have an issue that needs addressing. People do have autonomy of choice, but this falls within a much wider social arena. It is too simplistic to think that a cut in income will result in a reduction in unhealthy lifestyles. It will more likely cause further problems because it will drive people to continue engaging in risky behaviours. It is an ideology doomed to fail if the government believes that unhealthy lifestyles are simply the result of individual choices. Craig Hopkins is a multiple sclerosis clinical nurse specialist at Hull and East Yorkshire Hospitals NHS Trust
Join the debate What do you think? Share your views on the Nursing Standard Facebook page
Starting out
HELPING TO MANAGE A PATIENT’S CARE UNDERLINED THE SKILLS I HAD LEARNED During an emergency care placement in my final year of training, I helped to care for a 32-year-old male who presented with epigastric pain. Routine questioning about his alcohol intake revealed he drank 168 units a week – six times the recommended level. This indicated alcohol dependency, and a diagnosis of acute pancreatitis was suspected. As a third-year student, I was given the opportunity to manage the care of the patient under supervision. Investigations and treatments required included haematology screening, ultrasound imaging, pain relief and intravenous fluid therapy. This meant the patient would have to be admitted, predisposing him to alcohol withdrawal. With the patient’s consent, I referred him to the alcohol liaison nurse. Fortunately, he was open about his alcohol use, enabling the nurse to carry out an accurate assessment. He was then started on medication to manage his alcohol withdrawal. The patient initially seemed apprehensive when informed that hospital admission was required, but he became more relaxed when referral to the specialist alcohol team was suggested; the unpleasant symptoms of withdrawal were the patient’s main concern, but the involvement of a specialist nurse seemed to reduce his anxiety. Research shows that non-compliance and discharge against medical advice is increased in male patients with a history of alcohol or substance misuse. Early referral to the alcohol liaison nurse helped prevent the patient from
self-discharging, allowing the team to treat his pancreatitis. Researchers have also highlighted how patients with alcohol-related disorders sometimes experience negative reactions from healthcare staff. Although the patient’s history of alcohol misuse did not alter my approach to his care, I did feel that some of my colleagues viewed him as a ‘time waster’. Reflecting on this experience made me aware of the communication, leadership and management skills that I have developed throughout my nursing career. By questioning the patient appropriately on his arrival to the department, I demonstrated confidence in history taking, and alcohol dependence was identified. Recognising the potential for alcohol withdrawal, I took the appropriate action by referring the patient to the alcohol liaison service. This provided comfort for the patient, prevented harm, and allowed full delivery of treatment. To enhance my knowledge in this area, I also completed the Alcohol Identification and Brief Advice e-Learning tool from Public Health England. This will support my future practice for patients with complex and co-existing alcohol-related health needs. This experience highlighted how effective patient care requires the correct attitude alongside appropriate practice. I feel that the knowledge I gained from caring for this patient will be transferable to others. Catherine Baxter is a third-year nursing student at the University of Worcester
On the web http://rcni.com/students. Send your experience, between 500 and 600 words, to [email protected]
NURSING march 11 ::other vol uses 29 no 28 :: permission. 2015 29 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 23, 2015. For personal use only. No without Copyright © 2015 RCNi Ltd. All rights reserved.
to corporate tax evasion these days, why not start there? Scott Justice is a staff nurse from Edinburgh currently on a career break in Tokyo
This is a blatant move towards ‘victim blaming’ As a practice nurse working with people living with diabetes, I am acutely aware of the shortage of interventions to support people who long to change their lifestyle or behaviours. The waiting list for access to psychological therapies is long, places on rehabilitation programmes for substance misusers are like gold dust and there is a shortage of evidence-based weight loss initiatives to help people living with obesity. The suggestion that benefits should depend on a person’s willingness to engage in medical treatments is deeply insulting to all those trapped in a cycle of poor health, and is a blatant move towards ‘victim blaming’. Linda Drake is a practice nurse in south London
Cut in income is more likely to exacerbate the problem Most people living with obesity, or drug or alcohol addiction, are well aware they have an issue that needs addressing. People do have autonomy of choice, but this falls within a much wider social arena. It is too simplistic to think that a cut in income will result in a reduction in unhealthy lifestyles. It will more likely cause further problems because it will drive people to continue engaging in risky behaviours. It is an ideology doomed to fail if the government believes that unhealthy lifestyles are simply the result of individual choices. Craig Hopkins is a multiple sclerosis clinical nurse specialist at Hull and East Yorkshire Hospitals NHS Trust
Join the debate What do you think? Share your views on the Nursing Standard Facebook page
Starting out
HELPING TO MANAGE A PATIENT’S CARE UNDERLINED THE SKILLS I HAD LEARNED During an emergency care placement in my final year of training, I helped to care for a 32-year-old male who presented with epigastric pain. Routine questioning about his alcohol intake revealed he drank 168 units a week – six times the recommended level. This indicated alcohol dependency, and a diagnosis of acute pancreatitis was suspected. As a third-year student, I was given the opportunity to manage the care of the patient under supervision. Investigations and treatments required included haematology screening, ultrasound imaging, pain relief and intravenous fluid therapy. This meant the patient would have to be admitted, predisposing him to alcohol withdrawal. With the patient’s consent, I referred him to the alcohol liaison nurse. Fortunately, he was open about his alcohol use, enabling the nurse to carry out an accurate assessment. He was then started on medication to manage his alcohol withdrawal. The patient initially seemed apprehensive when informed that hospital admission was required, but he became more relaxed when referral to the specialist alcohol team was suggested; the unpleasant symptoms of withdrawal were the patient’s main concern, but the involvement of a specialist nurse seemed to reduce his anxiety. Research shows that non-compliance and discharge against medical advice is increased in male patients with a history of alcohol or substance misuse. Early referral to the alcohol liaison nurse helped prevent the patient from
self-discharging, allowing the team to treat his pancreatitis. Researchers have also highlighted how patients with alcohol-related disorders sometimes experience negative reactions from healthcare staff. Although the patient’s history of alcohol misuse did not alter my approach to his care, I did feel that some of my colleagues viewed him as a ‘time waster’. Reflecting on this experience made me aware of the communication, leadership and management skills that I have developed throughout my nursing career. By questioning the patient appropriately on his arrival to the department, I demonstrated confidence in history taking, and alcohol dependence was identified. Recognising the potential for alcohol withdrawal, I took the appropriate action by referring the patient to the alcohol liaison service. This provided comfort for the patient, prevented harm, and allowed full delivery of treatment. To enhance my knowledge in this area, I also completed the Alcohol Identification and Brief Advice e-Learning tool from Public Health England. This will support my future practice for patients with complex and co-existing alcohol-related health needs. This experience highlighted how effective patient care requires the correct attitude alongside appropriate practice. I feel that the knowledge I gained from caring for this patient will be transferable to others. Catherine Baxter is a third-year nursing student at the University of Worcester
On the web http://rcni.com/students. Send your experience, between 500 and 600 words, to [email protected]
NURSING march 11 ::other vol uses 29 no 28 :: permission. 2015 29 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 23, 2015. For personal use only. No without Copyright © 2015 RCNi Ltd. All rights reserved.
