Anaphylaxis learning module and guidance for registered nurses in health and social care

All registered nurses in health and social care can now access anaphylaxis training via a landing page on Turas Learn. This is not specific to care homes but for use across NHS and social care.  If staff are not already registered they can use the link below. This is an elearning module provided by NHS Grampian and can be used as an educational resource and will provide a print off completion certificate. This is not a competency certificate therefore current local arrangements would apply, as with any training. Hopefully this will assist staff training in advance of the commencement of the flu season however if staff have already undertaken the relevant training then there is no need to complete this module.

To register for a Turas Learn account in order to be able to access the NES resources including the anaphylaxis please click on .

Please see below for more information on this module.


Anaphylaxis: Learning module and guidance for Registered Nurses in health and care settings  

  • By undertaking this module, you agree to read and consolidate the information below, which highlights important considerations in the context of your work place. 
  • NHS Grampian have kindly shared open access to this resource, developed to enhance staff knowledge in responding to acute needs when a person develops anaphylaxis.  

Learning Aim: 

Recognition and treatment of anaphylaxis is required to ensure that people receive a high standard of care from trained and competent practitioners, in line with legal and professional requirements. 

Learning Outcomes:  

  • Define the term anaphylaxis; 
  • Identify triggers that could cause an anaphylactic reaction; 
  • Describe the signs and symptoms of an anaphylactic reaction; 
  • Describe the management of a patient with an anaphylactic reaction; 
  • State the dose and route of adrenaline (epinephrine) to be administered to an adult; 
  • Know how and where to gain safe and appropriate access to  Adrenaline.

Successful completion of this learning module indicates you have met the learning objectives.  It supports increasing your knowledge regarding how to deal with an anaphylactic reaction in an adult.  You may wish to discuss the associated learning outcomes alongside any local, relevant issues with your peers.   

This resource should be viewed in tandem with local policy in the facility within which you are based and in conjunction with standard guidance for managing a deteriorating person/ cardiac arrest.   

Links at the base of this page can guide you to supplementary resources. 

In this context, it is important that a registered nurse in any health and care setting 

  • Always functions within their scope of professional practice
  • Can respond effectively in a potential emergency, following local protocol to manage an emergency situation
  • Is current with recommendations for access to and administration of emergency medication such as adrenaline within the facility they are based
  • Knows where and how to access such medication 

This eLearning module was developed by NHS Grampian, in accordance with guidance from the Resuscitation Council UK.  It refers to NHS Grampian regarding access to medication (Adrenaline) and administration in an emergency situation. Any such references should be replaced by  local policy in your care facility. 

Useful learning resources: 

  1. Resuscitation Council UK: Emergency Treatment of Anaphylactic Reactions   https://www.resus.org.uk/sites/default/files/2020-06/EmergencyTreatmentOfAnaphylacticReactionsPPT.pdf 
  2. Recognising a deteriorating person; guidance regarding how to respond when an adult deteriorates can be found at the following link
    https://learn.nes.nhs.scot/28267/coronavirus-covid-19/assessment-and-care-of-people-with-covid-19  

Return to practice programmes

Return to practice programmes – Things have now got easier.

We recognise that staff leave the register for a number of reasons and often later regret this. If you are thinking about returning to nursing practice then consider returning to work within social care nursing on a paid placement? The programme is provided by Glasgow Caledonian University (GCU) and The Robert Gordon University (RGU).

Take advantage of the Gov. supported initiative perhaps for some #lifechangingwork in a care home.

For more info check out

https://nes.scot.nhs.uk/education-and-training/by- discipline/nursing-and-midwifery/careers-and-recruitment/return-to-practice.aspx 

https://learn.sssc.uk.com/careers/

Funded places available – Graduate Diploma in Integrated Community Nursing

There are 200 funded places available in this year’s intake of the new 2-year part-time work-based Graduate Diploma in Integrated Community Nursing (GDipICN) which is designed for nurses working at level 5 of the Career Framework for Health (Agenda for Change Band 5 equivalent).

NES has commissioned two universities to deliver the programme; Queen Margaret University (east and north regions) commencing in September 2020 and the University of the West of Scotland (west region) commencing October 2020.   See Appendix 1 for NHS Boards associated with each region.

It is expected approximately 150 places will be allocated to nurses from district nursing teams, 50 places to nurses from care home and prison healthcare settings and 40 places to nurses working in general practice.

More information about the programme is available at:

 https://nes.scot.nhs.uk/education-and-training/by-discipline/nursing-and-midwifery/careers-and-recruitment/transforming-nmahp-roles/graduate-diploma-integrated-community-nursing.aspx

Below is a letter from Jane Harris, the Head of Programme detailing more information on funding. There is also a spreadsheet for providers to complete with details of all individual nurses who require funding.

Completed spreadsheets must be returned to [email protected]  by 24th July 2020.

Mental Health Week – 18 -24 May

This week is Mental Health week and its important we recognise that fact that the times we are living in is having significant impact on people of all ages.

The theme this year is kindness .

Below are some links that you may find helpful resource to support you , friends , work colleagues and family to remain positive during these challenging times.

https://www.bbc.co.uk/newsround/52557800

https://www.time-to-change.org.uk/get-involved/get-your-workplace-involved/resources/mental-health-calendar

https://www.mentalhealth.org.uk/campaigns/mental-health-awareness-week

https://www.itv.com/news/meridian/2020-05-18/mental-health-awareness-week-looking-after-you/

International Nurses Week (6 – 12 May)

You may be aware next week  commencing from the 6th– 12th May, marks ‘International Nurses Week’

As the theme for this year is compassion, I would like to request the use of good news stories from individual care homes to highlight the excellent work being provided by our nurses and teams as a whole. We require a short vlog on a story you feel highlights compassion shown by your staff. We will require enough stories for the 7 days, and I have requested a student story also to raise their experience of being placed in a care home during these challenging times alongside others.

‘International Nurses Day’ lies on Tuesday 12th May, and  I am aware many of you will already have started your own preparations to celebrate. As we are no longer able to hold the Nurses Celebration day we had planned can I ask if you would support this as Take a T break day , with T referring to Thank you as well as Team and Timeout to recognise the amazing work of our nurses, carers and everyone within the sector.

We will be in touch to provide more detailing on how we would like you all to get involved in the 12th to make this a day to celebrate our staff within care homes deserve and ensure this is highlighted and cascaded across social media etc.

If you would like to take part and share your stories or vlogs with us for this celebration week, please send them along to [email protected] by close of play on Monday 5th May.

Can I apologise for the short notice and ask for your active participation in this to make this happen.

Thank you

Jacqui Neil

Transforming Workforce Lead

 

New nursing blog – ‘With change comes new beginnings’

With Change Comes New Beginnings…

As the National Transforming Workforce Lead For Nursing my aspiration for 2020 was looking forward to a year of celebrating nursing, in this ‘The International Year of the Nurse and Midwife.’ Nursing was finally being given a platform to showcase the profession, as nurses in the main are not known for blowing their own trumpets -being a nurse is simply what they do. However, we find ourselves celebrating the invaluable work nurses have done, and continue to do, as a direct result of the new reality we are living in.

Historically nurse leadership has been core to ensuring progress, quality care and recognition for nursing achievements and this was highlighted in my March nursing blog around inspirational leaders, which is hard believe was only last month.

Over recent years the nursing profession has however shown signs of erosion, with a decline in nurse applicants across the country, particularly in the school leaver age group and an increase in experienced staff leaving in advance of their retirement date, and in some sectors leaving in advance of the early retirement date. There was recognition that both the NHS and social care sector were facing increasing pressures on services, compounded by a significant number of vacancies across medical, nursing and allied health professionals and social care staff, resulting in critical concerns around recruitment, retention and sustainability.  The reduction in university applications in nurse training in some rural areas had also resulted to some degree of sustainability issues for pre and post registration education.

There was therefore a concerted effort and desire to transform roles to manage our changing demographics. The formation of Health and Social Care Partnerships (HSCP) ideally were to address this and support our frontline workforce. Transformational programmes were being adopted across all sectors to ensure the future sustainability of the workforce, from changes to nurse education to primary and secondary care restructures. Working across different professions and sectors to achieve this had resulted in slow progress for true integration, as there was limited alignment of budgets, competing agendas and a significant lack of understanding of the pressures staff were under, which has led to demotivation and low morale, with staff leaving as a result of this.

Burnout had reached an all-time high. This was highlighted within a number of reports and surveys since the inception of integration in 2015. According to the Royal College of Nursing (RCN) Employment Survey in 2019, pressures have increased year on year. A high majority of nurses were feeling continuously under pressure, with ninety per cent saying that they frequently worked through their breaks and sixty-three per cent saying that they were too busy to provide the level of care they would like.  Most concerning was that seventy-nine per cent of nursing staff felt that staffing levels at their place of work were insufficient to meet patient needs and seventy-seven per cent felt that patient care was compromised throughout the month due to short-staffing. Nurses had become fearful of losing their registrations and in light of this the Nursing and Midwifery Council (NMC) had finally recognised the need for a support phone line to prevent further distress and mental health issues within nurses.

The year started in a state of crisis, however there was also a real sense of hope and positivity  that we could improve the global recruitment and retention of frontline staff under the light of the International Year of the Nurse and Midwife .We had a prime opportunity to show the public, alongside existing and future staff the good work being done in our NHS hospitals,  but as importantly our communities, especially our care homes, who were providing quality care in a homely setting to an increasing number of people with significant health issues. These were physical and psychological, with dementia and frailty now being the key reasons for admission.

Little consideration had previously been given to social care nursing, often thought of as the Cinderella Service, with nurses and carers often viewed as less academically qualified, lacking leadership skills and not providing specialist care. There is no doubt nurses who work within the sector have high levels of compassion and empathy but alongside this have high levels of leadership, autonomy and expertise, and possess professional academic achievements which would challenge any specialism. Despite the desire not to promote care homes as clinical areas, this has no reflection on the quality of clinical care provided within a holistic ethos.

Then came something that would test everything, a coronavirus pandemic.

The last 6 weeks have without question witnessed the greatest level of transformation that health and social care has ever seen. No longer was there time to debate or mull over ideas or options but instead there needed to be a national pulling-together to manage a crisis that had the potential to cause destruction on a level never seen before in our lifetimes. Nursing had responded to many events in history, however at no point in time would our services and ability to care be challenged to this degree.

Sadly, the downside would be that lives would be lost on a global scale and it was imperative that those dependent on our services would have access to the appropriate care and be given the necessary dignity and respect at this time, underpinned by safe practice, compassion and honesty. Nursing was now under the microscope and being catapulted into a new world which required immediate action.

To prevent further decline in our nursing workforce an emergency recruitment campaign aimed at those staff who had left the register in the last 3 years to return during this crisis resulted in approximately 8000 nurses and midwives rejoining the register. This has most recently been further extended to staff who have left up to 5 years ago, which accounts for approximately another 40,000 staff and around a further 1,800 overseas staff. Included in this was the redeployment of staff to the key areas as well as emergency recruitment of nursing students in their final 6 months of training and subsequently 2nd year students also, who both had the choice to opt in or out. This was a request that has caused a lot of deliberation for qualified staff, as well as students. This level of change, alongside delays in information around use and access to PPE, testing and shielding of staff has resulted in our nurses and carers working within extreme physical and psychological situations , further stretching staff who had already been working above and beyond.  NHS was rightly the initial priority area for staff redeployment, however due to matching staff skills we now have staff and students placed within our care homes, which has been welcomed and hopefully strengthens our existing workforce.

The degree of media coverage has been welcomed but needs to remain balanced. However, this has finally positively highlighted that our care home staff are key frontline staff, covering the determination, devotion, knowledge and skills of our social care workforce against the sad reality of the impact to the sector. We are seeing a move to more community integration and resilience, with clinical in-reach to our care homes supported by our hard working ,often under recognised community nursing teams, who have been instrumental in being the conduit between NHS, HSCP’s and social care.

As this virus predominantly attacks people over the age of 75 years it is unavoidable that we continue to see this demand and incidence within social care and within our communities during lockdown. Nurses and carers have been there from the beginning trying to manage the care of their residents with empathy and ensure advocacy for all those under their care, at all times. With this has come great frustration and impact on the health and wellbeing of residents and their family due to being isolated throughout lockdown. Staff have been left feeling helpless and unprepared at times to deal with their own emotional and psychological issues due to the loss they have witness and the need to continue to provide quality care, whilst struggling themselves.

Our care sector has sadly seen a continual increase in residents losing their lives to covid-19 and in some areas experiencing cluster outbreaks, this has had a significant impact on wellbeing. Care home staff provide an excellent level of care and especially in relation to palliative and end of life care, after all it is the last thing we can do for our residents.

In recognition of this nurses have united to ensure the people within our communities receive the optimum care during this time and are utilising every guidance and resource available in relation to infection control, palliation and also around wellbeing and mental health for staff and residents alike. This has become increasingly important during this pandemic due to the reduced contact with families and decisions that have had to be made to protect people. One of most distressing elements of this reality is some families have not been able to be there when their relative was dying. This has been due to the protective restrictions which were necessary over the last few weeks. However, the humanity shown by our nurses and carers has been a welcomed comfort to families, to know their loved ones have not died alone. As guidance and knowledge around infection control and use of PPE improves this will hopefully not prevent any other families from being together with their loved one at the end of life.

The facts are that despite the unbelievable pressures put upon our staff they continue to come to work each day, do overtime, with some staying within the care homes to minimise risk. This has resulted in positive realisation of the work our staff do, despite minimum wage, they do the job cause they genuinely care, the key requirement of anyone wanting a career in care. Unfortunately, some staff have also lost their lives across the country, with some of these being staff who had returned to practice to help. In addition, many staff have had to deal with the loss of colleagues and residents, who were, for all intents and purposes their care home family.

In this week of compassionate communities think about how people respond to crisis, how we need to support people to continue and most importantly how we never go back to not recognising what our nurses and carers give every day.

We can’t go back, we must continue to progress and keep and build on the relationships that have been formed over this short period when the world has achieved phenomenal feats.

If we can build temporary hospital in a few days surely we can build a sustainable workforce, value the contribution  and sacrifices our staff make daily and make nursing a career to strive for, after all its what we do that matters ……

According to Louis L’armour ‘there will come a time you will believe everything is finished; that will be the beginning’.

We look forward to a ‘new normal’ that means there is no shortage of nurses and everyone can access care provided by the right person, at the right place, at the right time.

Jacqui Neil

Transforming Workforce Lead for Nursing

‘Who inspired you to be a nurse?” – Nursing Blog by Transforming Workforce Lead

In this the International year of the Nurse/Midwife we can look back in history and see examples of nurses who have been inspirational in encouraging people to make nursing their career.

There are some women and men who have been instrumental in making nursing and midwifery what it is today.

Some historians would argue that as far back as 250AD, men were in fact predominantly the ones who provided nursing care to the sick and the poor, with the first nursing school thought to be all male in India.

St Agatha of Sicily is the most well known patron saint of nurses, with three other patron saints, St Catherine, St Elizabeth with St Camillus de Lellis being a male. In fact, he is one of the first male nurses of the profession. He decided to become a priest only to resign in 1607 to continue to care for people affected with alcoholism. All these saints were known to inspire nurses.

Despite this, many view Florence Nightingale as the founder of modern nursing. However she was thought to hold the view that nursing was more natural to a woman and this was detrimental to the acceptance of males into the profession. More recently there was Clara Barton who was the founder of the American Red Cross and was an inspiration for going into the battlefields to help those needing first aid. Males were also present on the frontlines but were thought to have had less training.

Elizabeth Grace Neill was responsible amongst other things for creating the nurse register that ensured nursing was seen as a profession. In 1919 males also were recognised by a register.

The Nursing Theory was developed by Avenel Henderson, who was considered as the most famous nurse of the 20th Century , with all her contributions and influence to American and international nursing education, practice, research as well as its implications.

There was also Mary Eliza Mahoney who was the first registered black nurse, who continued to work throughout her career to fight discrimination and co-founded the National Asssociation of Colored Graduate Nurses in 1908 .The NACGN became Mahoney’s instrument in improving the status of black nurses in the profession nationwide.

In relation to recognising mental health issues, Dorothea Dix was the first advocate nurse who fought to improve care for people with mental health issues, with Margaret Sangar who was instrumental in ensuring the rights of women and worked for over 40 years to ensure birth control was available to women from the 1950s.

Edward Lyon in 1955 became the very first male nurse to be commissioned in the Army Nurse Corps in the US as a reserve officer.

These are only a selection of international nurses who worked tirelessly to ensure the rights of all people, alongside challenging legislation to establish nursing and midwifery as it is today, which is now devoid of discrimination . Nurses can now work and lead in all fields which offer positive career pathways, regardless of background, race, ethnicity or gender.

Nowadays we often see the young student nurse who has spent their whole childhood dreaming of being a nurse, but for many their decision comes out of a personal or family situation that changed them in such a way that they  were inspired to want to be an nurse themselves.

The more I explore this subject, the one thing that can’t be disputed is that those who choose nursing as a profession want to make a difference, to give back, they are determined and genuinely care for people, often going above and beyond.

For me personally, my childhood dream was to be a police officer, not a nurse, because I felt that by joining the police it was the one job I could help people, keep them safe and which would challenge me and make me a stronger person.

I believed this was the job that I would get the most satisfaction from and that would make me a better person in the process.

The year before I applied, my gran suffered a stroke in her late 70s. Post-stroke despite still being mobile, she was no longer able to look after herself and she subsequently came to live with us.

Psychologically she had changed due to the stroke, as did our relationship. My gran was my inspiration and to see her dependent changed my whole mindset and view on what really mattered in life.

I was always close to my gran, but our roles had reversed,  having to care for her and hold her hand and comfort her, to help her understand things and still to enjoy life despite its frustrations,  as well as being beside her, 3 years later, when she passed away peacefully at home .

Alongside this, I watched my mother with two teenagers take on the role of carer, give up her job and manage all the dynamics of the family.

It made me realise that nursing someone can give so much joy and gave me everything that being a police officer would’ve and more importantly gave me the empathy that ultimately directed me into nursing. Nursing someone you love is different, as its personal, but it gives you the insight to understand what the families of those you nurse are going through. Never underestimate this.

I believe her illness gave me the best gift. I started my training in 1987 and haven’t looked back.

Our patients and residents without question remind us every day why we are nurses, they let us into their lives, tell us their secrets and trust us to provide the care they need, literally for some, putting their lives in our hands.

The nurse-patient/resident relationship differs depending on which area of nursing you choose to work in, but can teach you how to be compassionate, and develop a patient centred approach, which ensures people’s needs and rights are met.

We know these are challenging times and there will be points in your career that you question if you still want to be in nursing, but I ask you to stop and remember why you became a nurse, and maybe  consider that you may just need a change of environment, not a change of job.

As the workforce lead for Nursing at Scottish Care I would promote  working with older people in care home nursing, as it offers a homely environment to build relationships with residents and families and provides the potential for an exceptional career pathway for you as a nurse. We do need an increase of younger people, men and people over the age of 40 years, as well as more people from Black, Asian and ethnic minority backgrounds to continue to join the profession, to ensure future workforce stability.

As nurses we hope we inspire others to do their best, nothing more or less and others to continue to inspire us in the same way.

 

Jacqui Neil

Transforming Workforce Lead for Nursing, Scottish Care

@TransformNurse

University of Dundee Education Opportunities

University of Dundee has offered these free  modules  to care home nurses in the first instance. All interested staff must register before 6th April as places will then be opened up to NHS staff. These online modules commence in May.

Please don’t miss this opportunity for free access. These are open to any care home nurses not just Dundee area as online.

Date and time

Subject

Audiences

11 March, 2 – 3

New test of Competence

Employers, nurses, midwives, registrants lapsed from the register

23 March, 13.00-14.00

My future my midwife

Midwifery educators

20 April, 12.30 – 1.30

Nurse proficiencies

Nurses, students, educators, professionals supporting nurses in practice, employers

28 April, 1 – 2

New test of Competence

Employers, nurses, midwives, registrants lapsed from the register

University of Dundee Education opportunity for May 2020