profile of learning opportunities
TRANSCRIPT
Profile of learning opportunities
CONTENTS
Guidance for learners and mentors. Page : 3.
Medical Directorate. Page : 4.
Medical wards / Day Units. Page : 5 – 8.
Learning Zones. Page : 9.
Key Elements. Page : 10 – 26.
Who’s Who Page : 27.
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GUIDENCE FOR LEARNERS AND MENTORS.
This document, (POLO) has been produced to detail all the learning opportunities available in
the medical directorate.
The learning opportunities are fairly generic to all the medical wards, however there are
specific learning opportunities unique to the individual areas.
It is intended that learners and mentors work together to help the individuals, to select the
appropriate opportunities to meet their specific competencies for the placement.
Learners should not expect to access all of these opportunities while on the placement.
However think of this POLO as a window of learning opportunities available, and select those
that are relevant to them.
JUNE GORDON 2005.
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The Medical Directorate is…….
a diverse, innovative collaborative and friendly environment to work, that
embraces and encourages learning.
The Medical Directorate consists of…….
10 in–patients wards covering a number of specialties. Plus the
Diabetes Centre, Rheumatology day unit, Cardiac Diagnostic Services and the Procedure
Investigation Unit (PIU).
The Medical Directorate Structure…….
Clinical Director Consultants
Service Manager Personal Assistant Junior Medical Staff
Clinical Leaders Assistant Service Manager
4 Modern Matrons
Wards Departments Medical Secretaries
Sisters & Charge Nurses
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MEDICAL WARDS.
WARD 1.
A 19-bedded ward whose specialty is acute medicine for older people. The occupational
Therapists are based on the ward. There is a purpose built activities daily living (ADL) kitchen
for patient’s assessments on the ward.
WARD 2.
A 25-bedded ward that also specializes in acute medicine for older people. The occupational
therapy facilities are shared with ward 1. The staff work closely with the older persons liaison
team and the community resource team.
Both these wards offer a vast and varied experience of medical problems in the
older patient, such as Parkinson’s disease, Stroke, Heart failure, Diabetes and
unstable blood pressure. Learners will also be given the opportunity to spend
time with the individual specialist nurses.
WARD 3.
A 20-bedded ward that is primarily an acute Stroke unit, but also takes general medical
patients, so there is the opportunity to gain a fast variety of experiences. The ward staff works
closely with the stroke research team, and assist with clinical trials. The unit has close links
with the community stroke team and the rehabilitation ward, 22 on the Jubilee wing. Learners
are encouraged to visit and work with the Stroke Research Nurse, Occupational Therapist,
(OT), Community Liaison, Secondary Prevention Nurse, (CLASPN), and the Stroke
Assessment Nurse (SAN). All learners are given every opportunity to gain knowledge in all
aspects of Stroke, as well as general medicine.
WARD 4.
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A 25-bedded ward that is primarily a respiratory unit, but also takes some general medical
patients, so there is the opportunity to gain a wide range of experiences. Many of the qualified
staff are trained to use the Bipap machine, this is used for patients who need none invasive
ventilation. The ward staff also have some responsibility for the twice weekly pulmonary
rehabilitation clinic. The unit has close links with the Respiratory nurse specialist; the Lung
Cancer Nurse specialist and the Chronic Obstructive Pulmonary Disease (COPD) assisted
discharge team. All learners will have the opportunity to spend time and work with the
individual nurse specialists, and learn all aspects of respiratory care.
WARD 5.
A 26-bedded Cardiology / medical ward. The ward works with, the Coronary Care Unit,
Cardiac Catheterisation lab, (CATH LAB), Heart Failure Nurses specialist, Cardiac
Rehabilitation Team, Chest Pain Clinic, and the Cardiology Nurse Practitioners. Some of the
staff rotate onto Coronary care and cat lab. Learners will be given the opportunity to visit the
various cardiac areas, spend time and work with the individual nurse specialists, enhancing
their learning opportunities in all aspects of cardiology as well as general medicine.
CORONARY CARE UNIT. (CCU)
An 8-bedded unit. There are a number of nurse practitioners that work alongside the team
dealing with all aspects of cardiology, such as rehabilitation; thrombolysis, chest pain
assessment and myocardial infarction (MI) follow up clinics. All learners will be able to spend
time and work with the individual specialists.
WARD 6.
A 24-bedded acute medical ward, that specializes in Rheumatology and Endocrinology
disorders. The ward has close links with the Physiotherapy team, Pain team and the
Rheumatology nurse specialist. All learners will be able to spend time and work with the
individual nurse specialists and gain knowledge in Rheumatology and Endocrinology as well
as general medicine.
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MEDICAL ASSESSMENT UNIT (MAU).
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A 24-bedded medical ward, which receives all medical admissions from accident and
emergency (A&E) or direct from general practitioners (GPs).
A nurse sees all patients to assess them within fifteen minutes of arrival, they are seen by a doctor in
order of priority.
The patients can have a length of stay on the unit of less than 24hrs.
There are 4 nurse practitioners that work along side the nursing and medical teams to assist in the
triage and assessment and clerking of patients.
Learners will be able to gain a vast and varied experience of patients admitted with medical
problems, as well as observing/assisting with a variety of procedures such as lumber punctures.
WARD 16.
A 21-bedded medical ward, that specializes in diabetes and endocrinology, but also takes
other medical admissions. The ward also caters for accident and emergency (A&E) inpatients,
such as self harm, drug overdoses, alcohol intoxication, soft tissue injuries, head injuries or
falls. The ward has developed close links with the drug / alcohol and the self harm team for
early intervention. Learners will be able to gain a very varied experience of medical patients,
A/E patients, as well as spending time with the individual specialist nurses.
WARD 17.
A24-bedded ward that is primarily a hematology and gastroenterology ward but also takes
general medical and oncology patients.
The ward has developed close links with the Endoscopy department and the Chemotherapy day
unit,(CDU). Ward 17 trained staff supports the Hematology Nurse Practitioner in running the
weekly Hematology Procedure clinic held on (CDU). Learners will have the opportunity to
visit these day units, and gain experience in hematology and chemotherapy
The ward offers all learners the opportunity to gain a variety of experiences, and spend time and
work with the individual specialist nurses.
DAY UNITS.
PROCEDURE INVESTIGATION UNIT (PIU).
This unit provides a service to the medical outpatients taking a lead in a number of clinical
procedures such as angiography, endopscopic retrograde colangiopancreatography (ERCP), blood
pressure monitoring (BP) and investigations into endocrine disorders.
DIABETIC CENTRE,
This department has a number of diabetic specialist nurses and research staff, who provide advice
and support for inpatients, ward staff and outpatients, running a number of different clinics.
RHEUMATOLOGY DAY UNIT,
This day unit runs a number of clinics to provide specialist treatment for patients with
rheumatology conditions. The specialist nurse runs nurse led clinics providing
treatments, advice and support for patients.
CARDIAC DIAGNOSTIC SERVICES.
This unit is an integral part of the cardiology service providing in and out patient diagnostic services
which include Electro cardio graph (ECG), ECHO, Transoephageal echo, exercise testing and has
links with nuclear medicine.
Learners can access all these day units from their base ward by
utilizing the learning zones on the ward.
DIETICIAN
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KEY ELEMENTS
Anatomy, Physiology and Pathology.
Clinical Nursing Skills.
Communication Skills.
Health Education and Promotion.
Management and Managerial Issues.
Management of Patient Care.
Staff development.
Quality Issues.
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ANATOMY AND PHSIOLOGY AND PATHOLOGY.
Learning Opportunity. Relevant Resource. Normal anatomy, physiology and pathology.
Mentor, nursing staff, doctors, education and resource files, books, posters, x-rays.
CADIOV CARDIOVASCULAR.
Angina.Myocardial infarction.Heart failure, LVF.ECG. / Pacing.Cardiac arrhythmia’s.Cardiac arrest.Cardiomyopathy.Medication.Angiogram.Angioplasty.Coronary Artery bypass grafts.
Mentor, nursing staff, education resource files, coronary care staff, specialist nurses, doctors, books,ECG technicians, pharmacy.In house training days.
DISTURBANCES ELECTROLYTE BALANCE.Normal fluid balance.Dehydration.Recording and understanding fluid balance charts.Fluid retention, / Oedema.Acidosis.Reading and understanding blood results
Mentor, nursing staff, doctors.Books, education resource files.
ENDOCRINE SYSTEM.Diabetes.Thyroid problems.Pituitary problems.Pancreatitis.Medication.
Mentor, nursing staff, Doctors, education and resource files books, Diabetic nurse specialist, dietician and pharmacy.In house training days.
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Learning Opportunity. Re Relevant Resource
GASTROINTESTINAL SYSTEM.Nausea and vomiting.Diarrhoea.Constipation.Haematemesis / Maleana.Dysphagia.Ulceration and cancers – upper and lower GI tract.MANAGEMENT OF:Nasogastric feeding.Peg feeding.Preparation for GI investigations.Post procedure care.Bowel preparation.
Mentor, nursing staff, doctors, education and resource files books. Nutritional nurse specialist, endoscopy staff. Dysphagia nurse specialist, Macmillan and cancer specialist nurses, Dietician.
HAEMATOLOGY.Blood formation and bone marrow function.Red cells.White cells.Platelets.Collecting blood specimens.Blood transfusion.Haemorrhage.Thrombosis.
Mentor, nursing staff, doctors resource files
and books.
Blood transfusion literature, nurse specialist, hospital and infection control policies. Hematology and phlebotomy staff
INFECTION CAUSES.Spread.Infection screening.Specimen collection.Prevention.Barrier nursing.Reverse barrier nursing.
Mentor, nursing staff, doctors infection control team and policies, as well as hospital policies.
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Learning Opportunity. Relevant Resource. Liver and Biliary system.Jaundice.Tumours.Clotting disorder.Liver failure.Alcohol liver disease.Cirrhosis.ERCP. Ascitis.Hepatorenal syndrome.Hyponatraemia.Liver biopsy.
Mentor nursing staff and doctors.Books education resource files.Nurse specialist.
Muscular System.Sub Lux shoulder.Shoulder protocol.Muscle tone- tightening / loss.Bot tox.Drop foot.Posture.Contractures of limbs and fingers.
Mentor, nursing staff, resource files and books. Physiotherapy team, doctors and occupational therapy team.
Nervous System.Brain tumours.C.V.A.T.I.A.Epilepsy.Parkinsons.M.S.Guyllain Barrie Syndrome.Headaches.Infections.C.T. scans.M.R.I. scan.
Mentor, nursing staff.Stroke team, and doctors. Books,Educational and resource files.The various nurse specialists.
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Learning Opportunity. Relevant Resource. Renal and urinary system.Acute/chronic renal failure.Urinary tract infections.Urine testing.Specimen collection.Catheter insertion / removal.Fluid balance.
Mentor, nursing staff, infectionControl team, specialist nurse.Books and education resource file.
Respiratory System.Chest infections.Aspiration.C.O.P.D.Asthma.Drugs, inhalers, nebulisers.Oxygen therapy.Tumours / lung cancer.
Mentor, nursing staff, doctors.Respiratory nurse specialists team.Books and education resource file.Pharmacy team.Lung cancer nurse specialist.
Skeletal System.Rheumatoid / Osteo arthritis.Infections.Osteoporosis.
Mentor, nursing staff and doctors.Books, education resource files.Nurse specialist.
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CLINICAL NURSING SKILLS.
Learning Opportunity. Relevant resource.Administration Of medication.Using drug / IV / S/C charts. Oral medication.Nasal gastric / peg medication.Intravenous medication.Subcutaneous medication.Rectal medication. S/C and I/V Infusions.Controlled drugs.
Mentor, nursing staff, Pharmacy.Education resource file, leaflets,Medical staff.
Aseptic technique.Dressings.Wound management.Catheterisation.Site IV/ S/C Venflons.Obtaining blood specimens.
Canulatio
Mentor, nursing staff, tissue viabilityNurse, infection control team.Mentor, nursing staff, and doctors.O.D. training department.
Clinical Devices.Using and checking : : :Infusion pumps.Syringe drivers.Space lab monitors.E.C.G machine.Crash trolley / defibrillator.B.M. machine.Urine testing machine.
Mentor, nursing staff.O.D. training department.E.C.G. department,Resuscitation officer, cascade trainer.Policy files.
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Learning Opportunity. Relevant Resource.Moving and handling. Risk assessing patient. Use of equipment :Hoist.Slings.Glide sheets.Sam hall turnerBanana slide.Pat slide.
Mentor, nursing staff, PhysiotherapyTeam, ergonomics department.Risk assessment and policy file.Education resource file
Physiological observations.Blood pressure.Temperature, pulse, respiration.Oxygen saturation’s.Blood glucose.Urinalysis.Urine volumes.Weight.Maintaining accurate charts.Snobs.Neurological observations.
Mentor, nursing staff.Respiratory team.Education resource files.Books and leaflets.
Preparation for investigations.Obtaining consent Informationfor each investigation.Administering the preparation.C.T. scan of head.C.T. scan chest / abdomen.Ultrasound scan.M.R.I. scan.Endoscopy.Barium studies.Sigmoidoscopy.Colonoscopy.
Mentor, nursing staff doctors.Endoscopy, ultrasound, sonar and All departments ultrasound. Books, literature,Leaflets procedure and policy files.
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Learning Opportunity. Relevant Resource.Risk assessment of a patient and The appropriate action.Falls.Mouth care.Nutrition.Risk of pressure damage.Documentation.
Mentor, nursing staff. Policy files.Dietician tissue viability nurse.Falls clinic.
Setting up equipment.Catheter insertion.Lumbar puncture.C.V.P. line insertion / removal.Wound dressing.Fine bore feeding tube insertion.Abdominal Paracentesis.
Mentor, nursing staff, doctors.Procedure file. Nurse specialists.Education resource file.
Using specialist beds and chairs.Assessing patient for bed. Ordering beds.Types of beds and how to use them.Assessing patient for type of chair.Chairs available such as, upright Parker knoll Suffolk.
Mentor, nursing staff, policy fileTissue viability nurse.
Physiotherapy team, occupationaltherapy team.
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COMMUNICATION SKILLS.
Learning Opportunity. Relevant Resource.Verbal communication.Using the telephone.Receiving / giving information.Bleep system.Nurse handovers.Doctors ward rounds.Patient / relative enquiries.Patient transfers within the trust.
Mentor, nursing staff, ward clerk.Switch board.
None verbal communication.White boards.Referral forms.Multidisciplinary team notes.Ward diary.Discharge medication sheets.Discharge letter for D/N orNursing home. Patient transfers to other trusts.
Mentor, nursing staff, ward clerk.M.D.T. staff.Discharge liaison nurse.
Computer Skills.Understanding confidentiality.Access nursing documentation.Access patient information.Access patient’s results.Use the trust internet / E-mail.Ordering equipment i.e. beds.Booking ambulances.
Mentor, nursing staff, ward clerk.IT department.
Policy / procedure file.
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HEALTH EDUCATION AND PROMOTION.
Learning Opportunities. Relevant Resource.Healthy lifestyle changes inrelation to :-Obesity.Smoking.Alcoholic liver disease.Drug / alcohol abuse.Bowel disorders.
Heart disease.Diabetes.Raised cholesterol.
Hypertention.Stroke rehabilitation.
Mentor, nursing staff, doctors.Dietician, smoking sensation nurse.Gastroenterology team,Drug and alcohol team.
Cardiac rehab team.Diabetic team, dietician.
Stroke team, SALT, OTSpecialist nurse.
Health education / promotion.Models of health.Promotion of regular exercise.Diet / healthy eating.Pain assessment / management.
Counselling.
Interface between hospital and
Leaflets, health promotionTeam, library.Mentor, nursing staff, dietician.Physiotherapy, rehab teams.Leaflets education resource file.Doctors, pain control team.
Chapliancy, Macmillan nurses,And clinical psychologist. Drug and alcohol addiction team.
Discharge liaison nurse, CROP,
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Community care. ICIS, community stroke team.All the MDT.Primary care team.
MANAGEMENT and MANAGEERIAL ISSUES.
Learning Opportunity. Relevant Resource. Emergency situations.Cardiac arrest.
Patient falls.Fast bleep.Fire.Violent incidents.Security alarm systems.
Mentor, nursing staff, CCU staff, Resuscitation officer, OD training,Cascade trainers.
Procedure / policy file falls clinic.Switch board.Fire officer.Security / hospital policeman.
Managing a team.Mentorship / Preceptorship –Supervision of new staff.Organisational skills.Delegation.Prioritising.Time management.Leadership.Off duty / bank staff.Standards of care.Implementing change.
Mentor, education leads.Ward managers. Audit tools.Books, research articles.
Resource management.Budget control.Stock control.None stock.Drugs.Stationary.Skill mix.
Ward manager, budget sheets.Stores.
Pharmacy
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Learning Opportunity. Relevant resource.
Risk management.Policies and procedures.Moving and handling.Staff training updates.
Equipment safety checks / audits.Medical devices.
Environment assessment / audit.Quality control.Infection control.Health and safety.Waste disposal.
Mentor, ward manager, policiesProcedure files, health/safety team.OD training. Ergonomics team,Moving handling facilitator.
Electronics, health/safety team.Procedure file. Ward manager.
Domestic team, estates departmentWard manager.Infection control team.Health/safety team.Policy / procedure files.Porters.Waste management.
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MANAGEMENT OF PATIENT CARE.
Learning Opportunities. Relevant Resource.Use of :-Nursing model.Essence of care.Documentation used.Standards / protocols/ policies.Named nurse.
Mentor, nursing staff.Essence of care files.Policy / procedure files, intranetCare plans/ pathways.
Assessment.What is assessed?Who is assessed?How is assessment carried out?When is assessment carried out?
Mentor, qualified staff.Policies / procedure files.Patients / carers, medical notes.Education resource file.
Planning.Risk assessment tools.Care plans.Care pathways, i.e. stroke, or thedying patient.
MDT involvement, i.e. physio, OTSpecialists nurses community based services.Discharge planning.
Mentor, qualified nurses. Specialists nurses. Research literature.
MDT team members, individualSpecialist nurses and communityservices.Discharge liaison nurse.
Implementing / evaluation anddocumentation.Ward rounds.MDT meetings.
Mentor, qualified nurses, doctorsMDT team members. Patient and
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Care plans / document evaluatedocument interventions.
relatives.
Learning Opportunity. Relevant Resource.Patients hygiene.Mouth care.Skin care.Pressure area care.
Continence.Washing / dressing.Bathing.
Mentor, nursing staff, assessmenttools. Education resource files.Tissue viability nurse. Research.
Continence adviser.OT, physiotherapy.
Nutrition.Nutritional assessment.Food charts.Supplements.
Swallow assessment.Altered texture/ thickened fluids.
Feeding problems, i.e. positional,use of lap trays, straws, beakers.
Nasal gastric feeding tubes andPeg tubes / insertion/ care.Feeding regimes pumps.
Mentor, nursing staff, dietician.Research articles.
SALT team, dysphasia trained staff on the ward, specialist nurse.
OT, staff.
Dietician, nurse specialist. Procedure / policy file.
Communication.With patients, verbally and flashcards.Relatives, verbally, leaflets and Pamphlets.Medical staff, ward rounds.
MDT team, meetings, white boards
Mentor, nursing staff, SALT.
Health education staff, strokeResearch and stroke association.Medical staff.
MDT pathway, ward clerk andIndividual MDT members.
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Referrals to other agencies. Protocols, information file.
Learning Opportunity. Relevant resource.Difficult situations :Self discharge.Missing patient.Patient/staff/visitors incident/accident.Missing property.
Deceased patients.
Mentor, qualified staff, policy file.Modern matron.
Security/ hospital policeman.
Chaplains.Religious needs.Special diets.Access to patients own particularreligious representative.Time and place to prayer.Communion.
Dietician catering staff. MentorNursing staff. Switch board.Religious and cultural file. Hospital chaplain service.
Drug administration policy.Controlled drugs.Oral drugs.Intravenous drugs.Subcutaneous drugs
Mentor, qualified nurses.Policy file, pharmacy staff.
Anti embolic stocking.When / why to use.How to measure correctly.How to apply.
Mentor, nursing staff, doctors, Research articles.
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STAFF DEVELOPMENT.
Learning Opportunities. Relevant r Relevant Resource.
Staff development :Clinical supervision.Reflective practice.Contacts.Personal development plans.Staff development prospectus.UNN.
Mentor, qualified staff.Modern matron.Development programmes.OD training department.
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QUALITY ISSUES.
Learning Opportunities. Relevant Resource.Quality issues.Policies.Procedures.Standards of practice.Research.Clinical audits.Changing practice.Handling complaints.Clinical incident reporting ( IRI )
Mentor, qualified nursing staff.Modern matron / medicaldirective team.Research articles, library internet.Research / audit departments.Practice development nurses.
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Who’s Who
Bright purple with white piping Modern Matron
Navy with white piping Sister
Burgundy with white piping Nurse Practitioner/ Specialists
Navy Junior Sister
Blue Staff Nurse
Lilac Auxiliary Nurse
White with University logo Student Nurses
White with red piping Cadet Nurses
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