HAWTHORN WARD
STUDENT INFORMATION PACK
We hope that your placement with us provides you with many learning opportunities as
well as being enjoyable. As there is a variety of students from different courses that
access placements on Hawthorn we hope to ensure a flexible environment. In order to
promote this flexibility you will be assigned a qualified nominated mentor from the team
for the duration of your placement. You will be expected to work at least 50% of your
time your mentor. You will have a preliminary meeting with your mentor within your first
three days of commencing your placement.
During this preliminary meeting you will be able to discuss:
-
Your personal training needs and learning opportunities available
Achievement of specific skills
Confidentiality
Supervision/Study time
Professional standards/Time Keeping/Uniform Policy
Fire Procedures/Safety Issues
Sick leave/Off duty/Absence
Although your guidance facilitator may not attend the ward a tri partite meeting can be
arranged with the practice placement facilitator should the need arise. The information
in this pack will hopefully act as a guide to various aspects of the ward and you are
encouraged to use it. The whole of the ward team takes pride in offering a sound
learning environment to students and we welcome your comments and suggestions on
ways of improving upon the learning environment. At the end of your placement we will
ask you to complete an evaluation questionnaire regarding your experience on
Hawthorn.
Last updated March 2010
THE HAWTHORN NURSING TEAM
The ward team will be responsible for assessing needs, planning and delivering care
after full discussion and agreement with the patient. We are all here to support and
promote your learning needs.
The ward team consists of:
SERVICE MANAGER:
Carron Yeouart
WARD MANAGER:
Ian Gee
SENIOR STAFF NURSE:
Moira Brown
STAFF NURSES:
Samantha Cooke
Lisa Donohue
Paul Robinson
Carol Porter
Sharon Kalu
Stephen Miller
Heather Crawford
NURSING ASSISTANTS:
Pamela Ayre
Bronya Barr
Heather Chambers
Caroline Fletcher
Sharon Heskett
Kirsty Greenwell
Sandra Briggs
Lynn Mullen
Michelle Pearson
Gillian Lewin
June Thomas
Maureen Royal
Christine Stoker
Brenda White
Last updated March 2010
MEDICAL STAFF
Hawthorn has 4 consultants who each work with a Senior House Officer. SHO‟s usually
rotate every six months. Each consultant holds a once weekly review of their patients.
This involves the whole of the multidisciplinary team, the patient and their carers.
DR. DANSON
Monday
10:30am – 12:30am
DR. COOPER
Tuesday
15:00pm - 17:00pm
DR. HOBSON
Wednesday
10:30am - 12:00pm
DR. BARAKAT
Wednesday
15:00pm - 17:00pm
All of the above consultants have a senior house officer who works alongside them and
visits the ward on a daily basis. You will also work with other members of staff such as
ward clerk, occupational therapist, physiotherapist, social workers, etc. Hawthorn also
has an outreach nurse. The role of the outreach nurse is to support the patient and
their family once they leave hospital. The outreach nurse meets with the patient and
their family during the assessment period to get to know them prior to discharge. The
outreach nurse also attends and participates in the MDT review. There will be an
opportunity for you to spend the day with the outreach nurse which many students find a
valuable learning experience. Hawthorn also has access to a Care of the Elderly nurse
who is a valuable resource in maintaining patients physical health.
Last updated March 2010
SPECIAL INTERESTS
Each member of the qualified nursing team has a particular interest/speciality, which
they would be very happy to discuss/explore with you. These are:
CHILD PROTECTION:
Carol Porter
ESSENCE OF CARE:
Moira Brown / Lisa Donohue
C.P.A:
Emma Tomys
MANDATORY TRIANING:
Ian Gee / Moira Brown
PRECEPTORSHIP:
Ian Gee
MENTORSHIP:
Lisa Donohue
INFECTION CONTROL:
Carol Porter
PERSON CENTRED CARE / DCM:
Lisa Donohue, Ian Gee, Moira Brown
EDUCATION / AUDIT:
Lisa Donohue
STUDENT INFO:
Lisa Donohue
IMPROVING WORKING LIVES:
Heather Crawford
AIMS:
Ian Gee
DIGNITY CHAMPION:
Paul Robinson
CARER SUPPORT:
Rita Wilson / Paul Robinson
Last updated March 2010
AN INTRODUCTION TO HAWTHORN WARD
Hawthorn is an admission / assessment ward for male and female patients aged
65years and over who are experiencing varying degrees of organic mental health
impairment. The ward also accepts patients aged less than 65yrs with signs of
impairment. Hawthorn is situated in the Grove complex and is part of Cherry Knowle
hospital. There are 23 beds on Hawthorn and the ward is designed so that male and
female dormitories and side rooms are separated. Patients are admitted from all
sectors within Sunderland and catchments areas also include Seaham, Murton, Hetton,
Houghton and Washington.
The aim of the team is to assess the needs of each individual taking into account
physical, psychological and social aspects, and planning care jointly with patients and
carers so that these needs can be met. Assessment is conducted via an eclectic
model, (copy in green file in ward office), based on elements of “Maslow‟s”, “Orem‟s”,
“Peplau‟s” & “Roper et al‟s” models. This “Major Review of Care” began in 1995 and is
now known as the Specialist Mental Health Assessment. The assessment document
aims to secure a holistic appraisal of individual needs, facilitates the negotiated
production of a plan of care & ensures that care is person centred rather than task
centred.
The ward routine is very generalised and is not intended to be a rigid “pattern of life”.
Indeed the very nature of the ward requires flexibility to be able to respond as and when
individual patient needs occur. Person centred care focuses on meeting those
individual needs, whether it is assisting someone to the toilet/a short notice appointment
or co-ordinating M.D.T. working. At the beginning of each shift the nurse in charge,
usually identified by the red dot on the duty rota will in conjunction with the staff on the
duty complete a Shift Plan. The Shift Plan allocates responsibility for a certain duty to a
member of the team; this ensures a consistent approach to the day and a delivery of
care. You will also be included into the Shift Plan which will hopefully assist your
integration into the ward team and ward routine.
N.B. If you ever feel uncomfortable about something or being asked to do
something, PLEASE SAY SO, NEVER take a chance or ‘hope for the best’.
If you have a question about policy, practice or anything else, then ask,
whether it is your mentor, a staff nurse, a nursing assistant or the ward
manager. Also, please remember to:
1.
Ensure all entries in Nursing Process are counter signed by a qualified
nurse.
2.
Please negotiate any study leave with your mentor but ensure the ward
manager is aware.
3.
Contact the ward, as well as the university, as soon as possible if you are
going to be off due to sickness.
Last updated March 2010
WARD ROUTINE
07:00
Handover from night duty staff. Nurse in Charge to complete Shift
Plan with A Duty Staff.
07:30 - 08:30
Nursing staff assist patients to dress, meeting personal care needs
08:30 – 09:15
Breakfast – all patients to be offered full choice of menu
09:15 – 10:15
Medication round
10:15 – 10:30
B.P. / Fluid balance / food charts: handover to Day Duty Staff. Also
commence diary work / plan for the morning according to the shift
pattern.
10:30 – 11:00
Patients offered a choice of hot drinks
11:00 – 12:00
Therapeutic / Diversional activities / Assessment Groups, O.T.
Groups
12:00 – 12:45
Lunch
12:45 – 13:30
Medication round and controlled drugs check
13:30 – 14:15
Handover to afternoon staff, Nurse in Charge completes Shift Plan
with B Duty Staff
14:15 – 14:30
Patients offered hot drinks
14:00 – 16:00
Visiting time and Therapeutic / Diversional activities
17:00 – 18:00
Evening meal
18:00 – 18:30
Medication round
18:00 – 20:00
Visiting time
20:00 – 12mnt
Preparing for bed, bathing, meeting personal care
20:30 – 21:00
Handover to Night Duty Staff and controlled drugs check
22:00 – 23:00
Medication round
Last updated March 2010
EXPECTATIONS OF THE WARD
Hawthorn is keen to maintain high standards of practice and will expect a similar effort
from you. Listed below are some of the wards‟ hopes in terms of what we feel we can
reasonably expect from you. If any of these appear unclear and/or unreasonable
please discuss them with your mentor.
-
Punctuality for your duty
-
Smart appearance (uniform)
-
Professional attitude/approach to your work
-
Maintain Confidentiality
-
Involvement in daily ward activities
-
Passing on of relevant information to the Nurse in Charge
-
Formulate/plan time scale for achieving skills with mentor
Last updated March 2010
UNDER SUPERVISION OF A QUALIFIED NURSE
1st year student
Implement care plans
Participate in group work
Assist in the administration of medicine
Gain understanding of M.D.T. roles/links
Undertake tasks allocated by Nurse in Charge
from ward diary
Escort patients to appointments with members of staff
Minor tasks in admissions/discharges
2nd year student as per 1st year student +
Assist qualified nurse in dispensing medication
Assist in planning, implementing & evaluating group
activities
Assess, plan, implement and evaluate care supervised by
mentor/assessor
Attend ward MDT reviews
Assist Nurse in Charge in ward diary/ward management
role
3rd year student: as per 1st year & 2nd year student +
Small case load in the Primary nurse role
Assessment/planning/implementing & evaluating care
Dispensing medication with the qualified nurse
Present own clients in the MDT review
Liaise with MDT members & external agencies
Complete ward diary work/ward management
Admissions/Discharges
Liaise with relatives/carers
Manage the ward for a full shift
Undertake observation duties
Last updated March 2010
OTHER INFORMATION
1.
OBSERVATION DUTIES
Whilst on placement on Hawthorn you may be asked to undertake the role of
„within eye contact observation‟ of a patient. Such an observation level would be
indicative of a patient considered to be at a higher degree of risk (to self and
others) than that in general and you will need to be familiar with the observation
policy and the appropriate documentation. The involvement of student nurses in
this role is always at the discretion of the Nurse in Charge; however the ward in
consultation with the university consider this role to be a valuable learning
experience for a 3rd year student nurse. You will not be asked to undertake arms
length observations.
2.
NO SMOKING POLICY
Northumberland, Tyne and Wear NHS Foundation Trust operates a strictly NO
SMOKING POLICY. Patients, visitors and staff are not permitted to smoke on the
premises. A copy of the smoking policy is available if you wish to read it please
ask a member of staff. Anyone admitted to Hawthorn who wishes to give up
smoking can access smoking cessation services provided by the Trust to support
their wish to stop smoking.
3.
DEMENTIA CARE MAPPING
On occasions Dementia Care Mapping is carried out on Hawthorn. Dementia Care
Mapping or DCM is an observational tool used to look at the care of people with
dementia from the viewpoint of the person with dementia. The results can assist
with the further development of person centred care. The focus of the mapping is
on the person with dementia and their experience rather than the nursing staff or
visitors. It involves 2 or 3 members of staff, known as “mappers” sitting in areas
such as the lounge or dining areas and observing what happens over the course of
a day. You may be on duty when a map takes place, please do not hesitate to
speak to a member of staff if you have any questions.
Last updated March 2010
LEARNING ZONES
PROFILE OF LEARNING OPPORTUNITIES
KEY ELEMENT:
INTERPERSONAL SKILLS
LEARNING OPPORTUNITIES
RESOURCE
Ward Management
Managing a Team
Q/N, Mentor, C/N
Organisational Skills
Q/N, Mentor
Delegation Skills
Q/N, Mentor, C/N
Prioritisation Skills
Mentor, C/N
Time Management
Q/N, Mentor
Leadership Skills
Q/N, Mentor, C/N
Off Duty
Mentor, C/N
Handover Skills
Mentor, C/N
Communication Skills
Communication / Interaction with patients,
medical staff, social workers, staff, carers
and other disciplines
C/N, Snr S/N, Q/N, Mentor &
Ward
Use of the Telephone
Answering calls
Making calls
Ring back etc
Bleep system
Ward Clerk & Ward Staff
Use of the Computer
E-mail access
Clerk / Mentor
Intranet
Last updated March 2010
Ward
KEY ELEMENT:
CLINICAL SKILLS
LEARNING OPPORTUNITIES
RESOURCE
Aseptic Techniques
- Wound Care
- Dressings
Tissue Viability Nurse,
Q/n, Mentor,
Wound care link nurse
Use of Hoists
Q/N, Mentor,
Manual Handling
Training co coordinator
Moving & Handling
Q/N, Mentor, N/A,
Physiotherapist
Manual Handling
Link nurse
Infection Control
Q/N, Mentor, IPC link
Nurse,
Infection Control nurse
Infection Control dept
PHYSIOLOGICAL CARE
Heart Disease
C.O.A.D
Urine Infections
- Input/output
Constipation
Catheter Care
Terminal/Palliative Care
Food/Fluid Intake
Q/N, C.O.T.E liaison nurse
SRH, Mentor, N/A
Medical staff
DIAGNOSTIC INVESTIGATIONS
X-RAYS
CT SCAN
CP SCAN
BLOODS & MSU
ECG
Medical staff, Q/N, N/A,
SRH, Phlebotomist
PATIENT HYGIENE
Mouth Care
Last updated March 2010
Q/N, N/A, Patient, Mentor
Hair/nail care
Skin Care
Pressure Area Asst
Continence/Incontinence
Use of Incontinence Aids
Continence link nurse
RECORDING OF PHYSIOLOGICAL OBSERVATIONS
Blood Pressures, Obtaining a pulse
Respirations
Urine input / output
Q/N, Mentor, N/A
Medical staff
DRUG ADMINISTRATION
Administration of medication
Dispensing of medication
Prescription of medication
Ordering of Medication
Legislation
Side effects/Contraindications
Intramuscular/Oral Administration
Last updated March 2010
Q/N, Mentor
Q/N, Mentor, N/A
Medical Staff
Q/N, Pharmacist
Q/N, Mentor, C/N
Q/N, Medical Staff, Mentor,
Pharmacist
Q/N, Medical Staff, Pharmacist
KEY ELEMENT:
CLINICAL KNOWLEDGE
LEARNING OPPORTUNITIES
RESOURCE
KNOWLEDGE OF THE MENTAL HEALTH ACT
Use of the Mental Health Act
Correct Documentation & Dates
Of expiry
Patients Rights
Appeals Process
Tribunals
Report Writing
Q/N, Mentor, C/N, Consultant
Q/N & Medical records
Q/N, MHA resource file &
Medical records
Patient, Q/N, C/N &
Medical records
Review Tribunal, Q/N, C/N
& Medical records
Q/N, C/N & Medical records
CARE OF THE OLDER PERSON WITH DEMENTIA
Person Centred Care
Dementia Care Mapping
Aetiology of Dementia
Toxic confusional states
& delirium
Medication/Treatment
Empowerment
Challenging Behaviour
Care of the Carer
Psychosocial Approach
Last updated March 2010
Q/N, Mentor, Ward Staff & Senior
S/N
Mapping Team, C/N & Senior
S/N
Q/N, Medical Staff
C.O.T.E nurse, Q/N, Medical
Staff
Q/N, Medical Staff & Pharmacist
Q/N, Advocacy
Q/N, Medical Staff & Sycamore
Q/N, Carers Groups & Outreach
nurse
Q/N, C/N & Ward Staff
KEY ELEMENT:
MANAGEMENT OF CARE
LEARNING OPPORTUNITIES
RESOURCE
ASSESSMENT OF NEEDS
ASSESSMENT TOOLS
Admission Documentation
Face Risk Assessment
Braden Assessment
Fall Risk Assessment
MEAMS Assessment
MMSE
Manual Handling Asst
Religious Assessment
Life Story Profile
Specialist Mental Health
Assessment
Communication/Daily Living
Skills Assessment
Challenging Behaviour
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor & O.T
Q/N, Mentor, C/N & SS/N
Q/N, Mentor & O.T
Q/N, Mentor
CARE PLANNING SKILLS
Identification of patients individual
Needs
Client/Carer perception & understanding
Of needs
Identification & understanding of
Nursing interventions
Evaluation of care plans
Implementation of care plans
Empowerment of patients
Use of Nursing Model
Philosophy Of Care
Q/N, Mentor
Nursing Documentation
- Use of Rio
- Validation of documentation
Q/N, Mentor
Referrals to other agencies
- Occupational Therapy
Q/N, Mentor
Last updated March 2010
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
Q/N, Mentor
-
Social Services
District Nurses
S.A.L.T
Chiropody
Community Dentist
DISCHARGE PLANNING
MDT discharge reviews
Discharge aftercare
CPA discharge documentation
Discharge care plans
Leave/Discharge Supporting
information
Policies, Protocols & Procedures
Untoward/Serious Incidents
Deceased Patients
Care of the Dying Patient
Last updated March 2010
Q/N, Mentor & Medical staff
Outreach nurse & medical sta
Outreach nurse
Outreach Nurse, Q/N
Q/N, Mentor
Q/N, Mentor & C/N
Q/N, Mentor, C/N
Q/N, Mentor, Medical Staff
Q/N, Mentor, Medical staff &
Palliative care team
KEY ELEMENT:
ORGANISATIONAL AND MANAGERIAL ISSUES
LEARNING OPPORTUNITIES
RESOURCE
MANAGING A TEAM
Organisational Skills
Delegation Skills
Prioritising Skills
Time Management
Leadership Skills
Standards of Care
Implementing Change
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
GIVING INFORMATION TO
Nursing Staff
Medical Staff
Patients
Carers
MDT Team
Other Departments
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
Q/N, Mentor & C/N
RESOURCES
Staffing Levels
Stock Control
Stationery
Budget Control
Q/N, Mentor & C/N
Q/N, Mentor &C/N
C/N & Unit Clerk
C/N & Service Manager
MANAGING RISK
Violent Incidents
Equipment Safety Checks
Quality Control
Infection Control
Manual Handling
Last updated March 2010
Q/N, Mentor & C/N
Q/N & Bureau
Health & Safety officer
Infection Control nurse & Ward
link nurse
Training dept, Physio & Ward link
nurse
EMERGENCY SITUATIONS
Violent Incidents
Fire
Cardiac Arrest
Falls
Last updated March 2010
Q/N, C/N & Service Manager
Q/N, C/N & Fire Officer
Q/N & Medical Staff
Q/N & Medical staff
Elderly Resource Team –
District Nurse, Chiropodist,
Dietician, Geriatrical
Medical Records –
Mental Health Act
Commissioners
Control of Infection
Occupational
Therapist
Health and Safety
District Nurse
Voluntary Groups
Age Concern
Alzheimer Society
Stroke Association
Elderly Mentally
Nursing Infirm Homes
Speech Therapist
Care of the Elderly
Liaison Nurses
Chaplain
Dietician
Funeral Director
Pharmacist
Day Facilities:
Grange Day Unit
Poplars Day Unit
HAWTHORN
WARD
ADMISSION /
ASSESSMENT
Nurse Assessors
Registered Nurse
contribution to care
Chiropodist
Environmental Health
Consultants via MDT
Reviews
Psychiatric Liaison
Nurses
Sue McKenna
Outreach Nurse
Social Workers
SHO’s
Medical Students
Fire Brigade
RIO IT Department
Medical Wards /
SRH
National Care Standards
Commission
Physiotherapists
Training Department
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