SCHOOL OF NURSING AND MIDWIFERY

Transcription

1 SCHOOL OF NURSING AND MIDWIFERY SERVICE LEARNING ACTIVITY An illustrated guide for preceptors and supervisors of student nurses in Professional Experience Placement

2 This Service Learning Activity illustrated guide is supported by funding from the Australian Government under the Increased Clinical Training Capacity Program. COMPILED BY Rosy Green Lecturer, PEP Community Placement Helen Zournazis Academic Clinician Tasmanian Clinical Placement Partnership Project OCTOBER 2012 PRINTED BY UNIPRINT GRAPHIC DESIGNER - ELISE BOSVELD

3 Contents I have Asthma just like you National Youth Week bicycle ride Children s Art work Smoking Cessation package Reminiscence Brochure Help for you and your carers - booklet Gardasil Immunisation poster The Renel Report: Salt the hidden story - Newsletter Albinism and Respiratory Health Assessment -info sheets My journey as a young woman with breast cancer - info booklet Non latex condoms - leaflet Window to the future - wall painting Facing the Storm: A journey with Dementia - Documentary DVD Wound Care Management: a guide for student nurses Urinalysis: What is this? Info booklet Birch Song Book - Song book A Student Information Guide to to Documentation longford Community Health Centre - Nursing Orientation Manual Emergency Evacuation Instructions for Haemodialysis Patients Latent Tuberculosis: Sleepy TB flyer

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5 SCHOOL OF NURSING AND MIDWIFERY SERVICE LEARNING ACTIVITY An illustrated guide for preceptors and supervisors of student nurses in Professional Experience Placement INTRODUCTION Final year nursing students undertake four weeks of professional experience in Community placements and four weeks in mental health placements. They also complete a concurrent theoretical unit to broaden their knowledge and skills. For their final assessment student choose to undertake either: A Service Learning Activity (SLA) - a negotiated project of potential benefit to your service. or A Client Report an in-depth study of a client they are caring for. Once a student decides which theoretical assessment they wish to undertake, they work closely with their preceptor or supervisor and UTAS tutor to assist them in successfully completing their task. This guide provides you with information about the SLA and samples of student achievements. These demonstrate the types of activities that are undertaken and the kinds of products that may be of value to your service.

6 WHAT IS A SERVICE LEARNING ACTIVITY? The SLA project is an assessment item undertaken by a student on placement. In line with particular criteria, this piece of assessment is graded by the unit coordinator. This concept was first proposed by John Dewey in early the 20th Century and is defined as: a formalised, reciprocal learning activity that addresses student learning objectives by directly connecting their theory with practice experience (Bailey et. al. 2002). Students who undertake an SLA negotiate with their preceptor/ supervisor and UTAS lecturer to create an intervention that can be of real value to their placement organisation. Collaborative links are maintained between the university and the practice sites and the student gains marks to progress in their course. All participants work in partnership and stand to gain from the process. WHAT PROJECTS BECOME SERVICE LEARNING ACTIVITIES? SLAs provide creative opportunities and encompass a wide range of activities and resources. As the project is optional, students who choose this option are self- motivated and committed to completing the task. Projects are initially discussed and negotiated between students and preceptors. The student then has the responsibility of writing a proposal and having it approved by their UTAS lecturer. An identified project is ready to be undertaken once it meets the learning requirements for the student and the needs of the organisation. In essence the activity needs to reflect the application of nursing theory into a practice setting. Examples of SLAs may include a brochure, poster, DVD, education day, fun run, painting, policy, instillation, focus group, activity, therapy, information booklet or children s story. The only limit is the student s imagination and the parameters of the Service. WHAT TYPE OF SUPPORT IS REQUIRED? The SLA is overseen and directed by the preceptor/ supervisor in a collaborative relationship with the student. However, the overall decisions are made in partnership with university lecturers. It is the student s responsibility to drive the process, be responsive to Service needs and to ensure all parties are kept informed of progress. Time can be negotiated towards completion of the task.

7 POTENTIAL BENEFITS Service Learning Activities aim to benefit all partners and participants. This provides a sense of achievement for both the student and the organisation in the creation of tangible products. Additional benefits to the community at large can result from these projects as they have a focus on health education, health promotion and health literacy. 1) Benefits for health services: Provide a student focus and enhance time on placement; Encourage and motivate learners; Increase student awareness and sense of belonging; Attract potential future staff; Create potential outcomes of value to the Service; Foster a sense of achievement and collaboration; Improve cohesion and understanding between the University and Industry. (AUCEA 2006; Barnett et. al. 2008, Champagne 2006) 2) Benefits for students: Enrich the student s experience; Provide authentic learning; Encourage deep transformational learning; Be supported in decision making; Enhance communication & reflection on practice; Develop insight and involvement with community issues; Promote of self-esteem and confidence; Develop awareness of the broader professional role. (Bentley & Ellison 2005; Laplante 2009) 3) Benefits for Universities: Engage the student with assessment items; Link student closely to required learning outcomes of the unit; Foster a sense of community responsibility; Reducing opportunities for plagiarism; Support practice sites for student placements; Further student confidence and competence; Promote community engagement & research; Enhance professional attributes. (Flanagan, Baldwin & Clarke 2000; Walsh 2007) IN SUMMARY Your service can use this folder to develop ideas and adapt concepts for Service Learning Activities. The following examples are only a small selection of the work that students have produced. A wide range of products have been created and continue to be used in community and mental health settings. The only limits are time, Service considerations and your imagination. Enjoy!!!!

8 I have asthma just like you Written by Jade Elford, Illustrated by David Fooks

9 Hello, my name is Hugh. I have asthma, just like you. Asthma can make breathing hard sometimes. Asthma can make you feel other things too. You might cough, have an itchy throat or get a sore tummy. If these things happen, tell your daddy or your mummy. 1 2 My breathing can make whistling noises called wheezes as well. If it happens to you, make sure that there is someone to tell. There are some things that can make us feel this way. Some sports and running games can make breathing hard in the day I HAVE ASTHMA JUST LIKE YOU Story book by Jade Elford and illustrated by David Fooks During placement with the Asthma foundation, Jade developed this engaging story book to assist young children understand and manage their Asthma; The story is written from a child s perspective using the language and experience of a real child with asthma. The words and illustrations are all by Jade, with evidenced - based information and resources; The Asthma Foundation uses this innovative book to support and educate children and their families with this diagnosis.

10 He dressed himself in cycling clothes, resplendent to be seen; A.B.Patterson. Promote the bike ride in your service, bring your colleagues and clients, and come riding with us. Royal Park to Rosevears Pontoon for lunch, and return. 16th April, 9:30 for 10:00 Peleton départ. Enquiries: CAMHS Registration: Please include name, contact & agency.

11 NATIONAL YOUTH WEEK BICYCLE RIDE 2collaborative project for youth week - by Bev Barrett and Nikki Madden This activity was developed for National Youth Week to raise awareness and assist youth with strategies to overcome depression; Two students worked together with guidance and support of preceptors from Child and Adolescent Mental Health, Launceston and a number of related services; It involved a range of activities from initiation, participation in the activity and, evaluation on completion.

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13 3 by CHILDREN S ART WORK - ART PIECE Amy Bradford Amy created this vibrant art piece for the Newstead Medical Centre to engage children, identify colours and shapes for health checks and distract them from medical procedures; It was also designed to create a bright and enjoyable atmosphere in the procedure room; An unexpected benefit of this project is that it has become a focal talking point and distraction for a wide range of clientele - not just the very young.

14 Statewide Correctional Health Services Smoking Cessation Package for Health Staff and Future Students May

15 4 Educational SMOKING CESSATION PACKAGE FOR HEALTH STAFF AND FUTURE STUDENTS Tool - by Emma Wilson This educational package on smoking cessation was created for State-wide Correctional Health Services to assist staff in facilitating quit smoking programs for inmates; Emma created a complete tool kit including research articles, group information and presentation material in hardcopy and e-format; This has become a valuable resource for Correctional Health nursing staff to support and educate prison inmates seeking to quit smoking.

16 LIFE STORY WORK Go and catch a falling star... Over a period of time, a client s Memorabilia Box may contribute to their Life Story. This could involve friends and relatives anecdotes about a person. It is possible to put together a scrap book with a selection of stories important to the individual. As a person s longer term memory also fades, it will be possible in the future for somebody to read to them their very autobiography. This may be a source of great joy and pride for the person living with dementia and their friends and family alike. For more information about TIME for dementia please contact: The Australia Centre for Evidence Based Aged Care Tel: (03) Fax: (03) ALZHEIMER S AUSTRALIA Launceston Dementia & Memory Centre Tel: The Old Vicarage, Hobart Tel: REMINISCENCE ONE-ON-ONE INTERACTION IN DEMENTIA CARE A GUIDE FOR SUPPORT WORKERS AT DAY CENTRES FOR INDIVIDUALS LIVING WITH MEMORY LOSS

17 5 Brochure REMINISCENCE - ONE ON ONE INTERACTION IN DEMENTIA CARE - by Louise This SLA assisted Louise in developing an understanding of dementia care as initially she found her placement at Alzheimer s Australia bewildering and confronting; The brochure was designed to both enhance her own learning and be used as a guide for support workers and carers; It outlines Reminiscence therapy approaches for people who have memory loss and includes construction of a personal memorabilia box.

18 Help for You And Your Carers A Guide for Patients with a life-limiting illness

19 Palliative Care Nurse: Palliative Care Services Palliative Care covers the many aspects of care that is needed for a client diagnosed with a terminal illness. Palliative nurses work in close partnership with your general practitioner (GP), Palliative specialist doctors and the Community nurses. Services: Pain Management Symptom Control Night Sits (for end stage) Organisation of Respite Support and Counselling for clients and their families Hours: Monday to Friday 8 a.m to 4 p.m (After Hours Contact Community Nurse (see page 4) Phone: (03) Referral: Self referral, Family, General Practitioner (GP), or Community nurse Hospice: Is a volunteer service that supports people through the progression of their lifelimiting illness, allowing them to keep a dignified lifestyle in the surroundings of their choice. Services: Stay with client to allow carer to have time out Sit with clients day, evening, or night in their own home Read to you, play board or card games Assist with transport (Hospice do not undertake any medical duties) Hours: Monday to Friday 8.30 a.m to 4 p.m Phone: (03) Referral: Self referral, Friend, Family, GP, or Community nurse. 2 6 Booklet HELP FOR YOU AND YOUR CARERS - by Lia Porteus During Lia s placement with Palliative Care, she realised that clients and their families were often overwhelmed and confused about what services were available for end of life care in the home; Based on extensive research and discussion, this booklet was created to explain the range of local services available in North West Tasmania; Lia has used clear language, large font and a simple black and white presentation to create a product with resources, explanations and contact information for families facing a life limiting illness.

20 GARDASIL I ll have what she s having... Hey did you know that Gardasil isn t just for girls but guys can be protected by it as well! SO LET S PROTECT EACH OTHER If you are between the ages of: 9-46 for Girls 9-25 for Boys Then maybe you can protect yourself from Cervial Cancer INCLUDE INFO HERE THEN INCL WEB- SITES FOR MORE INFORMATION CONTACT YOUR LOCAL GP OR NURSE Provided by PMC??

21 7 GARDASIL IMMUNISATION Poster - by Monnique Innes Monnique was placed in a busy Medical practice and became interested in Gardasil immunization for Human Papilloma Virus (HPV); At this time immunisation was routinely given to girls and staff were keen to promote the value of boys being vaccinated as well; This colourful poster and a matching leaflet were developed by Monnique for the waiting room to highlight the vaccine as a health promotion activity and encourage its application for boys as well as girls.

22 June 2012 Volume 1, Issue 1 Kings Meadows Renal Unit The Renal Report Salt The hidden story While our bodies require a certain amount of salt to function, many of us consume over and above what we do need and most of the time we don t even realize we are doing it! While many of us ditch the salt shaker before commencing dialysis, salt is hidden in many of the day to day products that we buy at the supermarket, corner shop or indeed the restaurant where we are dining and we eat it not even realizing. Even for those without kidney issues this can be problematic however aside from high blood pressure, swelling in ankles, hands and face, and shortness of breath, with increased salt comes increased thirst and on fluid restrictions, this is not a happy ending to what may have been a delicious story! While some foods scream out that they are salty such as processed meats like bacon and hams there are many of the canned foods and easy meals which are very salty indeed. Navigating your way through the shopping aisles can be a dangerous affair if you are not salt savvy however help is at hand with many manufacturers offering low salt or indeed no salt options for the more popular choices. One of the best tools that you have at your disposal is the nutritional information on each and every packet or container on the shelf. If you really want to scare yourself, many of the big takeaway chains also have this information on hand if you want it! Stay Salt Savvy! Fresh is best! Buy and prepare instead of opening a can or heating a frozen meal. Not only a cheaper option but lower salt content as well and much more delicious!! Read your labels. Salt is hiding everywhere! Don t be tempted! Dump the salt shaker and don t replace with salty sauces like soy or teriyaki or tricky salts like garlic salt. Shop smarter. Look for low or no added salt options in what you buy Inside this issue: Rose to the Rescue 2 Star Patient 2 Love it or hate it, it is in just about everything we eat! The Fish Bowl 3 Kidney Week 3 As a guideline, for something to be considered low salt it must be under 120mg of sodium per 100g for solid items or 100mls if it is liquid. Anything over that is high in salt and will just make you thirsty. A note of caution however when reading labels is to make sure you are checking the serving size and how many in a packet. A 185 gram packet of potato chips for example has a sodium content of 156 mg per serving. While we already know that this is not low salt, reading carefully we also learn that there are nearly seven serves in a bag of this size. That s a lot of salt! If in doubt, ask a nurse for guidance! Recipe Corner 4 Student Invasion 4 Angel Alert 5

23 Chicken Noodle Soup A hot nutritious winter warmer that won t leave you feeling guilty! Ingredients 1 cooked chicken 8 cups low salt chicken stock 1/2 onion chopped 1 cup celery sliced 1 cup carrots sliced 150 grams dry wide noodles Method 1. Remove chicken from bones, chop and measure four cups 2. Put stock in large pot and bring to the boil 3. Add chicken, vegetables and noodles 4. Bring to the boil and cook until noodles and vegetables are soft. 5. Serve scattered with parsley This recipe makes 10 servings of 1-1/4 cups of delicious soup! Vegetables can be modified to suit your tastes or what you have in the fridge! Enjoy! 8 Newsletter THE RENAL REPORT: Salt the hidden story - by Bea Butler Bea was the first student nurse to attend the newly opened Renal Satellite unit in Kings Meadows and wanted to contribute something fun and engaging for the clients; She decided to develop a Newsletter and called it The Renal Report - her intention was that it could be the start of a regular activity- perhaps taken on by successive future students; A chatty style of writing is used to provide information related to kidney health, explain common problems and highlight the hardworking staff. Kidney friendly recipes are included and a star patient is interviewed.

24 1 Albinism Definition Albinism is an inherited, genetic condition which due to the lack of an enzyme tyronsinase results in a deficiency of the pigment melanin. Melanin is responsible for the colouring of a person s skin, hair and the iris of the eyes. Thus an absence or deficiency of this pigment affects an individual s appearance. There are different types of albinism oculocutaneous albinism is the most common and skin, hair and eyes are all affected. An African person with albinism often has very pale chalky skin, light coloured sandy hair and eyes which are either light brown or blue. Without the protection that melanin offers from the damaging effects of ultraviolet (UV) radiation, people with albinism are more likely to suffer injury to the skin and are at risk of developing skin cancers. Albinism also affects eyesight causing varying degrees of visual impairment. Prevalence and relevant statistics Albinism is far more prevalent in sub- saharan Africa than in most other populations groups throughout the world. It is estimated that the rate of albinism in Tanzania is as high as 1 in 1429 people. This is approximately 14 times greater than the estimated rate of 1 in seen in most population groups. One theory presented for this disparity is the small gene pools and practice of consanguineous marriages between relatives with common ancestors.... Albinism is a The Peter Hewitt Care for Africa Foundation Inc. encouraging philanthropic endeavour in Australia s youth

25 9 Information ALBINISM AND RESPIRATORY HEALTH ASSESSMENT: The Peter Hewitt Care for Africa Foundation Inc. sheets for volunteer s manual - by Angela Downes and Nicole Woodfield Final year students at UTAS have the opportunity to work for the local charity The Care for Africa Foun dation Inc supporting one of the world s most impoverished areas - Tarime in Tanzania, Africa; This SLA project involves creating an information sheet for a manual that is being collated for aid workers going into the district. The language must be simple and accessible as it will be used by a wide range of volunteers not just health care professionals; Angela researched the complex issue of Albinism - a common genetic disorder with profound health impacts and cultural superstitions in Tarime; Nicole extensively researched respiratory health and received a donation of stethoscopes from the University bookshop which have been sent out to Tarime, Africa. Numerous contributions by students have been made including traditional medicine, language and culture, Malaria, birthing practices and Dysentery.

26 My journey as a young woman with breast cancer.

27 My name is Yvette, but everyone calls me Paddy and I am 39 years old. My cancer journey began when I discovered a large lump in my left breast while examining myself last October. I check my breasts fairly regularly, perhaps not as regularly as I should have - but that is how it is being the mother of a three year old child. The lump hadn t been there the month before, it wasn t sore but I knew instinctively that is was something bad. I phoned my GP but she was away on holidays until the following week so I decided to leave it until she came back. Initial diagnosis I visited my GP on the following Monday and she arranged for a mammogram a few days later. Following the mammogram they also did a deep core biopsy and an ultrasound. We spent the weekend in shock, the family cried together. That first week was spent in a daze. The staff were very gentle and kind. I was asked to sit in the waiting room and a short time later someone came out and said I am not going to lie to you, there is a lot of calcification and it can be linked to breast cancer. This was the first gap in service delivery that I experienced. I work in the health sector and knew that it could have been handled a lot better than it was. It would have been better if they could have spared ten or fifteen minutes and told me in a private room over a cup of tea perhaps, given some counselling rather than being told in front of the older women in the waiting room. I remember walking to my car and having a howl. I needed someone to hold my hand, drive me home as I didn t want to have a car accident. I have great family support but I didn t want anyone there at the beginning of this journey, I needed to get my head around it all first. The wait was difficult as I knew that the news was going to be bad as we have extensive cancer in the family. There are days when I feel down, and I just need to look at my son and he re-ignites my motivation As a single mother I do wonder about meeting a future partner, and it does feel daunting but I will deal with it when it happens. Right now my body needs a rest and recovery time before I can even consider a relationship. Having a hysterectomy seems less daunting than having my breasts removed, because it is internal and nobody can see inside. Looking towards the future: This has been a huge personal learning curve and I have learnt a lot about myself. It has made me realise that I need to be more assertive, say what s real at the time and not hold onto old stuff. It s funny you know, if I was to sum up my journey I would say that the first week I felt out of control but I can now honestly say that once I knew where I was going I felt more positive about my survival. There have been days when I have felt down, and I just need to look at my son and he reignites my motivation to surviving. My need and want to be there as a mother to my son, my maternal drive is very strong. The end of my cancer journey will be the beginning of my new adventure. Ten days after having my reconstruction I will begin my new life with new boobs and a ten day trip to Italy. My Mother came with me to the GP that Friday. My GP confirmed my worst fears Yes you have cancer, an aggressive cancer called ductal carcinoma in situ. It is a cancer of the milk ducts. Strangely enough I had had two bouts of mastitis in the same breast whilst breast feeding my son, was there some kind of connection? This has been a huge personal learning curve and I have learnt a lot about myself. 10 information MY JOURNEY AS A YOUNG WOMAN WITH BREAST CANCER booklet A student working with breast care nurses identified a lack of educational material to support younger women coping with a diagnosis of breast cancer; She worked closely with a client to develop this sensitive and personal account of her experiences; The simple and engaging diary format follows a client s journey from diagnosis through treatment. It has become a valuable resource for women.

28 Available at:. Capital Chemist. Chemist Warehouse. Coles. IGA. Priceline. Terry White Chemist. Woolworths MANIX SUPREME NON-LATEX Available at:. Priceline. Secret Women s Business. Terry White Chemist NATURAL SENSATIONS UNIQUE NON-LATEX Available at:. Secret Women s Business Business Locations Capital Chemist Brisbane Street, Launceston.. 86 Hobart Road, Kings Meadows Elphin Road, Newstead.. Shop 4 Riverside Shopping Centre Invermay Road, Mowbray Heights. Coles.128 Wellington Street, East Launceston..198 Charles Street, Launceston.. 15 Racecourse Crescent, Launceston Hobart Road, Kings Meadows.. 71 Galvin Street, South Launceston.. 159/163 Elphin Road, Newstead. Chemist warehouse. 112a/ Charles Street, Launceston. Priceline. 88 Charles Street, Launceston.. 15 Racecourse Crescent, Launceston. Secret Women s Business. 205 Charles Street, Launceston. IGA.113 George Town Road, Newnham.. 5 Brougham Street, West Launceston.. 44 Invermay Road, Invermay.. 42 Wentworth Street, Newstead.. 86/78-96 Wellington Street, Launceston.. 1 Norwood Avenue, Norwood. Terry White Chemist. 86A St John Street, Launceston. Woolworths.111 Hobart Road, Kings Meadows Invermay Road, Mowbray. *References: www. condomshop.com.au Dannika M. Allergies and products. More common than you think!

29 What is it all about? Do you sometimes have pain or a slight discomfort during sex? Do you find it is less painful without a condom? Do you sometimes opt to not use a condom because of this discomfort or pain? You may have a latex allergy without realising it. There are different types of allergic reactions ranging from a small rash to a full blown anaphylactic shock. Both Men and women can become allergic to latex prophylactics (condoms)*.the problem is, for women in particular, it is harder to find if a reaction has occurred, because, well, it can t be seen as easily. There are hundreds of condoms out there and sometimes walking into a shop to buy them can be daunting. This pamphlet has simple information on which condoms are non latex, where they are sold and just to make things easier, what they look like. So you don t have to read every packet or ask for help. Products These condoms are made from polyisoprene which is much softer and more elastic than polyurethane. They are easier to put on and provide a supple, natural feel for the user. Polyisoprene condoms react similarly to latex condoms in the presence of oil, so it is important to use only water-based or silicone lubricants with them.* ANSELL LIFESTYLES SKYN Closest thing to wearing nothing Ansell Lifestyles Skyn condoms are manufactured from polyisoprene. Ansell Lifestyles Skyn prophylactics really are the closest thing to wearing nothing! Feel what you've been missing.* - Available in a 10 pack and 20 pack - Average cost 10 pack $8.00-$ Average cost 20 pack $15.00 MANIX SUPREME NON-LATEX Sex without latex! Manix Supreme condoms are also made from polyisoprene. They provide softer, more natural feel and have been clinically proven to enhance stimulation. They are packed using new disc technology to make opening easier and to reduce the chance of damaging the condom during opening. Manix is your pleasure partner!* - Available in a 10 pack - Average cost $12.00-$15.00 NATURAL SENSATIONS UNIQUE NON- LATEX With Unique Pull System Natural Sensation Unique non-latex condoms are packaged in a discreet credit card style 3 pack. These condoms are suitable for users with a latex intolerance. The Unique Pull System allows the condom to go on fast and with no hassle.* - Available in a credit card style 3 pack - Average cost $9.50 ANSELL LIFESTYLES SKYN 11 leaflet NON LATEX CONDOMS - by Dannika Moles This leaflet highlights the issue of latex allergies and contraception using condoms; It contains clear and simple information on non-latex condoms, what they look like and where they can be obtained in Launceston; This resource identifies a gap in popular contraceptive programs in a no-nonsense approach aimed at young people.

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31 12 wall WINDOW TO THE FUTURE painting A student placed at Richmond Fellowship drew on previous life skills as a builder and helped prepare a wall space at the centre for clients to use as a motivational painting exercise and an engaging activity; Once prepared each client was encouraged to paint their own window pane vision of the future as part of Mental Health week for the centre; As well as having a message of hope and recovery, the wall is also a decoration and talking point and can be extended and adapted for future clients.

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33 THE OLD GREY FOG In the morning I rise, everything is fine, I dream my dreams seeing the sun, feeling it s warmth, I run and run. The world is full of wonders true, The birds cry out, flowers bloom, The wonder of life in everything. Then that old grey fog comes rolling in, Obscuring the sun, what a state I m in, Turning everything to grey, it leaches the colour from my day. On the outside I am fine, No one sees the inner fog that makes me blue and sad, For I cannot see beyond my nose for the fog is so thick and bad. Moving in slow motion now, Unsure of myself, confidence failing, unable to cope, I am just wailing for the fog obscures everything turning it to grey. My friends have gone for they cannot see the fog that makes it hard for me, They think I ve lost interest, do not care about the things that used to fill my day, Caring and sharing, loving and life are all so far away when the fog obscures my day. I do a bit, I rest a lot, Trying not to fret or worry, living life as best I can, Turning to the sun, I try to have some fun before the fog rolls in. I now have caring friends who understand my needs, Seeing the look of exhaustion, moving in to support my slowly sinking boat, Lost in that old grey fog. 13 documentary FACING THE STORM: A journey with Dementia DVD - produced by Julie Kingston This DVD explores the story of a person with early onset dementia through poetry and painting; The painting is a potent illustration of the Old Grey Fog and the poem is an intimate window into the innermost experience of memory loss; This DVD is used to educate carers and staff at Alzheimer s Australia, Tasmania with insight into the issues that arise when someone has a profound awareness of memory loss.

34 Wound Care Management: a guide for Student Nurses

35 Acknowledgement: This wound care manual is aimed to provide important aspects of managing a person and their wound. It will enable students to integrate and further enhance the knowledge acquired from their practical placement at the Newstead Medical Centre and the Bachelor of Nursing Degree. Contents: Acknowledgements Pages Skin layers and functions 1 Two broad types of skin wounds 2 Healing by Primary and Secondary intention 3 Wound Healing Phases 4 Phases 5 Wound Management an Holistic Approach 6 Assessment of systemic conditions affecting wound healing 7 Extrinsic factors 8 Local factors that influence wound healing 9 Assessment of wound aetiology, site and depth grading 10 The stage of wound healing The type of exudates 13 Wound edges and surrounding skin Assessment 14 Infection and Odour Assessments 15 Pain Assessment 16 Preparing the wound bed using the TIME pneumonic 17 Debridement 18 Cleaning the wound 19 Plan wound dressing type is appropriate for the wound 20 Wound dressing Inert/Passive Dressing First-Line Interactive/Bioactive Dressings Second-Line Interactive/Bioactive Dressings (University of Tasmania, 2010) Evaluate Dressing and Documentation 34 References Resource WOUND CARE MANAGEMENT: a guide for student nurses package - by Mandy Canning When starting placement at a local medical practice, Mandy was overwhelmed with the complexity of wound care products and techniques used in the surgery; She decided to create a comprehensive guide to assist future student nurses in navigating the numerous products, types of wounds and treatments utilised; The product was very successful and has continued to be a valued resource, for students, nursing and medical staff.

36 What is this reading? Specific Gravity-the concentration of solutes in the urine. It reflects the ability of the kidneys to concentrate the urine. ph-measures the acidity of the urine. Bacteria can make the urine more alkaline and also an alkaline urine provides a better environment for bacteria to grow in. Leukocytes are white blood cells and part of the immune system. Nitrite- converted from dietary nitrates by gram -ve bacteria. Some bacteria do not produce these. Protein- this should be filtered out by the glomerulus in the kidney. Glucose- indicates blood glucose levels are high. Ketones- produced during fat metabolism. Urobilinogen formed by breakdown of bilirubin. Bilirubin produced from blood cell breakdown. Blood should not be present. Haemoglobin should not be present. How to take a urine sample for urinalysis Collect a sample of mid-stream clean-catch urine (MSU) in a sterile, clear sample pot. Ask the patient to clean the genital area, urinate a small amount, then catch some in the sample pot. Store in fridge if there is a delay, but analysis must occur within 2 hours of collection. To analyse, wash hands, put on gloves and lay out a paper towel and 1 dipstick. Check the expiry date on pot. Dip the stick completely in the urine pot and dab gently onto the paper towel before lying it flat for 1 minute, then check on the chart as per timing instructions for reading dipstick. What else should you observe? Smell- does it smell of Faeces- there may be a gastrointestinal-bladder fistula.fruity/ sweet it may be ketoacidosis due to breakdown of fats with diabetes. Ammonia- alkaline fermentation possible UTI or is sample old? Asparagus-from eating a lot of asparagus. Colour: It should be a straw or yellow colour. If not is it: Dark yellow may be due to dehydration. Bright yellow- this may be due to vitamin or herbal medications, or excess bilirubin. Red- may indicate blood, beetroot or haemoglobin Dark brown- may be due to Iron supplements or prophobilin or urobilin from the intestines Transparent- drinking large volumes or excess urine production. Dipstick Urinalysis what is this?...an inexpensive tool for early diagnosis of disease. It is a chemical analysis of urine involving a plastic strip with pads that react and change colour when dipped in urine. An information booklet for all health workers and students For use with the Combur Urinalysis kit

37 What unexpected colour changes mean Specific gravity ph Leukocytes Nitrite Protein Glucose Ketones Urobilinogen Bilirubin Blood Haemoglobin Low SG may be due to excessive fluid intake (oral or IV fluids), renal failure, acute golmerulonephritis, pyelonephritis, acute tubular necrosis, diabetes insipidus, hyperaldosteronism or ADH insufficiency. High SG may be due to dehydration due to poor fluid intake, sweating, vomiting or diarrhoea, cardiac failure, liver failure, or adrenal insufficiency. A high solute concentration may be from glucose due to diabetes mellitus or IV glucose, or protein. Low ph (acidic) acidic dietary intake eg cranberries or high protein diet, metabolic or respiratory acidosis, diabetes mellitus, diarrhea, starvation, or medications. High ph (alkaline) may be due to a low carb or vegetarian diet, renal calculi, some medications, respiratory or metabolic alkalosis, or a UTI. UTI. Caution- negative to UTI caused by pseudomona sp., staphylococci or enterococci. May be indicative of inflammation of urinary tract, such as pyelonephritis/ glomerulonephritis/ cystitis or urethritis. UTI. Formed by Gram negative bacteria. Some bacteria, eg staphylococci, entercocci or pseudomonas spp, which cause UTIs do not produce nitrites. A diet without vegetables or high doses of vitamin C can lead to a false negative. Causes of proteinuria are high protein diet, strenuous exercise, dehydration, vomiting, fever or emotional stress, or indicate early sign of kidney disease or injury to the urinary tract, bladder or urethra, inflammation, malignancies, multiple myeloma, diabetic nephropathy, errors of metabolism, severe venous congestion of the kidney, CCF or pre eclampsia. A false positive may occur if ph is high. May indicate diabetes, liver disease, medications such as steroids, tetracycline, lithium, penicillin or cephalosporins, sudden shock or pain, pancreatitis, AMI, pregnancy. Diabetes mellitus, alcoholism,eclampsia, restricted carbohydrate intake from starvation, anorexia or dieting, or altered carbohydrate/ fat metabolism due to vomiting or severe diarrhea or inborn errors, breakdown of muscle tissue in marathon runners, Ketoacidosis is a medical emergency. Raised levels may be due to liver cirrhosis, hepatitis, hepatic necrosis, liver cancer, haemolytic and pernicious anaemia, malaria and CCF. Low levels- may be due to bile duct blockage or some antibiotics. Raised levels may indicate liver disease or biliary tract infection, stricture or stones. Presence may be due to trauma, smoking, infection, renal calculi or strenuous exercise. It may also be present with UTI, damage to the glomerulas or tumours of bladder or kidneys, acute tubular necrosis, traumatic catheterization, damage by the passage of kidney stones, or menstrual contamination. Positive but no blood indicates excessive destruction of RBC in vascular system eg sickle cell anaemia, malaria or a reaction to the wrong blood used in a transfusion. Hb and blood may be due to kidney disease. The dipstick is very sensitive to RBC, but even more to free Hb. 15 Information URINALYSIS: WHAT IS THIS? booklet - by Kathryn Scott This booklet was written for State-wide Continence Services to enable health workers and students to better understand dipstick urinalysis; It describes both the purpose of and procedure for conducting a urinalysis; Using a simple but highly effective colour chart this booklet clearly identifies and describes the related health conditions arising from dipstick colouration changes.

38 BIRCH songbook 30 of your favourite old songs

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`$ -GFMERF$RFHWWM$UHMPKL$ )$WOIF$MOQ$ $ )$GFHR$JHJPFU$\RMN$)$SHV\G$VGF[$LROS$ -GFMEWW$WFHRK$[Q\G$[ORF$VGHK$)EWW$FIFR$YKOS$ 0KZ$)$VGPKY$VO$[MUFWT$ %GHV$H$SOKZFRTQW$SORWZ$ $ <FU$)$VGPKY$VO$[MUFWTN$SGHV$H$SOKZFRTQW$SORWZ$ 16 Song BIRCH SONG BOOK book - by Sarah Hammond Sarah undertook placement with Bruny Island Community Nursing and encountered an elderly gentleman who was withdrawn and suffering from poor nutrition; She discovered he loved to sing and so compiled a list of all his favourite tunes and created a song - book in simple print and a large font. The front cover is an evocative photograph she took of the Island; A regular singing session was instigated at the local Birch Community Centre. This became a popular event and encouraged him to attend the centre, participate in an activity he loved and partake in nutritious meals.

40 A Student Information Guide to - Documentation at Hobart Community Health Nursing (HCHN) 1

41 17 Student A STUDENT INFORMATION GUIDE TO DOCUMENTATION learning package - by Tania Harris, Laura Hinchen & Elizabeth Dannals Three students collaborated with their preceptors to create this learning package for future students undertaking placement at Hobart Community Health Nursing (HCHN); Documentation requirements in health care organisations can be daunting and confusing for students and this package was designed to explain and illustrate the documentation requirements for HCHN; The package included a PowerPoint presentation, examples of correct documentation, a sample of patient notes and numerous resources to help students navigate this important aspect of nursing care.

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43 18 Nursing LONGFORD COMMUNITY HEALTH CENTRE Orientation Manual - by Joanna Praciak This extensive SLA was created by Joanna for the nurses at the newly opened Longford community centre. The product is a large lever arch file containing a great range of resources; Joanna has introduced the centre and collated a wide variety of relevant information, literature, policies and procedures. This has proved an invaluable resource for nursing staff in getting the newly opened centre up and running, which continues to be used.

44 Emergency Evacuation Instructions for Haemodialysis Patients REMAIN CALM LISTEN FOR INSTRUCTIONS IF EVACUATION IS REQUIRED FOLLOW THESE STEPS : (1) PUT SEAT IN UPRIGHT POSITION (2) REMOVE YOUR BP CUFF (3) PRESS TO STOP BLOOD PUMP (4) CLOSE 4 CLAMPS ON BLOOD LINES (5) DISCONNECT or cut THE LINES (6) ENSURE YOUR 2 NEEDLES / VASCATH ARE SECURE REMAIN SEATED WAIT FOR INSTRUCTION TO EVACUATE

45 19 EMERGENCY EVACUATION INSTRUCTIONS FOR HAEMODIALYSIS PATIENTS instruction card - by Jenny Jordan On placement with the Northwest renal unit Jenny identified that there was no evacuation information for clients on dialysis. She felt that an emergency situation could prove extremely stressful for clients undergoing treatment; In collaboration with staff she created a simple instruction card with six simple steps for dis connecting the machine in case of an emergency; The cards have been laminated in A4 size, and attached to each chair for easy access. Staff are now able to alert patients to the card giving them a sense of autonomy and independence in disconnection should the need ever arise.

46 People with LTBI are not infectious and cannot spread TB infection to others. They do not feel sick and or have any symptoms. They are infected with Mycobacterium tuberculosis, but do not have TB disease. The only sign of LTBI is a positive reaction to the tuberculin skin test or TB blood test. A person with LTBI: Usually has a positive skin test or blood result Has a normal chest x- ray and a negative sputum test Has TB bacteria in his/her body that are alive, but inactive Does not feel sick Cannot spread TB bacteria to others Needs treatment for LTBI to prevent TB disease. What is the treatment for LTBI? The usual medication given to treat LTBI is Isoniazid. The tablets are taken daily for 6 months, as it takes this long to kill the inactive TB germs. You may be given pyridoxine (Vitamin B6) to prevent possible side effects of Isoniazid. Isoniazid tablets are to be taken every day of the week for 6 months LATENT TUBERCULOSIS INFECTION LTBI OR SLEEPY TB Clinical Nurse Consultant Telephone:

47 म ल कसर$ औष ध ख न? तप ईल सब औष ध एक पटकम न#न पछ# तप ईल ई औष ध ख न य द!दल उनक ल ग प # म च#ह लग एर व ड य$रम ल ख र व ख न ख न भ"द आध घ"#ट अग $ड औष ध ख एर म"त म#न स"छ य"द तप ईल एक!दन औष ध ख न!ब स%न भय भन, अक#!दन प"हल क जसर$ न औष ध ख न (तर द ई!दनक औष ध एक!दनम नख न ) य"द तप ईल ध र पटक औष ध ख न!ब स%न भय भन,!टब र गक!कट ण म न$ य"क!भ व कम ह #छ तप ईल!ब स%र ( भय भन आ"न ड #टर व नस#ल ई भ"न ह स य औष ध ख द तप ईल र"#स स वन नगन $ अ" नय औष ध ख न स # गन $ भ"द प"हल आ"न ड #टरल ई स ध र म # ख न,!कनभन क तपय औष धल स त क!टब क उपच रक ल ग ख एक औष धल ई असर गन# स"छ ल ट #ट!यर ग अथव स त क!टब क म ल म र य उपच रक ब र म अ" कस ल ई भ"न आव#यक छ? स त क!टब भएक!य#$ ए"ल ल अ"ल ई!टब स न$ स"द न,!यस क रण, य"द तप ई च ह न ह #न भन अ" कस ल ई,!बध लयम व क मम भ"न आव#यक छ न तप ईल जच उन अ" क न ड #टरल ई य"क ब र म बत उन र उह ह% य क र ग #य र # छन ( च"#कह& ह' क *त क -दन ६ म"हन स'म ख न पछ' र च"#कह& ह' क *त क, स मब र, बधब र र श!ब र ६ म"हन क ल ग ख न पछ/ ) फ"न Clinical Nurse Consultant Telephone: अ"!य न!दन पन# क र ह &: म थ उ"ल %खत क र ब ह क: तप ईक अ! क न!व!थय स"ब$%ध सम#य व तप ई गभ#व त ह न ह #छ, व गभ#व त ह न च ह न ह #छ भन आ"न ड #टरल ई भ"न ह स 20 by LATENT TUBERCULOSIS: SLEEPY TB FLYER Mahima Dahal Mahima was placed at Refugee Health and noticed that latent tuberculosis (TB) was a common problem with refugee clients. TB was poorly understood and often resulted in reluctance to take the prescribed treatment. As many clients were from her home country of Nepal, Mahima worked in collaboration with her preceptor and medical staff to create a simple A4 leaflet in both Nepalese and English. The leaflet is easy to reproduce and explains why and how medication is needed to treat the condition. It has become a valuable ongoing resource for Refugee Health and an example of how students bring life skills to enhance their clinical placement.

48 REFERENCES: Australian Universities Community Engagement Alliance (AUCEA) (2006) Universities and Community Engagement position Paper, accessed at on 14th September Barnett T, Cross M, Jacob E, Shahwan-Akl L, Welch A, Caldwell A & Berry, R (2008), Building capacity for the clinical placement of nursing students, Collegian 15 (2) : Bentley R, & Ellison JE (2005) Impact of a service-learning project on nursing students, Nursing Education Perspectives, 26 (5): Champagne, N (2006) Service learning: Its origin, evolution, and connection to health education, American Journal of Health Education, 37: Flanagan, J., Baldwin, S., & Clarke, D. (2000) Work based learning as a means of developing and assessing nursing competence. Journal of Clinical Nursing, 9, Laplante, N (2009) Discovering the meaning of reciprocity for students engaged in service-learning, Nurse Educator, 34 (1) : 6-8. Walsh, A. (2007). An exploration of Biggs constructive alignment in the context of work-based learning. Assessment & Evaluation in Higher Education, 32, (1),