Paediatric Bone Marrow Transplant Liaison team Profile of learning Opportunities Ward 3 day unit Great North Children s Hospital Student Nurse: Start Date: Mentor: Co-mentor
Student Welcome Information and Orientation The Bone Marrow Transplant Liaison team and Children s Immunology and allergy Nursing team would like to take this opportunity to welcome you to the team and we hope that you find your placement with us a valuable and enjoyable learning experience. The experience of working with the BMT Liaison team will offer understanding and experience of organising and implementing care for children and families in varying stages of the bone marrow transplantation process for severe immunodeficiency s. Whilst working with Children s immunology and allergy nursing team will offer an insight and understanding in to the care of Children with immune and allergy related conditions. This booklet aims to enhance your learning and identify your learning needs through offering an insight into our teams, the multidisciplinary teams and the BMT unit the liaison team are attached to. You will be assigned a mentor on the BMT liaison team who will co-ordinate your placement in conjunction with the Immunology/ Allergy and the HIV/AIDS nursing teams whilst also helping to identify learning opportunities. We would appreciate all feedback on your placement with us so as to identify changes and improvements to be made to improve our services, care and student placements. The BMT Liaison Team
Children s Bone Marrow Transplant Liaison Team The children s Bone marrow Transplant liaison team is attached to the Children s Bone Marrow Transplant unit (CBMTU). The CBMTU is a 10- bedded unit two of which are for the Haemo-oncology patients. The other eight beds are available for a range of immuno-deficiency patients and more recently children with juvenile idiopathic arthritis. This is a busy dynamic unit at the forefront of developing care for these children and families. The Liaison team office is situated on this unit (Ward 3 GNCH). The CBMTU Liaison Team offers support and continued care to the immuno-deficiency and JIA patients pre and post transplant the catchment area for these children and families is from the midlands up through Scotland and includes Ireland. Effective communication and multidisciplinary team working with local care teams and family centred care is an integral aspect of the CBMTU Liaison Team to ensure effective local care delivery. As the actual BMT process requires strict isolation and hygiene care on the unit the children and families usually move from the unit in to one of five halfway houses close to the hospital to ensure a safe transitional process where the liaison team care for the children and families whilst planning for full discharge home. As part of your learning experience you will have opportunity to work directly with the teams and disciplines involved in the child and families care in Newcastle whilst communicating and assisting in arranging packages of care with the care teams in the local areas.
ESSENTIALS Off Duty The CBMTU Liaison Team and the Immunology nursing team working week comprises of 37.5 hours, Mon-Fri 0900 1700 with a 30min meal break. However depending on the learning experiences you identify this may vary. Sickness You must report any sickness or absence to the liaison team as soon as possible who will notify any discipline you may be working with that day, if you need to report it out of hours you can leave a message with staff on ward 3. It is courtesy to update your mentor on the liaison team with developments regarding your absence including return to work. The university also needs to be informed as per student sickness policy. Uniforms The uniform policy is situated on the trust internet and in your student handbook. The liaison team and immunology nursing team wear the standard hospital uniform therefore you should wear your student uniform whilst working with the teams this may vary day to day however depending on the learning experiences you undertake, we will advise you on this at the time. No jewellery except a wedding band should be worn and no nail polish should be worn. Security There is keypad entry to the CBMTU unit and visual monitor door release for the children and families safety we would ask you be vigilant with this and ask identity of all visitors you answer the door to. Your student identification badge must be worn at all times. Mentorship We hope that you enjoy your combined placement on the CBMTU liaison team and Immunology/Allergy nursing team your mentor will work closely with you to facilitate the learning opportunities available. We are aware that at times there may be some reason that the student does not feel they are achieving the best out of the placement and would promote that you speak to your mentor or liaison sister Helen Harvey who will endeavour to offer advice and solutions to enhance the placement and learning experience.
Children s Immunology and Allergy Nursing Team Newcastle is the northern regional centre for immunology compromising of adult immunology/allergy based at the RVI and paediatric immunology/allergy based at the Great North Children s Hospital. The region covered ranges from North Yorkshire to the Scottish borders and from West coast to East coast with a few satellite patients from as far as Aberdeenshire. The Treatment for severe immunodeficiency is bone marrow transplantation, which is undertaken on the specialised unit on ward 3. Treatment for most other immunodeficiency is prophylactic oral antibiotics and/or immunoglobulin replacement therapy. This is usually undertaken in the children s day unit. Occasionally the children may be transferred to ward 2 in the evenings or if a rare adverse reaction occurs for observation. Immunoglobulin therapy may be given at home after parents or infusion partners have undertaken a specialist home therapy programme, which is delivered by the nursing team. The immunology team including a dietician mainly see allergy patients in the Children s outpatient department (COPD). The initial outpatient assessment for allergy will include consultation, diagnostic testing such as blood or skin prick testing leading to treatment management, which may include EpiPen training and on going support and advice. Those requiring food, antibiotic, anaesthetic challenges or desensitisation are admitted to the day unit. They are admitted to ward 6 if they need a double blind placebo challenge, which is carried out as three separate challenges over three consecutive days where neither staff nor patient is aware which is allergen or placebo. Lucia Russell (Senior immunology nurse specialist) and Lisa Salter (Immunology nurse specialist) support and oversee the patients within the service both in hospital and at home. They provide support and advice to children, parents, staff and other multidisciplinary teams and outside agencies such as schools and community nurses. Lucia is a nurse presciber and runs nurse led clinics where initial allergy diagnosis and treatment plans are made.
Paediatric HIV/ AIDS Nurse Specialist Ailsa Pickering is the nurse specialist for paediatric HIV/AIDS. The children come from throughout the region for specialist care and advice. Ailsa reviews the patients when they attend for review in Newcastle and also provides support at home. The nurse specialist works closely with the adult immunology team as usually the mother is also affected and also with midwifery services co-ordinating the care of the neonate from infected mothers in order o try to prevent the infant being affected by HIV. Due to the sensitivity surrounding HIV/AIDS many of the families will not allow students to be present during consultations however students will be accommodated whenever possible.
Multidisciplinary Team for Combined Teams Rheumatology team CJD Nurse Support Groups Infection Control Child, Family and Carers Biochemistry, Haematology, Immunology Ward 3 BMT Unit Ward 1a Social Worker GP Medical Staff Pharmacy Asthma nurse Dietician Dentist Community Nurses The BMT Liaison Team Radiology/ Immunology/ Allergy Nurse specialist team Physiotherapist Audiologist Local Consultant Occupational Therapist Local Hospital Adult Immunology Team Nursery Nurses Health Visitor Ward 2 The Multidisciplinary teams are Newcastle and the childs local area based
Information and Orientation Shown around unit Introduced to Staff Saving lives documentation ANTT Protective isolation Handwashing/Scrubbing Introduction to patient group Student competencies Our expectations of students Emergency Numbers/Bleep Health & Safety Issues Initial discussion with Mentor Family- Centered care Introduced to patient group Nursing Care in protective Isolation Methods of isolation Monitoring Procedures Restrictions in care personnel Drug Administration Multi-disciplinary team Care Plan Updating Immunsations/subcut Maintain safe medication environment Pyrexia protocol Normal Blood Values Care of Central Venous Lines Hygiene in patient group Documentation and Administration Nursing Observation charts Pharmacy/ Regular orders P re Admission planning Computer Use Nursing Care Plan writing Hospital policies/procedures Discharge Planning from Discharge planning home ward Consolidation Interim report Nursery nurse Play date... specialist day Plan for outcomes to achieve Ward 3
Discussion with Clinical Educator Day with teacher Centre for life Allergy/ immunology nurse specialist Day with HIV nurse specialist Tissue typing Immunology lab We hope that you have enjoyed the allocation and extended your knowledge and skills and felt a part of the team.