NORTH TYNESIDE PRIMARY CARE TRUST. PROFILE OF LEARNING OPPORTUNITIES. COMMUNITY BASE: Spring Tce Health Centre District Nurse Team. Last updated Jan 10
GUIDANCE FOR MENTORS AND STUDENTS This profile of learning opportunities is a document which details learning opportunities within your community / primary care placement area. It is a growing and dynamic document, with staff and students being responsible for keeping it updated and relevant for their clinical area. Mentors and students should use this resource to select appropriate learning opportunities to help students meet their specified competencies. It is expected that students will use this file as a resource and be proactive in identifying their learning needs. Most of these learning opportunities will take place with a variety of community nurses including district nurses, health visitors, public health nurses, school health advisors, specialist nurses and practice nurses. There will also be opportunities to work with allied health professionals. Despite the diversity in learning opportunities within primary care, not all of these opportunities will be accessible during placement and each student will have a unique placement experience. However, this resource gives an overview of potential inter-agency and multiprofessional contacts which students may encounter during their community / primary care placement. All students are expected to receive an orientation to their specific practice area. Please ensure that the orientation checklist is completed and retained in this portfolio. Following placements, on-line student evaluation forms will be returned to the practice area. These should be used to inform and develop good mentor practice. Please retain student evaluations in this portfolio for audit purposes. Jennifer Logan Practice Placement Facilitator Tel: 0191 2196052 / 07833480442 2
CONTENTS 1. AREA PROFILE. 2. LEARNING ZONES. 2.1. District Nurse. 2.2. Health Visitor. 2.3. Public Health Nurse. 2.4. Practice nurse. 3. LEARNING OPPORTUNITES. 3
1. AREA PROFILE. CLINICAL AREA : Spring Tce HC LOCATION: Spring Tce North Shields TELEPHONE NUMBER: 0191 2196630 SHIFT PATTERNS: Day shifts 8.30-5.00 Evening and weekend shifts negotiated via mentor NURSING MODEL USED: Based on Roper Logan and Teirney modified by North Tyneside PCT MENTORS: Angie Ridley Marie Summer Connie Smith Margaret Wootton NAMED PERSON RESPONSIBLE FOR POLO Maria Summers 4
STUDENT NURSE INDUCTION CHECKLIST Student Name: Start Date: This programme is a guide to assessors to aid the integration of student nurses into the working environment. It is good practice to have the document completed within the first two days of the placement. Student nurses must be allocated an assessor at least one week before the commencement of the placement. Within the school health service, the mentor will arrange to be with the student on their first day of placement. NB It must be remembered that the student must work 50% of the week with her/his assessor. ORIENTATION CHECKLIST SIGNATURE DATE Shown around the working environment Introduction to team members Working hours discussed Parking & Transport discussed Procedure for reporting sick Discuss dress code Given student nurse profile & philosophy Dining room or lunch arrangements TO BE SHOWN Health & safety file Trust policies Control of infection policies Service standards & protocol file Home visiting policy Emergency exits Fire drill & procedure Fire extinguishers 5
2. LEARNING ZONES. 2.1. District Nurse. 2.2. Health Visitor. 2.3. Public Health Nurse. 2.4. Practice nurse. 6
2.1 District nurse. Pharmacist Community disabilities Practice nurse Age concern/ voluntary agencies Chiropody Cardiac rehab nurse Palliative care District nurse Diabetic specialist Tissue viability nurse Social services CPN s & other specialist nurses. Wheel chair services/ joint loans Sexual health/ midwives Moving & handling Others include, Health visitors. GP s. Marie Curie day hospice. Caring for Cancer at Home. 7
1.2 Health visitor. Dieticians Social services Practice nurse Learning disability team Dental department Child & Family psychiatry GP s Health visitor Community physiotherapist Nursery nurse Speech & language therapist Health promotion Midwives Public health nurse Smoking cessation Others include, Family support teams. Perinatal mental health service Community paediatric nurse. 8
2.3 Public health nurse. Ward 10 NTDGH. Nursery nurses Teenage pregnancy services Education welfare officers. EWO Sexual health services Police, YOT. Public health nurse CAMH s Child +Family services Learning mentors. Teachers Speech therapy Asylum seekers unit. Dental health Youth services Others include, Nursery, Primary and Secondary schools. Health promotion department. Youth workers. Mosaic. 9
2.4 Practice nurse. Asylum seekers team. Health visitor District nurse Social service. Relate. Mental health service. Admin support. Practice Nurse Citizen Advice Bureau. Special nurse teams Chiropody Tissue viability nurse Pharmacy Staff. Dietician Public health nurses 10
2. LEARNING OPPORTUNITIES. 11
INTERPERSONAL SKILLS. LEARNING OPPORTUNITY Effective communication, talking/ interaction with patients/clients /carers/relatives/teaching staff in a variety of settings. RESOURCE/PERSONNEL. District nursing team/ health visitors/ practice nurse/ nursery nurse/ public health nurses (PHN). Awareness of own communication skills both verbal and non-verbal. Use of telephone/answering calls/bleep Systems/ring back. Use of computer, email and internet Multi-disciplinary and multi agency meetings. Discussions with other relevant professionals involved in patients care. Holistic care of different groups of people, young, elderly, asylum seekers, dying. Admin support. District nursing team/ health visitors/ practice nurse/ nursery nurse/phn. District nursing team/ health visitors/ practice nurse/ nursery nurse. District nursing team/ health visitors/ practice nurse/ nursery nurse/phn. District nursing team health visitors/ practice nurse/ nursery nurse/phn. Cancer care/macmillan team/ward 10/ Avenues acorns. Promotion patients compliance and concordance with treatment/ medications/health promotion strategies Demonstrate sensitivity for patients/carers in relation to distressing information. Support and enable patients/carers/groups and communities to take action and prioritise health needs. District nursing team/ health visitors/ practice nurse/ nursery nurse/phn/ practice nurse. District nursing team/practice nurse/health visitor/phn/ Cancer Care/ Macmillan team. District nurse/health visitor/ practice nurse/phn/ Health Development Team. Demonstrate effective communication between primary care networks. District nursing team/ health visitors/ practice nurse/ nursery nurse/phn/ practice nurse. 12
Bereavement support. Primary mental health care team. Perinatal mental health service. Councillors. Clinical psychologists. Experiences with clients from a variety of ethnic backgrounds and asylum seekers Transitional care team. Interpreting services. 13
CLINICAL SKILLS. LEARNING OPPORTUNITY Aseptic/ clean dressing techniques RESOURCE/PERSONNEL. District nursing team/practice nurse. Clinifax. TPR, BP, ECG, BMI, weight & height, pulse oximitry, urinalysis, fluid balance, blood glucose, peak flow taking, fluid balance, neurological observations, monitoring, recording, and interpreting. Observation of venepuncture. District nursing team/ health visitor/phn/ Practice nurse. District nurse/ practice nurse. Awareness of nutritional score/ needs for patients. Weaning babies / formula/ breast milk District nursing team/ health visitor/ Practice nurse/community dieticians. Health visitor /Nursery nurse. Promotion of continence and Management of continence and use of appropriate aids (Indwelling and external). District nursing team/phn enuresis clinic/ Stoma specialist nurses/continence advisor. Apply knowledge of pharmacology to patients. Community pharmacists. District nursing team/health visitor/practice nurse. Pharmofax. Management of patients with acute/chronic pain. District nursing team/ Cancer care/ Practice nurse. Health screening/health surveillance. Immunisations. Awareness of patient handling scores. District nurse/health visitor/practice nurse/phn. District nurse/health visitor/practice nurse/phn. District nurse. 14
Awareness of pressure risk scores. Awareness of psychosocial/ behavioural problems. Identify any communication difficulties. Antenatal care. District nurse District nurse/health visitor/practice nurse/phn. District nurse/health visitor/practice nurse/phn. Midwife/health visitor. Cardiac rehabilitation after myocardial infarction and revascularisation. Health visitor/ district nurse/ cardiac rehab nurse/ GP/ healthy Hearts Team. Post natal screening/ support Health visitor/ GP/midwife//Perinatal mental health team. Child developmental assessment, parent held records, centile charts. Health Visitor/PHN/Nursery nurse 15
HEALTH PROMOTION OPPORTUNITIES. LEARNING OPPORTUNITY Network with professional and nonprofessional agencies involved with health promotion/health education. RESOURCE/PERSONNEL. Health development team. Sexual health services. Dieticians. Community nutrition team Community Pharmacist. Sure start. Dental services. Participate in smoking cessation, well women/ well man, diabetic, asthma, coronary heart disease, family planning, well baby clinics, immunisation and vaccine campaigns. Health education; topics include, Hygiene. Dental care. Healthy lifestyles. First aid. National targets for coronary heart disease, teenage pregnancy, accident prevention, mental ill health. District nursing / health visitor/ Practice nurse/phn/ smoking cessation. PHN/practice nurse/health visitor/district nurse/ health promotion/local community services/local authority/police/ fire service/ smoking cessation/ primary mental health care team/ dieticians/ sexual health/voluntary organisations etc. Sexual health; topics include, Contraception. Sexually transmitted diseases. Testicular/breast cancer awareness. Puberty. Breast feeding/ post natal support groups. Baby massage. Health visitor/ midwife. Health visitor/ nursery nurse/ Sure Start. Participate in groups promoting physical and mental wellbeing. Health visitor/ nursery nurse/ Sure Start. 16
Participate in Public health work including, displays, community drop-ins, community events. Health visitor/ nursery nurse/ Sure Start/ community development worker/phn. Participate in opportunistic health promotion activities, for example visiting house bound clients/ carers. District nurse/ health visitor. 17
CARE MANAGEMENT OPPORTUNITIES. LEARNING OPPORTUNITY Use of computer to access patient information both written and electronic if available. RESOURCE/PERSONNEL. District nurse/health visitor/practice nurse/phn. Collecting patient notes from GP surgery/ District nurse filing system. GP reception staff. District nurse/practice nurse/ health visitor/phn. Patient/ client handovers/information sharing both written & verbal between teams. District nursing team health visitors/ practice nurse/ nursery nurse/phn. Undertake assessment based on patients/clients holistic needs. District nursing team health visitors/ practice nurse/phn. Participate in ongoing assessment of holistic health needs District nursing team health visitors/ practice nurse/phn. Patient documentation/care assessment/ planning/implementation and evaluation. District nursing team health visitors/ practice nurse/phn. Identify timescales related to patient outcomes. District nursing team health visitors/ practice nurse/ nursery nurse/phn. Identifying the role of non professional, voluntary and statutory agencies in patient care. Analyse and interpret information to inform care delivery and take appropriate action. District nursing team health visitors/ practice nurse/ nursery nurse/phn. District nursing team health visitors/ practice nurse/ nursery nurse/phn. Refer to information files. Clinical audit. Health promotion opportunities. District nurse/health visitors/ practice nurse/phn. District nurse/health visitors/ practice nurse/ nursery nurse/phn. 18
Sleep, feeding and behaviour problems in children. Cardiac rehabilitation. Child protection, case conferences, care team meetings, strategy meetings. Health visitor/ nursery nurse/ PHN/ family support team/ social services. District nurse/health visitors/ practice nurse/cardiac rehab nurse. Social services/ Health visitor/ PHN/police/ probation/ legal departments/education/nursery workers. Working with ethnic minorities. Special needs. Primary healthcare team/gp/practice nurse/ transitional care team/ support workers/education/housing/voluntary agencies. Special needs team/primary healthcare teams/community physiotherapists/phn/paediatricians/social services/education/voluntary agencies/respite care. Report writing, including Child protection/ referrals/interagency referrals Health visitor/ district nurse/phn/sure Start. 19
ORGANISATIONAL/MANAGEMENT OPPORTUNITIES. LEARNING OPPORTUNITY Use of computer systems/ EMIS/ email/internet/intranet. RESOURCE/PERSONNEL. Admin support. District nursing team/ health visitor//phn. Practice nurse. Accessing patient results and planning appropriate action. District nursing team/ health visitor//phn. Practice nurse. Time management/ prioritising needs. District nursing team/ health visitor//phn. Practice nurse. Interprofessional working. Geographical prioritising. Locality awareness/health needs assessment. District nursing team/ health visitor//phn. Practice nurse. District nurse/health visitors/practice nurse/phn. Sure Start. Healthy living centres. Caseload delegation. Community development work/ Health need assessment. District nurse/health visitor/practice nurse/phn. Health visitor/district nurse/ community development team/local authority / local health statistics/national heal statistics/case load assessments/primary health care teams. Effective team management including appropriate delegation of duties. District nurse/ health visitor. Awareness of knowledge base and skill mix. District nurse/ health visitor. 20
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Student s Visiting Specialist Nurses / Professionals Form. Date of visit: During the allocated time with the Specialist Nurse / Professional, the student will discuss the objectives that they would like to achieve. What do you expect from the day (please complete before attending): Furthermore, at the end of the placement visit the student will demonstrate: AIMS EVIDENCE GATHERED REFLECTION / EVALUATION Name of Student: Name of Specialist Nurse/ Professional: Date: Signature of Student: Signature of Specialist Nurse / Professional: Date: 22
STUDENT DUTY ROTA DATE W/C MON MENTOR TUE MENTOR WEDS MENTOR THUR MENTOR FRI MENTOR 23
MAD students 2 nd year Adult/Child Branch Placement Guidelines. Weeks 1-2 The student requires a comprehensive orientation into the clinical area and to complete an induction checklist in the POLO. During this important formative period the foundations for the placement will be laid. The student and mentor will discuss the required learning outcomes, negotiate a learning contract and agree an action plan, utilising the POLO file and student portfolio. The student s role during this initial period will be mainly one of observation, shadowing the district nurse, health visitor and other members of the community and practice nursing team. The student will be introduced to PHCT members and practice support staff, including surgery receptionists and admin staff at the locality base, and will start to become familiar with practice routines and regular channels of communication. The student will be introduced to patients and should begin to develop a general awareness of both the practice profile and the current district nursing caseload. Weeks 2 4 This period will be used to consolidate relationships and clinical practice and to address targets outlined in the action plan at the commencement of the placement. The student and mentor will be expected to participate in reflective discussions with the mutual expectation that any areas of concern or confusion will be identified promptly and resolved in an open and professional manner. It is expected that the student will take a progressively more active part in care under supervision and negotiation with mentor. Weeks 4 8 During this period the student will be expected to participate in patient care and to demonstrate progress in terms of the acquisition of knowledge, skills and attitudes relevant to community health care. Any issues raised during placement must be addressed with the student s guidance facilitator and the PPF so that an action plan can be agreed to facilitate further progress and achievement of competencies. The summative assessment and final marking of the student by the mentor will be completed. The student evaluation of their placement must be photocopied and retained in the POLO for audit purposes. 24
MAD students 3 rd year Adult/Child Branch Internship Placement Guidelines. Weeks 1-2 During this important formative period the foundations for the placement will be laid. The student and mentor will discuss the required learning outcomes, negotiate a learning contract and agree an action plan. The student s role during this initial period will be mainly one of observation, shadowing the district nursing sister and other members of the community and practice nursing team. The student will be introduced to PHCT members and practice support staff, including surgery receptionists and admin staff at the locality base, and will start to become familiar with practice routines and regular channels of communication. The student will be introduced to patients and should begin to develop a general awareness of both the practice profile and the current district nursing caseload. Weeks 2-4 This period will be used to consolidate relationships and clinical practice and to address targets outlined in the action plan at the commencement of the placement. The student and mentor will be expected to participate in reflective discussions with the mutual expectation that any areas of concern or confusion will be identified promptly and resolved in an open and professional manner. It is expected that the student will take a progressively more active part in patient care in negotiation with mentor. Weeks 4-6 During this period the student will be expected to participate fully in patient care and to demonstrate progress in terms of the acquisition of knowledge, skills and attitudes relevant to community health care. The student will be expected to commence independent visits delegated by the mentor, or a designated supervisor. The student will be encouraged to discuss patients suitable for inclusion in their personal caseload of patients and negotiate with mentor regarding final selection. Weeks 6-18 During the final part of the placement the student will follow an internship model of practice. They will continue to work thorough their competencies and devise action plans based on their individual learning needs. The aim is to achieve a balance of responsibility somewhere between the levels of 3 rd year student and first year D grade staff nurse, with optimum (negotiated) independence versus supervision. The student may: make independent visits to their caseload patients and to others delegated by mentor (or designated supervisor) 25
undertake full (repeat) patient assessments and complete sample care-plans for selected personal caseload patients for discussion with mentor arrange daily meetings with mentor (or designated supervisor) for supervision seek timely support and advice from mentor (or designated supervisor) as appropriate be professionally responsible with regard to limitations of practice, in accordance with the Code of Professional Conduct (NMC 2002) N.B. Mentor will provide emergency contact telephone numbers and the student must ensure that these are carried whenever on duty It is vital that the patient s safety is assured, as well as that of the student and mentor. Therefore the above suggestions are based on the discretion of the individual mentor and their knowledge of the student s competencies and patients within their caseload. Student assessment will be carried out during the final week, along with student evaluation of the placement (individual and group). This feedback will assist both the mentor and the trust in planning future internship placements. N.B. Students may find it helpful to refer to An NMC guide for students of nursing and midwifery (NMC 2002). Pages 4 & 5 are particularly relevant 26