#nhsct

Tuesday was spent at the University.  We had a full agenda with several speakers and even a luncheon with Professor Hugh McKenna, Dean of Faculty of Life and Health Services.  

Marina Lupari, Assistant Director of Nursing, began our morning with her lecture, "Introduction to the Northern Health and Social Care Trust," or NHSCT.  The trust holds 5000 nurses.  She explained all of the positions appointed in the trust and levels for salaries available.  It was surprising how different the publicly funded UK's health system is from the US'.  They also have so many budgets and plans and rules.

One of the issues I had with doing clinicals at the Causeway Hospital was seeing their 6-bed rooms.  As I said yesterday, I think they destroy patient privacy and decrease rest by increasing noise and distraction levels.  Well, that situation will likely not change in Northern Ireland as an increased staff ratio is needed for single-bed rooms, and the Trust does not have the finances for increased staff.

I also found it interesting that patients need to be transferred to Antrim from the Causeway to get an MRI or have certain treatments or surgeries.  Living in the Akron/Cleveland area, we are not used to that since we live in a healthcare hub.

For infection control, all of the nursing staff is getting new scrubs.  Additionally, the hospitals are very strict on hair (pulled back!), nails (no polish!), earrings (only 1 small pair), and arms (forearms and wrists free from clothing or jewelry).  As opposed to home, these rules are strictly enforced.

One of the best parts of the Trust?  It/the government pays student nurses' tuitions and fees, except for textbooks.  Nursing is a public service position that they run, so that's just how things work around here. That would save us Kent students around $9000/yr, even more if we live out of state.  But their education is a lot different and - not to start a debate - I think American BSN-RNs are better educated than nurses in the UK at the graduation level.  Marina even said we are much more advanced in critical understanding and pathophysiology while nurses in Ireland are task-oriented.

Marina said right now in Ireland, nurse leaders are working on implementing the following: - Redefine to whole system approach - Center on case management - Predictive risk - who needs service the most? - Nurse-led discharge - Call rapid response nurse vs. calling 999

Additionally, nurses need to understand politics and the relationships existing between things so they can deal with measuring health expenses.  Marina said if one understands that, they are way ahead of the game.

After Marina's lecture, we had a lunch with Professor Hugh McKenna.  He treated us to a catered lunch, and we discussed our future career goals and recommendations he had for us.  I found him friendly and wise, like in a sage sort of way.  He seemed to be  very good at his job with a strong ability to see the "big picture."  It was an honor to meet him.

After lunch, Ann Marie Tunney spoke to us about a concept called Practice Development, based upon standards, communication, critical thinking, and continuing education.  It is defined by a continuous process of improvement … through the enabling of nurses and healthcare teams to transform the culture and context of care. - McCormack

She described Practice Development as deriving a culture, a way of life, or "the way we do things around here."  The context is the setting of care and the idea works with qualities and skills as well as perceived roles.  The E's of Practice Development are: Enlightenment, Empowerment, Emancipation, and Evaluation.  Ann Marie then gave us example studies such as Developing person-centred palliative care in NHSCT as well as From venus to LUMAS - Improving service delivery for patients with leg ulcers in NHSCT - the journey so far.  The key is: A systematic change in practice leads to new research and the cycle repeats itself.

Next, Patricia Holley, my stroke nurse from yesterday, came and spoke to us about her project, a support group for stroke patients' carers geared to meet their specific expressed needs.  The group was developed because as a stroke nurse, Patricia noticed that her patients' spouses were often left to tirelessly care for their spouses without any type of respite.  She initiated the group as an outlet for them to come talk, express themselves, or just listen.  Her group has baked, had reflexology, participated in mind mapping, visited gardens, and enjoyed special visitors and speakers.  The group has been so much help to the members but is continually evolving to find just the right medium to continue its success.  Such research is called active research as it's continually changing, dependent on members' desires and needs.