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Hello,
Welcome to C33, Head and Neck. We hope you have a great
placement with us and take away a great deal of knowledge with
you.
This pack provides some topics which can be discussed with your
mentor and in turn, give you a greater insight into head and neck
care.
We have a “ Named Nurse “ system in a team approach to nursing,
this involves two teams one of which is deemed low dependency
and the other high dependency.
To enable you to achieve your learning outcomes you will be
allocated a named mentor who has had the required training to
undertake assessment of nursing students.
Your mentor will re view your learning outcomes at agreed periods
throughout your stay, giving you the opportunity to discuss your
progress and any other issues which may come from this.
BACKGROUND INFORMATION
Welcome to the Head and Neck Directorate, which consists of
ENT and Oro-maxillo facial specialities. The Directorate
comprises of one ward, the Head and Neck Centre (outpatient‟s
clinic) pre assessment clinics and an Audiology Department. The
Directorate also has outpatient clinics in other parts of the
region including University of Durham Hospitals South Shields
and Washington. Although not included in the Directorate we
liase closely with Ward F63 the children‟s ward also the two ENT
theatres and one oro-maxillo facial theatre.
The following Consultants work within the Directorate:
ENT ORO-MAXILLO FACIAL
Mr Samuel Mr Martin( Clinical Director)
Mr Leontsinis Mr Ryan
Mr Lindsey Mr Burns
Miss Heaton Mr Keith
Mr Hartley
Mr Waldron
Mr Arul
The work of the directorate closely involves the multi disciplinary
team, which consists of :-
Rachael Bannister-Young Head & Neck Specialist Nurse
Dawn Ivison Head &Neck Specialist Nurse
Michaela Olmez Head & Neck Specialist Nurse
Ann Hurren Speech Therapist
Jo Patterson Swallowing Therapist
Gill Watson Oral Hygienist
Carole Springett Dietician
Varies according to rota Physiotherapist
Varies according to rota Occupational Therapist
Varies according to rota Medical Social Worker
Ward Staff .
We have a matron attatched to Head and Neck, then a ward
manager, then a ward sister who predominantly acts as deputy to
ward manager in her absence but is clinically placed.
There are 24 band 5 nurses of varying experience, and 8 health
care assistants.
We also have an attatched Pre assessment Clinic situated in
Chester Wing where the majority of our elective patients attend.
It is a nurse led clinic and medical staff are only called upon if
there is a problem outside the nursing remit. Various
investigations are carried out in PAAC, depending on the tyoe of
surgery, the age and their physical condition.
This is to ensure that they are physically prepared for surgery.
The clinic also acts to ensure patients have the correct
knowledge regarding their hospital stay, answering any questions
and/or allaying any fears they may have.
INFORMATION ABOUT WARD C33
Ward C33 Head & Neck consist of two specialities, these are Ear,
Nose and Throat (ENT) and Oral Maxillo/Facial. Each speciality
has its own medical team, outpatients department and theatre.
ENT ward rounds take place at 8am every morning. Oral ward
rounds are carried out at 8.30am and also 5pm.
C 33 is a 28 bed ward, with four „6 bed „ bays and 4 side wards.
Bays 1&2 are for high dependency patients and 3&4 are for low
dependency patients.
The side wards are used for whoever needs them most.
There are 2 grades of Doctors on the ward, these are:-
Senior House Offices (SHO)
Registrar
C33 is on call at all times and each consultant is on call on a
weekly basis
WARD ADMISSIONS
Patients are admitted at various times over the course of the
day, and the times they will go to theatre vary accordingly:-
8am admissions theatre AM or PM if on all day list.
10.30am admissions theatre PM.
1pm admissions theatre PM.
2pm admissions theatre next day.
MULTI-DISCIPLINARY TEAM
During your placement on Ward C33 you will note that the nursing
team have a lot of involvement with the multi-disciplinary team as
a whole. Working closely with them to ensure the best quality of
care is provided for the patients. These may include:-
1. Medical Staff
2. Speech and Language Therapist
3. Swallowing Therapist
4. Dietician
5. Medical Social Worker
6. Occupational Therapist
7. Physiotherapist
8. Head & Neck Oncology Nurse
9. Chaplaincy
SHIFT PATTERNS & REQUEST SYSTEM
Prior to your placement, you will be allocated a mentor. This is a
qualified nurse with the relevant experience and courses to be
able to guide you through your placement. Shift patterns will be
negotiated with your mentor, and wherever there are any special
requests or requirements these will be accomodated where
possible. There is a specific book where you may write any
special requests. The shifts you may be required to work include:-
7.30am - 1pm
7.30am - 4.15pm
7.30am - 8.30pm
12.30pm - 8.30pm
It may also be necessary to work night duty, weekends and bank
holidays if your mentor is rostered for same.
You are expected to work at least 40% of your shifts with your
mentor.
Wherever your mentor is working either high or low dependency
will determine where the bulk of your time is spent, however, we
appreciate that experience is to be gained from working on both
ends and so some of your working time will be spent with your
associate mentor. They should hopefully be working on the other
“end”
SICKNESS PROCEDURE
It is very important that you contact the Ward to inform them of
any absence as soon as possible. The university should also be
informed of it.
TELEPHONE & BLEEP SYSTEM
CARDIAC ARREST
In the event of a cardiac arrest dial 2222 State the ward and
the hospital. Crash trolley is located opposite the nurses station.
A defibrillator is outside of the side room 4.
FIRE
In the event of a fire Dial 333. State the ward and hospital.
There are 3 fire exits :-
the initial entrance to the ward
Bay 1, at the opposite end of the ward entrance, leading to
C32
Familiarise yourself with the locality of the exits and fire
extinguishers as soon as possible after your arrival on the ward.
BLEEP SYSTEM
All telephone numbers throughout City Hospitals Sunderland
begin with 497 then the ward number i.e. Ward C33 = 49733.
Bleep numbers begin with 5. Simply call the 5 digit number and
after ringing twice the line will go dead. The person you have
bleeped should call you back. It is best to stay near the
telephone.
EDUCATION
There is an education & training centre within the hospital
grounds. This contains journals, articles and books as well as
studies pertaining to the Head & Neck area. Please feel free to
use this facility during any quiet times on the ward. There is also
a selection of books available on Ward C33 covering a range of
topics, from Head & Neck to such issues as Acute Pain
Management, Health & Safety and Palliative care issues.
For audit purposes we would like to ask your permission to
photocopy your initial, intermediate and final interviews.
Also any evaluations that you may have from your time with us.
COMMON ABBREVIATIONS
DCR: Dacroystorhinotomy (opening into tear
duct)
BCC: Basal Cell Carcinoma
SCC: Squamous Cell Carcinoma
MRSA: Methicillin Resistant Staphylococcus
Aureaus
PNS: Post nasal space
FESS: Functional Endoscopic Sinus Surgery
BAWO: Bilateral Antral Washout
IV: Intravenous
NG: Nasogastric
ECTOMY: Removal of
OSCOPY: Look into
OSTOMY: Opening into
PLASTY: Repair of
COMMON CONDITIONS/SURGERY ON HEAD & NECK
SURGERY
SEPTOPLASTY: Straightening of nasal cartilage
RHINOPLASTY: Cosmetic enhancement (nose job)
POLYPECTOMY: Removal of polyps. (Grape
like tissue can be from the nose
or ear)
OESOPHAGOSCOPY: Camera to examine Oesophagus
(Gullet)
LARYNGOSCOPY: Camera to examine vocal cords
MYRINGOPLASTY: Repair of perforated eardrum
TONSILLECTOMY: Removal of tonsils
LARYNGECTOMY: Removal of “voice box”
DYSPHAGIA: Difficulty eating/drinking
EPISTAXIS: Nasal bleeding
QUINSY: Throat abcess - one
tonsil filled with pus
STRIDOR: Noisy breathing
PEG: Tube into stomach for feeding
purposes, per cutaneous gastrostomy
GROMMET: Plastic „aeration‟tube
inserted into drum
FRACTURED MANDIBLE: Broken jaw
FRACTURED ZYGOMA: Broken cheek bone
WARD PHILOSOPHY C33
A Philosophy of Care is an essential foundation for developing nursing in any health care area. It is an important communication tool that tells patients/visitors about the wards beliefs and values. In producing a ward philosophy we are aiming to provide a statement of the professional service offered to patients and hence form the basis for a partnership in care.
Ward C33 has the following philosophy :
We are bound by our professional code of conduct to maintain
safety, privacy, dignity, advocacy, accountability and
confidentiality.
We aim to help patients attain, maintain and restore health via
problem solving, goal/objective setting, leadership and decision
making.
Using knowledge and expertise we provide individualized,
evidence based care in a professional but relaxed atmosphere.
We aim to provide a therapeutic and homely environment that
is both safe and clean.
We recognize the following patients rights:
1. The right to skilled, safe care delivered respectfully and
with consideration
2. All records and communication be dealt with confidentially
3. The right of informed choice, to be aware of care and
involved in treatments and to be informed of progress
made.
The patient is an individual who is part of a family within the
community. We recognize the contribution of family and
friends who provide support and care during and after
hospitalization.
The system of care in place on C33 is the named nurse
system. The named nurse will be accountable for the
assessment, planning, implementation and evaluation of
nursing care and will co ordinate all aspects of multi
disciplinary team members‟ interventions.
Nursing care on C33 will be holistic and patient focused,
aiming to care for the physical, social, spiritual, emotional,
psychological, religious and cultural needs of each patient.
.
Patients and relatives will be offered information, teaching
and counselling appropriate to their needs and wishes. They
will be given the opportunity to participate in care through
choice with their Named Nurse, involving them in all stages of
assessment, planning, implementation and evaluation of care.
Staff education and training is ongoing and all members of
staff have annual performance reviews where development
needs are identified and further education/training planned.
We are always looking at ways to improve the quality of the
service we provide and therefore actively encourage patients
and carers opinions, comments and suggestions as part of our
quality monitoring, which also includes various audits and
surveys.
Discharge from hospital is planned and co ordinated
effectively and facilitated by the named nurse.
STUDENTS RESPONSIBILITIES
It is very important to your learning that you ensure you
document your progress and achievements in your portfolios.
The education resource file (section 2) describes all your
responsibilities as set out by your University.
Although you are a university student you must comply with
the Trusts practice and procedures policies. These can be
found in the ward office.
The Trust has a complaints procedure which should be
followed in the event of any complaint or grievance.
Information can be obtained from the Trusts policies and
procedure files or leaflets in information stands around the
ward.
What We Expect From You
Be on time for your shift.
To make the most of the Educational Opportunities the ward has to
offer.
Inform the ward as soon as possible if you are sick and give a date for
your return
Report for duty clean and tidy with minimum jewellery. Long hair
should be tired back.
Wear an identification badge
Remember that we can also learn from you.
We encourage the use of up to date practices and welcome the
sharing of the new information.
Responsibility for the maintenance of confidentiality within the
patient/nurse relationship, and within the Multi-disciplinary team.
To ask if you are not sure of anything.
To be an active member of the ward team.
Orientation to Ward
Please Photocopy this sheet once fully signed and give copy to mentor for educational link
file.
Check List (Student and mentor to sign) Student Mentor
Give Student Booklet
Initial Interview/ Learning Needs Assessment
Ward Tour
Explain Procedure for:
Cardiac Arrest
Identify Resus Equipment
Fire
Identify Fire Extinguishers
Off Duty Requests
Bleep System
Introduce to Staff
Identify Hospital Policies Files
Explain Students Responsibilities Regarding University Sickness Policy/And Hospital Policies
Awareness of Policies/Procedures/Grievences
Discussed Complaints Policy
Explain Ward Routine
Educational Link File Location
To Discuss
Date Signature
Layout of Ward:-
Bays
Sidewards
Offices
Call system
Storage
Contract No‟s
Team Members:-
Nursing Staff
Consultants
Doctors
Ward Clerk
Physiotherapist
Dress Code:-
Stud earrings
Hair tied back
Smart & clean
Procedure for Cardiac
Arrest:-
Location & Understanding of
Emergency Equipment:-
Crash trolley
Defibrillator
Suction equipment
Emergency call system
Location of Manual Handling
Equipment:-
Hoist
Pat slides
Slide sheets etc.
To Discuss
Date Signature
Procedure in the event of
fire:-
Location of fire points and
fire fighting equipment:-
Procedure for disposal of:-
Sharps
Body fluids
Drugs
Blood products
Procedure for referral to
other agencies i.e.:-
Dietician
District Nurse
Home Support Services
McMillan Nurses
Medical Social Worker
Occupational Therapy
Physiotherapist
Speech & Language Therapy
Head & Neck Specialist
Swallowing Therapist
Outreach Team
(ICCU)
Peg Nurse
To Discuss Date Signature
Demonstrate knowledge &
understanding of issues
surrounding head & neck
care for e.g.
Communication
Nutrition
Mobility
Social problems
Altered body image
Preparation & Procedure for
investigations such as:-
Routine x-rays
Ultra sound scans
CT scans
MRI
Etc.
Location of
policy/procedure files in:-
Nursing policies
Health & safety
Infection control
COSHH
Moving/Handling
Complaints
Care of dying
Etc.
Knowledge & understanding
of the HISS system:-
Admission/Discharge/Transf
er
Evaluation
Nursing System (care
planning etc)
Electronic prescribing
Patient care enquiry
Order entry