the newcastle upon tyne hospitals nhs trust ... newcastle upon tyne hospitals nhs trust...

The Newcastle upon Tyne Hospitals NHS Trust

Gastrointestinal Nursing

INFORMATION FOR STUDENTS

Welcome to your Gastrointestinal Nursing placement. We hope that your placement

will not only be educational, but enjoyable. During your placement you will work

with one of the specialist nurses who will co ordinate your 8 week placement. You

will the opportunity to spend time working with different G.I. Nurse Specialist in the

ward setting, out-patients department, endoscopy unit and in the community and

therefore have the opportunity to follow a patients pathway of care. All the nurses

work mon-fri and are band 6 and 7 grades. If you wish to arrange a pre placement

visit please contact RVI (0191) 2824116 or FRH (0191) 28248521

Amended 2010 JAN

Review date 2011 JAN

WHO ARE THE GASTROINTESTINAL NURSING TEAM?

RVI Freeman Hospital

Upper G.I. Nurse Specialist Hepato-biliary Nurse Specialist Clare Sedgwick Alison Mcdonald

Rachel Davison Joanne Wilkin

Colorectal Nurse Specialists Colorectal Nurse Specialists

Allison Sharpe Liz Robinson

Andrea Read Ruth Christer

Deborah Hall Clare Bird

Amanda Logan

Gastroenterology Nurse Specialist Nutritional Nurse Specialists Mandy Elsender Jo Ledger

Jane Robinson

PEG Nurse Specialist Gastroenterology Nurse Specialist

Stephanie White Elaine Stoker

Carol Wardle Lesley Jeffrey

Bowel Screening Nurse Specialist

Heather Dixon

Lesley Dodd

Julie James

GASTROINTESTINAL DISEASES/DISORDERS

Oesophageal Cancer

Stomach Cancer

Peptic/Duodenal Ulcers

Coeliac Disease

Colorectal Cancer

Inflammatory Bowel Disease

Diverticular Disease

Constipation

Incontinence

Entercuteneous Fistulas

Perianal Disorders

Short Bowel Syndrome

Liver Cancer

Pancreatic Cancer

SURGERY

Oesphagectomies

Gastrectomy

Small Bowel Resection

Large Bowel Resection

Rectal Cancer Surgery

Ileo-anal Pouch Formation

Colostomy & Ileostomy Formation

Whipple’s Resections

Liver surgery

Pancreatectomies

COMMON INVESTIGATIONS

Gastroscopy

Colonoscopy/ Flexible Sigmoidoscopy

Computed Tomography (CT) Scan

Ultrasound Scans

Magnetic Resonance Imaging (MRI) Scans

Barium Enema

Barium Meal and Follow Through

Anal Manometry

Anal Ultrasound

Hepatic Angiograms

ERCP

PTC

White Cell Score

CT Colongraphy

Capsule Endoscope

Try to find out about what these involve before you start to gain maximum benefit

from your placement.

LEARNING OPPORTUNITIES

There are many learning opportunities available in the Gastrointestinal Unit, so try

and experience:-

Nutritional support

Stoma care

Pain management

Infection Control

Patient Education Sessions

Admission and discharge of patients

Pre-assessment ward visits

Multi-Disciplinary Team Meetings

Out-Patients Clinics

Theatre

Nurse-Led Clinics

Endoscopy

Specialist Meetings

Patient Support Groups

Bowel screening clinic

Outreach community flexible sigmoidoscopy clinic

Students are allowed to use the department computer to access selected information.

We also have a selection of books, leaflets, journals, educational resource files and

handouts.

KEY ELEMENT

INTERPERSONAL SKILLS


RESOURCE/RELEVANT PERSONNEL/

DEPARTMENT

Use of the telephone

Answering calls

Making calls

Use of the Computer to get:

Patient investigation results

Patient information

Internet

e-mail access

Communication with:

Patients

Relatives

Doctors

Nurses in other departments, eg. Endoscopy,

Out-Patients

Multi-disciplinary team

Primary Care

Participation in:

MDT meetings

Patient transfer outside the Trust

Discharge of ward patients

Nurse Hand-overs

Team Working

Colorectal Nurse Specialist/Secretary

G.I. Nurse Specialist


Secretary

Ward Clerk/Team Assistant

Ward/Departmental Nurses

Medical Staff

Ward Nurses

Out-Patient Nurses

Endoscopy Nurses

G.I. Nurse Specialists

Members of the MDT

Community Stoma Care Nurses


Members of the MDT

Ward Staff

Patient Services Co-ordinator

KEY ELEMENT

CLINICAL SKILLS


RESOURCE/RELEVANT

PERSONEL/DEPARTMENT

Patient hygiene

Mouth Care

Skin Care

Nutritional Assessments

Weight

Maintaining Accurate Charts

Giving Medications

Medical devices

Nutritional Intake

BMI Nutritional Assessment

Must tools

Braden

Moving & Handling

Infection Control

MRSA screening

VIP scores

Catheter scores

Patient Safety

Falls assessment

Preparation for investigations/Theatre

Consent

Information

Invasive radiology

Non-invasive radiology

Transferring to Theatre

Bowel preparation

Stoma siting

Registered/HCA/G.I. Nurse Specialist

Registered Nurse/HCA/G.I. Nurse Specialist

Registered Nurse/HCA/G.I. Nurse Specialist

Registered Nurse/G.I. Nurse Specialist


Registered Nurse/G.I. Nurse Specialist/Medical

Electronics

Registered Nurse/Dietician/Nutritional Nurse Specialist

Registered Nurse/Nutritional Nurse Specialist

Registered Nurse/Tissue Viability Nurse

Registered Nurse/G.I. Nurse Specialist, Moving &

Handling Facilitator

Registered Nurse/G.I. Nurse Specialist/Control of

Infection Nurse Specialist


Doctors/G.I. Nurse Specialists

Doctors/Registered Nurse/G.I. Nurse Specialist

Radiologist/Registered Nurse

Radiologist/Registered Nurse

Registered Nurse/HCA

KEY ELEMENT

PATHOPHYSIOLOGICAL PROCESSES



DEPARTMENT

COLO-RECTAL

Anatomy & Physiology

Disorders

Investigations

Infections

Treatment

Surgery

Drugs

Stoma Care

Appliances

Management of Care

Out-Patient Clinics

Biofeedback

MDT Meetings

HEPATO-BILIARY


Disorders

Symptoms

Investigations

Treatment options

Surgery

Drugs

NUTRITION

Nutritional assessment

Types of supplements/feed and reason for use

Naso-gastric tubes/feeds

Naso-jejernal tubes/feeds

Jejenostomy tubes/feeds

Gastrostomy tubes/feeds

Total parenteral nutrition

UPPER GASTROINTESTINAL TRACT


Disorders

Investigations

Infections

Treatment

Surgery

Drugs

Registered Nurse/G.I.Nurse Specialist/

Doctors/Books/Computer

Microbiology/Infection Control

Pharmacy/Registered Nurse/Doctor/Nurse

Specialist/Registered Nurse


Company Representatives

Registered Nurse/Nurse

Specialist/Doctors/Books/Computer

Pharmacy/Registered Nurse/Doctor/Hepato-biliary

Nurse Specialist

Registered Nurse/Nurse Specialist/Nutritional Nurse

Specialist/Dietician

Registered Nurse/G.I. Nurse Specialist/Doctors/

Books/Computer/Pharmacy/Dietician

KEY ELEMENT

HEALTH DEVELOPMENT OPPORTUNITIES



DEPARTMENT

Healthy lifestyle strategies in relation to:

Smoking cessation

Alcoholic Liver Disease

Bowel Disorders

Cancer

Obesity

Diabetes

Drug and Alcohol Abuse

Promotion of exercise

Health education & health promotion literature

Models of health promotion/education

Interface between hospital and community care

Counselling

Bowel screening clinics

Colonoscopy

Consultant Clinics

Counselling

Telephone Calls

Arranging follow-up

Referral to surgical team

Smoking cessation advisor/Registered Nurse

Dietician/Registered Nurse/Doctor

Dietician/Nutritional Nurse/Colorectal Nurse Spec.

Palliative Care Nurse

Dietician/Nutritional Nurse/Registered Nurse

Dietician/Diabetees Nurse Specialist

Drug & Alcohol Team

Physiotherapist

Health Promotion Unit/Patient wise data base/

Internet/National Cancer Charities

Specialist Nurse Clinics/Discussion with

Mentor/Library

Health Action Zone (HAZ)/District Nurse/Patient

Advisory Liaison Service (PALS)

Specialist Nurses/Palliative Care/Clinical

Psychology/National & Local Support Groups

Bowel screening specialist nurses

KEY ELEMENT

MANAGEMENT OF CARE

LEARNING OPPORTUNITES


DEPARTMENT

Use of Nursing model

Philosophy of Care

Documentation used

Nursing Process

Assessment

Who assesses

How is assessment carried out/Open or closed

questions

What is assessed

Where does it take place

Planning

Care Plans

Risk assessment tools

Care Pathways

Multi-Disciplinary plan

Discharge Planning

Referrals to other agencies:-

OT

Physio

Social Worker

District Nurse

Discharge Liaison

Specialist Nurses

Macmillan Nurse

Hospice

Relevant Departments

Implementatio/Evaluation

Ward rounds

MDT working

Documentation

Standards

Protocols

Policies

Communication/Rel/patient

Time Management

Planning Workload






KEY ELEMENT

ORGANISATIONAL & MANAGERIAL ISSUES



DEPARTMENT

Managing a Team

Organisational skills

Delegation skills

Prioritising skills

Time Management

Leadership

Managing patient work-load

Quality

Standards of Care

Implementing Change

Documentation

Giving information to:

Staff

Doctors

Patients

Relatives

Multi-Disciplinary Team Members

Other Departments

Resources

Stock Control – stoma/fistula

Managing Risk

Policies & Procedures

Equipment safety checks

Quality Control

Weekly environment checks

Infection control

Moving & Handling

Emergency Situations

Cardiac arrest

Fast bleep system

Violent incidents

Fire

Bed alerts

Patient falls

Staff Developments

Clinical supervision

Reflective practice

IPR

G.I. Nurse Specialist/Registered Nurse

Registered Nurse

Registered Nurse

Registered Nurse

Registered Nurse/All Ward Staff

Ward/Unit Sister/G.I. Nurse Specialist


Registered Nurse/Audit Tools/Specialist Nurses




Sister/Nurse Manager/G.I. Nurse Specialist

Sister/Registered Nurse/G.I. Nurse Specialist

Registered Nurse/Doctors/G.I. Nurse Specialist


G.I. Nurse Specialist/MDT Co-ordinator

Registered Nurse/Doctors/G.I. Nurse Specialist


Sister/Registered Nurse/Computer/G.I. Nurse

Specialist/Intranet

Health & Safety Officer/Electronics/Housekeeper

Health & Safety Officer

Infection Control Nurse Specialist/Ward

Sister/Manager/Matron

Moving & Handling Co-ordinator

Cardiac Arrest Team/Registered Nurses

Registered Nurses/Switchboard

Registered Nurse/Security Officer

Fire Officer/Registered Nurse

Registered Nurse/Patient Services Co-ordinator

Registered Nurse/Health & Safety Officer

Registered Nurses/G.I. Nurse Specialist

Registered Nurses/G.I. Nurse Specialist

Line Manager

Gastrointestinal Nursing Allocation

8 Week Placement Week 1

Monday Tuesday Wednesday Thursday Friday

Colorectal

Nurse

Specialist

RVI

Colorectal

Nurse

Specialist

RVI

Colorectal

Nurse

Specialist

RVI

Gastroenterology

Nurse

Specialist

RVI

Gastroenterology

Nurse Specialist

RVI

Study

Week 2


Pre-assessment

clinic

Colorectal

Nurse

Specialist

RVI

Colorectal

Nurse

Specialist

RVI

PEG

Nurse Specialist

RVI

Bowel

Dysfunction

Nurse

Specialist

RVI

Study

Week 3


Colorectal

Nurse

Specialist

RVI

Staff Nurse

Ward 46

Colorectal surgery

RVI

Colorectal

Nurse

Specialist

RVI

Nutritional

Nurse

Specialist

Freeman

Nutritional

Nurse

Specialist

Freeman

Study

Week 4


Colorectal

Nurse

Specialist

Bowel

Screening

Nurse

Specialist

Staff Nurse

Ward 46

RVI

Upper

G.I. Nurse

Specialist

Upper G.I

Nurse

Specialist

Study

Week 5


Colorectal

Nurse

Specialist

RVI

Colorectal

Nurse

Specialist

Colorectal

Nurse

Specialist

Freeman Hosp.

HPB

Nurse

Specialist

Freeman Hosp.

HPB

Nurse

Specialist

Freeman Hospital

Study

Week 6


Colorectal

Nurse

Specialist

RVI

Colorectal

Nurse

Specialist

RVI

Gastroenterology

Nurse

Specialist

Freeman Hospital

Gastroenterology

Nurse

Specialist

Colorectal

Nurse

Specialist

RVI

Study

Week 7


Biddlestone

Clinic

Colorectal

Nurse

Specialist

RVI

Colorectal

Nurse Specialist

RVI

Staff Nurse

Ward 46

Colorectal surgery

RVI

Community Stoma

Care Nurse

Newcastle

Primary Care Trust

Study

Week 8


Colorectal

Nurse

Specialist

Freeman Hosp.

Colorectal

Nurse

Specialist

Freeman Hosp.

Colorectal

Nurse

Specialist

RVI

Colorectal

Nurse Specialist

RVI

Colorectal Nurse

Specialist

RVI

Study

the newcastle upon tyne hospitals nhs trust ... newcastle upon tyne hospitals nhs trust...

Documents