“I am proud to be part of the fantastic team in the Pharmacy Department”

claireboxallsocialmedia

I have been working for the Trust for 14 years and, during my time, I have had various job roles within the Pharmacy department. I was Project Manager for the new Pharmacy computer system (Ascribe) and the implementation of automation; I have been the Deputy Dispensary Manager; the Medicines Management Technician and Rotational Technician.

 

I have gained a vast amount of experience from these opportunities that have made me the person I am today.

 

However currently, I am a Senior Pharmacy Technician and my job title is Education/Training and Logistics Management Wholesale Distribution Authorisation (WDAH) Lead.

 

I absolutely love my job. Both I, and my job role, have developed over time and I am proud to say I manage the best hospital transport service in the South West.

 

Working in collaboration with our courier service CitySprint, we have bespoke Standard Operating Procedures (SOPs) in place for all consignment deliveries. Together, not only have we developed the service for supply to our peripheral sites, we have developed a service to the Trust delivering medication to patients who have been discharged before the completion of their ‘To-Take-Away’s’ (TTAs). This ensures patients are discharged in a timely manner freeing up beds, but also ensures that they receive their medication; this had also reduced missed doses.

 

The Trust holds a Wholesale Dealers Authorisation (WDA) which enables our department to sell medicinal products to other organisations generating a healthy annual income. I work in collaboration with the GDP inspectorate and Medicines and Healthcare products Regulatory Agency (MHRA) to ensure that the service being provided meets with the all the current legislation and guidelines issued.

 

Being responsible for the day to day management of this license and adherence all strict guidelines has earned me the extra responsibility of being the Contract lead for the Cornwall and Devon Partnership Trust contracts.

 

I am responsible for the management of setting up and supporting the supply of medication to retail establishments under the WDA(H) which involves regular service review meetings, cost saving schemes, contract and Service Level Agreement reviews  ensuring the best possible service to all our clients.

 

I am also responsible for all aspects of the education/training and in house competencies for all Pharmacy staff in connection with the WDA(H) requirements.

 

The department recently had an WDA(H) audit which is carried out by an external GDP inspectorate on behalf of the MHRA and I am very proud to say that the audit was the best we’ve ever had. This proves our department is a great team pulling together to provide the best service possible.

 

I love my job, and the challenges it brings on a day to day basis, and I am proud to be part of the fantastic team in the Pharmacy Department.

 

Claire Boxall

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Claire is writing as part of the #WeCare2 campaign that will be running across our Trust communications. Look out for more from Pharmacy, and their AHP and HCS colleagues, on our social media pages, Trust screensavers, Daily Email, Vital Signs and much more.

“It never ceases to amaze me that the ball of cells we see in the lab, can develop into a healthy baby”

I began my career in Embryology back in 1995 at Kings College Hospital in London, but I have been the Principal Embryologist at the South West Centre for Reproductive Medicine for quite some time now, joining the team in 2004.

A day in the life of an Embryologist

A typical day starts with opening up the laboratory. This is where sperm, eggs and embryos are kept during patient’s treatment. The first thing we do is check all of the equipment to make sure everything is working correctly. We then check how the embryos have developed over night and we ring the patients to give them an update.

 

Next is to deal with the patients coming in for treatment that day; this might involve egg collections, sperm preparations for treatments and patients coming in for embryo transfer.

 

We have a special time-lapse incubator called an embryoscope that uses time-lapse cinematography to take images of the embryos every ten minutes, which then forms a video we can use to really assess the embryos development very closely. This helps us to pinpoint the best embryo for transfer into the patient which we think will give the patient the best chances of a pregnancy.

 

a

 (Two-day old embryo)

b 

(Five-day old Blastocyst)

We are also trying really hard to only replace one embryo in the majority of our patients to try and reduce the multiple birth rates which is the biggest risk factor of IVF treatment.

 

Procedures are very intricate and need to be done at certain times. The mornings are typically very busy, checking fertilisation, ringing patients, collecting eggs and sperm.

 

In the afternoon we perform a specialist micromanipulation procedure called Intra-cytoplasmic sperm injection (ICSI) where we inject a single sperm into patient eggs – a successful treatment for male factor infertility. We also freeze patient’s embryos using a fast freeze method called vitrification which enables us to store patient’s spare embryos for future treatment cycles.

c

(ICSI procedure)

Embryos are very small, smaller than a full stop on a page in fact, so we use microscopes to look and manipulate them.

 

At the end of the day, we check that all of the treatments have been completed and everything required for the next day has been set up, check all of the equipment and shut down the lab for the day.

 

There are huge amounts of regulations and a code of practice that we must follow. A large part of my job is completing paperwork and audits, but it is the laboratory work that I love.

 

I am incredibly proud of the IVF laboratory. It never ceases to amaze me that the ball of cells we see in the lab can develop into a healthy baby. It is a truly wonderful job and through our expertise we can help our patients fulfil their dream of having a family.

 

I have been involved in the creation of hundreds of babies over the years which really is quite mind-blowing!

 

Sally Doidge

Principal Embryologist

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Sally is writing as part of the #WeCare2 campaign that will be running across our Trust communications. Look out for more from Reproductive Science, and their AHP and HCS colleagues, on our social media pages, Trust screensavers, Daily Email, Vital Signs and much more.

“Quite simply, this is something I love doing”

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(Jill Field, left of image)

The general public need to be able to understand hearing loss and be able to communicate effectively with any of the 11 million hard-of-hearing people currently in the UK.

I have worked in Audiology since leaving school in 1978 after seeing a job advert in the local paper for a Student Audiology Technician – it ticked all my boxes academically. Back then, it was very much a ‘Cinderella’ service, that no-one had heard of!

Each patient that walks through the door is generally an unknown quantity. Some are challenging, others straightforward. The pleasure in my role is finding out about the individual and being able help them be able to hear once more. That role can only be achieved with the combined work of a good team. I have met some great characters over the last 39 years, particularly the elderly, who often have some fascinating stories to tell!

My hearing is also tested too…

Another part of my job is to lead and supervise our students. What is more important than the education and training of new audiologists to carry on a very essential service? Bright new ideas are essential, as are potential leaders for the future. Not only are people living longer; modern technology is becoming more readily available for people to address their hearing loss at a younger age. This means that Audiology, and the role of an Audiologist, will always be a very necessary profession.

Teaching, training and educating, doesn’t stop with our students. The general public need to be able to understand hearing loss and be able to communicate effectively with any of the 11 million hard-of-hearing people currently in the UK. This can be a role for an audiologist/hearing therapist or any of the allied agencies we work with.

Quite simply, this is something I love doing.

Jill Field

Senior Audiologist

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Jill is writing as part of the #WeCare2 campaign that will be running across our Trust communications. Look out for more from Audiology, and their AHP and HCS colleagues, on our social media pages, Trust screensavers, Daily Email, Vital Signs and much more.

We are leaders in Stereotactic Radiosurgery

laura barry image

I’d like to take this opportunity to tell you about a treatment that we are lucky to have here at the Trust.

In Radiotherapy we have recently treated our 100th patient using Stereotactic Radiosurgery (SRS). This is a complex type of radiotherapy not available at all hospitals due to the highly specialist equipment and training required. We work alongside Bristol Haematology and Oncology Centre as the only provider of this treatment in the peninsula, to both malignant and benign tumours.

SRS is different to conventional radiotherapy as the area being targeted needs to be small, usually less than 3cm. This is to ensure the beams of radiation can conform tightly around the tumour, facilitating high dose delivery to the target volume whilst minimising dose to surrounding healthy brain tissue, which helps to reduce side effects.

There are many advantages of SRS, such as much quicker recovery times compared to surgery, a viable treatment option for patients’ whose tumours may be inoperable, no requirement for general anaesthetic, fewer side effects and risks typically associated with SRS in comparison to surgery or conventional brain radiotherapy. In addition to those advantages, rarely is a hospital admission required, so the entire process can be carried out as an outpatient over a few visits.

The process…

The first visit after meeting with the Consultant involves making a thermoplastic mask. This is placed in a hot water bath to become soft and malleable, it is then placed over the individual’s face and conformed to their features, personalising this mask to them only. This is kept in place until it has solidified and cooled down. The reason a mask is required is to prevent motion during the treatment due to the accuracy and precision of the treatment coupled with the sensitivity of surrounding organs. The shell needs to be a tight fit to do its job, but it does not hurt. There are many little holes in the shell to ensure easy breathing for the patient throughout this process.

A CT planning scan is also undertaken at the first appointment. This is like a normal CT scan except there are no diagnostic results available; it is purely used to plan each person’s treatment on an individual basis.

This planning can take a few weeks due to the complex nature. SRS is carried out in one treatment appointment once the plan is ready. Other cases of SRS can be carried out over a number of appointments. Prior to each patient’s first treatment they will have a discussion with one of the team where they will be given additional information regarding possible side effects and their management and are also given an opportunity to ask any questions they may have.

We are lucky to be local

We are fortunate to be able to provide this specialised service to our patients in Devon and Cornwall, saving them a long journey to Bristol. We are also lucky as staff group to have the opportunity to work with such remarkable equipment and technology, optimising both patient care and service provision in conjunction with continuing our professional development. I for one, certainly feel privileged to be able to help provide this service to our patients.

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Laura is writing as part of the #WeCare2 campaign that will be running across our Trust communications. Look out for more from Radiography, and their AHP and HCS colleagues, on our social media pages, Trust screensavers, Daily Email, Vital Signs and much more.

‘Take care of your body – it’s the only place you have to live’

alison hill

My name is Alison Hill and I have been a Dietitian for over 20 years. But, for the past year, I have been working as a Home Enteral Feeding Community Dietitian. This means I visit adults in their own home who have a tube for feeding, either as a sole source of nutrition or in addition to their oral diet.

A day in the life of a home enteral feeding Dietitian

Let me take you through one of my day’s from not so long ago.

My day starts at 08:30, the sun is shining (unusual for Plymouth) and I’m on the road to deepest, darkest Cornwall (passport and Tamar tag in hand). I cover East Cornwall, from Bude to Looe and Liskeard to Saltash. My car boot is filled with the tools of my trade – feeding review checklist, spare feeding tubes, extension sets, tube adaptors, and various others.

I head off to my first visit of the day but I have a wee bit of difficulty trying to locate the house. Cornwall is filled with houses with names but no numbers – who knew?!

My patient is an older gentleman who has just spent the first few days at home using a feeding tube for the first time. He has recently been diagnosed with cancer, is unable to have any food or fluids orally and he’s understandably, quite anxious.

We’ve not met before and I ask him how he’s coping with his feed now he’s at home and not under the safe care of the doctors and nurses on the ward he’s just come from. He tells me he’s doing great but his daughter is concerned he’s lost weight. I weigh him and he’s reassured by this as his weight has stayed steady. My visit involves ensuring he is giving himself the correct feed and that he’s tolerating it well, so I’m looking for things like good urine output, bowels opening regularly, tube stoma site is clean and free from infection.

As I go through my checklist I’m bombarded with questions about his feeding. His main concern was he didn’t want to feed overnight but, could he alter the timing of his feed to allow him to get out and about during the day? I suggest I arrange a rucksack to be delivered which is specifically designed to hold the feeding system to enable him to be more mobile and I arrange our enteral feeding nurses to come and teach him how to use it.

Having answered all his questions, I give him my contact details and encourage him to contact me if he has any further queries. I inform him I will phone him on set dates and as I say goodbye, I can physically see the anxious face I had encountered when I arrived, was looking much more relaxed.

I call the office to let them know I haven’t been kidnapped and held hostage (the usual process for each visit), and I am safe and head off to my next destination.

My next visit is about 20 minutes away to a patient who is well known to me having visited her several times recently due to the degenerative nature of her condition. She has Motor Neurone Disease (MND) which is a term used to describe a group of diseases that affect the nerves (motor neurones) in the brain and spinal cord that tell your muscles what to do.

As I arrive, she greets me with a smile despite all she is going through. She has been finding it increasingly difficult to take oral diet and fluids and as a result we have the discussion (via iPad as her speech has become difficult) about increasing her feed via her feeding tube to ensure she is getting adequate nutrition. As I know her well, I tailor a plan to suit her lifestyle and I will send her an updated feeding regimen. Communication is so important in my job and I make a note to self to discuss this patient at the next MND multidisciplinary team meeting I attend.

I have a few more visits in Cornwall before I head back to the big smoke that is Plymouth.

Once back in the office I busy myself updating feeding regimens, liaising with our Dietetic Assistant to request the necessary changes in feed and any equipment required. The assistant in turn notifies the feed company via an online ordering system to ensure my patients have the necessary deliveries.

Our department is privileged enough to have the expertise of Fresenius (other feed companies are available) enteral feeding nurses to call upon if there are problems with a patient’s tube e.g. blocking or stoma site e.g. infection. It’s the end of my working day and I’ve still got plenty of paperwork to do but that will have to wait until tomorrow. I’m a dietitian – not a magician!

As I’m driving home from work I’m thinking I have the privilege of meeting the most amazing, inspirational people. I see a vast range of people with a wide variety of illnesses requiring home enteral feeding.

What am I most proud of in my job?

Everyone wants to know they are doing well in their job and to me it’s the little things that make me proud to be doing what I do. I have received emails from patients thanking me for my help, appreciative of my input and that I am very easy to talk to.

I am prepared to go the extra distance for my patients – there’s no traffic jams along the extra mile!

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Alison is writing as part of the #WeCare2 campaign that will be running across our Trust communications. Look out for more from Dietetics, and their AHP and HCS colleagues, on our social media pages, Trust screensavers, Daily Email, Vital Signs and much more.

“A teacher without a voice? Unimaginable!”

I have been in post as Clinical Lead for voice since September 2016 and I am proud to be part of the Voice Service. We are two therapists and an administrator, who work closely with Ear, Nose and Throat to help patients with a variety of voice disorders.

One of the questions that I am frequently asked about my job is: “How does it differ from other SLT posts?” Within the Voice Clinic we specialise in the voice, voice disorders and their remediation. We generally don’t look at swallowing difficulties, dysfluency (stammering), acquired communication disorders (e.g. aphasia post-stroke) or motor-speech difficulties (dysarthrias) secondary to either stroke or neurological disorders; all of which are areas generally covered by SLT.

What it’s like to lose the power of speech

For many people, unless they have experienced a voice difficulty themselves or know someone who has, they may not have thought much about their voice, how it works or the potential impact of it not being there. Voice problems can impact people socially, emotionally and financially.

We would encourage anyone who has noticed a change to the way that their voice sounds and feels, which lasts for over three to four weeks to seek advice from their GP. The GP will usually arrange for an assessment with an ENT consultant, who will take a case history and carefully examine the nose, throat, larynx and vocal cords with a nasendoscope. With clear information about the larynx they might then refer to the individual to us in the Voice Clinic.

Often, the way someone has learnt to use their voice over time is the main contributing factor to a voice problem and many people will have been living with and trying to manage their voice problems for many months before finally seeking help.

A Teacher without a voice? Unimaginable!

I recently treated a primary school teacher who had been experiencing difficulties with her voice on and off for well over a year. She found that her sounded rough and breathy; lacked power and tired quickly. She found that by the end of the working day, her voice was very effortful to produce and she struggled to make herself heard in her busy, boisterous classroom. She was understandably very anxious about her voice as she was worried about her future as a teacher.

ENT found that she had small vocal cord nodules (small bilateral lesions on the vocal cords).  Nodules are usually present because of vocal overuse (because of having to speak a lot over background noise) but are treatable in the early stages by carefully changing vocal habits.

She was encouraged to drink plenty of water, avoid throat clearing and use a portable amplifier in class to support her voice in noisy situations. Exercises to reduce the strain and effort that she had developed over time when speaking (sometimes described as muscle tension) were practised and gradually the nodules resolved.

What else do we do?

We also work with transgender clients to achieve a voice that best reflects their identified gender. These are the only clients that do not need to come to us via ENT, as generally we are working with healthy voices to slightly alter the way that they sound. The process usually involves asking our clients what their goals for their voices are and how would they like it to sound.

We teach them them about how the voice works, how best to look after their voices and then working through structured exercises involving pitch change, intonation patterns and sometimes language. This is a collaborative process that may change overtime as our clients change.

The core of what we do within the Voice Service is working to help individuals improve, maintain and maximise their voices.

Denise Clifford

Specialist Speech and Language Therapist

Clinical Lead in Voice

The Voice Clinic

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Denise is writing as part of the #WeCare2 campaign that will be running across our Trust communications. Look out for more from Speech and Language Therapy, and their AHP and HCS colleagues, on our social media pages, Trust screensavers, Daily Email, Vital Signs and much more.

“I’m not going to change the world; but I can help to improve a patient’s world”

I qualified in 1984 as a young and enthusiastic Occupational Therapist full of energy and passion for my career. A ‘few years’ later I’m not so young, but I am still enthusiastic and passionate about all things OT and I like to think I have some energy reserves left for more.

I have always enjoyed the acute hospital setting where the pace is frenetic and plans change daily, if not hourly. My area of interest has always been Neurosciences but a few years back I was asked to also lead the HCE team, and I must say I have come to love this area equally as much.

The diversity of my job

So, one minute I might be dealing with a young head injury patient, and the next it might be an elderly patient struggling to manage alone. Either way, they need OT to support them to leave hospital and get home to continue living life the way they want to – and that is what it’s all about for me; enabling someone to live the life they deserve.

Of course, very few people want to be in hospital, but many also fear the reality of going home and managing their daily routine. We focus on activities of daily living, which when you’re well, can be taken for granted. When your body doesn’t move properly, your brain won’t process things properly and you’re feeling unwell, it gets more complicated.

As an OT I’m not going to change the world; but I can help to improve a patient’s world.

That’s why I look forward to coming into work and why I’m proud to be an Occupational Therapist…still!

Joanna Murphy

Occupational Therapist

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Joanna is writing as part of the #WeCare2 campaign that will be running across our Trust communications. Look out for more from Occupational Therapy, and their AHP and HCS colleagues, on our social media pages, Trust screensavers, Daily Email, Vital Signs and much more.