Can you imagine a life without food?

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My name is Claire and I am a Specialist Macmillan Head and Neck Dietitian at Derriford.

Firstly, let me start by saying I absolutely love my job, every day is different, varied and I feel a valued member of the Head and Neck team. Often, Dietitians are perceived as the ‘food police’ putting people on diets to help them lose weight. However, there is so much more to our roles that often people are not always aware of.

Hopefully this blog will give you an insight into the work I do

I see patients undergoing all types of treatment for head and neck cancer including radiotherapy, chemotherapy and/or surgery. I follow patients through the whole of their journey, from diagnosis to five-years post-treatment and I get to know my patients very well – this is one of the reasons I love my job!

The treatment for Head and Neck Cancer is brutal; patients can suffer from dry mouth, ulcers, thick, sticky secretions, pain, swallowing problems, nausea, loss of appetite and taste changes. As you can imagine, due to these side effects it becomes very difficult for a patient to eat and drink – and this is where I come in. So thought I might give you a little insight into a patient’s journey and how my role fits in.

My role in their journey

As soon as a patient is diagnosed with Head and Neck Cancer, I see them in a pre-assesment clinic alongside the Clinical Nurse Specialist and the Speech and Language Therapist. During this clinic I discuss the potential side effects of treatment which may impact on their ability to eat and drink and we discuss ways in which they can optimise their nutritional intake.

Depending on the size of their tumour and the treatment modality, a patient may also require a feeding tube before starting treatment. A feeding tube can help support a patient during their treatment, as it is a route for nutrition, hydration and medication if they are unable to swallow. The thought of having a feeding tube sticking out of their stomach can be very daunting and often patients seem to be more concerned about this procedure than the cancer treatment itself! During this appointment I talk them through the procedure and processes and provide them with information, hopefully helping to ease any concerns or worries they may have.

Working as part of an MDT

During a patient’s chemo/radiotherapy treatment, I see them every week for six-weeks alongside a Speech and Language Therapist. I monitor their weight, dietary intake, bloods, hydration, bowels and we assess the severity of the side effects of treatment.

I provide practical dietary advice on suitable foods to choose, texture modification, portion sizes, meal patterns, food fortification, the use of dietary supplements and feeding tubes in order to optimise their nutritional status. I am often advising patients to add cream, cheese and butter to foods, the opposite to what you might think a Dietitian does! Providing dietary advice can help to correct nutritional deficiencies, aid recovery, prevent treatment interruptions, prevent hospital admissions and maximise patient motivation.

After treatment, initially patients get seen in another joint clinic based in the Mustard Tree. Two weeks after treatment are often the worst in terms of side effects and we call this ‘peak reaction’. Nutrition at this stage is crucial for recovery and I provide advice and support in order to maximise their nutritional intake.

I then follow patients up on a monthly basis in a Head and Neck Clinic alongside the consultant. If patients are still struggling, we then invite them back to a joint Dietitian and SALT clinic where we provide support, discuss various strategies for dealing with the longer lasting side effects of treatment and set individualised goals.

Our aim is to get patients eating and drinking again, and to remove their feeding tubes as quickly as possible. Often patients need to adapt their diets in order to do this and eating and drinking may never be the same. However, I hope that our input helps them achieve a ‘new normal’ and helps improve their quality of life and motivation to eat and drink.

Why do I do it?

I am in awe of my patients and how they cope. I love eating, socialising and having meals out with friends and family, food is such a massive part of our lives! I can’t imagine how I would cope if someone told me I was going to have treatment that would stop me from doing these things.

However, my patients do and I am amazed by their positivity, resilience and motivation to cope. I feel my role is important and has a positive impact in supporting patients throughout their journey. Hopefully you feel the same way after reading my blog and can see there is much more to being a Dietitian!

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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 Dietetics, and their AHP and HCS colleagues, on our social media pages, Trust screensavers, Daily Email, Vital Signs and much more.

A day in the life of a Cardiac Physiologist

Vicky Church

I feel very fortunate to have discovered the profession of Cardiac Physiology; and it was quite by accident. After completing my BSc and MSc in Cardiac Physiology and my national accreditation in Echocardiography (nearly three-years ago) I have been working as a Cardiac Physiologist here at the Trust.

I’m based in the Cardiology Department on level 6, but frequently venture out the wards to perform portable echocardiograms, attach ambulatory heart monitors and check pacemakers and Implantable Cardioverter Defibrillators (ICDs) when the patient is too unwell to come to us. I also occasionally head to the Cath Lab, to assist in device implants, angioplasties and TAVIs (Trans-catheter AV insertion).

Although the profession of Cardiac Physiology may seem very niche, it is a very varied and specialist career which benefits from working in an MDT (Multi-Disciplinary Team) environment and also as an independent practitioner performing, interpreting and reporting diagnostic investigations such as Implanted Cardioverter Defibrillator interrogation, with re-programming when required, and echocardiography.

24 hours in Cardiac Physiology

Within this period, I could spend a morning performing echocardiograms on acutely unwell patients on ITU, occasionally peri-opertively and in the peri-arrest setting, or performing complex echocardiography of patients with congenital heart disease or stress testing.

In the afternoon, I might form part of a MDT consisting of a cardiologist, radiographers, nurses and GSAs performing a list of angiography or angioplasty and, at any moment, have a phone call that a PPCI (Primary Percutaneous Coronary Intervention) to be performed during an acute myocardial infarction (heart attack) is on its way.  At which point we swiftly complete or halt the procedure of the current patient, safely clear the Cath Lab and set up for the PPCI. The patient will arrive straight to the Cath Lab, without even pausing in ED, and within 150 minutes of the patient calling for help (999) the patient will not only be in the hospital, but the blocked artery causing the heart attack will be opened, restoring blood flow to the heart muscle once more.

As a department we cover 24 hours, seven days a week, 365 days a year. So, at 17:00 when my shift ends, it doesn’t mean I’m finished for the day as at least once a week I’m on call. Emergencies and call-outs come in all sorts of shapes and sizes including, but not limited to, patients having heart attacks, their hearts stopping requiring emergency pacemakers, ICDs firing and giving patients appropriate or inappropriate shocks and emergency echocardiography e.g. does the patient have fluid or collection around the heart require them to go back to theatre? …and by 09:00 it’s back to the ‘routine day again’.

I love the variety my career gives. The challenges of complex patients, the deciphering of difficult diagnostics at 03:00 that no one else in the trust at that time knows how to.

I love the patients I meet and feel privileged to be part of their journey. Whether it’s an annual pacemaker follow-up to give reassurance, or performing the echo on ITU that discovers why the patient is so unwell, and how to guide treatment to save their lives.

I enjoy the freedom and challenge of working as a solo practitioner, but also the camaraderie of working in a team.

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

“It is important to remember that there is a patient at the end of our processes”

Ann

Hello, I’m Ann Mason and I am the Deputy Production Manager in Production Services here in Pharmacy.

My journey to where I am now…

I am a registered Pharmacy Technician and I have worked in the NHS for 36 years with three-years ‘out’ working for a Private Pharmaceutical Company. The grass is not always greener, as I discovered, so I returned!

My career in Pharmacy started at the age of 18 after spending two years at Catering College. I didn’t fancy my hands smelling of onions for ever more! I applied for a variety of jobs at my local job centre and Pharmacy came up first. My first job as a Pharmacy Assistant involved washing bottles (yes we used to recycle in the 70’s) and packing orders for Community Clinics.

I eventually qualified as a Pharmacy Technician and have achieved extra qualifications including a Diploma in Pharmaceutical Technology and Quality Assurance.

Life is always busy in the NHS and I love the challenge. I see tangible results at the end of each day with the intravenous products that we have produced for patients.

I am so lucky to work with a fantastic team of people and I am grateful for their support.

We primarily produce sterile intravenous medicines and a few non-sterile products for children.

Preparation of Chemotherapy is the bulk of our workload but we also prepare intravenous feeds for patients.

We produce items in a cleanroom where we wear specialist cleanroom clothing covering us from head to foot. This protects the product from us, as a human being we are the biggest source of contamination.

Within the cleanroom we work within contained workstations which filter the air and ensure the working space is sterile.

Each product has a set of rigorous checks to ensure patient safety, so we work in accordance with Good Manufacturing Practice which is legislation that ensures products are consistently produced and controlled to particular quality standards.

A typical day

My typical work day starts with a team huddle where we pass on communication relating to current work, or discuss problems from the day before.

If I am not needed to help out on the shop floor I start with working on the Quality Management System. Review of any ‘out of specification results’, or ‘deviations to working practices’ is recorded and reviewed daily.

I am currently working on a development project to introduce a new disinfection and mopping system into the cleanroom suite. The benefits should be an easier and more thorough system. We have to clean our aseptic suite at the end of each working day which can include floors, walls and ceiling. This is quite onerous and not a task enjoyed by most!

Any change to working practices starts with raising a ‘change control’ so that all tasks are listed and monitored. I have written a validation protocol for the new disinfection system. To prove whether it is acceptable or not we will carry out contact agar plates before and after cleaning which will be incubated and checked for any growth of micro-organisms.

We are heavily regulated with procedures and part of my role is either writing or approving them.

We are audited by an external auditor every year and there are often actions to work on. For example some of my current actions are:

  • Updating the capacity plan (monitoring workload in terms of overall capacity of staff)
  • Arranging for work to be carried out in the aseptic suite (involves out of hours work)
  • Corrective and preventative actions relating to an untoward incident
  • Updating training records
  • Review of training and competency assessments
  • Reviewing our working practices to minimise the number of aseptic manipulations in any process
  • Sourcing sterile minigrip bags (ideally any item used in the clean room should be sterile)
  • Review of wiping and spraying transfer disinfection process, of items going into the aseptic suite
  • Implementing a system to record all components used if they are not currently recorded on worksheets

We also have our own internal audit system where we pick a section of work and review procedure and observe working practices to ensure they are being followed and that we are carrying out best practice. I am involved in ensuring these are kept on schedule.

What are the high points to my day? I would certainly say that knowing patients have received their treatment on time is right up there.

Then, alternatively, the low point is the complete opposite, when patients don’t receive their treatment on time. Having been a patient myself I know how frustrating it is if you have an appointment scheduled but are kept waiting.

It is important to remember that there is a patient at the end of our processes, and I try to instil this into all staff which includes visits to wards when they start working with us.

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Ann 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.

 

Being an Occupational Therapist – a fruitful and rewarding journey

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I was drawn to Occupational Therapy by chance when I got a job with Social Services as an Occupational Therapy assistant, thinking I might like to do social work. At that time, I had never even heard of Occupational Therapy!

I very soon realised that social work was not for me, but thought ‘what about this Occupational Therapy thing?’ As I worked alongside the Occupational Therapists I decided that this was going to be the career for me. It was about enabling people to be able to do things for themselves, often ordinary everyday things, but things that were important to them to be able to do.

I worked with this team for five-years and then went to St Loyes School of Occupational Therapy and completed a three-year diploma. My first job was working in an acute mental health ward at Moorhaven Hospital (which of course is now closed).

Although I loved this job, circumstances led me to move to Freedom Fields Hospital (also now closed!) to work on two, acute care of the elderly wards and later a split post with acute HCE and Oncology. During this time I completed my postgraduate Masters in Occupational Therapy – the first masters in OT. I also presented my research from my Masters at the World Federation of Occupational Therapists congress in Montreal – an incredibly proud moment for me.

Another closure, but a move to Derriford

As Freedom Fields Hospital began to close around me, I ended up moving here, to Derriford Hospital, when Oncology moved. I have continued to work in Oncology since then but with lots of variations along the way, some of which include working in the Mustard Tree cancer support centre, Cardiothoracics and, since 2000, being team led for the OT team which covers general medical, cardiothoracics and vascular surgery.

I have also worked at both local and regional level with the Royal College of Occupational Therapists. I have held a range of positions including, local group chairman and secretary, regional Council member, and most recently I have been chair of the South West regional committee for the last 14 years.

As I approach (slightly early) retirement, I still love being an Occupational Therapist and wouldn’t change a thing about my career pathway, it continues to be a rewarding and fruitful journey.

Jackie Perryman

Occupational Team,

Team Lead

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Jackie 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.

‘Over the years I’ve been a Dietitian, I have learnt that the most important skill is listening’

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My name is Heather Sadler and I’ve been a Renal Dietitian at the Trust since 1995. I work as part of a fantastic team of doctors, specialist nurses, healthcare assistants and other therapists, and I lead a team of Dietitians within our department.

 

We have less than two full-time Dietitians to provide a service for over 970 chronic kidney disease (CKD) patients, 200 dialysis patients, an inpatient ward and around 60 patients who have a kidney transplant each year. So, I am kept very busy!

 

Why do we need Renal Dietitians?

 

If you have CKD, eating the right way can slow the progression of the disease, improve symptoms, and reduce the risk of complications. Even small changes to your diet and lifestyle can make a huge impact on your health and quality of life – that’s where I come in.

 

Contrary to popular belief there is no such thing as a ‘renal diet’. Every patient is different – the diet they need depends on their level of kidney function, their blood biochemistry levels, fluid balance, medications, symptoms and how well-nourished they are.

 

Patients with CKD often have other conditions such as diabetes, vascular disease, cancer or gastrointestinal problems which need to be considered. Understanding their social situation, their values and beliefs around food and health, and their level of motivation is also important.

 

Many patients have to manage a special diet on top of an arduous dialysis regimen and multiple medications, so they need a lot of support. More of our patients are elderly which brings its challenges. We monitor patients closely and adjust their diet according to their blood biochemistry. But it’s just as much about what they CAN eat, as what they can’t eat. We want patients to enjoy their food – it is such an important part of life! Eating well is a priority because many of our patients are malnourished, and unnecessary restrictions can contribute to this.

 

Everybody has experience of, and opinions about, food. There is such easy access to nutrition information (and misinformation!) online these days and this can be very confusing for patients. We need to keep a step ahead so we can help them pick out the truths from the myths, and translate the evidence into practical advice relevant to them and their CKD.

 

Food is quite a personal and sensitive issue for some people – nobody wants to be told what to eat and what not to eat. As an enthusiastic young student Dietitian, I soon found out that giving advice is not enough to bring about behaviour change.  Yes, Dietitians provide information, but in a way which builds motivation and facilitates change in a non-judgemental way. I strongly believe that engaging with patients at an early stage of the disease helps with this. We are much better these days at working in a patient-centred way. After all, if you work together with a patient to come up with a diet plan they are much more likely to put it into practice then if you just tell them what to do.

 

Over the years I’ve been a Dietitian I have learnt that the most important skill is listening. Patients are more likely to listen to you if you listen to them, try to see things from their perspective and work with them, not against them – easier said than done! And a large dose of common sense and a sense of humour go a long way.

So what do I actually do?

Here are some of the things I might do in a typical week:

  • Give a talk to a group of CKD patients about healthy diet and lifestyle to help protect their kidney function
  • Talk to a patient on haemodialysis who is struggling to stick to a 1L fluid allowance, about ways to help manage thirst
  • Explore barriers to change with a patient who needs to lose weight in order to be accepted onto the kidney transplant waiting list
  • Encourage a haemodialysis patient with unwanted weight loss to relax her low potassium diet and eat more high energy foods.
  • Write to a GP to request nutritional supplements for a peritoneal dialysis patient who is struggling with eating due to an infection
  • Discuss a low potassium diet with a haemodialysis patient with a high blood potassium level
  • Liaise with the catering manager about a patient requiring a complex special diet while in hospital
  • Review monthly blood results for all my dialysis patients to identify patients with biochemistry levels outside target ranges
  • Discuss the dietary needs of a patient with dementia with the manager of their care home
  • Liaise with a consultant at an MDT meeting about adjusting medications for a patient with high blood phosphate levels
  • Arrange home delivery meals for a patient who is recently bereaved and struggling to cope alone
  • Phone an elderly dialysis patient in Bude to check how they are coping with their new diet plan
  • Liaise with the renal pharmacist about suitability of a new ‘supplement’ a patient has bought online
  • Assess the nutritional requirements of an acutely ill renal in–patient and design an enteral feeding regimen which fits with their dialysis and fluid restriction
  • Work with a young patient to adjust the menu plan given by their personal trainer to bring it in line with his renal diet requirements
  • Provide an immuno-compromised kidney transplant patient with information on food safety in order to reduce their risk of food poisoning
  • Review the evidence base for a new patient information leaflet
  • Deliver a teaching session on nutrition to a group of junior doctors

 

Why do I enjoy my job?

I became a Renal Dietitian because I love working with people; I enjoy the healthcare environment, I’m interested in biochemistry and I love food!

 

Working with patients with a chronic disease has its challenges but it is hugely rewarding to build a relationship with patients and their families over a long period of time and see them through their CKD journey from diagnosis through to transplantation and beyond.

 

I have had the privilege of getting to know patients over many years and help them through the ups and down. I am always amazed by the resilience of people who have to live with the burden of chronic disease and I am proud that what I do can make people feel better, reduce their anxiety, keep them out of hospital, and help them to live longer with a better quality of life.

 

I am proud to be a valued member of a team which works to a shared goal of helping people live the best life they can within the limits of their disease.

 

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Heather 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.

Healthcare Scientist in Diagnostic Radiology and Radiation Protection

emily seymour

This time last year I was working as a Radiation Protection Adviser in the Nuclear Decommissioning Industry. I had been looking to pursue a career in Medical Physics for over a year after speaking to a medical physicist presenting at a conference I attended. I wanted to work in a role where I was helping other people whilst using my physics background, and I also wanted to be challenged more technically and to work in a faster paced environment.

So, I applied for a role within the Clinical and Radiation Physics department at PHNT and was lucky enough to get the job!

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Having no previous experience in Medical Physics Quality Assurance programmes I was initially trained to perform routine and non-routine QA tests on X-Ray equipment within the Trust, which included our planar, mobile, fluoroscopy, CT, mammography and dental X-Ray systems. The Trust has approximately 100 X-ray units that require routine QA testing annually (sometimes biannually).

The department also has external contracts with the Peninsular Dental School, private dentists and even the British Antarctic Survey Unit. It can take several hours to perform routine QA tests on one X-ray system, and up to a week or more to accept and commission a larger piece of equipment like a CT scanner or Cardiac Catheter lab.

Owing to my radiation protection background, I was given the task of reviewing some of the hospital’s radiation risk assessments as part of a Trust wide campaign. The biggest (and nicest) surprise for me was the standard of the Radiation Protection infrastructure within the Trust – both administratively and operationally. In some respects the types of radiological hazards that hospitals have, are more challenging to manage than those in the nuclear industry (with far less money).

We are often required to work closely with Radiologists, Radiographers and Engineers to optimise exposure to ionising radiation, image quality and equipment performance. The wider team provides radiation protection services across the Trust and hosts investigations involving over-exposures of patients and staff.  Members of the team perform training, compliance audits and act as specialist advisers surrounding the interpretation and compliance with ionising radiation legislation.

The Nuclear Medicine physicists also work within the Clinical and Radiation Physics team. In Nuclear Medicine, physicists give scientific advice on using radioactive materials for diagnosing a wide range of conditions. They administer radioactive drugs to treat patients suffering from thyroid cancer, and advise them on how to minimise the radiation dose to their families, since they’re radioactive when they go home! They also get involved with new equipment, such as making sure the new PET/CT scanner is fit for use.

Why I love my job

My favourite aspect of my role is the variety of my day-to-day duties; no two days are the same. In the morning, I could be performing QA testing at one of our Peripheral X-ray sites; in the afternoon I could be completing skin dose calculations for our patients or writing a radiation risk assessment for staff working in our Controlled Areas.

From the start of my career in Healthcare Science I had the goal of attaining Clinical Scientist status.  When I initially joined the Trust there was no formal commitment to Clinical Scientist Training, however I knew Medical Physics was the career for me so I was happy for a foot in the door.

Almost nine-months on, the Trust has offered me an in-service post for the Scientist Training Programme – a nationwide three-year training programme that includes a part time master’s degree and work-based learning to attain registration as a Clinical Scientist (Medical Physics).  This means, of course, I am really excited to be starting in September 2017.

Emily Seymour

Member of the Clinical & Radiation Physics Team, Directorate of Healthcare Science and Technology

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

“I’m really proud of all my patients and the amazing things they can achieve”

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I think it’s fair to say most of us take our gut for granted. ,That is to say we are able to get on with our day-to-day life without suffering any ill effects. But there’s a lot going on inside us!

 

Firstly, some facts…

From churning of food with digestive enzymes to absorption of nutrients through the fronds of our beautifully designed small intestine and disposal of waste products through our colon, we owe a lot to our gut. Did you know that the small intestine (where we absorb nutrients) measures six-metres in length, the colon measures further two-metres long and we have 100 trillion micro-organisms inside our guts – that is equivalent to up to six pounds of bacteria lining our guts. A total of 70% of our immune system lives inside our gut and nerves inside our guts play a part in communicating messages to the brain. There is truth in the saying, ‘gut feeling’!

 

My role at the Trust

My job is fascinating as I get to care for a wide range of people who have gut conditions, and I specialise in helping people manage their diet for Inflammatory Bowel Disease (IBD).  IBD comprises of 2 conditions: Ulcerative Colitis and Crohn’s disease. Both cause inflammation and ulceration of the bowel and this can cause profound problems for people.

 

These conditions cause a lot of discomfort, especially when the disease is active – we often call this a ‘flare up’ – and I’ve been told it feels a lot like a severe case of sunburn inside the gut. IBD causes a lot of abdominal discomfort and often means people have to make frequent visits to the loo. So you can imagine that the last thing they want to do is eat at times.

 

Living with a gut condition can be really distressing and can have devastating effects on the body. A lot of people need special supplement drinks to take alongside bland food to help them absorb things better. Without these, people run low on vitamins and minerals and lose body weight very quickly which can have serious consequences.

 

Sometimes I advise the patients to “rest” the gut this way, to help their insides heal.  I also advise people to try special elimination diets to test whether they react to food.  This may involve cutting out gluten, milk or certain fruits and vegetables and fibre to see if they feel better. The science behind this is continually evolving and hopefully in the future we will be better able to know what diet is best to keep people symptom free. I am very fortunate to care for these patients alongside the specialist multidisciplinary team including Kathy Webb, Lead IBD nurse and the gastroenterology consultants. We meet every week to discuss the management of these patients and work out what medical or surgical and nutritional input these patients need.

 

Having these meetings helps to get to know the patients so that when I see them in clinic I am up-to-date with their own particular issues and needs. Working in this way is enormously beneficial to me and my patients. I get to know who needs help, and can arrange to see them in outpatient clinic and can work on keeping them out of hospital!

My other specialty – coeliac disease

Again, this is a condition which causes damage to the gut, this time the duodenum, the first part of the small intestine. It’s more common than most people think and affects 1 in 100 of the population.

 

It’s not an allergy or an intolerance but an auto-immune condition, in which the body launches an attack against gluten (a protein found in cereals) and damages itself. Coeliac disease, if left untreated, can cause malabsorption of vitamins and minerals, a change in bowel habits, thinning of the bones and even infertility and gut malignancy. A lot of medical conditions are treated by drugs, however coeliac disease is quite the opposite. The amazing thing about this condition is that the only treatment is one that eliminates gluten from the diet.

 

By the time most patients are referred to me for their first appointment, and have been formally diagnosed for coeliac through a blood test and biopsy of the small bowel, they have usually begun a gluten-free diet. It’s not an easy thing to do (gluten is found in bread, cereals and pasta) and it can be found in virtually everything that is processed – that’s everything in a wrapper! A lot of people struggle with gluten free bread. It’s come a long way since the 1950’s since it was first dispensed to people in tins…but it does take a bit of getting used to.

 

Everyone in clinic has their own style of eating, cooking and people’s lifestyle can vary a lot.  I get to find out what people feel about their new diet and then provide them with the information they don’t know or want extra support with. Such as alternatives to bread, or what gravy is gluten free, how to achieve a balanced diet or how to eat out safely and not get ‘glutened’.

 

Alongside this, I have to work out whether people are short of vitamins and minerals (I can check bloods and read food diaries) and whether people need a scan of their bones (DEXA bone scans) or other investigations. It’s a really rewarding clinic because I get to see people who attend for follow up. In the majority of the time, people are quick to tell me how fantastic they feel now their symptoms have gone.

 

One patient, a mum in her forties said she felt like a new woman with lots of new energy and enthusiasm for hill walking, something she had not done since she was a teenager.  It’s very humbling to be part to my patient’s journey to recovery.  I’m really proud of all my patients and the amazing things they can achieve.

 

So finally, if you’ve been suffering with a change in bowel habits, either diarrhoea, constipation or wind, or have been feeling tired, make an appointment to see your GP and discuss having a blood test for coeliac disease.  If you think you might have it, it’s important not to cut our gluten from your diet as it will affect your blood test.

 

Don’t suffer in silence, make an appointment and see your doctor!

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Lucy 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.

 

Pharmacy – there’s more to us than you think…

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When you tell people you work in Pharmacy their perception is that you spend your day in a dispensary sticking labels on boxes of medicines. Don’t get me wrong, we do stick labels on boxes, but there is so much more to Pharmacy than that. For example, did you know that all Pharmacists have a master’s degree as a standard?

I am a Pharmacy Technician, and my career started in Pharmacy at the age of 15 when I did two week’s work experience in my local Pharmacy which led to my first job as a Saturday girl. I then went on to train as a Technician, which takes two years of study to complete.  Since qualifying, I have been fortunate enough to have a varied career working in community Pharmacy, for the Ministry of Defence at HMS Drake, and then, the NHS.

During my 23 years in Pharmacy I have absolutely stuck labels on boxes, but I have also done so much more

I worked as a Medicines Management Technician on the wards for several years. This involved seeing patient’s every day, checking their medicines they brought in from home to ensure they were safe and still appropriate for them to use, ensuring they received their new medication and working with the ward staff to process their discharge medicines to take home.

From being predominantly patient facing, I then changed my role and moved into Pharmacy Procurement – what a change and a challenge! Procurement, like Pharmacy in general, is a misunderstood role within the NHS. Many people think that it means sitting at a computer and just shopping for medicines every day, if only this were the case. Every month over 6000 lines come in through Pharmacy Goods-In, and I have to ensure they are safe, economic, not falsified, their integrity (i.e. temperature, packaging) has been maintained, they have been purchased from an appropriate and bona fide supplier, our documentation is maintained, and contracts are adhered to – and that’s just all the simple stuff.

I also have to manage suppliers, develop and adjudicate contracts for medicines and associated services, ensure compliance to any new regulations or legislation, I gained my degree in purchasing, and then of course there are the shortages.

Unfortunately the medicines supply chain is extremely fragile and most days we experience difficulties in obtaining medicines. Mostly with a bit of work we are able to resolve the problem, however there are ones that require a huge amount of work and prove to be very challenging. When these occur then my role is to source from other hospitals, or to source an alternative product or to source from another country, all the while ensuring the product will be safe for our patient’s to use. This is by far the most challenging element of my role.

So, why do I do it?

Simply because I love working in Pharmacy and the challenges bring so much reward. I may not be patient facing anymore, but be under no illusions that I am still patient focused and every day my team have a positive impact on patient care.

For example, I spent most of today trying to source a vital injection for a young man who is extremely unwell. Unfortunately he can only have one medication and it is in short supply. It took several hours and countless phone calls up and down the country – but we did it! We managed to source some supply and this young man will now receive his treatment. That is why I do what I do.

There are many misconceptions about Pharmacy, but like so many of the support services, we are essential to the NHS and delivering the care our patients need. We may not see the patient’s day in and day out, but in Pharmacy we are no less patient focused than the doctors and nurses on the wards and that is why I love what I do, especially in the NHS, and will continue to do it for another 23 years!

Trudy Bown

Chief Pharmacy Procurement & IT Manager

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Trudy 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.

 

“Will and hope is universal and spawns all religions and races”

socialmediamike

My name is Mike, and I’d like to tell you a little more about why I enjoy my job as a Pulmonary/Sleep Physiologist, and how I got here!

I originally had keen interest in animal care and spent six-months doing voluntary work in South Africa to gain experience. Upon my return, I started working for the NHS part-time in the evenings and weekends in the Emergency Department as an X-ray Assistant Technical Officer. I loved working there; the atmosphere and people I worked with.

I then applied for a Respiratory Physiology student post (the first for Derriford) which I was accepted on (at my surprise!). Take all this into account, I have now been working for the NHS for almost 13 years, and will happily continue to do so for as long as I enjoy the work. I can be a bit laid back for some people perhaps, but I find it puts patients and their families at ease, a smile and a joke goes a long way.

The role…

As a Respiratory Physiologist, I find my role allows me to do some very rewarding work, although it can be very stressful at times, but there is always one thing that transcends throughout all that I see as a Physiologist – will.

The will for something I see all the time, in patients and staff alike, the will to live I see in those who are at their worst, and the will to help those in need even when they find it too hard to accept.

Will and hope is universal and spawns all religions and races. Those in healthcare have the will to help others in times of need, even in a society of strife and struggle in a world with recession and money problems and those who wish to break society with acts of terrorism in recent times.

Why I do, what I do

Simply, I do the job to help others and put their needs in front of mine. As I’ve mentioned, the job is stressful but rewarding, and although it is hard and I must admit to occasionally thinking ‘why am I doing this’, I always come back to the patients, and the service we deliver. And that, above all, is why I am very proud to be a part of what we have.

Mike Thynne

Pulmonary/Sleep Physiologist

Chest Clinic

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

‘Playing’ – a way of addressing fears and anxieties around care and treatment

MRI Play Scanner - obtain permission

My name is Sue, I am the Play Service Team Leader, and it is my team who primarily work with the children on Level 12.

I can hear you all saying: “what a fantastic job – you get to play all day!”. Yes, it is a brilliant job, and yes we do get to play, but there is always a purpose to our play. What can look like two people playing a game of Monopoly, chatting or seeing a child making a fantastic mess with syringes and paint, is in reality the start of a conversation around being bullied in school, or educating them to the use of syringes, explaining that they are not always used to inject or give medication. We use the word ‘play’ as a way of addressing fears and anxieties that our patients have around their care and treatments.

I’d like to tell you a little bit about a brilliant addition to our service

As the #WeCare2 campaign is about the difference that Allied Health Professionals and Healthcare Scientists make, I’d like to talk about a piece of equipment that has enabled us to carry out an essential part of our service, and further strengthen our working practice with our Radiographers here in the Trust.

We have recently received a ‘Soft Play MRI Scanner’ via the Charitable Funds Committee which allows us to help illustrate to our young patients what to expect when they are due to have a Magnetic Resonance Imaging (MRI) scan. This is a brilliant piece of equipment which has added to the resources that we already have. It has the same internal dimensions as an MRI scanner, so it enables the child that we are helping to prepare an understanding of how it may feel in the scanner.

We regularly get asked to work with children that are going to have MRI scans; we previously had YouTube clips and Lego models to be able to demonstrate the process with our patients, and now we are lucky to have this fantastic soft play space to add to our collection of useful tools. By having this in the Activity Centre, a lot of our children already go in and out of it to play, using it like a tunnel and encouraging their parents to go in it. Without realising, they are interacting with the ‘machine’. Unfortunately for the parents, one end is near a wall and not designed for adults to escape! This can bring a lot of giggles especially when the parent realises they have to try and crawl out.

On a serious level, by making the experience fun and including the children’s’ parents and carers, it reduces anxieties and concerns and enables the child to process what they will be doing at a level they can relate to.

The play tunnel in use

Recently we had a six-year old who was particularly anxious about having to go into a machine. “Does this mean I am going to be cooked?”, was his question. He came to the Activity Centre and whilst we were talking to mum we had suggested that he had a look around the room and have a play. The first place he went was the tunnel. He loved climbing in it, taking various toys in with him, as I explained to him that this ‘tunnel’ was actually the size of the MRI scanner and showed him some pictures of a scanner in Mansfield. “Ah a washing machine!”, was his response. He smirked at me and proceeded to go and lie in the ‘tunnel’. I then turned the noises on, replicating what it would be like in the real MRI so he knew what else to expect.  He lay there for about five-minutes, came out, smiling, and said “that’s easy, anyone can do that!”.

I am delighted to say he completed his MRI without General Anaesthetic, but more importantly, with no stress.

It is moments like this, that I really love my job.

Sue Rodgers

Play Service Team Leader

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