Dom Burdon talks about Nystagmus in our latest blog.

Nystagmus is an eye condition which causes the eyes to involuntarily oscillate in any one direction. It can result in the patient experiencing many problems with different visual functions, for example the time it takes to focus on targets; it can also result in symptoms where patients perceive the world to be moving, when it is actually still.

The aetiology for Nystagmus can range from chronic visual disorders to acute neurological emergency.  It is a lifelong eye condition and will affect a person’s ability to do all activities throughout daily life. Most people might have not heard of Nystagmus, however it is prevalent in 0.3% of the population.

In the Orthoptic department here in Ophthalmology, we pride ourselves on being a centre of excellence for Nystagmus. We are one of three centres nationally who have a clinical eye tracker, a specialist piece of equipment used to identify the type of Nystagmus and in turn, allows for swift investigation, diagnosis, management and support for these patients.

We accept far reaching referrals and are able to do the full workup for these patients, giving them answers relating to their condition which they would not have had available to them before. This support is not only provided during the Ocular Motility clinic which we run for these patients (where we use the eye tracker); we also keep in close contact with our patients even after they are discharged, in case they have any questions or concerns regarding their Nystagmus. To provide this high level of care and support we work with all multidisciplinary teams: Neuroscientists, Ophthalmologists, Optometrists, Imaging teams, Vision scientists, Genetic specialists, Neurologists, Paediatricians, visual impairment teachers and rehabilitation officers.

Through extensive clinical experience via the Ocular Motility clinic, the team here in the Orthoptic department are developing a national Nystagmus Care Pathway, to standardise care provided for patients with Nystagmus within the NHS and address present inconsistencies across the country reported by patients and families to the main nystagmus charity, Nystagmus Network. Thus, the Nystagmus Care Pathway’s purpose is to ensure that an evidence-based multi-disciplinary minimum standard of care is provided in every eye department across the UK.

Research is one of our core initiatives in the Ocular Motility clinic. Currently we are undergoing a literature review relating to the drug treatments for symptomatic Nystagmus patients. This will facilitate clinicians to make clear judgments about which drugs to trial, according to patient’s symptoms. We have exciting plans to develop the research structure in the department with Nystagmus as its core priority. We are working towards many future studies both “in house” and collaboratively with other centres. The UK is currently leading the way in Nystagmus research worldwide.

In summary, the Orthoptic team here in Ophthalmology feel very proud of the impact our centre of excellence for Nystagmus has made to patients.  As we develop our clinic further and progress with our associated research, we hope to be a stellar example of how specialist clinics and research should be represented and driven forward in an allied health profession setting.

Hembury Ward Manager, Sarah Corner, has been offering the jab during some of her night shifts to ensure those who are asleep during the day, are able to get the jab when they are awake at night…

“I do the flu jabs for a variety of personal reasons. For me, it’s not a competition. This is about protecting everyone: our patients, loved ones, ourselves and those who you might only meet in passing, in the shop, the street or on the bus. Compared to what else I see in the world, this is a gift!

I am often away at this time and the start of the campaign, but this year I would say that the uptake has been much quicker than drop-ins I have previously done.

I am always happy to vaccinate when I am on duty and feel that the night clinics are really useful for those who only work nights, as getting in or out during the day can be tricky. In general I have chatted to a lot more people who have experienced having ‘real flu’ and are almost desperate to be one of the first through the door when the campaign starts. Whilst that’s great, it might also suggest that flu is on the increase and that the message of its seriousness needs to be out there. I have met fewer people this year who believe in those common myths like “it made me very ill before”, “it gives you the flu” and some of the other common ones that surround the campaign.

Off the top of my head, from the night shift sessions I have conducted, I have met people from all over the hospital, from places like:

• Surgical Assessment Unit (SAU)
• Torcross
• Tavy Ward
• Medical Assessment Unit (MAU) Thrushel
• Hartor Ward
• Stonehouse
• Oncology
• Lynner Ward
• NHSP and trust staff
• And nine people from Sterilisation and Decontamination Unit (SDU) whose nightshift runs from 22:00 – 06:00 so outside of any daytime flu clinic on offer

Ultimately I actually enjoy meeting the huge variety of people that come to the door. It mixes up my shift in a good way and I find it very social. I do like to inject a bit of humour into the session for those who are feeling a little apprehensive at having it done.

A trip to Bangkok breaks up my flu-jab-giving sessions briefly, for my birthday, but I will resume flu clinics when I return. Thankfully I see this year’s quadrivalent vaccine covers the Phuket strain so feeling very happy about my little birthday trip!”

Sarah is now back from Thailand – look out for her flu clinics in Daily Email, Vital Signs, StaffNET and on the Trust social media channels.

Continuing our look into this year’s #flufighters, Nia Thielmann explains why she is seeing an increase of healthcare staff visiting her for their jabs…

“I’ve been a vaccinator for the Trust now for about five years or so. I do it to help keep patients, ourselves, family, friends and anyone we come into contact with, free of the flu. I try to take an active approach online too, and I tweet when I run my clinics and have informed the main campaign promotion too.

From offering the jab on my ward, in a central location in the hospital, I have noticed a few things. Staff are coming to me saying it’s convenient – they can’t always get to the main clinics on offer in the Discovery Library. Whilst the Trust has run a few great breakfast incentive sessions, a lot of nursing staff haven’t quite got enough time to go down to the Derriford Centre for Health and Wellbeing, as the queues have been a little  long and they can’t be spared from their wards to leave. A bacon bap would be nice though, so maybe this is something to look into for the future.

I’m finding that a lot more of my staff on the ward have been vaccinated this year in comparison to other years, and the other staff who have come to me, are also saying that they have had flu before and do not want it again. I think the minimal pain of the needle, is better than getting flu!

I do offer sweets as a reward which is my usual pacifier for staff and I have had a lot who come back to me every year.

At the time of writing (01 November, 2018), I’ve managed to vaccinate over 200 staff members so far, from the following areas:

• Clearbrook
• Crownhill
• Acute Care Team
• Torrington
• OT and Physiotherapy (Clearbrook based and throughout the Trust)
• Clinical Coding
• CEO Suite
• Consultants and Doctors – I tend to grab any visiting doctors and offer it!
• Medical Students
• Student Nurses
• Pharmacy staff
• SHIP
• Manual Handling
• REI
• USS and Imaging
• Xray
• Urology and Chestnut Clinic
• Mustard Tree
• Marlborough
• Meldon
• Complex Discharge team
• Volunteers, Pastoral Care and Patient Services
• Central Records
• Secretaries
• Labs
• Phlebotomy

I’ll keep going with the vaccination for the duration of the campaign, so please feel free to come and see me for your jab, and a sweet!”

Nia will be offering the flu jab from 10:00 – 17:00, Tuesday’s through to Friday’s, throughout the rest of the campaign.

The team on the Acute Assessment Unit (AAU) have taken a strong stance against the flu this year by offering the vaccine to fellow colleagues – and staff from across the Trust have responded. Jon King, tells us more about their #flufighter efforts…

“Firstly, I’d like to point out something – the flu vaccine is a choice. My personal approach is always one of offering a ‘no pressure’ stance, and I believe to chastise the person choosing not to get the jab is the wrong thing to do. I do however encourage them to consider it, look at the clinical evidence, and then advise where to come if they want it.

And in that regard I have found this year’s flu campaign very interesting. I have spoken to lots of people who normally avoid vaccination, yet this year, feel they should have it for a variety of reasons. Those few minutes I get with those coming for their jab, I try to listen to them and debunk the usual myth that you will get flu-like symptoms from the jab.

I took an interest in generating flu clinics here on the AAU when I initially saw the emails recruiting vaccinators. Anna (Jones) had always traditionally given vaccinations on the old ACU, and I thought being that we are now located in a more traditional outpatient setting, that the environment would easily support a drop in service, enabling easy access for staff.

The first thing was to ensure that all the band 6 nurses also supported this use of the service and were happy to complete the training. We aim to ensure there is always one vaccinator on, for every shift. This way we can deliver a consistent service throughout.

Advertising the service was always the challenge, but I think by beginning to tweet early, and having it shared by the main Trust accounts, people became aware of what we were offering.

I also initially did the rounds on level 6 with my trolley delivering vaccinations on the admissions unit, capturing different cohorts of staff including medical, nursing and ancillary teams. I really support this approach, as I think it gives a great opportunity to those that struggle to make the main clinics because of time pressures. I was also approached by the Royal Eye Infirmary (REI) to deliver a vaccination session at lunchtime, and was a great way to vaccinate a large group of staff.

A real positive for me is seeing the breadth of staff attending our AAU sessions – they really have come from many varied parts of our hospital.

If you’re thinking of getting your vaccine here at AAU, then listen to this. Everyone has said how relatively painless the injection has been! With all those that I have vaccinated, only one person has so far reported any viral symptoms, and a couple with a sore arm for a few days. Nothing in comparison to the flu though!

She’s joking – it doesn’t really hurt!

At the moment I think we are either about to hit, or have surpassed, the 300 vaccination point! (This figure is taken at the time of writing – 01 November, 2018). This is testament to the hard efforts of all those who’ve taken the time to offer the jab on AAU and of course to those who have shown up to protect themselves with the vaccine.

We will be here for the rest of the campaign offering jabs, so please come down and help keep yourselves, and others, safe from the flu this year.”

Jon, and the team on AAU, will be offering the flu jab Monday to Friday from 09:00 – 19:00.

It was a fantastic day, with more than 700 people coming through into our main Derriford Centre for Health and Wellbeing event, which included dozens of services on show as well as a Careers Fair. We also had our Plym Theatres Unit open so people could step inside a modern operating theatre (and see what one looked like in the past), take their teddy bears to the Teddy Bear Hospital and Plymouth Marjon University opened up their sports therapy facilities in support of the event.

We had so much on show – hopefully these pictures tell some of the story.

More photos can be found on Facebook.

Staff and visitors alike seemed to enjoy the day. Did you come along? If you came as a visitor we want to know what you thought about the event. Please can you take two minutes to answer the following quick questions: https://www.oc-meridian.com/plymouthnhs/survey/OpenDay2018

I’d like to wrap the event up by saying a few thanks to everyone who makes this type of big event possible, in particular:

• All our colleagues and volunteers within University Hospitals Plymouth who gave up their weekends to showcase their services, including our military colleagues
• Our fantastic staff at the Derriford Centre for Health and Wellbeing (as well as those in Site Services)
• Colleagues from Indigo and Warrens
• The students of Scott Medical and Healthcare College who acted as volunteers to help the day go so smoothly
• Colleagues from University of Plymouth who brought their services along to showcase
• All of those partners who contributed to our Careers Fair

A very big thank you.

Here’s to another 70 years of the #NHS so we can have even more to celebrate in the future!

Amanda

Amanda Nash
Head of Communications