Play is how young children share their stories and experiences

LisaClive

My name is Lisa Clive and I am a Clinical Psychologist working in Paediatrics since 2007. I love my job which involves working with children and their families with chronic illness and medically unexplained symptoms.

 

Every day brings new opportunity to support children, their parents and staff.  I love meeting children and their families and through therapy that supports them to develop their coping skills and recognise their own resilience and strengths. Working with children is great as they bring so much creativity and energy which together we harness to bring about positive change. Being in this job one of the most important things I have learnt is how resilient children are, and how easy it is as adults to underestimate their capacity to cope with even the biggest of health challenges.

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A really important part of my job is helping children and families develop and share stories of their experiences which can often be quite fragmented.

 

As Psychologists we call this building a narrative and the research shows us that this capacity to tell stories in our lives increases resilience and supports positive coping. Certainly clinically, I see so much change happening through this process; whether it is the adolescent who wants to build a story of their cancer journey as a child, or the young children who are trying to make sense of their medical experiences.

 

An example…

Recently I had so much fun with a delightful four-year old who very eloquently told me about the scary bits of his treatment and then together we wrote a story and began to think about what they would like to have done when the scary things happened.

 

What scared this child, was the number of medical professionals in the room when difficult interventions happened. So, with great glee, he told me how he wished he could have been a lion and roared and roared and scared the doctors away. We had great fun developing his roaring skills and building his story of developing his bravery as a lion and now he has been able to cope with ongoing complex medical treatment. It was interesting to reflect on this with the adults who supported him had not realised what had scared him most.

 

The lesson for me is to listen to the child so we can support them and don’t be afraid to have fun and be playful. It is amazing the power of play for children and how through play and laughter they can work through challenging experiences, after all play is how young children share their stories and experiences with us.

 

Something to take away…

As a Psychologist working with children I can’t emphasise enough the importance of taking the time to truly listen children big and small, have fun with them and be playful. It is amazing what a difference this can make even in the most challenging situations.

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

 

“I’ll never forget walking into a bay of post-operative cardiac surgery patients to see them all pretending to hide under the sheets to avoid physiotherapy treatment!”

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Like many of my colleagues, physiotherapy was not my first career choice. My journey started whilst working as a nursery nurse in a school for children with profound disabilities, where physiotherapy treatment was incorporated into the daily routine. I was lucky to work with a physiotherapist who enabled me to understand and see the benefits of treatment first hand. She also encouraged me to think about getting more experience and re-training as a physiotherapist.

As a result of this encouragement, I went on to gain a post as a Community Physiotherapy Assistant (whilst taking A-levels via a number of evening classes) before starting my three-year physiotherapy degree training. The experience I gained as an assistant was incredibly valuable, challenging, inspiring and absolutely fundamental to my ongoing learning and development as a physiotherapist.

In my first physiotherapy post, I sustained a manual handling injury being a bit too overenthusiastic whilst transferring a patient into a chair. From this incident, and thinking about the training delivered to therapists, I trained as a manual handling key worker alongside my physiotherapy role, in the hope of reducing staff injury and improving the training delivered.

Looking back on this now it also planted the seeds of my future interest in clinical governance. I had also developed a keen interest in respiratory physiotherapy and was able to be part of the pilot for a recovery at home system. My role was to assess respiratory patients in the medical assessment unit, facilitating discharge and continue acute physiotherapy treatment for a week prior to handing over to the community team.

All of the previous experience, additional training and support from staff was critical to me having the confidence, knowledge and skills necessary undertake this role – which I loved! Preventing hospital admission and having capacity to provide support to patients at home, seeing the difference this made to them, has remained a positive influence on me throughout my career.

To further my cardiorespiratory knowledge, I was fortunate to gain a senior respiratory post at the Trust, eventually becoming team lead for cardiothoracic physiotherapy; an area and role which remains one of the most enjoyable experiences I have had. I certainly had some interesting encounters.

For instance, I’ll never forget walking into a bay of post-operative cardiac surgery patients to see them all pretending to hide under the sheets to avoid physiotherapy treatment! It was funny, but also lovely that they had taken the time to organise it between them and go on to demonstrate how much improvement they had all made in their post-op recovery – it was wonderful to see. It also provided balance to the often difficult and challenging situations faced when treating critically unwell patients, together with the rewards being part of the healthcare team enabling patients in their recovery.

Physiotherapy is an incredibly diverse profession which always has the patient at the centre of care. It takes a holistic approach and encourages self-management of acute and long term conditions. In my current role I am fortunate to treat respiratory outpatients as well as being the Deputy Physiotherapy Manager. I could not do either without the experiences and support I have gained along the way. Working with and trying to get the best outcome for people – whether patients, carers, students or staff – is definitely hard work, but rewarding work which requires constant listening, learning and development as an individual.

I will always be grateful to the physiotherapist who set me on this path – I hope I have helped others to so the same!

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

Guardians of the radiation

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Who are those strange characters lurking behind lead glass and kept in their faraday cages?

Like many professions in the NHS, Radiography is not well known and people often don’t realise the breadth and depth to the job. The majority of patients (in, or out) that come into our hospital will need the care of a Radiographer, as over 1000 diagnostic imaging tests are performed daily in the Trust. This is the kind of numbers we are dealing with.

It’s very hard to simplify what Radiographers do when there are so many different specialties within the profession. At its core you could say that we are the last stop before a patient is exposed to radiation; call us ‘the guardians of radiation’. We need to check everything is correct and justified before pressing that button. But our roles don’t stop there, far from it. Over the years Radiographers have taken on more and more responsibility and what is expected of us has changed as well.

Many people think of Radiographers as button pushers or for me in CT according to my friends it’s “flashy flashy press press.” Don’t get me wrong; when that button flashes it brings me great joy pushing it but we all do so much more. We cannulate patients, make sure the exam is justified, check to make sure the entire area of interest is covered, a quick look to spot any obvious gross abnormalities and if we do spot something we then inform our fantastic Radiologists who can then take the appropriate next steps.

In Radiography you can choose many different specialties and they are all quite different, but we all start doing normal x-rays. While in that role we cover ED, dealing with traumas to broken toes, in theatre we provide live fluoroscopy during operations, outpatients X-rays, dental and portable x-rays on the wards.

From here we can progress into several other areas. Let me tell you about a few:

Nuclear Medicine – where they prepare and administer radioactive chemical compounds, known as radiopharmaceuticals and then perform many different scans. Mammography – where specialist Mammographers perform scans, biopsies and report the images.

Computed Tomography (CT)-  which I have spoken about in my previous post. Interventional Radiography – which again involves live images being acquired during interventional procedures.

Cath labs – Cardiac Radiographers help image during the majority of cardiac operations.

 

We can also move into reporting radiographers who form reports just like radiologists. They cover x-ray (where they can report on the appendicular skeleton), in CT (to report head scans) and MRI have both head and extremity reporting radiographers.

 

If you have had enough of radiation after a while, there’s the option to change to MRI or ultrasound. In ultrasound after one or two years of further study, you can become a Sonographer. This lovely bunch perform the majority of ultrasound scans from obstetric to Doppler, again forming their own reports like radiologists.

 

Finally, in MRI, Radiographers perform a variety of complicated scans from cardiac stress scans to head scans, while doing vital safety checks on each patient to make sure there are no contraindications.

 

As you can see, Radiography covers a wide variety of roles. So next time you see me pressing the flashing button remember we all do so much more and we are (like every job in the Trust) a vital cog in the big, hospital machine.

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

A view from a Speech and Language Assistant

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03 December 2014 – the day I started my job. I remember walking through the main doors and being over-whelmed by how busy and frantic the environment was. It was difficult to concentrate on anything else other than making sure I found my way to the department on time. It felt like I had just walked into a mini city.

 

Looking back I was oblivious and somewhat naive to the job I had applied for

It’s only when I look back over the last nearly three-years, I realise how much I have learned through the experiences I’ve been exposed to here at Derriford hospital.

Within my role I feel particularly lucky and honoured that such a large proportion is direct patient contact. In a short blog it’s hard to sum up what I do day-to-day because every day is so different; you can never predict what sort of patients you will meet.

I help support communication therapy sessions alongside the therapists in our team and I also create communication aids and resources for patients and support patients with swallowing difficulties. Recently, I have been able to support a Laryngectomy patient in using an electronic speech device; she hasn’t had a voice for over four-months.

I also feel lucky that I am currently on the pathway to hopefully qualifying as a Makaton tutor. The Speech and Language Therapy department have recently nominated me for a certificate of excellence which was a surprise and nice token of recognition.

I hope to have a long career within the NHS, and in this department in particular. If there is ever a chance to develop my role further with assistant practitioner apprentice training this is something I would aspire to complete in the future.

Rachael Wilson

Speech and Language Therapy Assistant

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Rachael 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.

One day, whilst I was waiting for a prescription, I thought that working in a pharmacy could be interesting

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I have had asthma and allergies for as long as I can remember, so going to pick up a prescription has just been the norm for me… although I never did understand why it took so long to, “just stick a label on a box”.

Fast forward a few years and I am a little bit tired of my call centre job and looking for a new challenge and something more career based. One day, whilst I was waiting for a prescription, I thought that working in a pharmacy could be interesting so I looked into what it took to work in a pharmacy.
After scrolling the internet, I decided it looked like something I would enjoy and realised that there were lots of different avenues to progress, and there was a lot more to pharmacy than people realise; I started job hunting.

Discovering Derriford

I found one in Derriford so I decided to apply. I was shortlisted and invited to an interview!
Now, when it came to the day of the interview I had a serious case of foot in mouth and when asked why I would like to work in pharmacy I responded with ‘well… I am on a lot of drugs’ and then suddenly realised what I had just said so frantically tried to back track and explain it wasn’t anything bad, I was just on inhalers and allergy tablets galore… somehow they saw the funny side and I got the job!
When I started I soon learnt that it wasn’t just a case of sticking a label on the box and letting the patient go on their merry way; every minute it takes from when we receive a prescription until they have their bag of medication is spent checking that all of the correct policies and processes are followed to ensure patient safety during the different stages which include receiving the prescription, clinical screening, dispensing – labelling the items, dispensing – assembling the items and having a final check.

I started off as an ATO (Assistant Technical Officer) and after training in different areas, I had a whole range of different duties which included working in the dispensary; dealing with the labelling and dispensing of medication for our TTAs (Discharge ‘to take away’ prescriptions) and in-patients, working in distribution where we issue and assemble stock to all of the wards in the hospital as well as local community hospitals, topping up wards – ensuring the wards had the correct stock levels and that everything was kept securely and is in date.

I was also required to ‘run’ (not actual running, thankfully!) to collect charts and medication from the wards then deliver it when ready – this was probably the hardest part, especially in the summer as we would often do up to 12 miles of walking up and down stairs and all over the hospital in half-a-day.
I had to cover reception, receiving in prescriptions, charts and dealing with general queries, I needed to fill up the liquid nitrogen canisters, clean leeches – yes we still use them and more regularly than you’d realise. I also needed to carry out general housekeeping such as restocking our supplies of boxes and bottles, cleaning and carrying out stock and date checks.

Moving on, but still in the Trust

After I had been here for a year, a position came up to carry out a two-year course to gain the qualifications required to become a pharmacy technician.

I applied and was fortunate enough to get the position – this was the real start of my career. The course was hard for me as I have been out of education for 15 or so years, and I had to get used to writing long assignments, going away to college for week long blocks to attend college lessons and live in student halls.

Trying to do two qualifications whilst working fulltime, keeping the house in an acceptable condition and looking after my man-child had its moments where I was left wondering if I’d made the right choice or not!

But I have finished now and am waiting to start my new position as a registered pharmacy technician in the coming weeks and looking forward to where I will end up and which path I will go down next.
I really enjoy working in the pharmacy as the day is varied and there is always something new to learn, we are constantly busy, even on days when its quiet (although we never say the “Q” word) there is always something to do to keep us occupied.

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Carly 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.

If I, or any of my relatives, needed the services of Cellular and Anatomical Pathology, I know that the service provided would be exceptional

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My name is Mike Biscombe and I am the Operations Manager for Cellular and Anatomical Pathology.

 

“What is that?” I’m sure some of you will be asking, but first of all let me say something about myself.

 

I am not an Allied Health Professional or a Healthcare Scientist. I am a fairly ordinary bloke from an industry background who has had the good fortune to end up working with a group of extraordinary people.

 

My team, the Cellular and Anatomical Pathology Team will not be known by a great deal of people within or outside of the hospital, but I’m sure that most people would soon realise if they weren’t around.

 

The team comprises of four main disciplines; Mortuary, Histology, Cytology and Neuropathology.

 

So, I would love to take this opportunity to tell you what they do and, most importantly, the huge difference they make to this Trust.

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Mortuary

Well it’s obvious what the mortuary staff do isn’t it? They store bodies. No – this group of unsung heroes do so much more than that. They assist the pathologists with autopsies, they ensure that the deceased are treated with dignity and respect, they spend time chasing paper work to ensure that the deceased’s transition from mortuary to funeral director happens in a smooth and timely manner, often having difficult conversations with overworked and weary medics. They also deal with relatives at a time when they are at their lowest, but always with good grace and good humour. I know that this is not a role that I could carry out.

 

Histology, Neuropathology and Cytology

Staff of all levels work tirelessly to ensure that patient’s cases progress through the system and are diagnosed and reported as quickly as possible. Secretarial and admin personnel work tirelessly making sure that the technical and medical part of the team have the resources they need to carry out their roles. They also ensure that there are effective links between Cell-path and all requesting departments.

 

The medical and scientific staff carry out highly technical work often in difficult circumstances.

They do not down tools and rush home at the end of the working day, but stay in order to ensure that work is completed and the department is left in an orderly state. They deal with complicated, often upsetting cases and at times are pressured to deliver quickly.

 

This is a team of many constituent parts: Admin, Secretarial, ATO, Technicians, Biomedical Scientists, Registrars and Consultants, but they are all constituent parts of a single, cohesive and truly effective team.

If I, or any of my relatives, needed the services of Cellular and Anatomical Pathology, I know that the service provided would be exceptional.

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I am extremely proud to be part of such an amazing team.

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

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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.