My experience being redeployed

My experience being redeployed

Rotational Midwife, Melanie Redding has temporarily left her job in the maternity unit behind to help out in the COVID Intensive Care Unit (ICU) Escalation Team after volunteering to be redeployed. She shares her experience below.

My name is Melanie Redding, although to my colleagues I’m known as Mel-Bell. I joined the Trust in 2006 when I commenced my post as a Registered Nurse in Theatres and the Emergency Department. However, for the last 9 years I have worked as a Rotational Midwife in the Maternity Unit.

On Sunday 5 April I was working my normal shift as a Midwife and on Monday 6 April I commenced my secondment to the Covid-19 ICU Escalation Team. How did this happen I hear you all say, surely they still need midwives during this pandemic? Did you offer or were you made to go? Do you feel safe doing this? What about your family? All these questions were asked to me by colleagues and now by my new colleagues. The truth is, I saw on the UHP Twitter page that they were asking for staff with previous Theatre experience and I couldn’t morally sit there knowing that I possessed these skills and say nothing, so I put my name forward. My Mother in Law also works for the Trust as a registered nurse and was due to retire in March. She has deferred this until July as she felt she could not leave the NHS at the time of a world pandemic which also helped my decision. I was fully supported by my Matrons, Charlotte Wilton and Sheralyn Neasham to be put forward for a secondment for as long as I was needed.

So on Monday morning I went to Pencarrow and Penrose where I was met by the Clinical Education Team to begin my ICU clinical training with other members of staff who were redeploying. Pete Barnfield, Elaine Johnstone, Tracey Watts and Michelle Gould ensured we had a packed day of training. This included donning and doffing of PPE, suctioning intubated and tracheostomy patients, how to prone patients, Arterial lines and CVP lines, how to use pumps that were specific to ICU and the A-E handover (airway, breathing, circulation, disability and exposure checks before shift handovers). Safe to say by the end of the day my head was fully overloaded and all I could think was ‘what have I got myself in for?’ I was lucky enough that last year I had completed my masters module in maternal critical care so had a lot of the theory behind what we were going to be doing, it was just the practical aspect that I had to learn. Bring on the night shifts…

Wednesday night I presented to Pencarrow with the ICU team, my anxiety was high. I was worried that staff would be thinking ‘wow, now I’ve been stuck with a midwife’, however, these fears were all relieved as I was greeted by the team with big smiles and lots of thanks for coming across to help out.

On my first night I was straight into the red zone, extremely well supported and hands on from the beginning. I would like to thank Kim Greenaway and Sarah Holmes from Penrose who have taught me so much but also made me feel part of the team. Their words were: ‘’It’s like you’re ex-ICU and fit straight back in.”

I am now competent in taking arterial blood gases and slowly learning the values and able to give drugs down CVP and PIC lines. I have cared for ventilated patients, patients with tracheostomies and patients who are proned all under the supervision of experienced ICU nurses. I have learnt that no question is a stupid question and the whole team are there to support you. I do have a giggle to myself as the only practical help I needed was catheter care for male patients as you can imagine we don’t get that in midwifery.

This week I was sent to Torrington to work in general ICU where I worked with the lovely ‘H’ and supported by sister Alli. Again, I have learnt so much and was able to get stuck straight in as I’d already learnt to use the Innovian monitors so was beginning to do clinical skills without being prompted.

I’m happy to report that in a time of world pandemic I am able to help as needed, I miss my midwifery colleagues but have been well supported and will return to my position as a midwife when this settles down.

My experience of Covid-19

30 April 2020
One member of staff has shared their experience of having COVID-19 and being tested. Their account is below:

I was really surprised to get the text that said my Covid test was positive. Until that point I honestly felt like I was making a bit of a fuss… it was embarrassing being off work for what was really just a bit of a headache and a croaky voice. But there was the iMessage evidence – now I felt embarrassed AND a bit weird. Who would I tell? Who should I tell? Did I really have to tell anyone?

I had gone home on the Tuesday evening with a sinking feeling; in my last conversation of the day I had needed to clear my throat repeatedly and it wasn’t getting better with sips of water. I wrestled that night and first thing the following morning. I wouldn’t normally take time off for this… but given the current climate I didn’t want to worry anyone. I mean, I didn’t have Covid, obviously! I don’t work in a clinical area, or get up close and personal with patients, where would I have got it from? But you just can’t go around a hospital coughing in the midst of a global pandemic. So I called in to the absence line, (suppressing my ‘mountain out of a molehill’ embarrassed feelings) and was advised to isolate for 7 days; did I want a test? Why not? That would mean my daughter could come home before Easter weekend, we could eat loads of chocolate, and I could get back to work the following week.

So I stayed home. I was tested. I coughed occasionally, answered emails, took paracetamol for a headache and mild sore throat. Ran the Microsoft teams gauntlet several times daily. And then, while I was waiting for the results I thought,

“What are the chances of just having a bit of a cold in the time of Covid?” and a little part of me wondered. But I still felt OK… I wasn’t struggling to breathe, I hadn’t lost my sense of smell, I didn’t have a temperature. (At least I didn’t think I did… I don’t have a thermometer. Turns out they’re quite hard to get hold of these days.)

So when the positive text came, I was a bit taken aback. I phoned my mum, a few close friends and got in touch with the absence line to let them know. Messaged my manager. That night my chest was tight and I couldn’t work out whether it was anxiety, Covid or all in my head! I slept and woke the next morning, had a little check in with myself… I didn’t feel worse. I could hold my breath comfortably, and I wasn’t breathless climbing stairs. The worst thing was telling my daughter on FaceTime; I didn’t want her to be worried, so I did my best to seem nonchalant and super healthy. I don’t think she noticed my efforts, being far more interested in the daily drama of online schooling, and what she would do at Daddy’s if she had to self-isolate there, but I made sure her Dad knew to check her temp and keep an eye out for anything suspicious.

Person preparing dough on a sunny day. Homemade bread, bakery while staying home.Person preparing dough on a sunny day.

In total I had 12 days at home, by myself. I occasionally had a tight chest, sometimes a bit of a headache, my throat was hoarse and a little uncomfortable at times. That’s the thing – everything came and went, so I found it quite handy filling in the Covid symptom tracker app every day; it helped me to feel useful too. These are the things Covid and I did together:

  • Pilates
  • Worked from home
  • Slept (badly sometimes… weird and restless dreams)
  • Baked bread, tarts, cake, a quiche and some disastrous cookies (which I still ate)
  • Had the occasional gin and tonic
  • Listened to music and danced around my kitchen
  • Got properly acquainted with Twitter
  • More online meetings/social successes and disasters
  • Checked in with friends regularly who wanted to make sure I was OK
  • FaceTimed my daughter
  • Painted my kitchen (well, half of it – ran out of paint)
  • Did some garden stuff
  • Worried before I went to sleep
  • Dodged my elderly neighbours while I put the bins out

And then I went back to work. The ‘frog in my throat’ feeling lingered for a bit, and I was tired more easily after a full day, but strangely I also felt a weight had lifted. I am aware a lot of people don’t get off so lightly, and I was relieved to have isolated straight away because at least I knew I had minimised the chances of infecting anyone else. Or at least, that is what I hoped. I suppose I also felt fortunate to be one of the people who categorically knew they had ‘had it’. It’s always better to know, isn’t it?  The time was one of contrasts – being isolated but feeling connected; working, but from home (something I know a lot of people have had to adjust to); feeling fine but wondering if I would get more sick; listening on Thursday nights to clapping but not feeling very worthy or useful or heroic. My brush with Covid has left me a bit tired, and with a better appreciation for just how big the spectrum of symptoms and severity is. I’m just glad to be back, unscathed.

If you would like to share your experience of either having COVID-19 or of working during the time of COVID-19, please contact communications.phnt@nhs.net

“Being able to see patients get well because of all the work nurses, healthcare assistants, doctors and many others do is amazing”

Maria

To kick off our celebrations for Year of the Nurse and Midwife, student nurse María Carruego tells us about her experience so far and her ambitions for the future.

What inspired you to study nursing?

I’ve wanted to study nursing for as long as I can remember. From a young age I was always interested in watching programmes that involved helping and looking after people and I loved receiving medical toys such as bandages and stethoscopes for my birthday so I could play with my sisters and pretend they were injured. But I’ve always had in my mind that working in a healthcare profession meant having to study hard, so when I looked at the entry requirements for University, this motivated me to work harder for my GCSE’s and A-Levels because the results of this would be being able to study for a career I  have always wanted to do.

What has been your best experience so far as a student nurse?

My best experience so far as a student nurse is having to put into practice what I’ve learnt at University. This is because you’re able to get really good feedback from patients, families and healthcare professionals, which is very rewarding at the end of the day. I’ve had patients thank me for how well I’ve been treating them during placement, and honestly, this makes me feel so happy because this kind of feedback makes me feel like I am doing a good job, which I think it’s quite reassuring for student nurses since it shows how grateful the patients are. Also, sometimes it can be the little things that just makes me think that I am doing well, and I can’t wait to qualify as a nurse to carry on helping more patients.

Is there anyone who has particularly inspired you during your training?

During placement practice I have been inspired by not just one person, but multiple. Being able to see patients get well because of all the work nurses, healthcare assistants, doctors and many others do is amazing, and it just makes me want to work harder towards my degree because I want to follow in their footsteps.

What are your ambitions for your future as a nurse/midwife?

My ambitions for the future would be, being able to be that person who makes a difference to someone’s life by contributing to their life and health. Also, with nursing I feel like there is always opportunities to get your hands on something you haven’t experienced before because this work field is always developing learning opportunities which are effective for learning new skills.

What would you say to anyone who is thinking about studying to become a nurse/midwife?

I think I would tell them to pursue their dreams and if this career is something they’ve been wanting to do for a long time, then they should give it a go! However, I think when it comes to this degree you have to have dedication, passion and commitment because although it can be challenging at times it can also be very rewarding which makes it worth it.

“I love the variety of the role, knowing that we are making a positive impact on the patient’s care”

As we celebrate National Pharmacy Technician Day , I thought I’d take this opportunity to give you an insight into the role we play in patient care.

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I am currently a Student Pharmacy Technician. For me, there isn’t a typical day. I go away to college several times a year to study, learning about subjects like the actions and uses of medicines, human physiology and pharmacy law. My time at work is spent rotating throughout the pharmacy, experiencing a variety of roles undertaken by pharmacy technicians.

 

In order to practise as a pharmacy technician, we must complete an approved qualification and register with the General Pharmaceutical Council. Our initial training usually takes two years, but we will be continuously learning, developing and improving throughout.

 

At the moment I am working with Medicines Management Technicians on the Medical Assessment Unit, taking medicine histories from patients, ensuring any medicines taken pre-admission are documented in the medical notes and prescribing discrepancies are highlighted to the pharmacist. I have found this the most engaging rotation as I love the interaction with patients, and the satisfaction I get from successfully and accurately investigating complex histories.

 

In pharmacy, we have a production unit. Technical Services are responsible for sourcing and producing products such as Monoclonal Antibodies (MABs), Chemotherapy and Parenteral Nutrition, ensuring all products are made in accordance with Good Manufacturing Practice (GMP). Technicians are involved in producing worksheets, assembling the raw materials, accuracy checking, and making the products. Alongside them, Quality Control technicians monitor the cleanliness of our aseptic suites and confirm all unlicensed medicines are safe for use.

 

Technicians in our procurement department are responsible for sourcing genuine products from approved suppliers in accordance with local and regional contracts. They ensure appropriate stock levels are maintained and source a variety of products including unlicensed medicines and controlled drugs.

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The majority of prescriptions and orders comes through the dispensary and distribution and technicians take a leadership role in these areas. Distribution, which deals with stock orders, is usually overseen by a technician. Their role involves issuing and picking orders and advising and supporting the pharmacy ATOs. In the dispensary, technicians label, dispense and accuracy check prescriptions, hand out to and counsel patients on their medicines and liaise with other healthcare professionals and community pharmacies to ensure the timely supply of medicines.

 

Pharmacy technicians don’t only work in hospitals, we can practice in variety of settings, each presenting their own challenges but all providing a rewarding career. Pharmacy technicians play a vital role in primary care, ensuring prescriptions are dispensed accurately and patients understand why and how to take their medicines. In community pharmacies, Technicians advise on over-the-counter medicines and can provide additional public health services such as smoking cessation. Technicians also work in prisons and care homes, dispensing medicines and ensuring patients get the most from their treatments, and for CCGs responsible for commissioning health and care services.

 

With experience, technicians are able to specialise, for example in education and training, IT, Medicines Information or paediatrics and most of our pharmacy managers and senior managers are technicians.

 

I love the variety of the role, knowing that we are making a positive impact on the patient’s care and continually improving and broadening my knowledge and skill set. I wasn’t in a position to be able to go back to university and so this qualification is allowing me to have a rewarding and fulfilling career.

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In the not too distant future, technicians will be more visible on the wards and be able to have a greater and more noticeable impact on patient care, taking some of the pressure off our pharmacists.

“If we don’t get it right at procurement, we can’t ensure the quality of the medicines we are supplying to patients…”

My name is Zoe and I am a Pharmacy Technician working in Procurement for the Trust.pharmacy.

I am proud to work with such hard working and patient focused people in my department. We work in such a variety of roles, from medicines management technicians focusing on medicines reconciliation and safe use of patients own medicines on the ward, to supply technicians who process discharges, inpatient and stock requests daily to ensure the hospital continues to provide excellent patient care.

It is not a job I originally knew anything about before I came to work at the trust five years ago as an ATO in Pharmacy. But I really liked the way that technicians help keep the medicine supply chain flowing and enabling great patient care. I was amazed at how many of my colleagues work hard every single day to make sure that we supply discharge medication, inpatient supplies, clinic specific medication and ward stock to keep the medicine supply chain going through the hospital. Pharmacy Technicians provide a safe, secure and quality supply chain, from procurement all the way through to the patient – through a variety of roles.

I took the opportunity to train as a Pharmacy Technician within my department and learnt what it meant to be a registered professional. During my training I had to work with many different teams, including the procurement team helping to order, receive and source medications. Managing the supply chain effectively allows us to deliver outstanding patient care and I knew that’s where I wanted to work.

My current role enables me to manage supply shortages and issues, support the day to day ordering, maintain our contract compliance as well as support the day to day activities of our busy procurement team. I love my role as if we don’t get it right at procurement, we can’t ensure the quality of the medicines we are supplying to patients.

“We are proud to be in a position of responsibility, where we hold extensive knowledge that allows us to put our patients first”

Blog by Carleen Barry – Band 5 rotational Dietitian covering Gastroenterology/Medical

 

As a newly qualified band 5 Dietitian I often carry a diverse caseload of patients.

I currently cover the band 5 Gastroenterology/Medical rotation at the Trust and I work alongside two part-time band 6 specialist gastroenterology Dietitians and between us we cover a specialised gastroenterology ward. In addition to this I also cover four medical wards including two medical assessment units.

My day-to-day is far from predictable and can all change from one simple phone call at 8:30am. Therefore, I thought I would share with you a regular Thursday of mine.

My days start at 8:30am in the office catching up on emails, checking our online referral system, and liaising with the rest of the Dietitians for a team huddle.

 

Artificially fed patient

My first patient of the day is a patient well known to our community Dietitian’s team whom requires artificial feeding via a tube into the stomach called a Percutaneous Endoscopic placed Gastrostomy (PEG). This patient had been admitted to Derriford for an organised PEG replacement due to complications. So, my role is to work with the broader multidisciplinary team to communicate and organise loose ends. This ensures the wider community team are up-to-date and as prepared as they can be for when the patient is discharged back into the community. Whilst this patient is on the wards I liaise with the multidisciplinary team to ensure particular post procedure checks are carried out and all supplies of feed, syringes, and after care tools are organised. The complexity of this particular patient is heightened due to a severe learning disability. This means all of my information comes from the patient’s parent, and their ability to understand the patient needs. A smooth admission and discharge is reliant on us all working together meticulously.

Complex Eating Disorder patient

Next up was a patient whom had not been under my care as such but had been seen by both the band 6 gastro Dietitians. It was a non-working day for both of them and this highly complex patient was pending discharge upon dietetic review. To prevent delaying discharge I arrived on the ward and spoke with the medical staff and the patient. Together we came to an agreement for the discharge plan and how this particular patient could be further supported in the community. Although eating disorders is a specialist area, we are able to provide the best possible care as a multidisciplinary team. Effective communication and active listening skills are central to successful patient treatment and discharges.

 

Re-feeding Syndrome patient

 

A patient on one of the Medical Assessment Units was referred for dietetic input after presenting with alcohol withdrawal and minimal nutritional intake. Both of these presenting conditions are just two of several factors which could put a patient at risk of re-feeding syndrome. Unless you work as a Dietitian or is someone who works within the clinical setting, it is unlikely you would have heard of this syndrome. Re-feeding syndrome is a serious but potentially preventable syndrome as long as it is identified early enough. A registered Dietitian like me will assess the patient and implement the trust protocol to ensure the risk is minimised. Not all patients who are referred to a Dietitian are at risk of re-feeding syndrome. However, we do rely on trained members of staff to use a specially designed tool to identify those patients at risk of malnutrition. Then I or another member of the dietetics team can carry out a fall nutritional assessment.

 

As with any patient it was vital I worked as part of the multidisciplinary team to highlight this patient as a risk. These includes working with the Doctors to prescribe essential vitamins, check biochemistry daily and treat promptly if any are out of range. I communicate effectively with the nursing staff to ensure they know the precautions they need to take in preventing an increased risk, and document my full assessment in the medical notes. I worked closely with this patient over the next coming days to gradually reintroduce nutrition until they were meeting their nutritional requirements and were no longer at risk of re-feeding syndrome.

 

 

Ulcerative Colitis Patient

 

My last patient of the day was diagnosed with Ulcerative Colitis, a form of irritable bowel disease, 6 months prior to this admission. They presented to the emergency department after disease symptoms had resulted in a minimal nutritional intake and weight loss. Although I am not a specialist gastroenterology Dietitian I can still play an important part in treating this patient whilst they are admitted to the ward.  This patient group can also be at risk of re-feeding syndrome, along with being malnourished, dehydrated and in a great deal of discomfort. I carried out a full nutritional assessment and discussed this with the patient to gain an understanding of their own knowledge of their disease. This particular patient had not had any input from a Dietitian before this admission and was very keen to further their understanding of how best to manage their symptoms and prevent further weight loss. I started them on oral nutritional supplements to support their limited nutritional intake. These are specialist drinks which can provide vital calories, protein, vitamins and minerals, when individuals cannot obtain enough from their diet alone. Again, I also worked alongside the multidisciplinary team to provide prescriptions of much needed vitamins and minerals. Whilst they are an inpatient my aim would be to prevent any further weight loss and support them as best as I can. Once they have been discharged they are often invited to an out-patient appointment to see the specialist gastroenterology Dietitian.

 

As we are registered professionals our patients can expect to be treated with only the most up-to-date evidenced based care. We are proud to be in a position of responsibility, where we hold extensive knowledge that allows us to put our patients first.

Healthcare Scientist in Nuclear Medicine

HSC week blogEver wondered what a career in Nuclear Medicine would look like? Clinical Scientist, Sarah Bell tells us a bit about her role.

I have been working in the Derriford Hospital Nuclear Medicine department for about a year and a half now. When I first started here I was still in the final year of the three year Scientist Training Programme (STP) in medical physics. I qualified as a Clinical Scientist about six months ago – although I’m finding that I still have a lot to learn!

I am part of a team of three qualified Clinical Scientists and generally at least one trainee in Nuclear Medicine. As Clinical Scientists we are actually a part of the Clinical and Radiation Physics group, who are a department within Healthcare Science and Technology, a service line of Clinical Support Services. As Nuclear Medicine specialists our jobs are very varied, and in my opinion very interesting!

Nuclear medicine is a branch of medical imaging that uses drugs labelled with a small amount of radioactive material to image physiological function in the body using special cameras. These images are used to diagnose or determine the severity of a variety of diseases. Radioactive drugs (called radiopharmaceuticals) can also be therapeutic rather than diagnostic and can be used to treat some diseases.

Part of our responsibilities includes the design and implementation of optimal acquisition protocols for specific studies. This means working out the best parameters to set on the camera to obtain the best images possible to send to the consultants to enable the right diagnosis. We are also involved in the computer processing of some of the more complex imaging studies to provide the right information for the consultants.

As I’m sure you can imagine – the work done in Nuclear Medicine could result in serious accidents if the right risk assessments and protocols aren’t in place to ensure the safety of both patients and staff. It is the responsibility of the Radiation Protection Advisor to ensure that there are safe working procedures and contingency plans in place to keep the risk to a minimum. I help the other two physicists, who are both certified Radiation Protection Advisors, by assisting with the risk assessments for new procedures or any modifications to existing ones. For example we are changing the radioactive isotope for one of our studies because the old one is not being manufactured any more. Does this mean that the staff preparing the patient injections will be exposed to a higher level of radiation? Will we need to change our existing procedure? What will be the clinical impact? These are all questions I try to answer before we give the go ahead.

Our responsibilities also include equipment management, which can include the specification and acceptance testing of new equipment, as well as regular quality control testing of existing equipment. We’re also lucky (in my opinion) that we have a radiopharmacy within in our department, which isn’t the case for all Nuclear Medicine departments. The radiopharmacy is where all of the radiopharmaceuticals are made each morning. I’ve recently been learning about quality control of the radiopharmaceuticals we manufacture and how we determine if they are safe to be injected into patients. I’m looking forward to getting more involved in the radiopharmacy side of the work we do here in Nuclear Medicine.

A few of the other responsibilities we have here include, but are not limited to, therapeutic treatments of patients with over-active thyroid, thyroid cancer remnant ablation, and prostate cancer metastases. Also, the management and disposal of all of the radioactive waste we accumulated in the department is managed by physicists. Finally we get involved in research and development and try to stay ahead of the game by attending conferences and courses to find out what everyone else is doing too.

I really enjoy working in Nuclear Medicine. It’s very much a team game where I get to work alongside technologists, consultants, nurses and clerical staff. It’s not just limited to our department either! From my experience Nuclear Medicine departments from other Trusts are more than happy to compare protocols and procedures and discuss new developments and guidelines and how these may best be brought into practice. There’s a great community feel to this field and I would definitely recommend a career in Nuclear Medicine to anyone who may be interested!

Day in the life of an embryologist at the Ocean Suite

HCS weekAverage day in the middle of a treatment week – Rebecca Matthews

From the crack of dawn we are up in the lab, turning on all of the equipment and getting ready for the busy day ahead of us (usually centred on making a strong coffee). Once the lab is cleaned, the eggs which were inseminated the day before are checked for signs of normal fertilisation.

Embryos from earlier in the treatment week are also checked for their development stage and quality. All of our patients from the previous day and earlier in the week are called with updates on their embryos and what the plan is regarding whether we culture the embryos on further, or whether we bring the patients in for their embryo transfer.

It is around this time when our first patient of the day is brought into theatre for their egg collection, my personal favourite job. One member of the embryology team will be in charge of the day’s worth of patients. If any frozen embryos needed to be thawed, this would also occur around this time.

Whilst the female partner is undergoing her egg collection, the semen from the male partner is being cleaned and prepped ready for use later on in the day by a separate embryologist.

The rest of the morning is normally filled with patient’s egg collections and sperm preparations. If any of the patient’s treatment plans need to be changed or decided upon, a member of the team will discuss this with the patients.

Prior to lunch, all of the embryo transfers are performed. This is usually a very exciting and happy time for our patients as well as for the staff.

After lunch and a lot more coffee, all of the mature eggs are fertilised either through IVF (the mixing of sperm and eggs in a dish) or ICSI (injection of one sperm into an egg). Once all of the mature eggs from all the patients are fertilised, they are put away into incubators until the next morning.

The next day’s cases need to be prepared and set up for and all of the paperwork from the day needs to be completed (to which there is many)! After all of our work is completed, the lab is cleaned and shut down for the day until the next morning.

I love my job and working in the embryology team is a great and rewarding job! The very best part of the job is seeing (and cuddling) the babies 9 months later. Being able to change someone’s life for the better is a fulfilling and a wonderful opportunity – definitely worth the mountains of paperwork!

The UHP Radiotherapy Physics Team

One of the least known departments within the hospital, the Radiotherapy Physics team provides a vital role supplying complex scientific and technical support to Plymouth’s Oncology department.  We are a team of 20 staff comprising Clinical Scientists, Dosimetrists and Engineers.

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No Radiotherapy treatments can be carried out without our involvement.  Our Dosimetrists provide a dedicated treatment planning service working closely with Oncologists to produce highly accurate plans for our treatment machines in order that they can deliver targeted doses of radiation with millimetre precision. The radiotherapy treatment plans are highly complex requiring sophisticated computing systems. Although required to deliver 24% of radical plans in this fashion, we regularly achieve over 60%.  Additionally, we are also responsible for designing and producing aids to immobilise patients enabling high levels of accuracy while they undergo treatment.  Our Engineers undertake specialist training to keep the treatment machines running at peak performance and act as a first line of support in the event of a breakdown.  Our HCPC-registered Clinical Scientists are all highly trained Physicists who have responsibility for ensuring that the treatment machines and associated clinical systems are calibrated to deliver the correct amount of radiation to the correct part of the body.  The margin of error between successful treatment and untoward side effects is extremely narrow, so highly precise plans and accurate monitoring are needed to deliver the desired clinical outcomes.

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In addition, we also advise our Oncology colleagues on aspects of radiobiology affecting patient treatments.  Radiotherapy Physics also co-ordinate the Trust’s Brachytherapy services, during which we calibrate and deliver highly radioactive sources within the patient’s body, to treat different types of cancer.  Our Stereotactic Radiotherapy service delivers highly precise treatment to cranial tumours using state of the art software and imaging to ensure that we deliver a fatal dose of radiation to the target whilst minimising damage to healthy surrounding tissue.

We are very involved in training within our section, providing teaching for the next generation of Clinical Scientists in addition to placements for student Radiographers and FRCR tutorials for Oncology Specialist Registrars. Staff also visit local schools as part of the STEM (Science, Technology, Engineering & Maths) programme, engaging students and promoting careers within Medical Physics, which they find extremely rewarding.

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The department has an active research and development programme, participating in national clinical trials and commissioning new cutting edge techniques in the fight against cancer.  Staff members contribute to scientific journals and have submitted posters to international conferences.  Several also sit on scientific committees within professional bodies, helping to shape the current and future direction of Radiotherapy services in the UK and Europe.

We are a sociable and diverse bunch, comprising staff from several countries including Portugal, Poland, Cyprus, Australia and even Scotland!  Above all we meet the challenge of an ever-increasing patient workload in partnership with our Radiographer and Oncologist colleagues with a constant cheery determination.

#WeCare2 – Nystagmus Centre of Excellence

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.burdonsocial

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.