Postgraduates Students Visit to Western General Hospital

On 16th October students from the MSc in Advanced Nursing Practice spent an unusual afternoon visiting the Western General Hospital, instead of having a regular Personal & Professional Development tutorial.

Western General Hospital

The group met a former MSc student, Angie Balfour, who gave the current students a nice opportunity to explore the hospital and provided them with a deeper insight about the environment of NHS in Lothian area.

Angie presenting ERAS project

First Angie presented her work as a senior research nurse at WGH mainly looking at ERAS (Enhanced Recovery After Surgery) a programme designed to aid fast recovery after surgical interventions.

Students had a good opportunity to ask questions and exchange knowledge and experience among a diverse multinational group.

Students in Colorectal Unit meeting room

Students discussing the NHS environment with Angie

By the end of the day, students were thankful to Angie for providing such an opportunity to explore the WGH, and for the new ideas they had after the ERAS presentation. Thanks to Sharon and Angie for organizing this visit. As a group, we are all looking forward to visiting other NHS settings in the Lothian area to learn and discover even more.

Esra Sinary
MSc Advanced Nursing Practice 2017-18

A ‘sepsis’ exchange!

Sepsis is a major health concern and its understanding and management forms a key part of our BN with Honours curriculum. It is a challenging concern and not always easily understood as the pathophysiology is complex and, once established, sepsis can be difficult to contain.  Despite this it is a most rewarding field of research and study.

It was therefore a real pleasure to approached by Edinburgh’s George Watson’s College to give a talk on Sepsis to their senior school students who were members of their Science and Engineering Society. Uncertain as to how to pitch this outwith the University setting and in a relatively short presentation time, I knew I had to rethink the content and messages to suit this particular audience.

Watson’s College is an impressive building which must inspire its students. The auditorium was equally so and the audience, both staff and students, was welcoming and enthusiastic. It worked. They were engaged, responsive and enquiring. I could not help but see them all as prospective undergraduates with us.  They left, I hope, with some key messages to help them understand how sepsis develops, how it might be prevented, who is at risk and what key early warning signs should alert them for action.  I also hope they sensed my passion for nursing and rewards from this career path and indeed that of all health care professions.

It would be a real joy if some of the student audience might bring their enthusiasm to our nursing degree or to medicine here at the University of Edinburgh.

I left with chocolates and a smile.

Tonks N Fawcett
Professor of Student Learning (Nurse Education)

Undergraduate Teaching on Clinical Information Management

Year 2 of our BN programme had a fascinating talk by a health informatician from NHS Lothian, as part of their ‘Professionalism’ course.

Marina Copping, Clinical Information Manager (Maternal, Children and Young People) described current developments of clinical IT systems and the importance of good record keeping.

She stressed that the focus of nursing care should always be the person and their holistic needs but reminded students that in the current financial climate without good data it is difficult to justify extra resources for nursing. Marina said that capturing the right data and having the means to safely share accurate and timely information is critical to maintaining safe and effective care. Year 2 students have another opportunity to consider eHealth and implications to community practice later on in this semester

Sharon and Colin hang out in China!

Our trip to China

Colin and I arrived to a hot and very humid metropolis where slow traffic and fumes were dominant – but we had a wonderful and extremely productive visit!

Having been briefed by our current Chinese students we hunted for a restaurant where the food was fresh and looked yummy – and found this fantastic place! The food was prepared by a chef with a black belt in noodle making and consumed using…chop sticks!.

 

We did use chopsticks!

We did use chopsticks!

With a full tummy we progressed on foot towards the Forbidden City. We never got there as we had to be back at the hotel where we set to meet a student who graduated 2 years ago. She now works full time in Beijing as a medical editor in a start-up company, acting as an interface to technology colleagues who develop software and hardware for expected mothers and unborn babies. The dinner was (again) delicious and the discussion was fascinating.

The following morning we were set to give a presentation at a recruitment agency that acts as a mediator between potential students and the University. We arrived there using the underground train – which was easy to navigate and very modern (and with air condition – phew!). The meeting itself included a videoconference link to two other sites and it was part of their routine process to be inclusive of colleagues in remote sites– fantastic! We went back to the underground to get train tickets for our trip to Hangzhou the following day. The station was MASSIVE but we were helped by a few young people who spoke very good English. In fact, Beijing is full young professionals and both Colin and I had a sense that we were the only people with grey hair … maybe that was the reason a few people on at the station asked if they could take a picture with us….

Art at the underground

Art at the underground

The 2 ex-ANP students we met that evening treated us to the best Peking Duck we ever had. They paid for the taxi and the bill using their mobile phones and told us they never carry cash – no need to ‘be bothered’ with coins. It was great hearing their stories and get the latest news (weddings, boyfriends, children…) from the MSc cohort from last year – we were very proud of their achievements!

We were fortunate to be staying very close to Peking University but the short walk was done in the pouring (torrential!) rain. In fact, we realised that it only rained in China when we had no umbrellas with us… but in general we had good and dry weather during our 5 day visit. We got slightly lost on the way to the Medical Humanities building and ended up in a locked psychiatric ward (long story…). The ‘exposure’ to that clinical environment in Beijing was unexpected and augmented other site visits we had in Hangzhou. Overall, the discussion we had with key staff in Peking University was very useful and we are hoping to follow it up soon.

Professor Lu Nursing department Peking University with Sharon and Colin

Professor Lu Nursing department Peking University with Sharon and Colin

We left Beijing with mixed feelings. It is a very modern, vibrant and easy to manage city with plenty of traffic (people and cars) but you could be anywhere in the world – really. We saw hardly any birds and the smog was evident but did not affected us – health wise. The 5 hours trip to Hangzhou on a train, traveling at 300 Kilometre an hour, revealed more of the construction ‘miracle’ that engulfed China – as we passed though clusters of large tower blocks with hundreds of busy cranes.

We arrived late at night and prepared for a meeting we had the following morning with the dean of the Nursing department at Zhenjiang University. We were picked up by two nursing lecturers and the discussion in the car was so intensive that we ended up in a minor car accident. Undeterred – we walked the last 500 meter to our meeting that was held in the campus’ coffee shop – informal and refreshing. We were treated to a fantastic lunch and a tour of the famous Sir Run Run Shao Hospital where 7000 people attend the outpatient department – daily!

Nursing station in an inpatient ward at Run Run hospital

Nursing station in an inpatient ward at Run Run hospital

We were shown around the campus and had an afternoon (green) tea at a traditional dwelling, which was uprooted and placed at the heart of a large garden. Students have such a wonderful place to wander around – with large grassy area whilst listening to music that was blurring out of mushroom shaped speakers… judging from the catchy tunes I would not be surprised if China is the next nation to join the Eurovision song contest!

The following day we met nursing colleagues at Hangzhou Normal University and were introduced to the Director of the international office and his depute. The new Campus, which we toured using a Golf buggy, is currently being built but looks very impressive already. The lunch we had there was (yet again) FANTASTIC – rich and delicious! It was hard to focus on the afternoon ‘task’ – but Colin and I delivered a lecture to some 20 undergraduate students followed by a talk to some 20 PG students on what is ‘nursing’. We were very impressed by the level of engagement and the English of the students we saw and were delighted to be reunited with the 2 students who came to Edinburgh last year. It was their graduation day and Colin was able to demonstrate how to celebrate in style!

Colin and the Girls!

Colin and the Girls!

We were treated to a delicious dinner before our driver came to take us back to our hotel – to get ready for a site visit to following day…

This final day in China was dedicated to reviewing the facility for our exchange students and ensure they will be well looked after. After seeing their accommodation and the dedicated staff who are set to support them – whilst in Hangzhou – we remained concerned. We worry that the students will have such a good time that they may find it hard to go back to their NHS Lothian placements in year 4!

The goodbye party included… food… lots of it… and again delicious dishes to share. We will progress with potential collaboration with colleagues in China and next time we are there… we will make sure we fast a week prior to departure – to have a chance to try all of the dishes that we were offered!

food glorious food!

food glorious food!

Sharon & Colin June 2016

Olympic Weightlifting and Nursing Studies

Zoe Horseman is one of our final year student who is passionate about nursing. However, outside of the ward she is an avid weightlifter! She has been a member of the Edinburgh University Weightlifting Club for the past two years. This year Zoe has been working towards her biggest competition yet; the British University and College Weightlifting Championships. Zoe describes this as one of the most challenging and rewarding years of her life.

“I was incredibly nervous about undertaking the fourth and final year of my nursing degree. The prospect of writing a dissertation whilst training a minimum of 6 times a week for the competition was very daunting.”

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Zoe submitted her honours dissertation on a Thursday afternoon, and the next day flew down to London travelling to St. Marys University in Twickenham on the Saturday. Luckily she didn’t have to cut weight, and weighed in at 66kgs to compete in the afternoon.

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“I snatched 70kgs, then clean and jerked 85kgs, this gave me the winning total of 155kgs. It was such a big achievement to win the gold medal two days after submitting my dissertation. A fantastic experience, competing against some very talented lifters.”

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Zoe is looking forward to next year when she hopes to defend the title – then as a nurse graduate and a fantastic sportswoman!

 

Tonks N Fawcett

Professor of Student learning (Nurse Education)

 

Professor Pam Smith’s Lessons from a Decade’s Research on Poverty: Innovation, Engagement and Impact

 Lessons from a Decade’s Research on Poverty:   Innovation, Engagement and Impact

10th anniversary conference of the
ESRC—DFID Joint Fund for Poverty Alleviation Research

16—18 March 2016, Pretoria, South Africa

 

I participated in this exciting conference last week. I was invited because I am a Co-I in one of the projects in this programme. Dr Radha Adhikari and I recently posted a blog about our research “New Norms and Forms of Development” on international aid in Maternal and Child Health in Nepal and Malawi, funded by the ESRC (The Economic and Social Research Council) and DFID (The Department for International Development) http://www.blogs.hss.ed.ac.uk/nursing-tales/

During the three day conference I chaired a session on Childhood Nutrition and Public Health which included two stimulating presentations and a discussion which took me back to my community nurse teacher roots in Tanzania and Mozambique.

Rob Hope from Oxford University presented ‘new insights into the relationship between rainfall and water use using innovative hand pump monitoring technology’. Mary Amuyunzu-Nyamongo and Daniel Lang’o (African Institute for Health and Development) spoke about Tackling child nutrition and health through community-led interventions: lessons from an informal settlement in Kenya; Alice Lakati (Amref health Africa) Discussant reflected that the presentations:

• Clearly demonstrated the challenges to public health in sub-Saharan Africa and the positive effects of safe water and nutrition on the health and wellbeing of the community.
• Disease surveillance and baseline nutritional ‘before and after’ data are needed to demonstrate the effectiveness of interventions individually and collectively and their potential to reduce morbidity and improve food security.
• Business skills and social support enable communities to take control of their lives.

For me the presentations highlighted some key issues about women’s lives and gender:

The effective use and maintenance of hand pumps saved many hours of women’s time collecting water and prevented girls missing school especially during a drought.

Participatory action research supported women to gain farming, craft and business skills. They were twinned with mentoring groups who facilitated them to work as a team. The women reported on the positive impact of the training on their lives which enabled them to think differently and take decisions.

Conference Website
Different forms of social media, art and visual images are being used to convey the messages of the entire conference which you can see on the conference website http://bit.ly/22hUMCp

You will see images of an artist at work capturing highlights of the conference through images and words such as these: Good news for qualitative researchers!

 

 

 

a b c

Pam Smith

pam.smith@ed.ac.uk
March 20th 2016

Nursing Studies workshop with Eczema Outreach Scotland

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Eczema Outreach Scotland led a workshop for Nursing Studies students focusing on eczema and the effects it can have on the individual and the wider family unit.

With the first year students spending time with Health Visitors as part of their placements, considering eczema in this way is vital as it is estimated that 1.7 million children in the UK have this condition.

Eczema Outreach Scotland is a charity which delivers advice and support for the families of children living with eczema.

The aim of the workshop was to provide students with a realistic and honest account of the psychosocial effects of eczema on children and families.

Dr Jennifer Tocher, the UG programme director for Nursing Studies, felt the workshop was vital and the students gained a lot from this experience.

 

‘When they are in practice they will be able to draw on some of the practical advice to help patients,’

 

‘It has made them think a lot more. They all said that they knew people who had eczema, but did not realise how debilitating it can be or the amount of stress it can put on the family unit,’

To read more about this collaboration, the Journal Nursing Children & Young People have covered this in a piece entitled ‘Understanding the effects of eczema’ (2016) 28 (2) p9

The ongoing impact on people’s lives in Nepal of the major earthquakes of April and May 2015

Dr. Radha Adhikari shares her personal observation from visiting Nepal

 

Two major earthquakes in Nepal, the first on April 25th and the second on May 12th 2015, and hundreds of tremors in between them and thereafter, caused phenomenal devastation in the country. These incidents attracted global attention on Nepal. Within a few hours after the first quake in April, the world’s eyes were glued to social media, as people from most corners of the globe updated their understanding of the disaster. Relief efforts began shortly afterwards and aid started pouring into the country. The only international airport in Kathmandu experienced considerable traffic congestion due to the increasing volume of relief supplies.

This disaster caused total chaos in the lives of the public and damaged many infrastructures, including the health service in Nepal. Recently, in December 2015 and early January 2016, almost eight months after the first quake, I visited Nepal and found people still in deep trauma: psychologically, emotionally and economically. Many public services are still not functioning or are under-functioning. Public life has yet to arrive at a pre-quake stage. People often related their fears and spoke of the emotional ordeal they experienced during the all-too- regular aftershocks, fears that continued for several months after the earthquakes.

Eight months after the earthquakes, I found many health services being conducted in tents, and health professionals are still traumatised. In Sindhupalchok, eight health professionals lost their lives and 14 were reported to have had physical injuries. Long-term damage to the geological and ecological processes is difficult to fully comprehend and estimate. I present here some of my first hand observations and impressions of the medium term impact of the earthquakes on people’s lives in the country.

People’s personal stories psychosocial impact

Initial tremors and aftershocks were felt across the country and a vast majority of people in Nepal experienced them. A young lady, our former neighbour in Kathmandu, seemed still traumatised, as she shared her experiences. Crucially, her life perspectives have changed. Quite philosophically, she commented that “we invest so much in building a house and making it a home, we furnish our homes with the best possible furniture, and try hard to decorate and maintain it. Basically we pour in our emotions, wealth and everything we have to make it home. But during the earthquake, our own home became like our death trap, people did not want to go inside their own homes and do anything inside them. Staying outside was the best option and the safest way to save our lives.” Fortunately her house was spared, but thousands of people lost their relatives, family and properties. Such devastation is visible everywhere in the Kathmandu valley and in the Sindhupalchok district, north-east of the Kathmandu valley.

I heard many stories, from our current landlord and many others, that the fear of further earth tremors still dominates the everyday life of people in Kathmandu valley and in most parts of Nepal. People have lost their spirit, their Atma or soul, and their facial expressions have permanently changed. Basically people’s emotions have been damaged by such a terrifying experience. When they were experiencing those terrible tremors, there was nowhere else to escape to. All those formerly positive, almost jolly and bubbly, people have become like lifeless ghosts of their former selves. Some people behave in quite a short and unfriendly manner, appearing rude without realizing how they are acting. Nabin, our current landlord commented “perhaps internally they feel normal but it is sad to see them changed so much, as to how they behave”.

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These were private houses in Chautara town centre, now only rubble is left. Most of this rubble looks as if what remains of people’s homes truly are now death traps…

Impact on health services

While we (a Nepali research colleague and I) visited the district hospital in Sindhupalchok, nursing and midwifery staff we met there suggested that “the rate of pregnant women having miscarriages has increased in our observation”. Health professionals in the district have been noticing an increased number of women attending health facilities in the post-earthquake months. However, they seem to have no proper recording and reporting mechanism yet in place to substantiate this claim. The health system is not back to its pre-earthquake state, so it is difficult to monitor such events and estimate any figure accurately, and perhaps these are not current priorities either, while services are barely functioning. Nursing and midwifery staff also suspect that this is due to the stress of going through such traumatic events.

We visited the district hospital, where Maternal and Child Health clinics have been running in tents for months. Staff member reported that all has been kamchalau meaning a temporary measure or just to get by every day.

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The Majestic District Hospital building has been padlocked since the earthquake, as it has been considered unsafe to use.

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These tents now serve as male ward, female ward, dispensary, emergency room, counseling room etc.

Many birthing centres (where maternity including child health service is offered to rural people) across the district in Sindhupalchok have been damaged. So many birthing centres are currently non-functioning. Health services, provided by non-governmental organisations in the district have been disrupted too. Staff members are still traumatised, and yet they are providing services while dealing their personal and family’s trauma privately.

Another problem often related to us is the increase in the number of people with mental illness. It is not surprising that a major catastrophe, such as these earthquakes, would trigger mental illnesses in vulnerable people.

Impact on local economy and livelihood

“Paddy fields down in the valley have gone dry, as underground water sources have diverted when earth got shifted. People in Sindhupalchok are finding it difficult to continue their regular livelihood activities; the farmers say that there were not enough water supplies for paddy plantation this year. The freshwater supply in some areas has increased and in other areas the water sources have dried out” said the Chairman of Nagar Bikash Samiti (Town Development Committee) in Chautara. Everybody is having to readjust their lifestyle and livelihood strategies. Some businesses however, have benefited, albeit temporarily. In Chautara for example, business had been good immediately after the earthquake. Because of the scarcity of food and other supplies, people were forced to buy essentials in inflated rate and more money was coming in with the rescue operation. However people who run the business are still in trauma. Managing livelihood has also been kamchalau, any activity has been temporary and mainly for immediate survival.

It is not over yet, all feels raw?

People’s memories seem to be as raw as if it had just happened, and unsure as to how long it will take to heal and recover from such massive devastation.

In Nepal conversation often revolved round the economy having gone into negative figures; people being still traumatized and shaky, and school and hospital services being offered in tents in many parts of the country. The whole nation has been running as kamchalau, taking one day at a time, and working only for immediate survival.

What is happening to western media attention now? That immediate reaction to the first earthquake was just very visible and noteworthy, but has it all started fading away? The most recent earthquake-related news about Nepal in western media was in January 2016, when the finance minister of Nepal at the time of the earthquake received an award as ‘the best Finance Minister in the world’ from a London-based journal named the Banker- http://nepalinsider.com/2016/01/04/heres-why-dr-ram-sharan-mahat-was-named-best-finance-minister/  Apparently this is because he managed to attract the world’s attention and generated a significant amount of funds for rescue and rehabilitation work after the earthquake.

After three weeks in Nepal I came back to Edinburgh, where colleagues and friends asked me about the post earthquake situation in Nepal. I shared my experience with them but their immediate response has been “there has been no news in the western world and Nepal’s agony has already been forgotten”.

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When homes turned into a pile of rubble

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People live in Kamchalau tents

 

Natalie visits the Dominican Republic

 

Last winter Natalie, one of the MSc students, was  fortunate enough to travel with Partners for Rural Health to the Dominican Republic to provide healthcare to local populations.

After making our way through security with our individual carry-ons and checked bags full of donated medicines and supplies, we threw our bags into some old-school trucks and hopped on a charter bus which brought us into the mountainous region of Lajas. We stayed at a catholic retreat called Fusimaña, which was comprised of two main buildings, many gazebos, a small chapel, and many dorm-style rooms with bunk beds and mosquito nets.

 

mosquito netted beds

Natalie was able to spend time in a local hospital at Puerta Plata, several hours’ drive away from the retreat.  Patients wait in the crowded clinic for hours to be seen.  The group spent time with the staff in the hospital.

While visiting, we were able to give a talk to the hospital staff about diabetes and sugar consumption. Diabetes is a massive problem in the Dominican because of the amount of Diet Coke and other sugary products they consume. They don’t have access to or understand nutritional information the way that we do in the States. My peer who organized the talk had the idea to bring in plastic baggies with granulated sugar inside to get the point across, which was very effective and memorable. They were shocked to see a visual representation of how much sugar you’re supposed to consume in a day versus how much the average Dominican consumes in a day versus how much sugar is in a litre of Coke. The nurses were also given hand-outs to use when working with patients. It was an amazing experience.

 

Fusimana

For the most part, I worked on the paediatrics team under the supervision of Doctor Pat Patterson. In addition to running full physicals, giving anti-parasitic drugs, painting the children’s teeth with fluoride, and addressing any medical concerns, I helped to design and run an interactive information charla (chat) for the kids. We chose to talk to the kids about good foods and bad foods, during which we played a game to help them figure out which foods were good for us, which were bad for us, and why. Afterward, we played with the kids. They loved when we sung to them in English, especially when we played the hokey-pokey.

Listening to a Haitian boy's lungs in the village

 While physically, mentally, and emotionally challenging, I left the Dominican Republic exhausted, but happy. My experiences sparked my fascination with the globalisation of healthcare and ignited my passion for providing care to underserved populations. I learned how to take a health history and dissect the important parts of a story, how to do focused and comprehensive assessments, how to speak medical Spanish, how to work both collaboratively and independently, how to provide without western medical supplies, and how to trust my instincts, among numerous other things. I gained confidence in my medical abilities. I was able to see the direct results of my work and the effect that the sustenance of this 20-year-old program has had on the continuity of care in the community. As much as we gave to the Dominican people, they gave back to us ten-fold. Both medically and professionally, the experiences I had in the Dominican Republic have shaped me and advanced my global perspective, for which I am truly grateful.

 

More information on the trip:

Innovation in Nursing Studies

Dr Aisha Holloway and Dr Sarah Rhynas together with artist Ms Samantha Fraser attended the NMAHP Research awards ceremony last week and were delighted to be announced winners in the category for Innovation in Research. They were presented their Award by the Chief Nursing Officer for Scotland, Professor Fiona McQueen, with Director of NMAHP Prof Brian Williams and Mr Paul Gray, Chief Executive NHS Scotland and Director – General Health and Social Care at Scottish Government in attendance together with academic colleagues and clinicians from across Scotland.

Aisha

NMAHP Research Award for Innovation in Research Dr Aisha Holloway; Dr Sarah Rhynas; Ms Samantha Fraser

Feedback from Judges
The methodology used by this team is innovative and still being developed. Working with a hard to reach group who have had difficulty in ‘finding a voice’ they have used a multi-dimensional approach and have been successful in creating a partnership network which is not only productive in research terms but fits with the vision of the kind of groups the NHS would like to work with.

Congratulations to Aisha and Sarah!