MS NURSES SKILLS DEVELOPMENT

WORKSHOPEmma Matthews

Liz WilkinsonUKMSSNA Committee members

Aims of the session

• To provide some practical tips to managing communication & consultations effectively

• How to keep on top of the admin!• How and what to audit• How to develop and maintain being a

specialist• Where to find support

Typical problems experienced

How can we manage these

problems effectively?

Can the patient come Can the patient come to clinic?to clinic?

Is a Home Is a Home Visit Visit

Necessary?Necessary?Can it be dealt with Can it be dealt with on the telephone?on the telephone?

What about ward visits?What about ward visits?

Managing Consultation Time

How do we get How do we get pts to be pts to be

focussed?focussed?

Should we Should we make pts aware make pts aware

of how much of how much time there is?time there is?

Can lists be Can lists be useful?useful?

Can you Can you realistically realistically

address address everything?everything?

When When should we should we

see see complex complex

pts?pts?

Refer to Refer to others?others?

Things to think about

• Setting limits in clinic – we have x amount of time

• What’s the most important symptom…• We have 5 minutes left …• Bring a list?• Can you do a full assessment?• New pts ? Double slot ? HV

Things to think about

• Ask specific questions.• Stop consultation at relevant points? • Can I just take us back to your point about …?• Being more specific … Type of pain …Frequency

… Duration … How much of a problem?• Feeding back to the patient - Have I understood

correctly…?• Agreed course of action

Dependence

• How do pts contact you?

• Can we become “too” available?

• Do we create dependence?

• How can we reduce dependency?

How can we reduce dependence?

• Promoting Self Management at onset

• Realistic expectations

Managing Expectations

• Building the Relationship• Gaining Trust• Honesty• Education• Dispelling Myths• Appropriate Support• Shared Decision Making• Sometimes saying “No”

End of Consultation

• Shared Decision Making

• Agreement

• Management Plan

KEYPOINTS• Can we be too available?• Can we promote self

management?• Shared Decision Making• Prioritize appropriately• Manage our time

effectively• Plan treatment in

agreement with patient• Get pts to be specific• Get them back on track• Work within our own roles

and know when to refer on and to whom

• End the consultation on a positive note

• Build the relationship• Be reflective

practitioners• Know when to ask for

help/advice• Say “NO”• Know which consultation

slot is most appropriate• Balance between

building trust and not creating dependence

Managing the Admin.

“Organisation is like exercise, its not very effective if you do it only once. You have to keep at it” (Jill Pollack 2011)

Tips to becoming an organised Specialist

• Remember you cannot add hours to the day• Set your goals• Prioritise• ? Benefits of multi-tasking• Delegate where possible• Don’t suffer from inbox congestion• Treat phone calls like meetings• Know yourself (www.totaljobs.com (2011)

Audit

Audit• nursing audit is the systematic evaluation of

nursing which results in an improvement in the quality of patient care.

• Florence Nightingale undertook one of the first nursing audits during the Crimean War

• Different types of audit:- standards-based audit

- patient surveys

What to audit and why?

• Patient satisfaction• Service standards

e.g. response times • Service against

national guidelines or standards

• MS patient admissions

• Identifies good practice and demonstrates effective service

• Lead to service improvements

• Improve working relationships

Changing Landscape

• Increase in demand for our time

• Reducing cost but improving quality

• Need to think differently about how we do things

Building Personal and Professional Development

Personal and Professional Development

• MS Trust / MS Society Study Days• Journals• Competencies• Degree modules - Liverpool and

Birmingham• Pharma Sponsored Courses• Neuro skills assessment course

Manchester• Non medical prescribing• MS Nurse International Certification Exam

Using modern technology

• RSS feeds• Apps for smart phones• Twitter/Facebook/social media

Sources of SupportUKMSSNA

MSTrust

MS Society

Regional meetingsWork

colleagues

Line manager

Clinical supervisio

n

NMCguidance

Some Useful websites• www.ukmssna.org.uk• www.mstrust.org.uk• www.mssociety.org.uk• www.nice.org.uk• www.dh.gov.uk/en/index.htm• www.msif.org/en/• www.msactivesource.co.uk/• www.atlasofms.org

Any questions?