HEALING TOUCH Fiona Geiger, Matron S. R. N; Dip
-
Upload
brice-hill -
Category
Documents
-
view
213 -
download
0
description
Transcript of HEALING TOUCH Fiona Geiger, Matron S. R. N; Dip
HEALING TOUCH Fiona Geiger, Matron S. R. N; Dip
HEALING TOUCHFiona Geiger, MatronS.R.N; Dip. Nursing Siobhan
Doolan, Clinical Educator R.G.N; BSc (Hons); PG Cert; FHEA Welcome,
thank you for choosing to attend this workshop today, in which we
will be focussing on care and compassion in Nursing. We would like
to share our story on how we introduced trained Volunteers to
deliver hand rub therapies within the division, to improve the
patient experience. DRIVERS Healing Environments Project
Nursing and Midwifery Strategy 2012 (Central Manchester University
Hospitals) Compassion in Practice (DoH 2012) 1 The Mid
Staffordshire NHS Foundation Trust Public Inquiry - Francis Report
(2013) 2 HEALING ENVIRONMENT/ACTIVITIES PROJECT- Initially borne
from the Kissing it Better national initiative, introduced to the
Trust in The Trust developed the healing environments project which
focuses on bringing various activities to wards and out patient
areas to engage with patients, to relieve stress and boredom, to
distract and entertain patients, and to, ultimately bring a smile
to patients faces, which will improve the patient journey. JANE
TILLEY OFFERED HAND RUB THERAPY AT ONE OF THE MONTHLY HEALING
ENVIRONMENT MEETINGS. LOCALLY, within CMFT, the Nursing and
Midwifery Strategy was launched in This underpinned a set of values
of how CMFT nurses and midwives want to deliver care and how
patients, families and service users want to receive care.
DIVISIONALLY- we chose to identify Compassion, Dignity, Respect,
Consideration, Empathy and Pride, as our values. COMPASSION IN
PRACTICE -6Cs- Care, Compassion, Competence, Communication, Courage
and Commitment. These are the values that motivate us want to work
within healthcare. These are powerful words, are they words, or are
you transferring them into practice? As frontline staff we are the
people who can and will make a difference FRANCIS REPORT -Briefly
mention poor standard ofcare, patients suffering whilst in hospital
care, management failing to respond to patient complaints
effectively. Meeting targets, but as a trust,allowed themselves to
become complacent and naively assumed that targets = high standard
of care. Despite being informed by staff, the warnings were
ignored. In reality the care was far below the level of acceptable
which should have been delivered. As health care professionals, we
should learn from this drastic mistake and question the care weare
delivering, directly or indirectly. There is no room for
complacency, Mid Staffs proved targets do not = quality of care,we
can and should always strive to improve!!! BACKGROUND Supporting
patients Ageing population Extended roles
Nurturing of Intelligent Kindness Service users expectations
Patient Experience We are privileged to support patients at the
most memorable and possibly their most vulnerable times of their
lives, highest highs, e.g. children being born to their lowestlows
major trauma, serious illness/loss of friends/family and sometimes
death of a dearly loved husband, wife, son, daughter, grand ma,
grand dad. Divisionally, we support patients when they undergo
minor surgery, resulting in a short stay in hospital to major
surgical interventions, which may be life changing or severely
affect the quality of their lives.. People are living longer, with
many complex health needs, remember these patients are often
frightened, vulnerable and sometimes enduring prolonged hospital
stays. Within an ever changing working environment, we are required
to utilise our skills to include extended roles, following complex
surgical interventions. Eg IV therapies, VAC dressings,
Tracheostomy care. Some of sciences within nursing are indeed being
celebrated today. This results in patients who require intense
support and high quality nursing care to recover. These are
difficult times for our patients who endure longer stays within a
hospital setting. Prolonged hospital stays can lead to episodes of
depression, mood swings, poor nutritional intake, change in their
own identity-lack of confidence, lack of motivation, isolation,
feelings of lonliness, fatigue. These are whilst patients are
dealing with trying to recover both physically and psychologically
from serious illness/trauma. From an educationalist perspective, it
is essential that the workforce is equipped with skills to be
deemed as competent practitioners. Whilst this is important, we
emphasise the importance of ensuring care and compassion are high
priority for our patients. Within Surgery, we are striving to
balance competency, compassion and kindness intelligent kindness.
Service Users now have high expectations of care they would like to
be delivered, Patients can even choose where they would like to
receive their treatment/surgery. As a Trust we are closely
monitoring the patients journey, asking them via several methods,
if they were happy with care being delivered. This may be via the
patient Tracker, Quality care rounds or via the friends and family
test? Would you recommend our Trust to your family and friends? The
feedback reflects, that it is the little things, which make a
massive improvement to the patient experience, whilst in our care
here at CMFT. I ask you to take a couple of seconds to think about
when you or one of your family are poorly,we want our husband, mum,
partner/ to be kind to us, this may be by holding our hands,
rubbing our back if we feel sickly, mopping our brow, or even
simply holding our hands. The power of touch should never be
underestimated. TOUCH PATIENTS: BARRIERS: Elderly population 3
Living with Dementia 4
Language barriers Disabilities BARRIERS: Lack of consent Cultural
Lack of authenticity TOUCH As we have agreed, when we are at the
most vulnerable times in our lives, we need touch.eg hold hand, rub
back if feeling sick. It is such acts of kindness which patients
remember, as being shown this kindness and compassion when feeling
sick, frightened, sad, anxious, suffering. This is also true for
patients whoa re living with DEMENTIA , touch is soothing, calming,
reassuring when unsure of surroundings and strange people. LANGUAGE
BARRIERS- we can smile and rub their hand as reassurance and
support (non verbal communication). How would you feel if you were
admitted to hospital whilst abroad, when you may not speak the same
language, but you are very ill? If you were shown this act of
kindness, would you feel reassured? DISABILITIES blind patients,
who may be very sensitive to touch, deaf patients who cannot hear
us or lip read, special need patients with multiple communication
deficits. BARRIERS Culturally, this may be a sign of disrespect to
touch patients. eg Muslim Men or Orthodox Jewish Men Always seek
consent, this may be implied. If patient not responsive, do not
carry out procedures, as this could potentially offend the patient.
Lack of authenticity- Touch MUST be authentic and coupled with the
appropriate verbal and non verbal body language I would like to
show you a very short DVD of an interaction between a volunteer and
a patient. This Volunteer has undergone Hand Rub Therapy training,
which is offered by the Volunteer leaders. Please look at the
various communications which are taking place within this
interaction. SIT DOWN!! LINK I am sure you will agree, this patient
enjoyed the therapy and we saw some of the benefits of the hand
massage. This lady when asked how she felt prior to the hand rub
scored herself 3/10. on completion she scored herself 8/10 and
reported even her headache has eased!!! BENEFITS OF TOUCH
Distraction Decreases the sense of isolation
Physiological changes (lower blood pressure and lower pulse rate) 5
Reduces stress levels 5 Increases the production of endorphins
Promotes the feeling of well being Reduces tension Promotes
relaxation Increases the range of motion for patients with
arthritis 6 BENEFITS OF TOUCH Sometimes patients who live alone,
may go for long periods without being touched, this can lead to an
increased feeling of isolation. This may change whilst in hospital;
however, we should stop and think about the care we are delivering.
Do we only touch patients during care delivery? eg,to change a
dressing, to give IV Therapies etc. Alters Blood pressure and Pulse
rate refer to referencing on slides, which will be available after
the conference.ITA in neighboring Trust had hand massage therapy
whilst recovering from major surgery. I saw first hand, the
difference it made to her as a patient. I was driven by my mums
experience, to pursue this fgurther for the benefits of patients
undergoing surgery and treatment within this division INTRODUCTION
TO SURGERY
Challenges: Environment Diversity of patients Scepticism Raising
awareness with Division: Utilisation of Lewins Change Model Agenda
item at Senior Nurse Meeting Scoping Exercise Volunteer services
Vision to reality: Piloted on Ward 7 Volunteers allocated
Challenges: Busy environment,, emergency admissions, structured
routine, ward rounds, theatre schedules, acutely unwell patients,
not trialled before, may not be well received. LEWINS CHANGE MODEL:
UNFREEZE Preparing staff accept change is necessary, it is working
within other Trusts, it can work here!! My MUM CHANGE Staff to
believe this would work within their areas and want this for their
patients. TIME AND COMMUNICATION PARAMOUNT for this stage to be
successful REFREEZE When change is taking place and staff are
embracing of this, then RE FREEZENOW!!! Roll out: Asked for support
at Senior Nurse Meeting, from all ward managers for their areas.
Personally scoped areas, asking if staff felt this therapy would
make a difference to their patients, Dilemma women only? or to
include men All areas registered interest pilot area chosen Ward 7,
longer stay patients within division. 2 x volunteers weekly. (I
hour session x 2). Liaised with Volunteer services. Limited
volunteers trained. Were added to waiting list. Patient and staff
feedback very positive Rolled out divisionally in conjunction with
Voluntary services.LINK FORMALLY EVALUATED THE HAND RUB THERAPY
SESSIONS WITH EVALUATION FORMS, WHICH Ward 7 were instrumental in
collating the evidence. FEEDBACK I didnt expect to have a hand rub.
It was heaven
It was so relaxing My hands felt so good, it was a lovely
experience After having the hand rub, I noticed a difference in my
arthritis pain in my hands I dont feel like I have been in hospital
I really enjoyed chatting with the young lady It was 7 minutes of
uninterrupted time, by someone other than a nurse The acceptance of
alternative therapy in conjunction with traditional treatment , was
adopted by all managers within Surgery. The Art of Nursing is
enhancing holistic nursing where ALL nursing practice that has
healing the whole person as its goal . This embraces the use of all
agencies, including the Volunteer services, to improve the patient
experience. The pilot on Ward 7 was so successful, we rolled the
hand rub sessions out Divisionally HAND RUB ACTIVITY January June
2013
ESTU patients Ward patients Ward patients Ward patients Sourced
from the Healing Environments Annual Report, 2013 The therapy has
been a widespread success having delivered over 334 hand rubs to
our patients within the division of Surgery. Each of these
interactions will havehad an effect on the patient within the
Surgical ward environment and as you have seen the feedback has
been very positive. Unfortunately, in some areas the demand has
outweighed the supply of volunteers. So the areas, in which
patients endure a shorter hospitalisation, have less volunteer
visits. More volunteers have been re-trained in July, so we are
hoping to be allocated more to Wards 9/10, Ward 15, and ETCS. Each
quote in speech bubbles, will be added and one tap on the mouse for
each quoteis to be added individually and jump into the screen) The
therapy has been a widespread success having delivered over 521
hand rubs to our patients within the division of Surgery. Each of
these interactions will havehad an effect on the patient within the
Surgical ward environment. Lets see if the patients thought the
hand rub therapy were MOVING FORWARD Ongoing projects Entertainer
Music Therapy
Communal games Beauty Therapists to be introduced DVD film nights
Hand rub volunteers Manchester Academy Student visits The hand rub
therapy is only one work stream of the Healing Environment project.
Barrington - Magician /Entertainer, who not only works individually
with patients, but works so hard to build a community spirit on the
ward, by introducing patients to each other via his activities.
MUSIC THERAPY _ Childrens Choir in Main OPD, both patients,
families and the choir had a fantastic time. The choir were given a
fruit hamper to take away and they sent a thank you card to the
manager, as they had a fantastic time. WARD 9/10, Rev Peter Gomm,
played guitar within the ward setting Communal Games donated by
RMCH via the healing Environments group. To encourage communication
with patients Dementia, patients who could engage with each other.
Beauty Therapists Sept 2013 looking at introducing therapy students
form Openshaw college, to volunteer services for our patients,
hairdressing, nail painting. DVD Themed nights- Donated DVDs.
Currently scoping Division with a view to introducing Themed nights
within dayrooms. Eg ROM COM/ action/ thriller nights for patients
to go to the dayroom (Plan toadvertise film being shown, date/time)
College Student Visits favourable visits, young people chatted
about being 17 today and patients about when they were 17!!
Students felt like they had made a difference. We would like to
thank you for your time and beg, could these therapies be
introduced within your area. If it is possible in Surgery, it is
possible anywhere!!! As our patients told us IT IS THE LITTLE
THINGS THAT MAKE A BIG DIFFERENCE. ANY QUESTIONS ? Barrington our
Entertainer/Magician will be in the foyer downstairs and at
lunchtime, there will be a demonstration of hand rub therapy being
performed by one of our trained volunteers(? DIV SURG STAND!!!) in
the Post graduate centre. Please accept a little gift from us, as
you leave. REFERENCES 1Compassion in Practice. Nursing Midwifery
and Care Staff Our Vision and Strategy Department of Health
Commissioning Board 2012. 2Final Report Of The Independent Inquiry
Into Care Provided By Mid Staffordshire NHS Foundation Trust
Chaired by Robert Francis, QC, February 2013 3Baldwin, L. (1986)
The Therapeutic use of touch with the elderly. Physical and
Occupational Therapy in Geriatrics 4 : 45 50. 4 Kim, E.J. &
Buschmann, M.T. (1999). The effect of expressive physical touch on
patients with dementia. International Journal of Nursing Studies
36, 3, 5 Lindgren, L., Winso, O., Lehtipalo, S. et al. (2010).
Physiological responses to touch massage in healthy volunteers.
Autonomic Neuroscience: Basic and Clinical. 2010; 158: 105 110.
6Field, T., Diego, M., Hernandez-Reif, M., & Shea, J. (2007).
Hand arthritis pain is reduced by massage therapy. Journal of
Bodywork and Movement Therapies . Vol 11, 1, p21-24. *Music
composed by Mark Fisher and performed by Ros Hawley and Mark Fisher
Lead Musicians for Music for Health at LIME.