Nello knows the necessity of a plan and the courage to put it into action. It’s helped him to drink sherry with royalty, enjoy dinner at the House of Commons, play the clown in a circus, play football for Stoke City, wave to crowds from the launch of the Boat Race and ride in the Lord Mayor’s limousine in a parade through Newcastle-under-Lyme. We’re aiming for a goal that’s more achievable, but just as important – MARVELLOUS care for this shift.
And now you’ve consulted the team and checked your equipment you’re ready. Your patient is waiting for you and you’re going to give MARVELLOUS care.
So, in the last few moments before you spring into action, think of the following:
What will the next few hours be like for your patient? What will they need to do? What would they like to do? Are they the same thing? Can you see any difficulties or opportunities coming up? Will they have any challenging things to deal with like ward rounds or assessments?
And then there’s the routine stuff. Meals, groups, medication, visiting times, physical health checks, personal hygiene, care plans, laundry, cups of tea.
Tactic: The gift of time
Set aside extra time to do some of your usual tasks with a person with learning disabilities, often routine tasks will take a bit longer and if you’re prepared for that then it’s easier to manage your own emotions/frustrations/plan your time throughout the day. For example, people with learning disabilities often have more physical health problems than your average inpatient, so there may be on more medication – and therefore medication administration may take a lot longer.
Tactic: Meds help
There are easy-read medication patient information sheets available on the web which may be useful. A good example is the information provided by the University of Birmingham, found here.
The whole lot will come along at some time or another but luckily won’t all come along at the same time.
Not if you have a plan. For that’s what a plan is – an understanding of what the day should look like before the chaotic realities of life get in the way.
A very good tool that the fab Sarah Kennedy told us about comes from Helen Sanderson – learn more here.
We’ve taken the opportunity to prepare some templates for what a plan could look like for the three halves/shifts. Why not take a look at the plan for the shift you’re about to start? You’ll notice that the plan is something to share with your patient, but there’s no harm in having some idea of what will be expected of them over the next few hours.
BUT… we have to remember that plans belong to – YOUR PATIENT. You’ll see that the templates we’ve put together have both words and images, so you can talk to them about what they want to get out of the next few hours. And their priorities might not be yours. Favourite TV programmes may need to be added, watching a film, listening to loved music, the phone call to a friend, a game of cards – (remember THE TEAM – what did they say about favourite activities or unmissable routines? Have you factored these in?)
Tactic: Colleagues and consultants, lend me your ears
Don’t be frightened to be your patient’s advocate, particularly during times like ward rounds. These can be intimidating and confusing for many at the best of times, but ward rounds for patients with learning disabilities can include even more people than usual. It’s difficult enough for staff to process all the information flying around. So talk with the person first and make a list of what they want to say/express/ask for and make sure they get an opportunity to do so.