SWAN Newsletter #4

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Welcome to the latest issue of SWAN – Star Wards Action Network. I was fortunate to be able to visit North East Wales NHS Trust (thanks Simon and Wyn!) and learnt that even when you’ve got a unit which is physically incredibly difficult to work with, it’s still possible to provide an excellent service to patients. The three service user reps I met were fulsome in their praise of the unit, Llwyn y Groes, and of the positive changes that have been made.

Customer Service Inspiration, courtesy of Phil Dourado

“They may forget what you said, but they will never forget how you made them feel.”

Carl W Beuchner

News from trusts

North East Wales are using £3,000 they received from Shell (which has a local presence) towards implementing Star Wards’ ideas. Great! Although most of our ideas are low or no cost, most of them would certainly benefit from an injection of funds. We’d be really interested to know what other pilot sites are doing in terms of resourcing the ideas. One possibility is for Bright to apply for money to introduce something across all the sites – eg Mind’s publications. What do you think?

Ideas in action

I’ve decided to ditch the rather dogmatic ‘start at #1 and finish with #75’ approach, having visited Llwyn y Groes and feeling inspired about the possibilities of improving patients’ experiences of taking their medication.

#66 No more queuing for medication!

I’m not a pharmacist (among many other things I’m not…) so the following may be technically flawed. But I hope it’s a good starting point for discussion. The central issue is that in most hospitals, patients need take no responsibility for managing their medication all the time they’re there. But as soon as we’re back home, we’re completely in charge of it and there’s plenty of scope to forget to order it, take it, take the right combination at the right times etc.

A continuum of self-medication could look something like this, with the later options being reserved for those patients whose state of mind or nearness to discharge allows:

  • Carry On Queuing. Institutionalising and infantilising
  • Nurses call out (sic) to individual patients to come and taken their medication
  • Nurses take medication to individual patients
  • Patients know when they need to take their medication (using pill alarm box or equivalent if that helps and is sustainable back home) and go to treatment/dispensing room. Nurses find them if they haven’t collected their medication within agreed time parameters. Both sign for medication
  • As above, but there are individual locked compartments for each patient in the treatment room or in trolley. Patients who can manage have keys to these and access their medication with nurse present. Both sign for medication
  • Where there are individual bedrooms, each has a lockable cabinet for medication and valuables. If it’s legally etc necessary, nurse is present to see medication being taken and counter-sign chart. (Patient asks nurse to come into room for this.)

An important component of the self-medication regime would be having the alarmingly named ‘psychoeducation’ – sessions ideally with a pharmacist where patients:

  • Learn about the purpose of their medication, its side-effects, how to cope with the side-effects, the consequences of not taking it as prescribed or at all. (The Mental Health Bill adds an extra twist to not taking our medication.)
  • Ask questions about their medication or simply air their feelings about it
  • Discuss strategies for remembering to take the right doses at the right times
  • Learn about other aspects of medication, eg the effects of combining it with homeopathic treatments or with drink/street drugs; safe storage etc

#16 Exercise machines

It seems this is not as straight forward as it should be! Some wards may face excessive restrictions on patients using the equipment eg the training or even qualifications that staff need to hold when ‘supervising’ patients. The next thing will be patients needing to have training or even qualifications before using an exercise bike, walking around the ward above a certain speed…..

Seasons’ greetings!