Back to the floor - Eyes Right

Once upon a very long time ago when I was young, half the weight I am now and had no grey hairs I used to be a nurse. More to the point I was also an ophthalmic trained nurse. So when I got the chance to do one of my 'back to the floor' shifts in ophthalmology I jumped at the chance. Now I didn't expect for one moment that they would trust me to do something technical with a real patient but I hoped that some of my previous knowledge would come flooding back to me. I duly arrived for duty at the Eye Assessment Clinic and was met by the team (there are lots of people in the team you just never see them together at the same time because they're in and out of rooms and offices and treatment spaces - never saw them sit down!) Rosie Mowatt is the nurse in charge and clearly has great knowledge and experience. She allocated me to work with Helen who is a bright and bubbly Health Care Assistant - knows exactly what's what - and has been in ophthalmology for a while. Our first task was to go to ENT (Ear, Nose & Throat) to collect a scope to do a procedure. Ophthalmology don't have their own scopes so it was a long walk to ENT to get one and return with it. As soon as we had returned with it we were told that another one was required but the department is only allowed one scope at a time, so as soon as it had been used I offered to take it back to ENT, wait for it to be cleaned and then bring it back fresh and ready for the next patient. Helen had shown me a short cut and I offered to return it and collect the new one on my own to save her legs. Out of interest I counted the foot-steps to the department - there are 475 - unfortunately on the way back there were 700! That's because I forgot which door opened the short-cut to me; by trip number 4 however I had jolly well remembered! At one point I had to take the lift down to the department because I was pushing a trolley - the lift left a wee bit to be desired! It may be because it is being upgraded but there aren't any signs nearby to tell our staff and patients that we are sorting it out so Miles is going to see what he can do. At one point on the Unit I had a moment of déjà vu when I popped my head round the clinic door to be greeted with the words 'morning Sister' by Mark Vose Consultant Ophthalmologist We worked together at the Royal Eye Hospital many years ago and I have to say he hasn't changed one bit!

I met Glennis, one of our volunteers, who is a real support to the team. She does a really varied role including collecting notes and helping to escort patients who are often elderly and of course have difficulties with their sight. All the staff I spoke to said how valuable the volunteer service is to them and our patients. There aren't many ways we can say thank you them but at Christmas we had a proper sit-down Christmas lunch with all the trimmings and entertainment - almost 300 volunteers from both sites attended and it was so successful we're going to do it again. Which prompted me to think we need to look at more ways to show our appreciate to our volunteers.

 Rosie told me that  she has about 38 staff in Broughton and the Eye Assessment Clinic working together and they also support Ward 1 when necessary. Recently they have created a combined off-duty (which includes evenings and weekends) and staff work across the areas which makes it easier to provide cover for sickness and holidays. As a team they seem to be constantly looking for ways to improve the service in the most cost-effective way and they make sure they code everything with great accuracy to ensure the Trust is paid the relevant tariff. I must say the HCAs were super-clued up about procedure coding!

Rosie was extremely passionate about two support groups that provide great services to the eye wards and department; she wanted to know how we could let everyone in the Trust know about the work that they do and how they can be contacted; after all poorly-sighted patients aren't confined to the eye department! The two groups that Rosie mentioned were Action for Blind People (part of RNIB group contactable on 01772320550) and Galloway's Society for the Blind (contactable on 01772744148). Don't imagine that they only deal with patients who are totally blind - there are many levels of sight impairment. Both are excellent organisations and do things like demonstrating special aids to help people retain a little more independence, they also support people with sight difficulties in and out of employment plus a great deal more. Wouldn't it be good if ALL our visually impaired patients, wherever they may be in the hospital, had access to specialist support like this? Once again, anyone reading this who has any ideas how to do it please let me know.

I was lucky to be allowed to sit in a session with a patient and relative .....goodness me the memories came flooding back! I remembered almost everything - although to be truthful I was way slower than I would have been back in the day! I had forgotten how busy and demanding ophthalmology clinics are and how full all the waiting areas can be because most patients are accompanied by at least one relative but more often two. Staff kept patients in the waiting room up to date with waiting times so people felt informed. Of course, lots of our patients have been coming for years and know the staff, the routine and what to expect - it was nice to see genuine interest about each other from both patients and staff, particularly those who had known each other for many years. The patients and relatives that I spoke to expressed real admiration for the team (and I mean the wider team not just the doctors and nurses) and were so grateful for all the care they had received. We don't realise how terrifying it can be to lose our sight - when I was a trainee ophthalmic nurse we had to do an exercise where we were blindfolded or wore special glasses to mimic the effect of various serious eye problems. I was about 22 years old at the time and I was struck by how much independence I lost and how reliant I was on others to help me do almost everything that I previously took for granted.  I tried to put on make-up without a mirror to see how it would feel and look - it was extremely difficult and pretty smeary.

Staff told me that they get lots of queries everyday from nurse, district nurses, patients and relatives about a myriad of things - cancelled appointments, people who are muddled up about drops and prescriptions, concerns about deteriorating sight, sometimes just forgetting what was said in clinic. They showed me a book that they record all queries and their responses so there is a full tracking mechanism. It’s quite time consuming but necessary and I wonder how many additional things that no one ever sees are done in the normal course of a days work?

Although I didn't meet her I wanted to mention Sue Horrocks the Learning Disability Champion. Rosie said that Sue is fantastic at her job and explained how she de-sensitises patients who have learning disabilities, dementia or simply fears hospitals. She does this by bringing patients into the department and showing them round the area and the ward if that's appropriate, gets them involved in their own care, play with pinhole glasses and makes it as stress-free as possible till they're comfortable enough to return on another occasion for treatment. Sue has some excellent success stories - great clinical outcomes coupled with fabulous patient experience. Its what we're all aiming for!

It was a trip down memory lane but with advanced technology and nurses far more advanced than I was when I trained. Although I have mentioned one or two people by name I would like to thank everyone I haven't mentioned (there are a lot of them!) for everything that they do to support our patients and each other. A great bunch of people, a proper team with a superb vision for the future.

Karen Partington