WELCOME

TO

WARD

C33

Students Name:-

Mentors Name:-

Hello,

Welcome to C33, Head and Neck. We hope you have a great

placement with us and take away a great deal of knowledge with

you.

This pack provides some topics which can be discussed with your

mentor and in turn, give you a greater insight into head and neck

care.

We have a “ Named Nurse “ system in a team approach to nursing,

this involves two teams one of which is deemed low dependency

and the other high dependency.

To enable you to achieve your learning outcomes you will be

allocated a named mentor who has had the required training to

undertake assessment of nursing students.

Your mentor will re view your learning outcomes at agreed periods

throughout your stay, giving you the opportunity to discuss your

progress and any other issues which may come from this.

BACKGROUND INFORMATION

Welcome to the Head and Neck Directorate, which consists of

ENT and Oro-maxillo facial specialities. The Directorate

comprises of one ward, the Head and Neck Centre (outpatient‟s

clinic) pre assessment clinics and an Audiology Department. The

Directorate also has outpatient clinics in other parts of the

region including University of Durham Hospitals South Shields

and Washington. Although not included in the Directorate we

liase closely with Ward F63 the children‟s ward also the two ENT

theatres and one oro-maxillo facial theatre.

The following Consultants work within the Directorate:

ENT ORO-MAXILLO FACIAL

Mr Samuel Mr Martin( Clinical Director)

Mr Leontsinis Mr Ryan

Mr Lindsey Mr Burns

Miss Heaton Mr Keith

Mr Hartley

Mr Waldron

Mr Arul

The work of the directorate closely involves the multi disciplinary

team, which consists of :-

Rachael Bannister-Young Head & Neck Specialist Nurse

Dawn Ivison Head &Neck Specialist Nurse

Michaela Olmez Head & Neck Specialist Nurse

Ann Hurren Speech Therapist

Jo Patterson Swallowing Therapist

Gill Watson Oral Hygienist

Carole Springett Dietician

Varies according to rota Physiotherapist

Varies according to rota Occupational Therapist

Varies according to rota Medical Social Worker

Ward Staff .

We have a matron attatched to Head and Neck, then a ward

manager, then a ward sister who predominantly acts as deputy to

ward manager in her absence but is clinically placed.

There are 24 band 5 nurses of varying experience, and 8 health

care assistants.

We also have an attatched Pre assessment Clinic situated in

Chester Wing where the majority of our elective patients attend.

It is a nurse led clinic and medical staff are only called upon if

there is a problem outside the nursing remit. Various

investigations are carried out in PAAC, depending on the tyoe of

surgery, the age and their physical condition.

This is to ensure that they are physically prepared for surgery.

The clinic also acts to ensure patients have the correct

knowledge regarding their hospital stay, answering any questions

and/or allaying any fears they may have.

INFORMATION ABOUT WARD C33

Ward C33 Head & Neck consist of two specialities, these are Ear,

Nose and Throat (ENT) and Oral Maxillo/Facial. Each speciality

has its own medical team, outpatients department and theatre.

ENT ward rounds take place at 8am every morning. Oral ward

rounds are carried out at 8.30am and also 5pm.

C 33 is a 28 bed ward, with four „6 bed „ bays and 4 side wards.

Bays 1&2 are for high dependency patients and 3&4 are for low

dependency patients.

The side wards are used for whoever needs them most.

There are 2 grades of Doctors on the ward, these are:-

Senior House Offices (SHO)

Registrar

C33 is on call at all times and each consultant is on call on a

weekly basis

WARD ADMISSIONS

Patients are admitted at various times over the course of the

day, and the times they will go to theatre vary accordingly:-

8am admissions theatre AM or PM if on all day list.

10.30am admissions theatre PM.

1pm admissions theatre PM.

2pm admissions theatre next day.

MULTI-DISCIPLINARY TEAM

During your placement on Ward C33 you will note that the nursing

team have a lot of involvement with the multi-disciplinary team as

a whole. Working closely with them to ensure the best quality of

care is provided for the patients. These may include:-

1. Medical Staff

2. Speech and Language Therapist

3. Swallowing Therapist

4. Dietician

5. Medical Social Worker

6. Occupational Therapist

7. Physiotherapist

8. Head & Neck Oncology Nurse

9. Chaplaincy

SHIFT PATTERNS & REQUEST SYSTEM

Prior to your placement, you will be allocated a mentor. This is a

qualified nurse with the relevant experience and courses to be

able to guide you through your placement. Shift patterns will be

negotiated with your mentor, and wherever there are any special

requests or requirements these will be accomodated where

possible. There is a specific book where you may write any

special requests. The shifts you may be required to work include:-

7.30am - 1pm

7.30am - 4.15pm

7.30am - 8.30pm

12.30pm - 8.30pm

It may also be necessary to work night duty, weekends and bank

holidays if your mentor is rostered for same.

You are expected to work at least 40% of your shifts with your

mentor.

Wherever your mentor is working either high or low dependency

will determine where the bulk of your time is spent, however, we

appreciate that experience is to be gained from working on both

ends and so some of your working time will be spent with your

associate mentor. They should hopefully be working on the other

“end”

SICKNESS PROCEDURE

It is very important that you contact the Ward to inform them of

any absence as soon as possible. The university should also be

informed of it.

TELEPHONE & BLEEP SYSTEM

CARDIAC ARREST

In the event of a cardiac arrest dial 2222 State the ward and

the hospital. Crash trolley is located opposite the nurses station.

A defibrillator is outside of the side room 4.

FIRE

In the event of a fire Dial 333. State the ward and hospital.

There are 3 fire exits :-

the initial entrance to the ward

Bay 1, at the opposite end of the ward entrance, leading to

C32

Familiarise yourself with the locality of the exits and fire

extinguishers as soon as possible after your arrival on the ward.

BLEEP SYSTEM

All telephone numbers throughout City Hospitals Sunderland

begin with 497 then the ward number i.e. Ward C33 = 49733.

Bleep numbers begin with 5. Simply call the 5 digit number and

after ringing twice the line will go dead. The person you have

bleeped should call you back. It is best to stay near the

telephone.

EDUCATION

There is an education & training centre within the hospital

grounds. This contains journals, articles and books as well as

studies pertaining to the Head & Neck area. Please feel free to

use this facility during any quiet times on the ward. There is also

a selection of books available on Ward C33 covering a range of

topics, from Head & Neck to such issues as Acute Pain

Management, Health & Safety and Palliative care issues.

For audit purposes we would like to ask your permission to

photocopy your initial, intermediate and final interviews.

Also any evaluations that you may have from your time with us.

COMMON ABBREVIATIONS

DCR: Dacroystorhinotomy (opening into tear

duct)

BCC: Basal Cell Carcinoma

SCC: Squamous Cell Carcinoma

MRSA: Methicillin Resistant Staphylococcus

Aureaus

PNS: Post nasal space

FESS: Functional Endoscopic Sinus Surgery

BAWO: Bilateral Antral Washout

IV: Intravenous

NG: Nasogastric

ECTOMY: Removal of

OSCOPY: Look into

OSTOMY: Opening into

PLASTY: Repair of

COMMON CONDITIONS/SURGERY ON HEAD & NECK

SURGERY

SEPTOPLASTY: Straightening of nasal cartilage

RHINOPLASTY: Cosmetic enhancement (nose job)

POLYPECTOMY: Removal of polyps. (Grape

like tissue can be from the nose

or ear)

OESOPHAGOSCOPY: Camera to examine Oesophagus

(Gullet)

LARYNGOSCOPY: Camera to examine vocal cords

MYRINGOPLASTY: Repair of perforated eardrum

TONSILLECTOMY: Removal of tonsils

LARYNGECTOMY: Removal of “voice box”

DYSPHAGIA: Difficulty eating/drinking

EPISTAXIS: Nasal bleeding

QUINSY: Throat abcess - one

tonsil filled with pus

STRIDOR: Noisy breathing

PEG: Tube into stomach for feeding

purposes, per cutaneous gastrostomy

GROMMET: Plastic „aeration‟tube

inserted into drum

FRACTURED MANDIBLE: Broken jaw

FRACTURED ZYGOMA: Broken cheek bone

WARD PHILOSOPHY C33

A Philosophy of Care is an essential foundation for developing nursing in any health care area. It is an important communication tool that tells patients/visitors about the wards beliefs and values. In producing a ward philosophy we are aiming to provide a statement of the professional service offered to patients and hence form the basis for a partnership in care.

Ward C33 has the following philosophy :

We are bound by our professional code of conduct to maintain

safety, privacy, dignity, advocacy, accountability and

confidentiality.

We aim to help patients attain, maintain and restore health via

problem solving, goal/objective setting, leadership and decision

making.

Using knowledge and expertise we provide individualized,

evidence based care in a professional but relaxed atmosphere.

We aim to provide a therapeutic and homely environment that

is both safe and clean.

We recognize the following patients rights:

1. The right to skilled, safe care delivered respectfully and

with consideration

2. All records and communication be dealt with confidentially

3. The right of informed choice, to be aware of care and

involved in treatments and to be informed of progress

made.

The patient is an individual who is part of a family within the

community. We recognize the contribution of family and

friends who provide support and care during and after

hospitalization.

The system of care in place on C33 is the named nurse

system. The named nurse will be accountable for the

assessment, planning, implementation and evaluation of

nursing care and will co ordinate all aspects of multi

disciplinary team members‟ interventions.

Nursing care on C33 will be holistic and patient focused,

aiming to care for the physical, social, spiritual, emotional,

psychological, religious and cultural needs of each patient.

.

Patients and relatives will be offered information, teaching

and counselling appropriate to their needs and wishes. They

will be given the opportunity to participate in care through

choice with their Named Nurse, involving them in all stages of

assessment, planning, implementation and evaluation of care.

Staff education and training is ongoing and all members of

staff have annual performance reviews where development

needs are identified and further education/training planned.

We are always looking at ways to improve the quality of the

service we provide and therefore actively encourage patients

and carers opinions, comments and suggestions as part of our

quality monitoring, which also includes various audits and

surveys.

Discharge from hospital is planned and co ordinated

effectively and facilitated by the named nurse.

STUDENTS RESPONSIBILITIES

It is very important to your learning that you ensure you

document your progress and achievements in your portfolios.

The education resource file (section 2) describes all your

responsibilities as set out by your University.

Although you are a university student you must comply with

the Trusts practice and procedures policies. These can be

found in the ward office.

The Trust has a complaints procedure which should be

followed in the event of any complaint or grievance.

Information can be obtained from the Trusts policies and

procedure files or leaflets in information stands around the

ward.

What We Expect From You

Be on time for your shift.

To make the most of the Educational Opportunities the ward has to

offer.

Inform the ward as soon as possible if you are sick and give a date for

your return

Report for duty clean and tidy with minimum jewellery. Long hair

should be tired back.

Wear an identification badge

Remember that we can also learn from you.

We encourage the use of up to date practices and welcome the

sharing of the new information.

Responsibility for the maintenance of confidentiality within the

patient/nurse relationship, and within the Multi-disciplinary team.

To ask if you are not sure of anything.

To be an active member of the ward team.

Orientation to Ward

Please Photocopy this sheet once fully signed and give copy to mentor for educational link

file.

Check List (Student and mentor to sign) Student Mentor

Give Student Booklet

Initial Interview/ Learning Needs Assessment

Ward Tour

Explain Procedure for:

Cardiac Arrest

Identify Resus Equipment

Fire

Identify Fire Extinguishers

Off Duty Requests

Bleep System

Introduce to Staff

Identify Hospital Policies Files

Explain Students Responsibilities Regarding University Sickness Policy/And Hospital Policies

Awareness of Policies/Procedures/Grievences

Discussed Complaints Policy

Explain Ward Routine

Educational Link File Location

To Discuss

Date Signature

Layout of Ward:-

Bays

Sidewards

Offices

Call system

Storage

Contract No‟s

Team Members:-

Nursing Staff

Consultants

Doctors

Ward Clerk

Physiotherapist

Dress Code:-

Stud earrings

Hair tied back

Smart & clean

Procedure for Cardiac

Arrest:-

Location & Understanding of

Emergency Equipment:-

Crash trolley

Defibrillator

Suction equipment

Emergency call system

Location of Manual Handling

Equipment:-

Hoist

Pat slides

Slide sheets etc.

To Discuss

Date Signature

Procedure in the event of

fire:-

Location of fire points and

fire fighting equipment:-

Procedure for disposal of:-

Sharps

Body fluids

Drugs

Blood products

Procedure for referral to

other agencies i.e.:-

Dietician

District Nurse

Home Support Services

McMillan Nurses

Medical Social Worker

Occupational Therapy

Physiotherapist

Speech & Language Therapy

Head & Neck Specialist

Swallowing Therapist

Outreach Team

(ICCU)

Peg Nurse

To Discuss Date Signature

Demonstrate knowledge &

understanding of issues

surrounding head & neck

care for e.g.

Communication

Nutrition

Mobility

Social problems

Altered body image

Preparation & Procedure for

investigations such as:-

Routine x-rays

Ultra sound scans

CT scans

MRI

Etc.

Location of

policy/procedure files in:-

Nursing policies

Health & safety

Infection control

COSHH

Moving/Handling

Complaints

Care of dying

Etc.

Knowledge & understanding

of the HISS system:-

Admission/Discharge/Transf

er

Evaluation

Nursing System (care

planning etc)

Electronic prescribing

Patient care enquiry

Order entry