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Determined to end the pain

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Seeing a patient in extreme pain inspired Charlotte Johnston to make students more aware of pressure ulcer prevention

Charlotte Johnston saw a patient in severe pain before she became a student nurse - and, instead of putting her off the profession, it inspired her to stop it happening again.

“About five years ago, I was working as a healthcare assistant for an agency, and I was always put on the one-to-one patients. I looked after one older woman with horrendous pressure ulcers - but at the time I didn’t know what they were, no one told me. To me, they just looked like wounds. They must have been so painful for her.

“After a couple of weeks, she started to deteriorate. One day that always stayed with me is the day she died. The nurses came in from the community to dress her wounds. The moment they started to turn her, she shook with the pain. The nurses did not communicate with her, and she was mute so I never heard her speak all the weeks I had been taking care of her, and yet on that day I heard such dreadful noises from her. And I thought it was a myth when people said that your eyes rolled to the back of your head when you’re in pain - but I saw it that day. It was clear she was in agony.

“Thinking back, if I had the knowledge I had now, I would have stopped it, but all I could do was hold her hand and tell her it would soon be over.”

Fast forward a few years to the end of 2012, and Ms Johnston started her first placement as a student with a community tissue viability nurse mentor, whom she describes as “passionate” about pressure ulcers.

“I remember once a patient told me she didn’t want her pressure-relieving mattress as it made her feel seasick,” says Ms Johnston. She told her mentor that the patient wanted it removed. “But my mentor told me to go back and tell her why it was important she should keep it and then she taught me ‘stop the pressure’,” she says.

“For four years I had practised with healthcare assistants and nurses, and I could have avoided causing pain for hundreds of patients if I had known what that nurse taught me then.”

That anger and sadness inspired her to educate her peers and other nurses about preventable pressure ulcers. “Have you ever had an idea that keeps you awake at night?” she asks. “I did. I thought what would happen if I could get other students to feel the way I did.”

Throughout the night, and after contacting Ruth May, the NHS England regional director of nursing for Midlands and East, the idea grew, and she thought of creating a mini conference involving Ms May.

After speaking with her supportive head of year, she managed to include the first and third years, as well as her own year. NHS IQ got involved to organise it. Helen Bevan of NHS IQ will be shown in a video encouraging students to challenge practice and be “boatrockers”. There will also be presentations from tissue viability experts such as Professor Jane Nixon and regional deputy chief nurse Lyn McIntyre.

More than 500 students (including some from other universities), directors of nursing, community matrons and caremakers will be attending and giving presentations at the event at Lincoln University on 15 October.

Everyone who attends will be asked to make a pledge to prevent pressure ulcers. This will be linked to NHS Change Day 2014 - Ms Johnston sits on its advisory forum.

“I realise that tissue viability is not exciting compared to A&E or other specialities,” says Ms Johnston.

“But students do such a lot of personal care and, if we can reach just 250 of the audience, and they prevent pressure ulcers in one patient per placement, the numbers can get really big and we can make a real difference.”

Jenni Middleton




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