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'We need to work together for the benefit of all involved'

Sian Rodger
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Let’s face it, we can’t know everything about every speciality, so it is important to work together and share our knowledge across disciplines. 

My area – spinal cord injury – is very specialised. When one of our outpatients is admitted to a local hospital we will offer support to our patient and the multidisciplinary team if they need it. We want to limit complications from their spinal cord injury by explaining why certain routines are essential.

What we recommend is not always seen as practical due to staffing levels or a lack of appropriately skilled staff, and we know it can be a little frustrating to be given a complex care plan when you are already rushed off your feet. 

The problem is that these care plans are important for the wellbeing of a patient with a spinal cord injury. We know that being asked to perform digital rectal stimulation/digital removal of faeces at the same time each day is hard when you have 10 patients to get ready for theatre, five admissions and five post-op patients to deal with, one of whom is the patient who is second on the list for removal of gallbladder due to stones.

When you feel exacerbated think about the patient who is getting frustrated because he cannot perform his own bowel care due to pain and wants to know when it can be done. He is worried that he is going to have a bowel accident on the operating table or an episode of life-threatening autonomic dysreflexia. It has been drummed into to him – probably by someone like me – why bowel management is so important during his specialist rehabilitation.

“As my career has progressed, I have benefited from learning about other specialties”

It is easy to get caught up in the routine in our clinical areas but there has to be flexibility to meet the needs of patients who fall outside of those established routines. Providing appropriate care to patients with a spinal cord injury when they are unwell is essential to prevent complications that could impact recovery and life post-discharge.

As my career has progressed I have benefited from learning about other specialties. Over the last few years I have consulted specialist in oncology as we are seeing more patients with spinal cord damage caused by primary and secondary tumours.

I feel my skills are lacking sometimes in how to teach patients about their spinal cord injury when they are also having to deal with chemotherapy and wondering how long they are going to live.

When specialties cross over, we need to work together for the benefit of all involved, ask questions and listen to the answers. If what is expected in a patient’s routine care plan cannot quite be provided in exactly the same way, then explain that to the patient and work with them to make a plan of care that can be sustained.

If anyone reading this wants to share any information or knowledge with me, then please comment. Sharing is caring.

Sian Rodger is health coaching nurse facilitator at the London Spinal Cord Injury Centre

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