T RAIN ING
Supporting ostomy and continence care teams
Dr. Terri Porrett and Karen Tomlin highlight the results of a survey of ostomy and continence care teams and reveal how the pandemic has impacted staff and services. They provide an insight into strategies for supporting specialist nurses during COVID-19.
Over the past eighteen months, workload demands on nurses have escalated and patients have faced delays in accessing services due to the closure of clinics, redeployment of specialist nurses, cessation of elective procedures and social distancing guidance. Nursing redeployment has meant that many specialist nursing teams have run with only skeleton staff. This is particularly relevant for ostomy and continence nursing teams, who provide a holistic approach to clinical care for patients with personal bladder and bowel conditions. For this cohort of patients, accessing timely and expert advice can be critical in managing their physical and mental wellbeing, which ultimately impacts their quality of life and independence.
Nursing redeployment Coloplast conducted snapshot surveys with NHS specialist nurses working in the
acute setting in England, Scotland and Wales during the first and second national lockdowns in 2020. In continence care, of the 219 nurse specialists that were surveyed in August, 82% provided feedback stating that their services were running at less than 50% of capacity. More worryingly, 29% of nurses were no longer doing any face-to-face consultations or training with their patients on the use of intermittent self-catheterisation (ISC). ISC allows patients to self-catheterise at intervals during the day with a removable device rather than having a fixed indwelling catheter, increasing patient independence and reducing the risks associated with long- term indwelling catheters. It was noted that for patients not being taught ISC, they were either being put on a waiting list, given an indwelling catheter or having to wait for a training appointment in the community.
Although all NHS services are experiencing some measure of disruption and many patients have felt isolated during the pandemic, it is important not to overlook the impact that situations in patient care, such as those described above, have on those with bladder and bowel conditions. Delays in accessing services can not only affect patient recovery, but also cause other physical and wellbeing impacts, including recurrent urinary tract infections and emotional stress triggered by anxiety. The situation in bowel management during the lockdowns meant that approximately 15% of specialist nursing staff were redeployed to other NHS departments to deal with COVID-19 and 77% were left on their own to manage their clinics, while others were shielding and working from home. By November 2020, 55% of clinics in the acute setting had still not restarted. 47% of nurses said that help regarding remote nursing support and training for patients in the community would be very welcome. Furthermore, due to the stretched capacity and increased workload caused by reduced staffing levels, continence and stoma clinical nurse specialists suggested, anecdotally, that they have been limited in their opportunities for personal and professional development. They were either too busy providing care, or there were few educational avenues that were open to them.
The impact of COVID-19 on nurse learning and education As our 2020 surveys revealed, without doubt, the pandemic has impacted the amount of time nurses have been able to dedicate to their learning and education. Coloplast undertook further research earlier this year to get a greater understanding of how significantly professional development has been affected and what this might mean for patients. One district nurse told us:
AUGUST 2021
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