Making compassionate nursing
practice explicit within the
pre registration curriculum: Two
educational practice developments
Liz Adamson Lecturer
Edinburgh Napier University ( Scotland)
Aim of presentation
• To share two educational practice developments
The developments
1. Recording patient, relative, staff and student stories and using them
as a teaching recourse within the curriculum
2. Embedding compassionate care within a level 9 module within the
bachelor of nursing programme of study
Team Development 1
Team Development 2
Liz Adamson: Lecturer
Belinda Dewar: Senior nurse Leadership
in Compassionate Care Programme
Anne Waugh: Senior Lecturer
Christine Pollock: Senior Lecturer
Liz Adamson: Lecturer
Belinda Dewar: Senior nurse Leadership
in Compassionate Care Programme
Wilma Thomson: Student nurse
Edinburgh Napier University.
Richard Mackay: Charge Nurse Western
General Hospital, Edinburgh.
Arlene Horsburgh: Charge Nurse, Royal
Infirmary Hospital, Edinburgh.
Leadership in Compassionate Care
Programme ( LCCP)
Joint venture between Edinburgh Napier University and NHS
Lothian (Scotland)
Funded by an external benefactor
A 3-year action research programme that is underpinned by
principles of appreciative inquiry and relationship centred
care.
The Vision:
To embed compassionate care as an integral aspect of
all nurse education and practice in Edinburgh Napier
University, NHS Lothian and beyond
Undergraduate
curriculum
Supporting NQ nurses
Beacon/development Wards/Sites
Supporting the development
of leadership skills
Stories
Patient, relative, staff and student stories were
gathered as part of the Beacon Wards /
Development Sites LCCP
Themes
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A deliberate welcome and a smile costs nothing
Helping others connect
Being kept in the loop
Knowing how people are feeling acting and responding
Knowing the little things that matter
Feeling you have been heard
Considering when you can and can’t do person centred care
Being open and real about expectations
Example 1: Helping others connect
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It makes a difference if you try to find out something about the person. There is a man
in bay 2 and even although it’s hard to talk to him – I’ve managed to have a wee bit of a
conversation with him – he likes Hearts – I told him what the Hearts score was
yesterday. I look in the notes or speak to the relatives to try to find something– this man
had a hearts strip – so I knew. It’s good to have common ground to work with. I always
try to do this. I’ve never come across a time when I couldn’t make some connection.
[Staff comment]
Example 2:Being kept in the loop
• It was important to us that any decisions about my father’s care or
simple changes to his treatment were communicated to us and the
staff did keep us fully updated. Minor alterations in medication or
change in the use of equipment could assume huge significance to
our untrained eyes, which could be alarming without any real need to
be, e.g. the intravenous infusion machine would suddenly beep
repeatedly and no-one would come rushing to attend to it. We were at
first quite alarmed by this until a nurse explained that it was just a
warning that the bag was running low and would need changed. It
would have been very easy for the doctors and nurses to bamboozle
us with all the medical terminology but they were very good at keeping
us informed without the use of jargon or confusing abbreviations
(Relative)
What next?
• The data and emerging themes were available
• Patient, relative, staff and student narratives
• How to make these available to lecturing staff?
• How to use this valuable insight to influence the nursing and midwifery
curriculum?
Audio files and Podcasts
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Podcast: An audio or video file that is made available on the Internet
for download and playback using a computer or a mobile device such
as an Ipod
The Process
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Funding: Edinburgh Napier Teaching Fellows Development Fund
Planning: Theming the stories, key words, categories
Recording studio and recording expert
Inviting participation: Staff and relatives read own story
Recording: photographs, reading the stories
Editing: music and ident
Setting up and customizing the podcast site, uploading
Sharing the resource
Listen to a story
• http://www.patientstories.podbean.com
How to use these in the curriculum
Could be
• Used within lectures
• Uploaded to WebCT for discussion
• Shared during reflective sessions
What we did: One example
• Action project
• Collaborative approach: Senior nurses,
Lecturer, Student, Charge Nurse Combined
Assessment & Acute Medicine for
Older People
The Module: Recognising acute illness
and deterioration
• Teaches students to recognise and respond to acute illness and
deterioration
• Blended learning: Theory through WebCT then application during
practical simulation sessions
• Practical sessions use patient scenarios followed by a
debrief/reflective session. Lecturers participate as members of the MD
team.
• Practical assessment and written exam
On of the patient scenarios
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A young man is in his first week of a new job. He is a type 1 diabetic. He
accompanies his colleagues to a wine bar and has a few drinks. He expects to
have something to eat but the kitchen has closed as the chef walked out. He
appears to be a little agitated. His friends find him collapsed in the toilet and
call an ambulance. They report to the paramedics that they think he may have
been fitting. He has small cut in his bottom lip.
Information/guidance for the actor patient
• Vital to success of the exercise
• Statements/questions that required a response for the student “ You
won’t leave me will you? ”
• Challenging the use of jargon
“I just do your obs now”
Reflective session (Debrief)
• Student have an opportunity to reflect on
What they have done,
What they missed
What they would have done differently
• What is required to ensure patient safety
• What is important to the patient
• Actor feedback
Podcasts
• A story will be released with each unit of online study
• Podcasts will be selected that relate to the topic taught within this unit
• http://www.raidmodule.podbean.com
Assessment
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Formative: Peer assessment
Summative: Invigilated practical assessment
Criteria: Essential and non essential
Aspects of compassionate care
Section of practical assessment criteria
Criteria
Provides patient with regular relevant information
Explains procedures and rationale for actions
Provides information about sequence of events. What he/she can expect
Achieved
Reflective practice: WebCT
CC theme: Being kept in the loop
“It would have been very easy for the doctors and nurses to bamboozle us with all
the medical terminology but they were very good at keeping us informed
without the use of jargon or confusing abbreviations” (Relative)
Reflect on an occasion when you have been aware that jargon has been used
when communicating with a patient or relative,. How could this have been
explained differently?
Evaluation
• Students, lecturers and actors will evaluate the module in its new form
in December 2010
• Lecturers will evaluate the audio and podcasts resource through
online comments and questionnaires
Summary
• Care can be compassionate even in emergency situations
• Patient stories provide real experiences that can influence the
curriculum
• Listening to a story can bring it alive
• Compassionate care can be assessed