Nevill Hall Hospital
LLANWENARTH SUITE
DAY SURGERY AND ENDOSCOPY
STUDENT NURSE
HANDBOOK
Name:
Mentor:
Start Date:
Jayne Rist April 2013
INTRODUCTION
Welcome to your Day Surgery/Endoscopy placement. Your time in
Llanwenarth Suite is an excellent opportunity for learning new skills
and gaining new information, both of which will enhance the care you
offer to patients further on in your career.
It is important that you see this experience as part of a bigger picture
of care. Many patients that you will care for will undergo some sort of
surgical/endoscopic intervention. By working in day surgery theatre
and endoscopy, you will better understand the patients experience
and be able to give more accurate information and support.
You will also have the opportunity to practice skills that you may not
have had the chance to be involved with before. These skills such as
insertion of an airway, scrubbing for a procedure or care of the
sedated patient will enhance your care on the wards. For example,
observe a procedure and see how the scrub practitioner maintains a
sterile field, this will enhance your own practice when performing a
dressing on the wards.
Llanwenarth Suite Philosophy of care
Llanwenarth Suite has a dedicated and committed multi-disciplinary
team, who will endeavour at all times to achieve high standards of
evidence based, individualised care using the concept of named and
team nursing, throughout their period of stay.
All Llanwenarth Suite staff will do their utmost within the given
resources to assess, plan, implement and evaluate the care of the
individual whilst respecting confidentiality, dignity and privacy.
We recognise that each and every patient has a right to individual and
holistic care regardless of his/her social, physical, psychological,
ethnic and spiritualistic needs.
Although the period of hospitalisation may be short, it is for most
people a stressful event. The staff at Llanwenarth Suite are committed
to ensuring that during this time optimum care will be delivered in a
relaxed yet efficient environment.
Llanwenarth Suite General Infomation
Llanwenarth Suite is a combined Day Surgery and Endoscopy unit.
It has 2 Day Surgery Theatres (with an anaesthetic room attached to
each), 2 Endoscopy Theatres, a 9 bedded ward/2nd stage recovery area
and a 4 bedded 1st stage recovery area which is used for both day
surgery and endoscopy patients.
The unit is open from 07:00hrs-19:00hrs, Monday to Friday. Closed
on Bank Holidays.
Day surgery theatre staff work 8:00am-18:00hrs, Ward/recovery staff
work 07:00-17:30hrs or 08:30-19:00hrs to cover the unit on opening
and closing and endoscopy staff work hours between 07:30-18:00hrs.
Day surgery sessions are:09:00hrs - 12:30hrs and 13:30-17:00hrs
Endoscopy sessions are:08.30/09:00hrs – 13:30-17:00hrs
We normally expect students to work 5 days per week around about
08:30- 16:30hrs as due to clinic times this is when you will gain the
best experience. These hours are negotiable if a particular request is
needed.
Sickness
If you are ill during your placement it is extremely important that you
inform the unit. Please call Llanwenarth suite on 01873 732668 and
ask to speak to the person in charge of the unit or your mentor if they
are on duty. You must also keep in touch if you are ill for more than
one day.
Lunch
You will have 30 minutes for lunch. We have a staff room with a fridge
and microwave, so you can either bring Lunch with you or you can
change and go to the dining room which is located on the first floor.
Jewellery
Jewellery is not allowed the only exception being a wedding ring.
Education & Teaching
We have computers in various locations within the unit with access to
the internet and Intranet which will give you access to Trust Policies
and procedures. A student education board is allocated outside the
staff room with a current topic displayed on it. Please feel free to take
a copy of the presentation for your own reading.
You are all very welcome to our department and what you must do is
make the most of this short placement, ask lots of questions join in
and enjoy it.
Who works where?
Each area within Llanwenarth Suite is led by a specific team leader.
Unit manager
Endoscopy
Recovery/Ward day surgery
Anaesthetics/Preassessments
Theatre day surgery
Sr Diane Fraser
Sr Catherine James
Sr Jayne Rist
SODP Katherin Jones
Sr Vivienne David
Mentors
You will be allocated a mentor/buddy. However, due to the nature of
the work in Llanwenarth Suite and the fact that we want you to have
as many opportunities to see different areas of practice as possible, it
will not always be possible for you to work with your main mentor.
Each day you will be allocated an area to work in either theatre,
anaesthetics, endoscopy, pre-assessment or recovery.
If you are with us on a 2 week placement, the areas you work in on a
daily basis will be planned for you prior to your start date and you
should have been given this on your first day with us.
The daily allocations are not set in stone so if you would like to
change your allocation to suit your training needs then this can be
done.
If you are with us on a 6 week placement, your first 2 weeks will be
allocated as above and then for the remaining 4 weeks you will be able
to choose in which area/s you would like to gain more experience.
Specialities/Learning opportunities in Llanwenarth
Suite
Day Surgery
Urology
Plastic surgery
Orthopaedic surgery
General surgery
Ophthalmology
Gynaecology
Community sexual health
Pain Clinics
Preassessment clinics
Anaesthetics
1st stage recovery
Endoscopy
Urology
Gastroscopy (OGD)
Colonoscopy/Polypectomy
Flexible Sigmoidoscopy
Banding of Haemorrhoids
Banding of Varices
Endoscopic Retrograde
Cholangiopancreatography(ERCP)
Thoracoscopy/Bronchoscopy
COMPETENCIES
In the following pages some suggestions have been made as to some
competencies you could work towards during your time in
Llanwenarth Suite.
ANAESTHETICS
Skills that can be practised
 Checking in of patients – the student will observe and participate
in the checking in procedure and be able to discuss the
associated clinical risks and management.
 The student will be able to discuss the importance of the
theatre/ward checklist and describe the fasting and consent
policies.
 The student will be able to demonstrate the ability to
communicate with patients, relatives and carers in an
appropriate manner
 The student will participate in the communication process
between theatre and recovery and members of the
multidisciplinary team.
 The student will be able to describe different types of anaesthetic
and its effects on patients.
 The student will observe airway management and assist where
possible
How can evidence be generated
Work with a qualified anaesthetic nurse or operating department
practitioner at all times in order to care for patients undergoing
anaesthesia, support the patient during this period and
communicate with carers as necessary. Observe and take part in
communication with other areas and members of the
multidisciplinary tea,
THEATRE
Skills that can be practised
 The student will have the opportunity to learn how to scrub and
maintain a sterile field by observing and taking part in operative
procedures.
 The student will have the opportunity to act as a “circulating
nurse” by helping to give the scrubbed practitioner the equipment
and supplementaries needed for each case, this will give chance
to help maintain a sterile field
 The student will have opportunities to take the skill of
handwashing one step further in to the skill of scrubbing
 The student will be able to observe how infection control is
applied to practice and to dispose safely of body fluids
 The student will have opportunities to deal with surgical
specimens
 The student will be able to support patients undergoing local
procedures and communicate with them.
 The student will have the opportunity to take part in
multidisciplinary care of patients
 The student will have the opportunity to complete documentation
and pass on information to other areas of care.
Suggestions for evidence generation
The student will work along side the scrub team and have the
opportunities to take part under supervision in aspects of patient
care. They will be given the opportunity to scrub and watch or assist
in an operative procedure, help in the care of specimens, maintain
infection control etc.
RECOVERY AND WARD AREA (DSU)
Skills that can be practised
 Maintain a patients airway
 Care of intravenous infusions
 Maintain patients fluid balance
 Care for a patient following different types of anaesthetic
 Take and record observations
 Communicate with other members of the multidisciplinary team
and relatives
 Pass on information regarding the plan of care
 Change the plan of care if necessary
 Admission and discharge of patients
Suggestions for evidence generation
The student nurse will work alongside the recovery and/or ward staff
to care for the patient following anaesthesia, opportunities will be
given to maintain airways, monitor and record patients vital signs,
communicate with patients and family members. If the nurse is
working on the ward they will have the opportunity to be involved
with the admission and discharge process.
ENDOSCOPY
Skills that can be practised
 Support the patient undergoing endoscopic procedures and
maintain dignity at all times.
 Observe the anatomy and physiology associated with endoscopic
procedures
 Take the opportunity to be involved with the admission of
patients on the endoscopy list
 Observe and record any changes in the patient’s condition and be
involved with changes in to the plan of care
 Spend time in the wash room and take part in the health and
safety considerations of caring for scopes.
Suggested ways to generate evidence
Spend time observing in endoscopy and take the opportunity to
observe all parts of the process, admission, procedure, scope wash
room, recovery and discharge.
Preadmission Clinic
Skills that can be practised
♦ Assessment of patients physical and social state to undergo general
anaesthesia
♦ Recording of baseline observations
♦ Communication with patients and relatives
Suggested ways to generate evidence
To work alongside pre-assessment person, observing practice and
taking part where appropriate