Clinical haematology wards are busy places, full of very sick patients – understanding the basics will put you ahead of the game.
Clinical haematology can encompass a range of sub-specialities such as; bone marrow transplant units, general haematology wards, haematology clinics, genetic mapping centres, obstetric haematology and day case units.
Throughout your placement you will be exposed to a multitude of haematological conditions and it will be a unique opportunity to develop skills, knowledge and gain confidence in dealing with these.
Patients in these areas, generally, have very poor immune systems – so you’ll be advised to stay away or wear a mask if you arrive at placement unwell.
What to Expect from your Placement
The ward or unit routine will differ from trust to trust, but this is something you will pick up quickly – so get as involved as you can.
You will see the day-to-day management of conditions such as; leukemias, lymphoma, myeloma, sickle-cell and various clotting disorders. Over-time these patients become very knowledgeable about their conditions – so use them as a resource to learn.
Most units actively participates in clinical trials governed by the National Cancer Research Network (NCRN). This will involve patients trialling potential new treatments for heamatological conditions.
You should get plenty of experience managing a septic patient. You should familiarise yourself with ‘Sepsis 6‘ and clinical escalation within your trust; Doctors, CCOT, Emergency Medical Teams, Hospital at Night etc.
Preparing for your Placement
There are a few things you can do to prepare for your placement within clinical haematology;
Try and visit your placement before you start. Wards and units can vary greatly. Visit the area you have been assigned to before you start and ask if there is anything you should be aware of prior to starting.
Identify your learning needs and outcomes. Identify these early and be aware of the skills you want to develop or learn – this will help you get the most from your placement.
Brush up on your anatomy and physiology. Familiarise yourself with the mechanisms of bone barrow and the haematopoietic stem cell cycle.
Read up on the basics. You should read up on the basics of haematology – familiarising yourself with the different types of leukemias, lymphomas and myelomas. The MacMillian, NHS Choices, Cancer Research and Bloodwise websites are fantastic recourses to help get to grip with the basics.
Understand the social impact on patients. A cancer diagnosis can be devastating to both an individual and a family, with individuals remaining inpatients for months at a time. Consider the impact this would have on a family; emotionally, financially, spiritual, sexual, professional etc.
Learn about neutropenic sepsis. Neutropenic sepsis is a life threatening complication of anticancer treatment and a genuine medical emergency. haematology patients have a tendency to deteriorate quickly so be sure to escalate to your mentor if you discover an unwell patient.
Research area-specific medications. You should read about commonly used anti-virals, anti-fungals and antibiotics. You could also invest in the Drugs in Use (Nursing and Health Survival Guides).
Understand the risks and complications of blood transfusions. You will see patients being frequently transfused with red blood cells or platelets. Understanding the complications and reasoning behind these transfusions will put you ahead of the game.
Look at ABCDE assessments and their importance. This systematic approach is used for the assessment and treatment of patients ABCDE model.
Chemotherapy will be administered in these areas. Although it will be interesting to watch you will be limited in your involvement due to the enhanced training required to administer.
Getting the most from your placement
haematology wards and units are usually very busy places, although you are supernumerary their will be jobs you’ll be asked to undertake independently once deemed able. There will be the chance to easily obtain learning outcomes and measures of practice.
You should use this placement to gain experience managing a patient load, managing a septic patient, clinical decision-making and, if possible, arranging insight visits with specialist areas.
The final and most important piece of advice I can give you is to ask questions and get involved.
Lucozade is no longer as effective at treating hypoglycemia
Due to changes in its recipe and a significant reduction in glucose, Lucozade will not be as effective as a treatment for hypoglycemic patients.
Recipe changes to Lucozade Original Energy product line mean it will no longer be as effective at treating hypoglycemic patients – this is due to a 50% reduction in glucose based carbohydrates. Healthcare Professionals should seek guidance from their local specialist team on alternative treatment protocols.
This change applies to all Lucozade Energy Flavours. New products started appearing on shelves in April 2017. However, for a short time, both the new and old recipe will be available.
Previously, 100ml of Lucozade Original contained 17g of carbohydrate; this was reduced to 8.9g in April 2017.
According to Diabietes.co.uk, patients who experience a hypoglycemic episode are advised to consume 15-20g of sugar when treating low blood sugar, but this will no longer be equivalent to 100ml of Lucozade.
Lucozade Ribena Suntory, which also makes Ribena and Orangina, among other drinks, is lowering its sugar content by replacing these sugars with low-calorie sweeteners, such as aspartame.
You can also visit www.lrsuntory.com/health for more information on Lucozade’s changing nutritional values or speak to your local diabetes specialist team.
Shift Planner for Nurses, Students & Support Staff
Shift planning is essential for safe care, some people using a piece of paper others have their thoughts well arranged in their head, either way everybody does it.
This shift planner has been designed with newly qualified nurses and student nurses in mind but would be suitable for anybody to use.
You can download our Shift Planner for FREE. You are free to download, print and distribute our shift planner as you wish. You will need a PDF reader on your PC to download.
The planner has been created with two primary columns, one for your main nursing priorities and one to remind you to hand over jobs to the next shift. It also features a small key and area for general notes. Due to limited space we have only included enough room to plan up to eight patients, if you need more we encourage you print doublesided.
We encourage you to make comments or suggestions in the comments section below. The most popular will be implemented in a version 2.
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