Liz and some of her nurse colleagues

 
We caught up with Dublin rehab nurse Liz Croxon, who has just returned from a two-week Motivation volunteer placement at a hospital in Tanzania. Liz was sharing her skills and experience with nurses who up until now have had little – if any – formal training in caring for patients with a spinal cord injury. Here’s Liz…

“I was working on the orthopaedic ward, where there were 93 patients but just 57 beds.
The remainder– mostly canvas stretchers and the odd trolley – were put wherever there was space. It was cramped and overcrowded, but it didn’t really shock me. You just have to get on with it.

I didn’t want to feel like a nuisance.
So when I introduced myself to the nurses, I explained that I wasn’t there to criticise them at all, that I wouldn’t just be observing, that I’d be working as part of the team. That seemed to go down well.

One of the biggest challenges was that the 16 spinal cord injury patients were in among the rest of the patients on the ward.
I explained that it would be better if they were all in one ward, because it’s very difficult to nurse spinal cord injury patients when they’re in among orthopaedic patients. They need a different kind of care.

Liz does some on-the-job training

The nurses hadn’t received specific training in caring for patients with a spinal cord injury.
So the idea was that I’d run three workshops. But often with as few as four nurses caring for 93 patients at a time, and some working up to 80 hours a week, the nurses just didn’t have the time or the energy for formal workshops. So I supported them on the job, getting across the basics of skin, bladder and bowel care regimes.

The nurses did have knowledge of pressure sores, but they didn’t realise how quickly they can happen with spinal cord injury patients.
Although the nurses were turning their patients, because they’re so busy, they weren’t turning them regularly enough. I gave them some advice on turning patients to prevent damage to the skin, how to position the arms and legs, and how to make sure the neck was adequately supported.

I was amazed at the patients’ relatives and how much they wanted to help.
No matter what you said, they’d take it and make sure they did it. So if the patients weren’t getting enough fluids, they’d make sure they got enough fluids. They absorbed any bit of info you gave them.

It was quite frustrating when we’d run out of basics like gloves and wipes for cleaning.
I’d have to go off and look for them, and it would take ages to find things. One day I needed some lubricant for a catheterisation and I had to go to the casualty department with a sterile glove and get a squirt of KY Jelly in it. You just had to improvise!

Tea break and photo opportunity!

We had trainee nurses too, and they were great students.
They were very keen to learn and they all took notes. That was good to see – the next generation of nurses having a real interest in spinal cord injury.”

Look out for more from Liz in a blog post we’re planning for International Women’s Day next month!