This is a guide to provide essential information about the ward, diabetes and endocrinology.

Telephone numbers: 01633234117

01633234116

Ward manager office number: 01633238963

Endrocrine conditions arise due to hormone imbalance, Autoimmune diseases, tumors, trauma injuries to glands, infections and lifestyle factors i.e. diet.

Here are some of the endocrine conditions

Diabetes

Pancreas

Type 1 - beta cells unable to produce insulin

Type 2 beta cells unable to produce enough insulin or body does not respond to insulin

Pituitary gland conditions

Hypopituitarism

Hyperpituitarism

Pituitary tumors

Thyroid conditions

Hyperthyroidism

Hyperthyroidism

Autoimmune conditions- graves disease and hashimoto disease

Adrenal gland conditions

Addisons disease

Cushings Syndrome

There is wide range of complications that an individual can have due to diabetes.

Hypoglycaemia (blood sugar is below 4).

Signs are confusion, blurred vision , dizziness, headache, pale and agitation.

This is caused by too much insulin, not eating enough and too much exercise. If not treated it can cause seizures, coma, brain damage and death.

Treatment depends of severity of the low blood sugar .

Mild and moderate- glucose tablets or glucose juice.

Severe- IV dextose or

IM Glucagon injection can be used, but not suitable for all patients e.g liver, starved patients.

Recheck blood sugar within 15 minutes. If below 4 repeat hypo treatment and recheck after 15 minutes. When blood sugar is

above 4 give 15-20g of carbohydrate

Fill out hypo sticker placement in medical notes, document and hand over

Hyperglycaemia ( blood sugar above 14) and always check ketones.

This caused by missed insulin, Late insulin, Poor injection technique,

Insulin pump failure, Lipohypertrophy

Signs - Increased thirst , increased urine output. Fatigue, blurred vision, feel hungry, weight loss, nausea, vomiting, increased heart rate, fast breathing , drowsy, difficulty concentrating, confusion

Treatment- Encourage to drink water,

ensure medication has been administered,avoid eating carbohydrates, IV fluids might require a variable rate scale

Alway inform the doctors about blood sugar and ketone levels as Hyperglycaemia can lead to a medical emergency called diabetic ketoacidosis (DKA) which requires a specific IV treatment.

Here are some of the Health care professionals we work together with

Tissue viability nurse (TVN)- Are specialised Nurses that diagnose wound type, treat and manage wounds above knee. They will create a wound care plan for the individual they assess, that the ward nurse will follow.

Lower limb Team- Are specialised healthcare professionals that diagnose the type of wound, treat and manage wounds below knee. For example a diabetic foot ulcer. They will create a wound care plan for the individual they assess, that the ward nurse will follow.

Dietician- Healthcare professionals that specialise in food and nutrition. They can provide specfic diet information. The WASSP risk assessment score indicates when a referral is needed. The dieticians that work on our ward provide specific diabetes education to individuals that require further education to help manage their diabetes .

Speech and Language Therapists (SALT) - Healthcare professionals that assess, diagnose and treat individuals with speech, language, communication and swallowing difficulties. Individuals can experience these type of challenges due to a various of conditions such as stroke, brain injuries, or progressive neurological disorders.

We refer to these specialists via Clinical work station completing the appropriate e-forms apart from the wound specialised nurses were we complete referral forms and email to the teams.

These assessments are:

Purpose T

Falls and bones

WASSP

Diabetic foot assessment

self-administration insulin policy

Mouth care

Continence

Daily nursing assessments

Skin bundle

Hordi

PVC

Staff room

There is a staff fridge, freezer, microwave, toaster and facilities to make tea and coffee with cups available.

There are lockers to put all your belonging in.

Research and familiarise yourself with endrocrine conditions.

Shadow HSCW for a few weeks to learn and gain knowledge about the fundamentals of care of c6 west patients, to learn about the essential role of HCSW and to further develop your teamwork skills.

Shadow your Practice supervisor. C6 West supervisors are:

Beth Salvador

Sarah Dormer

Joanna Wallace

Laura Cooper

Abigail Westerberg

Read patient files on you Practice supervisors case load to begin to understand the patients holistic care needs

Familiarise yourself with the ward paperwork and risk assessments.

Please follow uniform dress code.

Please follow health and safety and infections control policies

Please liase with practice supervisior/assessor to arrange intial, mid way, and end point meeting.

Please Liase with practice assessor in regards to end point assessments.

Please inform ward by phone if absent.

Orientation of the ward.

Assign you a Practice supervisor and assessor.

Fire safety information, where fire exists are, fire extinguishers, fire alarm break points etc

Infection control information

Learning opportunities

You will be working in a ward environment providing holistic care to patients with a variety of acute, chronic and complex care needs. You will be working closely with Healthcare support workers, nurses and other students.

We can arrange Additional learning days with pharmacy, diabetic nurse specialist team [DICE], TVN, Physiotherapist. Additionally you can follow a patient experience when appropriate for example going with a patient to x-ray, endoscopy, endrocrine tests, clinic appointments etc.

Medications- Hormone replacement

therapy and hormone suppression

Surgery-Removing tumors

Lifestyle changes- diet, exercise, smoking cessation and stress reduction

0700-1320

0700-1940

0700-1940

Day shifts you can do half days or full days.

Night shift:

1900-0740

Handover starts in the MDT room on the ward at the start of shift time.

Breaks

Breaks are allocated at certain times of the day by the nurse in charge on that day. If you have any medical conditions which affect what time you need to have your break, please let the nurse in charge know so we can accommodate this.

Breaks can either be taken in the staff room where we have facilities or in the restaurant on level 3 or Costa coffee on level 1. The restaurant and Costa are only open in the day. There are vending machines around the hospital which you can access anytime.

They educate patients with diabetes about their condition and how to recognise symptoms of hypoglycaemia and Hyperglycaemia. They train patients how to administer insulin safely guiding their technique and site rotation.

They also provide training to healthcare professionals to ensure staff can support and manage diabetes well.

Physiotherapist - are healthcare professionals that are trained to improve movement and function after and injury or illness. They can provide aids such as overloading shoes for patients that suffer from osteomyelitis.

Occupational therapist

Diabetic and Endrocrine Doctors

Pharmacy

Endrocrine nurse

Discharge liasons- healthcare professionals that lead safe discharge of patients to home by coordinating care packages, supporting families and finding out complex cases.

Begin to know and understand how to complete admission risk assessments. Find these in risk assessment section.

Participate in medication rounds, wound care under direct supervision from supervisor.

Start to be able to assess patients that are experience hypoglycaemia and Hyperglycaemia symptoms and gain the knowledge on how this should be treated. Always inform your supervisor so they can treat the patient appropriately.

Start developing communication skills with families and patients- observe best interest meetings, medical disciplinary team meetings

Develop knowledge in complications that can occur for patients with endocrine conditions

Start to take charge of patient care.

Able to complete risk assessments.

Assit in safe patient discharge

Organise additional learning days with endocrine nurse and diabetes specialist nurses, to support your development.

• A - Airway:

  Ensures a clear and open airway, addressing any obstructions. This may involve techniques like head-tilt chin-lift or suctioning.

• Are there any An oropharyngeal airway (OPA), also known as a Guedel. Or, nasopharyngeal airway (NPA), also known as a nasal trumpet or nose hose.

• B - Breathing:

  Assesses breathing effort, rate, and oxygen saturation. Interventions may include oxygen administration or assisted ventilation if needed. 

• C - Circulation:

  Evaluates heart rate, blood pressure, and signs of perfusion (e.g., capillary refill). Treatment may involve fluid resuscitation or addressing the cause of circulatory compromise. Hourly urine out put and fluid balance

• D - Disability:

  Assesses neurological status, including level of consciousness and any focal neurological deficits using tools like the AVPU scale (Alert, Voice, Pain, Unresponsive).  GCS stands for Glasgow Coma Scale It's a neurological scale used to assess the level of consciousness in individuals, especially after a head injury or other trauma.

• E - Exposure/Environment:

  Ensures the patient is fully exposed to allow for a thorough examination and assesses the environment to prevent hypothermia or other environmental factors from worsening the patient's condition,