NURSING

and frailty, my role also includes
We repeat the quiz at regular
produces lots of response
a lot of ‘hands on’ direct work
intervals during the day with
and interaction – including a
with residents and our 24
large audiences in the lounge and
spontaneous birthday competition
predominantly part-time staff.
larger communal areas as well
for those eager to claim the title
Today my work is very varied
as with random small clusters
of our oldest resident.
and includes the following.
of residents, visitors, staff and
This demonstrates to other
I carry out a planned
several one-to-one discussions.
staff members that activities can
performance review appraisal of
While the event is geared
emerge from the most innocent
the home’s registered manager.
to be fun, there is very much
and innocuous items, providing
Then there are three separate
an evidence gathering and
what for many in care home work
investigatory interviews with staff
observational element to the
see as the most vital ingredient
looking into some concerns at
exercise too – the continual
to a good home, namely having
the home – none of which lead
assessment of each resident’s
fun.
to any disciplinary actions being
required, thankfully
I have instigated a ‘Glen
Miller Appreciation Day’ and
participating in this includes
leading the ‘low intensity’ and
very entertaining multiple choice
quiz about his life and making
sure we play lots of his music
throughout the day.
The skills required to facilitate
the involvement of people with,
for many, very advanced features
of dementia are subtle, carefully
constructed and sophisticated.
I use the mental health
nursing skill set to ensure
that any awkwardness from
slow or delayed responses
from residents, arising from
the progressing verbal ability
difficulties they may have, does
not cause embarrassment but
can be delicately drawn and used
in a light-hearted manner, and
helps to provide a stimulating and
validating experience.
Assessing and contrasting
capability for people with
dementia is a daily reviewable
part of a mental health nurse’s
work to promote a satisfying and
balanced daily life in 24/7 care.
It may seem basic to an
onlooker, but clinical judgements
are as much about monitoring
and intervening regarding the
person’s retention, responses
and reaction skills as they are
about motor and co-ordination
skills.
changes is part of what goes on,
sometimes tacitly.
Later I carry out some
resident bedroom audits and
staff briefings on how we ensure
safe, person-centred and ageappropriate
environments at
our home is always kept under
scrutiny.
Specifically we need to
examine how we provide ‘lovely
bedrooms’ for our residents that
protect dignity in not having ‘on
display’ personal care items such
as creams and pads for those
needing them in the night time.
This is another aspect of the role
I perform in an ongoing way in
our homes.
Next I have a meeting with one
of the district nurses, reviewing
the care she is offering on this
day to our residents and also
agreeing that she will run a
series of massage sessions
for residents, as she has just
qualified as a certified massage
therapist.
I then spend some time
playing an impromptu and totally
invented in the moment game
of ‘snakes and ladders’, using a
small blob of Blu-tac as a counter
and gently engaging as many of
our residents as I can, asking
for favourite numbers, dates of
birth, as well as randomly called
numbers to climb ladders and
slide down snakes.
This proves most entertaining
and stimulating for many, and
Later I have a meeting with our
cook to talk about the upcoming
‘Devon Care Kite Mark Cooks
Bake Off’ event, where all the
cooks of kitemark member
homes will present a Christmas
cake for judging at our annual
Care Kite Mark Jamboree in
December.
In between these actions I
make numerous cups of tea for
residents, staff and visitors at
regular intervals – as well as
having several made for me too, I
should add.
During the day there is
also time spent overseeing
mealtime routines and practices,
particularly where staff are
supporting and assisting
residents to eat.
I am often involved in leading
training on issues such as this
and role modelling what we
regard as best practice to be
replicated by all staff involved at
all times.
I also spend time with
our newest resident and her
daughter, and it is pleasant to
hear about how thrilled and happy
they are now to be part of the
‘Pottles Court extended family’.
The work in 24/7 residential
care is as rich and colourful
as in any mainstream mental
health ward or unit – paperwork,
documentation and the range
of recording requirements are
as much a part of how we
provide high standards of care
as achieving a strong positive
culture, atmosphere and ensuring
quality of direct care to residents.
Our recent ‘Good’ Care Quality
Commission inspection outcome
was an emotional experience
– we are always checking and
double checking our systems,
and ‘back office’ work such as
care plans that capture how we
ensure consistency and continuity
of care.
Some of my day is spent
checking how well our new lady’s
needs and wants have been
recorded and shared in records
and handovers – so I talk to our
new lady, her daughter and our
staff and cross-reference the
detail accordingly.
My usual method is to
approach her and say: ‘Hello,
how do you do? My name is
George, I’m one of the owners
here – what would you like us to
call you?’
Occasionally we discover
that some residents reinvent
themselves with quite different
names to those they have used
for most of their lives.
The rest of my day is taken
up with incalculable chats,
slipper monitoring, hairdresser
bantering, window cleaning
reviews and lobby poster
refreshing.
As said – the role is multilayered,
varied and diverse – in
the nicest possible way. MHN
17