Thu Dec 08, 2011 12:06pm
Fall 2010
I was first introduced to the idea of a fellowship in the fall 2010. I did not have one sweet clue as to what it was, how it worked and, where to apply! I think the amazing thing about SEHC is that there is a whole team of people that are more than willing to rally around you and support your educational development.
Tags:
Wound Care
Hi Annika
Just wanted to say what a TERRIFIC idea this blog is! I completed an RPNAO Fellowship last year and felt the same as you did going in... not one clue...wouldn't even have known where to begin without the amazing people at corporate (Karen I know you'll read this;)
What a great tool this will be to educate and encourage others about the journey.
And for you... trust me... you will learn things you never knew you never knew.... Have fun! Keep us posted!
Tracy
Annika, sharing your fellowship experience like with the world like this is so incredibly brave, professional, and valuable. What are doing here will bring value to future RNAO and RPNAO Fellows, and to those considering undertaking a fellowship, and their employers for that matter. You are offering an intimate glimpse into the lived experience of an RNAO Fellow that has, to my knowledge, never been offered before. This will create a lasting and accessible archive that many others can and will benefit from in the future. This is truly an inovative approach to disemminating your knowledge and experience gained throughout your fellowship that provides a rich context that a summary report could never fully capture. Way to go, and keep it up!!!
I think the feeling of being overwhelmed is common!!
I think this is a common feeling among people that do Fellowships! seems so daunting in the beginning, but once you get started it is better......just keep your eye on the learning objectives and what you want to get out of the fellowship......you will get there!!
December 13
Another great experience at an SEHC location. This time I went to the London office to work with the WORN/ET. They also have a different structure than in Central East; the CCAC in that location has deamed the WORN/ET role as separate from the home visits. A WORN is in the community in the same way that an OT or PT would have a separate case load and admit and discharge their clts independently from the agency that is tending to the clt on a daily basis. Another major difference is that these nurses can debride wounds! They are able to go into a home see that a diabetic foot has built a hard callus around the edges that is slowing the healing and debride on site.
This is advantageous because the time to get into a doctor or chiropodist to have a wound debrided could take weeks. I am excited for the prospect of being able to being this knowledge into my clt base. Although it is important to note that I need more hands on experience (at a clinic) doing debriding work before I can practice independently in the community.
AS
December 1-4
The CAWC S series conference was absolutely fantastic I recommend it to anyone that has any involvement with wounds in their day to day activities! RN/RPN/MD/ET/OT/PT this course is for everyone. It is everyone’s responsibility to prevent wounds whenever possible.
Day 1
There was so much reading associated with day one. The day was spent covering basic theory learning the information needed to begin the assessment process. In the words of Julie Andrews it’s a very good place to start.
Importance was put on learning and understanding not only the cause of the wound but other underlying factors that could cause a wound to become stagnant or unhealable. Knowing all medications co morbidities and how each together and individually can affect a person. Social, economical, and environmental effects are also important to include in the treatment plan.
Another key point covered was assessment. How are you and your team going to monitor the healing of a wound? There has to be some unified method used to determine an individual’s risk of injury or to monitor an existing wound.
Day 2/3
Day two and three was focused around three topics: the different major types of wounds seen in clinics and hospitals; Diabetic Arterial, venous, and pressure ulcers, the products available to treat these wounds, and debridement.
This was the best part of the conference because we were able to discuss in detail the difference wounds I have seen in the community and was able to really see how I would be able to apply this knowledge to my practice. The critical take away from each section was: TREAT THE CAUSE! If your clt is diabetic with uncontrolled blood glucose and a foot ulcer the chances of healing are already reduced before your have decided what dressing to use.
That session was directly followed by one on dressing selection which was the best I have ever attended! We did not discuss branding when choosing a wound during a case study. We referred to products based on function ie hydrocolloid, hydrofiber, antimicrobial etc; which was very beneficial since the different conference attendees were from difference area with different supply contracts. Knowing the product type instead of the company name allows one to know what they are ordering based on functionality instead of brand name.
The last thing we covered before the end of day three was debridement. I found this exciting and scary both at the same time. It is amazing the difference in healing time when necrotic tissue is removed to make way for healthy viable tissue; but I am very nervous about the thought of cutting into a living person. We got the feel for the scalpel using a candle and a pig’s foot.
Day 4
This day was directed more towards individuals that want to be a change maker in their company. This session was spent discussing what changes we believed were needed and how to make those changes happen. For me this was a session that I could use in the future but I believe that our agency works within the RNAO BPG and works to uphold a high personal standard of care for our clts.
Knowing how to initiate and maintain change is very important and i believe that this skill will be very advantageous in the future as new procedures and techniques are developed in wound care.
AS
November 29
Thank you to the Kingston staff for being so welcoming to me! Amy and your team are such a professional and knowledgeable team of nurses.
SEHC has a clinic out of that office and I was amazed at the interdisciplinary team approach that is being used to treat not only diabetic foot ulcers but all wounds. In Kingston they had a group of doctors that have decided to specialize in the treatment, education, and prevention of diabetic foot issues. This is an amazing gift to clients who now have a Doctor that is looking at the whole picture of treating an individual with diabetes. This foot clinic also allows clts to be more closely monitored because they are seen by a physician q2weeks at regularly scheduled appointments; allowing for easier access to a doctor, as a number of patients may not have a family MD.
I believe that the most amazing part of this team approach is that there is open dialog between the RN’s/RPN’s and the treating physician; all opinions are respected and valued.
I would love to implement a clinic type facility in my community and when my fellowship is over will look into how to make that possible!
AS
November 22
There are so many facebook pages that you can go to discuss wound care and even those that are dedicated specifically to DFU!!
http://www.facebook.com/CanadianDiabetesAssociation
http://www.facebook.com/pages/Registered-Nurses-Association-of-Ontario/3...
AS
November 15
Placements are finally coming together! SEHC is so supportive of the education of staff. I have been in contact with employees of SEHC from different locations and they are all very receptive to the idea of me coming to their location and shadowing them as they do their wound assessments. It is so amazing to see how well our SEHC community come together to support my learning! THANK YOU
AS
November 1
I have finally figured out how to post on the CARE TO KNOW website. All my blog post were just sitting on my computer until I got on the website and started playing around. This is such a new experience for me because I am not technically savy. Welcome to the 20th century!
AS
October 25 2011
Great week. I am registering for the CAWC wound conference! A 3 day intensive workshop that is the prerequisite to the IIWC wound course. I am getting systematic review of articles together for an annotative bibliography this process was challenging because I’m lack of experience lead me down the wrong path at first. A quick meeting with my mentors (thank you Karen and Sarah!) and I think I`m back on track!
AS
October 18 2011.
Another challenging week. Still waiting to hear from my placements and missed my mentor check in meeting. Trying to regroup this week and rally my energy to keep going. This is an amazing opportunity and I do not want to let anyone on my team down!
Everyone should checkout this video on the Canadian Diabetes website about the seriousness of neuropathy:
http://www.getcheckednow.ca/
AS
October 11 2011
This was a CHALLANGING week! Juggling work, life and a fellowship is really difficult but my mentors have really helped to keep me focused and positive.
AS
October 4 2011
I have always been a hands on type person; I learn best from lived experience. Sitting for hours going through research has been very hard for me and my short attention span. But I have learnt a great deal so for and am very grateful for the opportunity. The RNAO Best Practice Guidelines (BPG) is a wealth of information from Diabetic statistics, prevention and treatment! But also the online learning provided by SECH At Your Side Colleague has also been a great sidekick tool to use with it. Both have expanded my knowledge and reaffirmed things that you need to effectively treat this growing segment of the population.
AS
September 2011
MY fellowship has officially been accepted; now comes the hard part getting time out of the district to focus on my research! As of the 27th I have an official ``fellowship day``. I thought that would be the hardest part of these beginning stages but I was wrong! The research and hearing back from potential placement opportunities is the most challenging.
AS
May 2011
It is official! Fellowship application is IN and I`m researching Diabetic Foot Ulcers! I would like to send out a BIG thank you to my team of SEHC mentors who have done an amazing job getting me organized and for making this all possible!
I can finally say that I understand the purpose and focus of my fellowship and how it is structured!
A fellowship in simple terms is an ISU (like in high school) you pick your focus create a plan and execute... I’m hoping that last part is as easy as it sounds!
So my focus is DFU and my plan is to research strategies for clt education, prevention, and treatment. I will be doing community and hospital placements to get more hands on experience and (slowly) stepping into the WORN role in my SDC to implement the strategies I have learned.
Very exciting times!
AS
Spring 2011
My team decided that we would postpone my fellowship application until the summer and have a fall start. This was great for me because I still have no idea how everything is going to come together into a workable proposal that the RNAO board of selectors is going to find interesting enough to financially support. I`m feeling so overwhelmed but excited.
AS