World Stop the Pressure Day: Tissue viability care in challenging environments

Last in our World Stop the Pressure Day spotlight today is Deborah Taylor. The Forensic/Mental Health Tissue Viability Specialist Nurse told us how she is working to develop her brand new role at the Trust. 

"My role supporting tissue viability (TV) in mental health, forensic and offender health services is a brand new one for the Trust, and it’s one we’re really excited about.

"I only started in the post on 31 August 2020 and have recently been redeployed back to district nursing to support the pandemic response, but I’ve already done a lot of preparation with the teams I’m going to be working with.

"My role will cover an extensive geographical patch including a range of services, from mental health patients within Highbury Hospital, Millbrook and our Child and Adolescent Mental Health Services (CAMHS), to forensic teams at Rampton Hospital, Arnold Lodge, Wathwood and the Wells Road Centre, offender health teams at seven prisons, and the health care team in an immigration removal centre."

A real range of issues to be addressed

"Within mental health services I will often be supporting mental health nurses as well as physical heath staff, so it’s important I give them the skills and confidence to know they are doing the right thing. Trusting relationships are key to us working together for the best patient care.

"The mental health patients we look after may have issues ranging from self harm, skin problems caused by moisture sometimes due to continence issues, and dementia, particularly in older people’s services. In addition, I can help teams to deal with leg ulcers and chronic wounds caused by past IV drug use or obesity.

"In offender health the reasons for TV care needs can vary, for example HMP Gartree has a higher proportion of older prisoners which means we have more issues similar to those seen in the wider community, from leg ulcers, risk of pressure ulcers and previous IV drug use to some self harm."

Empowering staff

"I have linked with all the teams that I’ll be supporting to scope their needs, with training being at the top of the agenda. It’s important that I now design the best way to deliver that training in the current circumstances of the pandemic.

"I plan to initially spend a day a week at Rampton where cases can be more complex, especially on the high secure wards, and be there to monitor patients and give more wound advice to the physical health team."

Reassuring our patients

"I hope that my involvement in their care will give increased confidence to any patients who are struggling with a wound. Specialist support should reinforce the knowledge that we are on their side, their health is important and we have their interests at heart. This will hopefully increase compliance with any treatment.

"I have spent 25 years’ in district nursing and am excited to be stepping outside of my direct comfort zone to be supporting this group of patients. I have always been a TV link nurse and have a good base of knowledge and skills to build on. I hope that together, I and the teams I work with will be able to rise above any difficulties and deliver the best possible care to our patients.

"Many cases, especially in our forensic and offender health services, aren’t textbook, for example we aren’t able to use compression bandages where we might usually because of the risk that patients may use them to self harm, so we have to work together to make the best of the solutions we have available.

"It’s a challenging but rewarding area, and I’m looking forward to taking on my role full time."