SGPET - Information and Learning about Covid19 - Weekly Update , Mon 23 March 2020
Date sent: Tuesday 24 March 2020
SGPET - Information and Learning about Covid19 - A Weekly Update
Due to Covid19 all SGPET events are now cancelled at least until the end of May. Education is always big part of being a healthcare professional and that is particularly so when there are new skills to learn and new ideas to understand. Everybody is having to learn a lot of new things now and SGPET will be helping as much as possible. In the absence of face to face teaching we are organising remote learning activities and resources and will also be sending out this SGPET update every week.
Upcoming virtual sessions are being planned around Telephone Triage, End of Life, Diabetes and Covid19, professional self-care and more will follow. We are very keen to hear from you about what sort of things would help you most so please send ideas and requests to firstname.lastname@example.org
Keeping Up To Date about COVID19:
There is a lot of news, articles and guidance but it can still be difficult to feel confident that you are seeing the bits that are important to your work.
The Hot Topic box on the Somerset LMC page https://www.somersetlmc.co.uk / includes “Covid19 government webpage” which is a link to up to date guidance from Public Health England and “Covid19 What’s new for general practice” which is the regular update from the BMA.
The NHS Primary Care Bulletin which is aimed at GPs, Nurses and Practice Managers usefully lists all the Covid19 guidance put out by NHSE/I the previous week. You can register for the bulletin at:https://www.england.nhs.uk/email-bulletins/general-practice-bulletin/
The health and care professionals council (hcpc) has created a COVID-19 hub with further advice and regular updates. https://www.hcpc-uk.org/covid-19/
Telephone and Video Consultations
The gradual increase to more remote consultations has suddenly accelerated dramatically. Some of you will have the confidence and skills required for others it will be something you hoped you would never have to do and it will feel intimidating.
Here are links to advice from Dr Gandalf from eGPLearning.
Quick telephone consult tips: https://egplearning.co.uk/quick-telephone-consultation-tips-for-primary-care/
Video consultation tips for GPs: https://www.youtube.com/watch?v=MxIDHfHwDU0
We are finalising a series of remote teaching sessions and resources about telephone triage with Andy Eaton Crewkerne GP and OOH trainer, but for now here is a summary of Andy’s Telephone Triage Top Tips
- Read the notes
- Do any recent past encounters suggest a particular diagnosis or course of action?
- Can you follow the longitudinal trail of events (what has the caller had to do to get as far as you?)
- Introduction - every time
- Early empathic statement
- Speak to patient / address concerns of caller / relative
- Listen as attentively as you can for “the golden minute”
- Keep your energy levels up
- Watch for bias
- Wellness bias (eg in daytime hardly any rare things most patients well, in OOH you get everyone’s rare conditions and see it all and most people calling are not as well)
- Confirmation bias (only asking for things that prove one hypothesis you have in your mind)
- Wrong train syndrome (ie correct outcome for that diagnosis but you jumped on the wrong train and didn’t switch when new info came to light)
- Verbalising a clear summary can give the patient the opportunity to confirm your understanding
- Possible Outcomes
- I don’t need to see them
- Give me a good reason to see them
- Give me a good reason not to see them
- I’m going to see them
- Wrapping up
- Have you addressed today’s problem? (their agenda NOT just yours)
- If you’re really stuck what to do
- Ask “is it getting better, worse or about the same?”
- think ICE (especially expectations)
- Have you reached a conclusion about what is going on - and shared it with the patient?
- Are you and the caller aligned / on the same page?
- “If you don’t get a YES you’ve got a NO”
- Have you safety netted & documented your worsening advice?
- Have you been mindful of any possible sources of bias?
- Consider waiting until the caller hangs up first (can be a source of enlightening feedback)
- Have you put yourself in a good enough state to tackle the next call?
Professional Wellbeing - Looking after self and others
We cannot hope to look after people, patients, our colleagues and our families if we do not at the same time proactively look after ourselves. Here are some very helpful recommendations and resources from Dr Andrew Tresidder, long time Somerset GP, Educator, Appraiser, CCG and Practitioner Health member.
Top Tips for Own Health (GP version Somerset LMC)
We’re in for the long haul. We all remember to put fuel in the tank, money in the bank. Attending to own health will serve us well over the months ahead. Health Professionals (HPs) are brilliant at helping others with illness – ‘administering oxygen’ – whilst often in a state of personal oxygen deficiency. As HPs, we often ignore the needs of our bodies and minds, because we are helping others.
This week’s Top Tips:
- Bodies like to move. Move your body every few minutes. Get up, walk around, stretch. Doing this, you release patterns of stress and tension held in the system
- Breathe – slowly, regularly, rhythmically, using your diaphragm. Your body is now onto Parasympathetic drive – rest, chill, digest and repair – the default setting for a mammal. Shallow, rapid, irregular upper chest breathing would put us into Sympathetic Drive – the fight and flight, adrenaline and fear based system – let’s avoid this! Try conscious slow breathing at least twice an hour.
- Keep well hydrated with water, avoid excessive caffeine. A well hydrated brain is more efficient.
- Find someone or something to smile at – and hold the feeling for at least 20 seconds, thus making new brain connections of positivity
- Connect with nature, whether by picture, imagination, or in reality. Pay attention to the landscape, seascape, clouds, trees, flowers, animals, or any other aspect of nature. This stirs something deep within us and soothes the system.
- Sleep well. Avoid blue light for an hour or two before sleep, ensure darkness in bedroom, and switch all devices off or onto airplane mode (unless really needed)
- Recognise when you need help, and ask for it. No one is invincible
We will have more from Andrew next week along with Clinical Information, Support for the New Ways of Working demanded by the outbreak and if, you let us have them, ideas and tips from you too.
Resources for GPs, Practice Managers and Practice Nurses:
- RCGP Guidance on workload prioritisation
- Andrew’s blog on NHSE https://www.england.nhs.uk/blog/take-your-health-seriously/ website
- 5 steps to mental wellbeing https://www.nhs.uk/conditions/stress-anxiety-depression/improve-mental-wellbeing/ Of course, advice needs modifying to take account of Social Distancing
- Professional Resources for Doctors:
- https://www.somersetsafehouse.co.uk Somerset LMC Safe House
- https://www.bma.org.uk/advice/work-life-support/your-wellbeing BMA web resources
- https://www.practitionerhealth.nhs.uk NHS Practitioner Health
- https://www.nottinghamshirelmc.co.uk/support/wellbeing/ Nottinghamshire LMC wellbeing resources (some are local, most generic)
Resources for Practice Nurse & others in similar roles
- https://www.rcn.org.uk/library/subject-guides/wellbeing-self-care-and-resilience RCN
- NHS Employers Strategic Advice https://www.nhsemployers.org/retention-and-staff-experience/health-and-wellbeing/developing-your-health-and-wellbeing-strategy
- Somerset LMC Nurse Advisor, Paula Messenger please contact email@example.com
External training - Links to other providers both in Somerset and further afield, offering E Learning and Distance Based Learning Courses
Somerset GP Education Trust
Crown Medical Centre
Taunton, TA2 8QY