THE SPECIALIST NURSE INTERVENTION: PROMOTING UNDERSTANDING. Marianne Peachey Epilepsy Specialist Nurse The Ipswich Hospital NHS Trust
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1 THE SPECIALIST NURSE INTERVENTION: PROMOTING UNDERSTANDING Epilepsy Specialist Nurse The Ipswich Hospital NHS Trust
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4 NURSING Is it Art or Science?
5 Hospital Consultants General Practitioners Hospital Nursing Staff Nursing/Residential Home Staff Occupational Therapist Community Psychiatric Nurses ESN Neurosurgeon British Epilepsy Association Psychologist Counsellors Disability Employment Advisor Social Services
6 AIMS OF THE EPILEPSY SPECIALIST NURSE INTERVENTION To identify the knowledge and beliefs people have about epilepsy To ask the right questions to discover people s s lifestyle and any concerns To build a comprehensive picture of how their lives could be affected by epilepsy To provide appropriate advice and information for each individual To empower people to take control and manage their condition
7 REFERRALS Newly diagnosed patients - from the fast track Suspected Seizure clinic Consultant Neurologists Ward referrals Hospital Physicians GP s 400 in Suffolk Paediatricians adolescent handover Obstetricians & Midwives during pregnancy Self-referral from patients via Helpline
8 A BROAD RANGE OF AGES Age-specific incidence of Epilepsy in industrialised countries
9 DO THEY KNOW? What epilepsy is Why they have epilepsy How it affects them What happens in the brain when they have a seizure What their usual seizures are like
10 DO THEY AND THEIR FAMILY KNOW? What to do when they have a seizure If they need any emergency medication How to use emergency medication When to get help and from whom Where to get identity jewellery from
11 DO THEY UNDERSTAND? Their treatment How it works How to take it What to do if they miss a dose What side effects to look for The need to take it regularly
12 MEDICATIONS Sodium Valproate* Carbemazepine* Lamotrigine* Levetiracetam Topiramate Gabapentin Pregabalin Phenytoin (Epilim) (Tegretol) (Lamictal) (Keppra) (Topamax) (Neurontin) (Lyrica) (Epanutin)
13 MEDICATION SCHEDULE
14 DO THEY KNOW? That lifestyle can affect their epilepsy
15 DISCOVER WHAT THEY THINK IS? The most frightening thing about having seizures The likelihood that someone will die during a seizure The best way to minimise the risk The risk of Suicide
16 HAVE THEY CONSIDERED? The driving regulations 1 year ban in the UK from date of last seizure That auras are classified as seizures How the driving regulations will affect their life in the UK up to 50% discount off public transport, buses free in some areas Access to work Scheme
17 DO THEY? Have realistic career plans especially for adolescents Know how a diagnosis of epilepsy may affect their employment safety, driving Know who can help them government agencies
18 DO THEY THINK? That there are some activities they should not do That some people have misconceptions about epilepsy That there are practical steps they can take to improve their safety
19 DO WOMEN KNOW? That some women have more seizures around the time of their period Whether their medication affects the contraceptive pill That they should seek advice from a doctor or an epilepsy nurse if they wish to become pregnant That people with epilepsy can expect to have a normal family life
20 WHAT ABOUT PREGNANCY? Seizure frequency 2/3 same or improve Women with epilepsy have slightly reduced fertility It is safe to increase medication after the first trimester Lamotrigine levels can drop during latter stages of pregnancy Pethidine can lower the seizure threshold Breastfeeding fine on all anti-epileptic drugs Discuss safety issues looking after baby
21 HAVE THEY? Felt anxious or depressed about the diagnosis of epilepsy Obtained any information about the condition Joined an epilepsy organisation Contacted a local support group Discussed their anxieties with anyone Developed coping strategies
22 SUMMARY LISTEN to people with epilepsy ASK the right questions to discover what they are concerned about PROVIDE people with relevant information and advice EMPOWER patients with the knowledge to take control and manage their condition and
23 ENJOY A NORMAL LIFE!
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