#WeLDNs - Tuesday 19th October 2021 8:30pm (GMT Standard Time) A right pain in the…

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Does this hurt? This weekend I broke my ankle, it hurt a lot and I’ve spent the few days following on from it demanding pain relief regularly, liaising with my GP to amend dosages, considering alternatives with a physicians associate and discussing with a very lively pharmacist about other options to supplement what’s been prescribed. 

I am lucky, I’m well enough versed in healthcare that I know who to speak to and when. I’m able to understand and articulate that something isn’t quite right and know what I need to do try and fix that. 

What if I wasn’t? What if I couldn’t? What if I had a learning disability which might make it more difficult to say “if I do this it’s fine, but *this* and I want to cry!”. 

This week we are going to discuss pain, now tell me, does it hurt when I press here…





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We’ve all felt pain, all the pain. From the sharp stabbing acute pain that takes your breath away to the low level persistent throbbing pain. And we all have our own perceptions about what that pain is, what it means and how to treat it. Codeine always makes me cry. But pain medication or analgesia, is a vital step in recovery from so many conditions. Tonight team @WeLDNurses discussed pain, how do we assess it? How do we treat it? How do we recognise it in people who are unable to talk about their symptoms? There are tools to support us, we discussed the DisDAT, Abbey Pain Scale and BILD - but are they making a difference? Are they doing enough to support the people with learning disabilities in our communities? We talked about the benefit of acute liaison nurses. This is rather a moot point for team WeLDNurses as we have always believed that acute liaison nurses are best placed to affect positive change in the health of the people we serve. From GP appointments, outpatients, elective and emergency treatment acute liaison nurses are best placed to advocate for the completion of hospital passports, reasonable adjustments and the correct prescribing of all analgesia. Whatever pain you’re experiencing- there’s always a remedy. We just sometimes need to be creative to ensure we’re sourcing and securing the right pain relief for you all.





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 #WeLDNs transcript

 
@WeLDnurses
19 October 2021 20:30
Well it’s that time! Good evening everyone and welcome to tonight’s chat about pain, do say hello and give us a wave, even if you’re lurking tonight ?? #StatsMatter #SayHello #WeLDNs
@salsa442
19 October 2021 20:31
Hi all, it’s Sal here waving from rainy Cumbria #WeLDNs
@ross_6479_RNLD
19 October 2021 20:31
@salsa442 Yesssss ?? #weldns
@paularich1977
19 October 2021 20:31
@WeLDnurses Evening everyone from a very wet South Wales #WeLDNs
@ross_6479_RNLD
19 October 2021 20:31
@WeLDnurses Hi #waves Ross here #weldns
@WeLDnurses
19 October 2021 20:31
@paularich1977 Lovely to see you Paula #WeLDNs
@WeLDnurses
19 October 2021 20:32
@ross_6479_RNLD Hi lovely #WeLDNs
@drliberty
19 October 2021 20:32
@WeLDnurses Hi all - lurking in wet and windy Gloucestershire #weldns
@NicBraid
19 October 2021 20:32
@WeLDnurses Hi everyone?? first chat I’ve joined in a while #WeLDNs
@ross_6479_RNLD
19 October 2021 20:32
@salsa442 Ooh you’re in Cumbria? ?? #weldns
@florenceella
19 October 2021 20:32
@salsa442 Hopefully a large glass! #WeLDNs
@steve_grimbleby
19 October 2021 20:32
@WeLDnurses It’s Steve from a rather wet Reading #WeLDNs https://t.co/VvNTvPaN7e
@WeLDnurses
19 October 2021 20:32
@drliberty The weather is very autumnal isn’t it? Hi and welcome, feel free to be a noisy lurker ???? #WeLDNs
@florenceella
19 October 2021 20:32
@WeLDnurses Evening all! Flo here waving from Birmingham ???? #WeLDNs
@WeLDnurses
19 October 2021 20:33
@NicBraid Lovely to see you Nicola #WeLDNs
@dmarsden49
19 October 2021 20:33
@WeLDnurses Hi guys, can't join you properly tonight, but have shared this chat with #5107S20 @NursingKingston #LearningDisabilityNurses group who have a session on pain later this week, suspect you'll have some #weldns lurkers. Have a good one!
@Shaun_LDNurse
19 October 2021 20:33
@WeLDnurses Hello, Shaun here! ?? … lurking from not so sunny Birmingham this evening. #WeLDNs
@raig2505
19 October 2021 20:33
@WeLDnurses Hello, another Ross here, from Worcester ?? #WeLDNs
@WeLDnurses
19 October 2021 20:33
@steve_grimbleby Hi Steve, great to see you #WeLDNs
@WeLDnurses
19 October 2021 20:33
@florenceella Hi Flo, good to see you #WeLDNs
@florenceella
19 October 2021 20:34
@Shaun_LDNurse @WeLDnurses It’s grim isn’t it!! #WeLDNs
@WeLDnurses
19 October 2021 20:34
@dmarsden49 @NursingKingston Fab, thanks for sharing Dan and hope to see some newbies tonight #WeLDNs
@WeLDnurses
19 October 2021 20:34
@Shaun_LDNurse Hi Shaun, lovely to see you #WeLDNs
@WeLDnurses
19 October 2021 20:34
@HannahBBloor Hiya #WeLDNs
@WeLDnurses
19 October 2021 20:35
Lovely to see some old and new faces tonight ?? shall we start with a question? #WeLDNs
@ross_6479_RNLD
19 October 2021 20:35
RT @WeLDnurses: Lovely to see some old and new faces tonight ?? shall we start with a question? #WeLDNs
@1985Deanne
19 October 2021 20:35
@WeLDnurses Hi Deanne here lurking as a parent of child with a disability #WeLDNs
@WeLDnurses
19 October 2021 20:35
Remember to use the hashtag #WeLDNs in every tweet and if you’re sharing any evidence also use #EBP
@ross_6479_RNLD
19 October 2021 20:36
RT @WeLDnurses: Remember to use the hashtag #WeLDNs in every tweet and if you’re sharing any evidence also use #EBP
@WeLDnurses
19 October 2021 20:36
@1985Deanne Lovely to have you here #WeLdNs
@florenceella
19 October 2021 20:36
@NicBraid @salsa442 Definitely! #WeLDNs
@WeLDnurses
19 October 2021 20:36
What is your experience of managing pain when supporting people with learning disabilities? #WeLDNs
@ross_6479_RNLD
19 October 2021 20:37
RT @WeLDnurses: What is your experience of managing pain when supporting people with learning disabilities? #WeLDNs
@Shaun_LDNurse
19 October 2021 20:37
@florenceella @WeLDnurses No better weather for the #WeLDNs tweet chat though (from the comfort of the sofa). ??
@salsa442
19 October 2021 20:37
@NicBraid @florenceella First of many ?? #WeLDNs
@HannahBBloor
19 October 2021 20:38
I've always found the DISDAT tool to be helpful when supporting people with learning disabilities and pain #weLDNs https://twitter.com/WeLDnurses/status/1450546485746077707
@steve_grimbleby
19 October 2021 20:38
@WeLDnurses I have seen pain very poorly controlled as some staff say they don’t know when patients are in pain #WeLDNs
@ross_6479_RNLD
19 October 2021 20:38
@WeLDnurses In one part of my job we see lots of people who struggle to communicate when they are in pain and work hard with them and those around them to find ways to support them with this, there can often be a lot of guess work and not always with much to go on #weldns
@1985Deanne
19 October 2021 20:38
@WeLDnurses I have an intrest in pain and how it is perceived and managed. My girls broke bones, had bad dislocations and not felt a thing. When she had a blockage in her bowel her pain presented in her behaviour and it was dismissed as challenging behaviour #WeLDNs
@WeLDnurses
19 October 2021 20:38
RT @steve_grimbleby: @WeLDnurses I have seen pain very poorly controlled as some staff say they don’t know when patients are in pain #WeLDNs
@salsa442
19 October 2021 20:38
I’ve found it really complex over the years to accurately assess and respond to pain indicators. Pain is such a subjective thing and it can be really tricky to spot subtle changes which may indicate pain #WeLDNs https://twitter.com/weldnurses/status/1450546485746077707
@WeLDnurses
19 October 2021 20:39
Is that quite common do we think? #WeLDNs https://twitter.com/steve_grimbleby/status/1450546902559301639
@salsa442
19 October 2021 20:39
I love the DisDAT too #WeLDNs https://twitter.com/hannahbbloor/status/1450546838105477124
@ross_6479_RNLD
19 October 2021 20:39
@WeLDnurses And I always here ‘has a high pain threshold’ which often I take to translate to isn’t always sure how to communicate #weldns
@WeLDnurses
19 October 2021 20:39
Diagnostic overshadowing raising its head again #weldns https://twitter.com/1985deanne/status/1450546933462876162
@salsa442
19 October 2021 20:40
DisDAT tool is one of my go to assessments https://www.wamhinpc.org.uk/sites/default/files/Dis%20DAT_Tool.pdf #EBP #WeLDNs
@salsa442
19 October 2021 20:40
RT @WeLDnurses: Is that quite common do we think? #WeLDNs
@florenceella
19 October 2021 20:40
@ross_6479_RNLD @WeLDnurses I think that’s a great point, in my experience you need to really know the person (or have someone who really knows them on hand) and their ‘normal’ so you can pick up on cues/ behaviour to workout when they’re in pain #WeLDNs
@florenceella
19 October 2021 20:41
RT @salsa442: DisDAT tool is one of my go to assessments https://www.wamhinpc.org.uk/sites/default/files/Dis%20DAT_Tool.pdf #EBP #WeLDNs
@steve_grimbleby
19 October 2021 20:41
@WeLDnurses Reading the persons hospital passport may give some great info about how the patient shows signs of pain / discomfort #WeLDNs
@florenceella
19 October 2021 20:41
RT @WeLDnurses: Diagnostic overshadowing raising its head again #weldns
@salsa442
19 October 2021 20:41
@ross_6479_RNLD @WeLDnurses This really annoys me, I get that pain is subjective, but if you’ve broken your ankle for example you’re going to be in pain. Massive pain. #WeLDNs
@NicBraid
19 October 2021 20:41
@WeLDnurses Identifying/ruling out, assessing and managing pain has been a core element of all my roles as an RNLD #WeLDNs
@WeLDnurses
19 October 2021 20:42
Dont forget to use your hashtag so everyone can follow along #WeLDNs https://twitter.com/misscreed/status/1450547325005438980
@drliberty
19 October 2021 20:42
@WeLDnurses Definitely- all comes back down to communication and challenging the ‘high pain threshold’ nonsense #weldns
@steve_grimbleby
19 October 2021 20:42
RT @salsa442: DisDAT tool is one of my go to assessments https://www.wamhinpc.org.uk/sites/default/files/Dis%20DAT_Tool.pdf #EBP #WeLDNs
@raig2505
19 October 2021 20:42
From an acute liaison point of view it’s really helpful if people come into hospital with recorded info about how to recognise pain, either in a DisDat, Hospital Passport, or other care plan. #WeLDNs https://twitter.com/weldnurses/status/1450546485746077707
@paularich1977
19 October 2021 20:43
@ross_6479_RNLD @WeLDnurses Annoys me immensely… just because I cannot tell you I’m in pain doesn’t mean I’m not…. What is my behaviour telling you? #weldns
@WeLDnurses
19 October 2021 20:43
Thanks for sharing this, what help have you eve received? #WeLDNs https://twitter.com/caz_1984/status/1450547677276614666
@salsa442
19 October 2021 20:43
@florenceella @ross_6479_RNLD @WeLDnurses I agree guys, it can be really difficult to translate how behavioural changes indicate pain, I’ve really relied on family/relatives/carers over the years to help me to understand #WeLDNs
@WeLDnurses
19 October 2021 20:43
@NicBraid What kinds of roles have these been? #WeLDNs
@WeLDnurses
19 October 2021 20:43
RT @drliberty: @WeLDnurses Definitely- all comes back down to communication and challenging the ‘high pain threshold’ nonsense #weldns
@florenceella
19 October 2021 20:44
@WeLDnurses If someone can’t verbally communicate we are often told they “can’t feel pain” or “have a high pain threshold”. With these people it is even more crucial to observe, understand and consider use of tools such as disdat #WeLDNs
@salsa442
19 October 2021 20:44
And it is utter nonsense #WeLDNs https://twitter.com/drliberty/status/1450547874362707982
@1985Deanne
19 October 2021 20:44
@florenceella @WeLDnurses @ross_6479_RNLD Absoutly agree knowing your patient and listing to carers or people who know then well, read any information provided is key. #WeLDNs
@WeLDnurses
19 October 2021 20:45
Lots of experience working with people in pain, but how do we measure this? What tools have people used to help people communicate their pain? #WeLDNs
@florenceella
19 October 2021 20:45
@salsa442 @ross_6479_RNLD @WeLDnurses Definitely, families/ carers and the hospital passport are my go to #WeLDNs
@ross_6479_RNLD
19 October 2021 20:45
@1985Deanne @florenceella @WeLDnurses Absolutely, working with the person and those who know them well can help to begin developing plans that support awareness and future care provision #weldns
@HannahBBloor
19 October 2021 20:45
@1985Deanne @WeLDnurses I teach PBS and I can't stress enough the importance of ruling out potential physical health ailments prior to labelling someone with "behaviours that challenge" #WeLDNs
@NicBraid
19 October 2021 20:46
@WeLDnurses Also knowing what the options of pain relief are and being able to fight for the most effective #WeLDNs
@salsa442
19 October 2021 20:46
I love the DisDAT tool but the Abbey Pain scale is also really useful #EBP #WeLDNs https://www.wamhinpc.org.uk/sites/default/files/Dis%20DAT_Tool.pdf https://twitter.com/weldnurses/status/1450548584001179650
@WeLDnurses
19 October 2021 20:46
How often is pain misinterpreted as Challenging behaviour do you think? #WeLDNs https://twitter.com/HannahBBloor/status/1450548719720480777
@salsa442
19 October 2021 20:46
@florenceella @ross_6479_RNLD @WeLDnurses Hospital passports can be so very helpful #WeLDNs
@WeLDnurses
19 October 2021 20:46
#WeLDNs https://twitter.com/SamScreaton/status/1450548968023330828
@WeLDnurses
19 October 2021 20:47
RT @salsa442: @florenceella @ross_6479_RNLD @WeLDnurses Hospital passports can be so very helpful #WeLDNs
@WeLDnurses
19 October 2021 20:47
@salsa442 @florenceella @ross_6479_RNLD We do love a good quality, well used passport #WeLDNs
@raig2505
19 October 2021 20:47
Also important to include awareness of pain when delivering learning disability awareness (regardless of setting) really important to educate about communication and diagnostic overshadowing #WeLDNs https://twitter.com/weldnurses/status/1450546485746077707
@WeCYPnurses
19 October 2021 20:47
RT @WeLDnurses: Lovely to see some old and new faces tonight ?? shall we start with a question? #WeLDNs
@florenceella
19 October 2021 20:47
RT @salsa442: I love the DisDAT tool but the Abbey Pain scale is also really useful #EBP #WeLDNs https://www.wamhinpc.org.uk/sites/default/files/Dis%20DAT_Tool.pdf
@WeCYPnurses
19 October 2021 20:47
RT @WeLDnurses: Remember to use the hashtag #WeLDNs in every tweet and if you’re sharing any evidence also use #EBP
@WeCYPnurses
19 October 2021 20:47
RT @WeLDnurses: What is your experience of managing pain when supporting people with learning disabilities? #WeLDNs
@paularich1977
19 October 2021 20:48
RT @salsa442: I love the DisDAT tool but the Abbey Pain scale is also really useful #EBP #WeLDNs https://www.wamhinpc.org.uk/sites/default/files/Dis%20DAT_Tool.pdf
@MaryReidy11
19 October 2021 20:48
@SamScreaton @WeLDnurses I use this in my classes with my ID student nurses when explaining pain measures #WeLDNs
@WeCYPnurses
19 October 2021 20:48
RT @steve_grimbleby: @WeLDnurses I have seen pain very poorly controlled as some staff say they don’t know when patients are in pain #WeLDNs
@florenceella
19 October 2021 20:48
@WeLDnurses Far too often!!! #WeLDNs
@NicBraid
19 October 2021 20:48
@WeLDnurses Inpatient A&T, community based service and a children’s ADHD service #WeLDNs
@salsa442
19 October 2021 20:48
Yes to this ?? in my experience the commonest ‘cause’ for behaviour which challenges is pain caused by physical health illnesses #WeLDNs https://twitter.com/hannahbbloor/status/1450548719720480777
@WeCYPnurses
19 October 2021 20:48
RT @WeLDnurses: Is that quite common do we think? #WeLDNs
@WeCYPnurses
19 October 2021 20:48
RT @WeLDnurses: Diagnostic overshadowing raising its head again #weldns
@WeLDnurses
19 October 2021 20:48
@raig2505 What kinds of things do you use for this? #WeLDNs
@steve_grimbleby
19 October 2021 20:48
@salsa442 Never seen DisDat before will have to give that a good look #WeLDNs
@florenceella
19 October 2021 20:48
@WeLDnurses @salsa442 @ross_6479_RNLD Good quality and up to date! #WeLDNs
@salsa442
19 October 2021 20:48
@WeLDnurses Too many times! #WeLDNs
@WeLDnurses
19 October 2021 20:48
@MaryReidy11 @SamScreaton Do you want to share some information on it, some good #EBP #WeLDNs
@ross_6479_RNLD
19 October 2021 20:48
@WeLDnurses I often see people where pain/discomfort is a key function to their behaviours, all behaviour is communication and its important we recognise this as such, and find ways to support #weldns
@WeCYPnurses
19 October 2021 20:48
RT @WeLDnurses: Thanks for sharing this, what help have you eve received? #WeLDNs
@WeCYPnurses
19 October 2021 20:48
RT @drliberty: @WeLDnurses Definitely- all comes back down to communication and challenging the ‘high pain threshold’ nonsense #weldns
@NicBraid
19 October 2021 20:49
@1985Deanne @WeLDnurses It’s the first thing that should be investigated and ruled out #weldns
@salsa442
19 October 2021 20:49
@steve_grimbleby https://www.wamhinpc.org.uk/sites/default/files/Dis%20DAT_Tool.pdf check it out, I’ve used it loads over the years, really helpful tool #WeLDNs
@WeCYPnurses
19 October 2021 20:49
RT @WeLDnurses: How often is pain misinterpreted as Challenging behaviour do you think? #WeLDNs
@WeLDnurses
19 October 2021 20:49
RT @NicBraid: @1985Deanne @WeLDnurses It’s the first thing that should be investigated and ruled out #weldns
@WeCYPnurses
19 October 2021 20:49
RT @salsa442: @florenceella @ross_6479_RNLD @WeLDnurses Hospital passports can be so very helpful #WeLDNs
@raig2505
19 October 2021 20:49
DisDat and also pain profile https://www.bild.org.uk/wp-content/uploads/2020/01/My-Pain-Profile-Nov-2018.pdf #WeLDNs https://twitter.com/weldnurses/status/1450548584001179650
@WeLDnurses
19 October 2021 20:50
Come through with that good evidence! #WeLDNs https://twitter.com/raig2505/status/1450549710956138498
@WeCYPnurses
19 October 2021 20:50
RT @NicBraid: @1985Deanne @WeLDnurses It’s the first thing that should be investigated and ruled out #weldns
@WeLDnurses
19 October 2021 20:50
How do we go about reducing the affect of staff turnover? #WeLDNs https://twitter.com/HannahBBloor/status/1450549844213485572
@florenceella
19 October 2021 20:50
RT @salsa442: @steve_grimbleby https://www.wamhinpc.org.uk/sites/default/files/Dis%20DAT_Tool.pdf check it out, I’ve used it loads over the years, really helpful tool #WeLDNs
@florenceella
19 October 2021 20:50
RT @raig2505: DisDat and also pain profile https://www.bild.org.uk/wp-content/uploads/2020/01/My-Pain-Profile-Nov-2018.pdf #WeLDNs
@WeCYPnurses
19 October 2021 20:50
RT @WeLDnurses: Come through with that good evidence! #WeLDNs
@WeCYPnurses
19 October 2021 20:51
RT @WeLDnurses: How do we go about reducing the affect of staff turnover? #WeLDNs
@raig2505
19 October 2021 20:51
@WeLDnurses Often share and discuss some case studies from reports such as Death by Indifference and CIPOLD, plus examples from own practice. Sometimes people attending have own example as well and can reflect on this #WeLDNs
@WeLDnurses
19 October 2021 20:51
@raig2505 Lived experiences have huge power #WeLDNs
@salsa442
19 October 2021 20:51
@HannahBBloor @WeLDnurses This is why people need really robust care plans, with baseline observations and pain assessments as standard #WeLDNs
@florenceella
19 October 2021 20:52
RT @WeLDnurses: @raig2505 Lived experiences have huge power #WeLDNs
@paularich1977
19 October 2021 20:52
RT @NicBraid: @1985Deanne @WeLDnurses It’s the first thing that should be investigated and ruled out #weldns
@florenceella
19 October 2021 20:52
This is so crucial #WeLDNs https://twitter.com/salsa442/status/1450550304995414027
@NicBraid
19 October 2021 20:52
@WeLDnurses Talking mats and rating scales, information gathered from the person and significant others, data to identify possible cycles or triggers #WeLDNs
@Shaun_LDNurse
19 October 2021 20:53
@WeLDnurses A great deal. What’s interesting though, if we extrapolate the issue of pain, who doesn’t get distressed, irritable, or cranky (etc) when in pain? Another example of possible standards from some (esp. if not experienced supporting people with #LearningDisabilities). #WeLDNs
@WeLDnurses
19 October 2021 20:53
@NicBraid Tell us more about how you used talking mats? #WeLDNs
@HannahBBloor
19 October 2021 20:54
@WeLDnurses Better staff support from care providers (supervision/appraisals), opportunities for development and training. #WeLDNs
@NicBraid
19 October 2021 20:55
@WeLDnurses I have used it in different ways depending on the need, to help identify where pain is, how pain makes someone feel, what help a person needs when they are in pain #weldns
@WeLDnurses
19 October 2021 20:55
Now, as great as we are, we have our limits, has anyone ever supported a person to access specialist pain services? #WeLDNs
@MaryReidy11
19 October 2021 20:55
@WeLDnurses @SamScreaton #WeLDNs here is the link to the website https://www.stoswaldsuk.org/how-we-help/we-educate/education/resources/disability-distress-assessment-tool-disdat/
@ross_6479_RNLD
19 October 2021 20:55
RT @WeLDnurses: Now, as great as we are, we have our limits, has anyone ever supported a person to access specialist pain services? #WeLDNs
@WeLDnurses
19 October 2021 20:55
Great use @TalkingMats to support communication #WeLDNs https://twitter.com/NicBraid/status/1450551143357198337
@drliberty
19 October 2021 20:55
@WeLDnurses Having robust plans in place using ‘soft sign’ tools such as RESTORE2, good care plans, annual health checks and follow up plans and education such as The Oliver McGowan Mandatory Training in Learning Disability and Autism #weldns
@paularich1977
19 October 2021 20:56
RT @WeLDnurses: Now, as great as we are, we have our limits, has anyone ever supported a person to access specialist pain services? #WeLDNs
@WeLDnurses
19 October 2021 20:56
Thanks for sharing! #EBP #WeLDNs https://twitter.com/MaryReidy11/status/1450551177305903113
@ross_6479_RNLD
19 October 2021 20:56
@WeLDnurses I worked really closely with the link GP who liaised with the pain services to support someone with complex pain (whatever that is!) and this worked really well when we all worked collaboratively #weldns
@WeLDnurses
19 October 2021 20:56
@drliberty Do you have more information on RESTORE2? #WeLDNs
@salsa442
19 October 2021 20:56
Yes, post operative pain management via the specialist pain team and also long term management for conditions like cancer - had some really good outcomes for people #WeLDNs https://twitter.com/weldnurses/status/1450551161900224517
@drliberty
19 October 2021 20:57
@WeLDnurses https://www.hampshiresouthamptonandisleofwightccg.nhs.uk/your-health/restore-official #weldns
@WeLDnurses
19 October 2021 20:58
Thanks #EBP #WeLDNs https://twitter.com/drliberty/status/1450551767540850698
@WeLDnurses
19 October 2021 20:58
@HannahBBloor Its not stealing, its sharing! #WeLDNs
@salsa442
19 October 2021 20:58
@ross_6479_RNLD @WeLDnurses Collaboration always gets the best results #WeLDNs
@NicBraid
19 October 2021 20:58
@WeLDnurses I’ve been part of a team who reached out to specialist services when we weren’t sure we were getting things right for a patient, mostly focused around medication options #WeLDNs
@raig2505
19 October 2021 20:59
I’ve not been involved in referral process so wouldn’t say I’ve supported access but do see pain team involvement in my acute liaison role particular post op and for people in intensive care. I would like to work with them more I’m sure I’d learn a lot #WeLDNs https://twitter.com/weldnurses/status/1450551161900224517
@salsa442
19 October 2021 20:59
@WeLDnurses @HannahBBloor And we all know that sharing is caring #WeLDNs
@florenceella
19 October 2021 20:59
@salsa442 @ross_6479_RNLD @WeLDnurses I fully agree with this! We also all come up with different ideas and approaches #WeLDNs
@WeLDnurses
19 October 2021 21:01
For those of you who have been in touch with pain specialists, how was it? What made it difficult? #WeLDNs
@ross_6479_RNLD
19 October 2021 21:01
RT @WeLDnurses: For those of you who have been in touch with pain specialists, how was it? What made it difficult? #WeLDNs
@drliberty
19 October 2021 21:01
@WeLDnurses Not specialist pain per se but have linked in with palliative care to look at wound care from self injury that kept opening - very interesting work around local anaesthetic #weldns
@salsa442
19 October 2021 21:03
Working in the acute setting makes it much easier to access specialist services like the pain team. I’ve found them very approachable and supportive, pain management is their bread and butter and they have so much knowledge and ways to adapt to meet individual need #WeLDNs https://twitter.com/weldnurses/status/1450552629889748995
@WeLDnurses
19 October 2021 21:03
@salsa442 Jumping ahead of me ;) saving the good for next :) #WeLDNs
@HannahBBloor
19 October 2021 21:04
@WeLDnurses https://aldhc.keele.ac.uk/wttk/ Making a difference toolkit is still a fantastic aid to help communiate needs of someone with LD when accessing acute services. There is a link to the PicTalk app at the bottom of this page to download also ?? #WeLDNs
@ross_6479_RNLD
19 October 2021 21:05
@WeLDnurses I have someone I work with who hates having physical obs done, will get verbally aggressive if people try, has acute infection and it can be a struggle to get support as people have been reluctant to assess or treat because they see them as challenging #weldns
@salsa442
19 October 2021 21:05
@WeLDnurses Whoops ????? I’m just trying to stay focussed on the positives clearly! And in truth I’ve not had any negatives from that team #WeLDNs
@florenceella
19 October 2021 21:05
@salsa442 I’ve had similar experiences Sal! Again I find collaboration key here - sharing communication needs and letting them do the rest! They are the experts after all #WeLDNs
@Shaun_LDNurse
19 October 2021 21:05
@WeLDnurses … [one measure amongst many] much more effectively written documentation and records; and insisting that staff actually read the documentation and records closely. ^ it always astonishes me how plans and like once written are often never referred to again. #WeLDNs
@salsa442
19 October 2021 21:06
@florenceella Exactly that, we’re just there to facilitate and as you say support with communication #WeLDNs
@WeLDnurses
19 October 2021 21:06
You know what Sally is right, lets celebrate too! Whats the great stuff that you have done also?! #WeLDNs https://twitter.com/salsa442/status/1450553633280507907
@salsa442
19 October 2021 21:07
RT @WeLDnurses: You know what Sally is right, lets celebrate too! Whats the great stuff that you have done also?! #WeLDNs
@NicBraid
19 October 2021 21:07
@WeLDnurses My experience has involved professionals seeking input and providing information, I can’t help wonder about how easy it would be for a person with a learning disability to contact and navigate the service #weldns
@WeLDnurses
19 October 2021 21:07
@Shaun_LDNurse Or even acknowledged... #WeLDNs
@salsa442
19 October 2021 21:08
@NicBraid @WeLDnurses I think this supports the need for sustained commitment to the acute liaison service, navigating through all the health systems can be really complicated #WeLDNs
@florenceella
19 October 2021 21:09
RT @salsa442: @florenceella Exactly that, we’re just there to facilitate and as you say support with communication #WeLDNs
@florenceella
19 October 2021 21:09
@NicBraid @WeLDnurses This is a great point #WeLDNs
@WeLDnurses
19 October 2021 21:10
Managing pain is complex, but can be more so for people with learning disabilities why do we think this is? #WeLDNs
@NicBraid
19 October 2021 21:10
@salsa442 @WeLDnurses Of course, are acute liaison nurses in your area involved in clinic appointments for those that are not admitted? #WeLDNs
@ross_6479_RNLD
19 October 2021 21:10
RT @WeLDnurses: Managing pain is complex, but can be more so for people with learning disabilities why do we think this is? #WeLDNs
@Shaun_LDNurse
19 October 2021 21:10
@WeLDnurses Definitely, but I just stress that shouldn’t absolve practitioners from writing robust, informative, and useful care proposals or plans. #WeLDNs ^ pain profiles and PBS plans can often be poorly composed, rendering them meaningless. ??
@salsa442
19 October 2021 21:11
@NicBraid @WeLDnurses If I’m honest I’d say this is patchy, for people who are known to services it’s more likely, but our LD team seem to be spread very thin at the moment - I’m hoping that’s going to change though #WeLDNs
@1985Deanne
19 October 2021 21:12
@WeLDnurses From my experience as a parent my girl sometimes dosent understand or can't explain exactly where the pain is or what it feels like. Her wrist just felt funny when it was broken and when she was really poorly she was hysterical and couldn't communicate well at all #WeLDNs
@Shaun_LDNurse
19 October 2021 21:12
@WeLDnurses I’ll stick my head above the parapet here: the prejudices and misconceptions of our colleagues in mainstream services at times. #WeLDNs
@WeLDnurses
19 October 2021 21:13
@1985Deanne And how did you get people to understand this was why if we can ask that! #WeLDNs
@NicBraid
19 October 2021 21:13
@salsa442 @WeLDnurses Fingers crossed! Unfortunately we all know that LDNs are not involved in everything that we would like to be, and that would make a difference to the people we support, enphasises the importance of education for others #WeLDNs
@WeLDnurses
19 October 2021 21:13
And within our own? Folk just being 'at it'? #WeLDNs https://twitter.com/Shaun_LDNurse/status/1450555551126073347
@florenceella
19 October 2021 21:13
@WeLDnurses Communication barriers, misunderstanding, assumptions, different presentation #WeLDNs
@drliberty
19 October 2021 21:14
@WeLDnurses Poly pharmacy issues, sensory processing difficulties, lack of insight into pain management from primary care and lack of feedback from knowledgeable staff #weldns
@WeLDnurses
19 October 2021 21:14
RT @florenceella: @WeLDnurses Communication barriers, misunderstanding, assumptions, different presentation #WeLDNs
@rsheridan2390
19 October 2021 21:14
@WeLDnurses It can be the classic communication barrier with the person not be able to describe the type of pain they are feeling for them to be able to get the optimum treatment #WeLDNs
@salsa442
19 October 2021 21:14
Ability to communicate pain -how bad it is,where it is, how long has it been hurting etc are all really tricky for many people with LD,we need to be really aware of subtle changes & use the assessment tools carefully in conjunction with someone who knows the person well #WeLDNs https://twitter.com/weldnurses/status/1450554869044158468
@Shaun_LDNurse
19 October 2021 21:15
@WeLDnurses * there’s that as well, #WeLDNs, also; and highlights the fact that we within learning disability services need to also “raise our game” on this issue (and many others).
@florenceella
19 October 2021 21:15
@NicBraid @salsa442 @WeLDnurses Oh gosh it would be so great if an LD nurse could be present at all clinic appointments/ pre-op appointments! #WeLDNs
@ross_6479_RNLD
19 October 2021 21:15
@WeLDnurses I know there are complexities in communication but i think it’s from two ways, the difficulty someone has in explaining how they are feeling and the difficulty the other side has in being able to listen or interpret, this in itself can become a barrier #weldns
@WeLDnurses
19 October 2021 21:16
RT @Shaun_LDNurse: @WeLDnurses * there’s that as well, #WeLDNs, also; and highlights the fact that we within learning disability services n…
@salsa442
19 October 2021 21:16
@Shaun_LDNurse @WeLDnurses How are we as LDNs challenging this? #WeLDNs
@everhopeful1000
19 October 2021 21:16
@WeLDnurses For autustic individuals difficulties with interoception can cause issues with identifying pain #WeLDNs
@WeLDnurses
19 October 2021 21:16
RT @everhopeful1000: @WeLDnurses For autustic individuals difficulties with interoception can cause issues with identifying pain #WeLDNs
@paularich1977
19 October 2021 21:16
@salsa442 “Someone who knows the person well” that is so key to managing pain… how often do people get supported to hospital/GP appointments by staff that don’t know them? #WeLDNs
@florenceella
19 October 2021 21:17
@ross_6479_RNLD @WeLDnurses 100%!! And allowing the time to listen, understand, interpret and then act appropriately #WeLDNs
@salsa442
19 October 2021 21:17
@florenceella @NicBraid @WeLDnurses Wouldn’t it just, it’s such a fundamental part of acute liaison role #WeLDNs
@florenceella
19 October 2021 21:17
RT @salsa442: @florenceella @NicBraid @WeLDnurses Wouldn’t it just, it’s such a fundamental part of acute liaison role #WeLDNs
@raig2505
19 October 2021 21:17
I’d need to be cloned several times but would love this ?? #WeLDNs https://twitter.com/florenceella/status/1450556325159657475
@salsa442
19 October 2021 21:17
@paularich1977 Probably too often #WeLDNs
@1985Deanne
19 October 2021 21:17
@WeLDnurses It's really hard actually as people don't listen or understand sometimes. That she really struggles to communicate when unwell and because of her long term conditions things feel different to her anyway.There's always the temptation to blame her disability as well. #WeLDNs
@WeLDnurses
19 October 2021 21:17
If we could extend our funding for these roles, would this be a good use of money? #WeLDNs https://twitter.com/salsa442/status/1450556620380033024
@WeLDnurses
19 October 2021 21:18
So, If you could share one piece of advice for supporting good pain management tonight, what would it be. #WeLDNs
@NicBraid
19 October 2021 21:18
@florenceella @salsa442 @WeLDnurses If only… not everyone with a learning disability is known to services to even begin to try to support this #WeLDNs
@paularich1977
19 October 2021 21:19
RT @WeLDnurses: So, If you could share one piece of advice for supporting good pain management tonight, what would it be. #WeLDNs
@ross_6479_RNLD
19 October 2021 21:19
@WeLDnurses Any funding spent on enhancing our patient experience or improving access to services would be very welcomed by me :) #weldns
@ross_6479_RNLD
19 October 2021 21:19
RT @WeLDnurses: So, If you could share one piece of advice for supporting good pain management tonight, what would it be. #WeLDNs
@steve_grimbleby
19 October 2021 21:19
@1985Deanne @WeLDnurses This where asking the parents / relatives and reading the hospital passport is vital #WeLDNs
@salsa442
19 October 2021 21:19
@WeLDnurses Well I think so yes, can be instrumental in facilitating a quality appointment,starting MCA discussions where needed, introduce Reasonable Adjustments and how to achieve them, translate any medical jargon, supporting development of pt/consultant relationship #WeLDNs
@1985Deanne
19 October 2021 21:20
@WeLDnurses When it works well Dr's & Nurse's listen to me as her mum when I say something Is really wrong. It was horrific when she was self harming because she was in so much pain and all they kept saying was did she have challenging behaviour. She was very unwell. #WeLDNs
@NicBraid
19 October 2021 21:20
@florenceella @ross_6479_RNLD @WeLDnurses YES! Thinking about the changes that have come about in accessing healthcare recently and the additional challenges that those being #WeLDNs
@drliberty
19 October 2021 21:21
@WeLDnurses Be curious and look beyond what you can see and what you expect to find - see the individual #weldns
@raig2505
19 October 2021 21:21
Just because someone might not be able to express pain the same way as you it doesn’t mean they’re not in pain, don’t dismiss it because it’s not explicitly communicated #WeLDNs https://twitter.com/WeLDnurses/status/1450557018826227712
@martsjourney
19 October 2021 21:21
@WeLDnurses Sorry I am very late #WeLDNs
@WeLDnurses
19 October 2021 21:21
RT @steve_grimbleby: @1985Deanne @WeLDnurses This where asking the parents / relatives and reading the hospital passport is vital #WeLDNs
@salsa442
19 October 2021 21:21
Use all your nursing skills, assess, listen to people who know the person, know how to refer to specialist pain management teams, plan carefully, be aware of side effects from analgesia and how to manage them and regular reviews of analgesia #WeLDNs https://twitter.com/WeLDnurses/status/1450557018826227712
@WeLDnurses
19 October 2021 21:22
@martsjourney Youve got time to catch up! #WeLDNs
@salsa442
19 October 2021 21:23
@1985Deanne @WeLDnurses That must have been so difficult for you, we all need to get better at recognising experts by experience #WeLDNs
@WeLDnurses
19 October 2021 21:23
This is true of all folks! #WeLDNs https://twitter.com/drliberty/status/1450557798371233800
@florenceella
19 October 2021 21:23
@NicBraid @salsa442 @WeLDnurses This is very true #WeLDNs
@salsa442
19 October 2021 21:23
@martsjourney @WeLDnurses But you’re here now and that’s what matters #WeLDNs
@steve_grimbleby
19 October 2021 21:24
@1985Deanne @WeLDnurses Sorry to hear this. We must improve our care of patients with learning disabilities who are in pain #WeLDNs
@raig2505
19 October 2021 21:24
@salsa442 Yep, advanced health assessment course really helped me further develop this, feel it’s made me think even more holistically. And now 4 weeks into my prescribing course so lots to learn and take away #WeLDNs
@WeLDnurses
19 October 2021 21:25
Heavens to Betsy! As always time has gotten away from as and we just have five more minutes left #WeLDNs
@salsa442
19 October 2021 21:25
@raig2505 I loved the advanced health Ax course too, massively improved my clinical confidence in assessing people #WeLDNs
@ross_6479_RNLD
19 October 2021 21:25
@WeLDnurses Listen, observe and be open to all different ways of finding out about how someone is feeling and how we can help #weldns
@ross_6479_RNLD
19 October 2021 21:25
RT @WeLDnurses: Heavens to Betsy! As always time has gotten away from as and we just have five more minutes left #WeLDNs
@WeLDnurses
19 October 2021 21:26
Tonight we have talked about communication, professional behaviours, the role of listening to people and the people who love them #WeLDNs
@martsjourney
19 October 2021 21:26
@WeLDnurses It always comes back to being person centred and having a plan with flexibility built in. Supporting an individual with a plan that can be adapted and include primary health care #communication #WeLDNs
@drliberty
19 October 2021 21:26
@raig2505 @salsa442 Prescribing qualifications is such a bonus to challenge poor prescribing and lack of pain management #weldns
@WeLDnurses
19 October 2021 21:26
What are you going to do tomorrow? Or the next day or the one after that to help better manage pain? #WeLDNs
@martsjourney
19 October 2021 21:26
@salsa442 @WeLDnurses Ahhh indeed ?? evening all #WeLDNs
@1985Deanne
19 October 2021 21:26
@salsa442 @WeLDnurses It was horrible but part of my reason for sharing is I'm quite skilled and not afraid to challenge and insisted she was admitted and second opinion was sort as I knew she was very unwell. She has a blockage in her bowel. So thankful I refused to take her home #WeLDNs
@NicBraid
19 October 2021 21:27
@WeLDnurses One size does not fit all with regards to assessment and management #WeLDNs
@ross_6479_RNLD
19 October 2021 21:27
@drliberty @raig2505 @salsa442 It makes such a difference for sure, even just from having a greater understanding of the role of meds and how they work (or for me anyway!) #weldns
@WeLDnurses
19 October 2021 21:27
@1985Deanne @salsa442 Its just a shame we have to have people who can navigate that! #WeLDNs
@salsa442
19 October 2021 21:28
@1985Deanne @WeLDnurses I’m m so thankful you were able to make that challenge and ensure your daughter was admitted to the right place at the right time, it’s so important you keep sharing this story, it makes us nurses better #WeLDNs
@ross_6479_RNLD
19 October 2021 21:28
RT @WeLDnurses: What are you going to do tomorrow? Or the next day or the one after that to help better manage pain? #WeLDNs
@1985Deanne
19 October 2021 21:28
@steve_grimbleby @WeLDnurses We really must and training and also a big think for me is recognising people sensory, communication difficulties and reactions are very much hightned when not well. There not been challenging #WeLDNs
@WeLDnurses
19 October 2021 21:28
RT @NicBraid: @WeLDnurses One size does not fit all with regards to assessment and management #WeLDNs
@florenceella
19 October 2021 21:28
@WeLDnurses I want to contact our specialist pain team to chat more about LD and how we can improve our service #WeLDNs
@ross_6479_RNLD
19 October 2021 21:29
RT @florenceella: @WeLDnurses I want to contact our specialist pain team to chat more about LD and how we can improve our service #WeLDNs
@WeLDnurses
19 October 2021 21:29
RT @florenceella: @WeLDnurses I want to contact our specialist pain team to chat more about LD and how we can improve our service #WeLDNs
@salsa442
19 October 2021 21:29
I’m going to listen, observe, assess and support. And now I’ve got a date with a hot tub! Thanks for a fab chat @samabdulla - back to the staycation vibe here now! #WeLDNs https://twitter.com/weldnurses/status/1450559059569033226




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