What is patient specialling and how can you excel at it?

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Finding yourself in hospital can be a distressing and often frightening experience for patients. Despite the reassurance of a family, friends and a medical team there are those with more particular needs, such as those suffering from memory problems, who will be confused and disorientated during their stay.

To manage potential risks to the patient and reduce any possible distress, the decision is sometimes taken to introduce 1:1 care or patient specialling into the patient’s care plan.

Patients can need specialling care for a variety of different reasons. They might be at high risk of falls, suffer from memory related issues or need more specific daily support.

Patient specialling means keeping the patient in sight at all times of the day and night. As well as carefully monitoring activity and health it also provides the opportunity to better understand the patient and really give patient-centred care.

So what do you need to know before a patient specialling shift?

  • Make sure to get a thorough handover from the nurse in charge on the ward
  • Gain a full understanding of why patient specialling has been implemented in the care plan
  • Read the patients notes, taking care for understand the day of admission as well as the most recent days to fully understand the patient’s experience so far
  • Speak to the previous 1:1 carer to gain an insight into how the patient has been during their shift
  • Clarify when breaks will be to ensure appropriate cover. A 1:1 patient should never be left without care

What should a patient specialling shift involve?

After ensuring you fully understand the patient’s needs, state of mind and best communication method you should then introduce yourself to the patient. Take the time to tell them your name, and how long you will be there. For those who are non-verbal, look out for the signs they may use for communication. Family, friends and the previous carer may be able to help with this.

You will need to talk to the patient and reassure them about what is happening throughout the day or night. You shift may also involve:

  • Speaking to any parents, carers or family members who might be there and answering any questions they have
  • Liaising with other staff to ensure the patient attends any appointments they need to
  • Understand any medications or tasks the patient needs to take or complete during your shift and support them with these
  • Ensure you have a good understanding of the patient’s routine and preferences (from food, to naps, to bathing and dressing)
  • Supporting their mobility when required
  • Assist with personal hygiene needs
  • Note any concerns from the patient or their family
  • Meet the cultural and spiritual needs of the patient.

What should handover at the end of the shift involve?

You must wait until the person taking over care of the patient has arrived. Never leave the patient unattended.

When handing over to the new carer share with them how the shift has been and the condition of the patient. If you have any details of activities, distraction techniques or things you have learnt about the patient during the course of your shift, it is worth sharing these.

Ensure you have written full and detailed notes of the how the patient has been during your shift in the care plan. If you are an unregistered nurse, your entry must have been countersigned by registered nurse.

Specialling can be very satisfying and rewarding and, when done well, can enormously benefit agitated patients.

Have you completed a 1:1 care shift? What would your top tips for this be? Let us know in the comments below.

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