Opthalmic Link Nurse

[Sweet]

Hey there!

Ok, after my teaching at work with foreign bodies in the eye, conjuntivitis and the removal of contact lenses (very important for unconscious patients), and getting some positive feedback, i have decided to take up their invitation to be an opthalmic link nurse. Hehe, what could this be? God knows, you tell me! We've never had one before so i guess i need to make a dam good job of it!! LOL!! Also, thanks John for adding my teaching to the home page, i did notice, just haven't mentioned it!

So last Friday after my check up at Moorfields, i dropped into 'A & E', where i am a little regular patient , and asked the senior nurse if she would mind me spending the day there to get some experience. She has very nicely told me to put it in writing and that she will sort out a day in the New Year! I'm very excited with this, because as most know this is an 'A & E' department specialising in eyes, so i'm hoping to learn loads to take back to work with me.

Now ... i need to sit down and think about what i am going to do with this new role, and indeed what other nurses would like me to teach them. To most of us here it is a normal thing to use lenses every day and think nothing of it, but a lot of people i work with have never come in contact with a lens before, (no joke intended there!). To me it is all rather odd, as it is fifteen years now since i started wearing one, and i've never had any problems putting anything in my eye! Was just wondering if any here have any input on this, and how i should manage teaching them.

Also, i now know my vision is 6/9 (-3 hehe SSHHHH! ) and i have said numerous times that our visual acuity chart needs to be redone. It is a chart on a door in a dark corridor without a light box and the patient is asked to stand six metres away. So to prove a point, i think i need to take the test tomorrow and see if i can get anywhere near 6/9, as at the minute i have to stand very near to it when listening to patients reading it!

I am hoping to email everyone in work soon and say the new role i have and ask what teaching etc they would like, and hopefully get things moving in the New Year. John any useful teaching i'll let you know! LOL!! Am hoping to get a board or some space soon to put some information up on eyes etc, and will be looking for some pictures, information and indeed a KC poster! I think it is about time that patients with KC in East London had some help, and so hopefully one will be put up at the Royal London hospital soon.

Ok, any help or ideas would be really appreciated, and thanks for listening!

Sweet X x X

[John Smith]

Hi Claire,

I'm interested in how you're advised to remove the contacts from an unconcious (or unco-operative? patient).

Are the nurses trained to tell the difference between the different sorts of corneal lenses - and are they/you issued with the little rubber suckers that I find I need to remove my scleral lens?

[Sweet]

Hehehe John!

Ok, before i frighten you all, no we aren't trained as nurses to remove lenses, or even to know what types of lenses there are. I'm not sure about hospitals specialising with eyes, as they may get teaching on this, but am aiming to find out on my day visit.

I'm going to teach only by what i know having worn these lenses for years, and am going to make this clear to those i am teaching. I'm not aiming to know everything here, but just enough so that we are able to remove lenses on unconscious patients before they go to ICU or theatre for example.

On unco-operative patients, as sad as it is, but i'm going to be saying to leave well alone! Intoxicated patients i think would be better to sober up and remove lenses themselves. Most of us have left them in for one night with no worries, indeed i did the same thing last Wednesday, so i am not concerned with this. Maybe giving them some saline drops will help until they can take them out themselves. I am more worried about those unconscious patients we send to different departments, including those who sometimes do not wake up for a long while.

On removing lenses it is slightly different to how we remove them ourselves, but have checked in with some optometrists (including Lynn who has been very helpful) on how they remove ours when we are first trying them! It is going to be slightly different as obviously unconscious patients are lying down, but then i think we have an advantage as they are less likely to fall on the floor!

On the different types of corneal lenses i don't honestly think it matters. the chances of finding someone with KC is relatively low, and then we would be more concerned with removing the lens not making sure what lens it was.

On sclerals i will be suggesting getting in touch with our opthalmology department for a sucker, although i seem to have acquired a little collection of these and will be putting them in the eye tray! This all goes with saying though if nurses indeed know what sclerals are! Having nursed here for over a year, i have yet to see anyone else with sclerals!!

I do have spare lenses though, so as i did last time i will be showing them and getting them to play with them, which is very helpful. So hopefully everyone will be very informed on lenses and how to remove them

[GarethB]

Sweet,

I am trying to get sorted witha Medic Alert bracelet which says I have KC. As I always have my lens stuff in my coat pocket (or my wifes bag if she is with me), having this put on the bracelet and instructions on using the sink plunger gizmo I have for removing lenses.

Was in casualty a few weeks back with a bad kidney infection. Getting fresh air at work and feedingt he ducks on the lake out side, it suddenly felt like I had been stabbed and breathing became really hard. I was in so much pain, my eyes were streaming making lens wear really uncomfortable. Got my lenses out very quickly and easily once in hospital. It was the nurses in A&E that said having a Medic Alert bracelet and instuctions for them would have been helpfull.

The plunger is just a case of opeing the ye lids slightly and gently dabbing on the plunger and hey presto there is a lens on the end.

Did nothing for the kidney pain, but at least it stopped the pain in my eyes of a lens floating around with so many tears.

Lookforward to hearing more on what you are going to teach.

Gareth

[Sweet]

Hehehe thanks!

Am going to write a letter as soon as i can to Moorfields and say what i would like to learn! Top of my plan is about a Morgan lens. Some here may not have heard of it, but it is kinda like a scleral lens which you attach to a giving set, enabling fluids to be passed onto the eye to flush it. (Very useful in emergency departments where an eye needs to be flushed with fluids). In the states they use it loads for foreign bodies, while in the UK it is mainly used for chemical eye injuries.

Most, (including myself until recently), have never seen one before, and so need some teaching on it. To me it makes perfect sense in how you need to insert it, as it is along the basic principle of a scleral lens. I think though that as most are very afraid of eyes and inserting lenses that it would be a very useful thing to teach along with removing lenses! Will let you know how it goes!!

Love Sweet X x X

[Andrew MacLean]

I was in hospital some years ago having a little job done on my Gall Bladder. I needed to have my lenses in so that I could do the cross word, but was trembling so much that I managed to miss my cornea.

I called a nurse and asked her to help me find the lens in my eye, and was a little surprised to find how much this freaked her. Still, give the nurse her due, she was both professional and caring enough to take out her little torch and tell me that the lens was at "five o'clock".

I prodded about and got my lens out before managing to put it in properly. The nurse and I spoke afterwards about what she had encountered as a gap in her training as a general nurse. She was delightful and genuinely interested in KC and the exoerience of lens wear. She was off to see someone to get a bit more professional help with a new area of her work

I know now that what she needed was an opthalmic link nurse. This was many years ago, and I don't imagine that there were too many of them around in those days.

Is this sort of appointment becoming very much more common in the NHS>

all the best with your new remit.

A

[Louise Pembroke]

Gareth, there are sites where you can fill in the form and print off credit card sized details for emergencies and get it lamenated.
I was thinking of getting a Medic Alert bracelet too and for the engraving to say 'Corneal transplants, lens RIGHT eye, Moorfields and my hospital number. That way, if I were unconscious, staff seeing that could just ring up Moorfields, access my notes and get advice about how to remove my lens.

[ChrisK]

HI Sweet,

Any more news?

[Sweet]

Hehe yea, have been following this thread but as it kinda went off topic have left it for a while!

I am planning to go to Moorfields and spend a day with their practice nurse next Tuesday! So if anyone is around then i'll see you there, but this time on the other side!!!!!!!!!!! Oohhh SPOOKY!!! LMAO!!!

I'm told they don't use a Morgan lens to flush eyes in case of chemical injuries etc but am invited to learn what they do use and they are going to go through what constitutes as an emergency to them and the paperwork they use. I'm getting really excited now!!!

Will let you know how it goes, but to any who are there Tuesday if you hear a little welsh nurse behind the desk, it is probably me!!!

Sweet X x X

[John Smith]

Best of luck for next Tuesday; please let us know how you get on.