Nurse of the year is a star of pain relief Sarah Lewis’s work with servicemen and women has earned her our top award. Lynne Pearce reports
Sarah Lewis: ‘Winning is the icing on the cake’
Headley Court in Epsom, Surrey. Although she has been in post only since August 2012, her work has already made such an impact that she has been named Nursing Standard’s nurse of the year. ‘Just being nominated is an immense honour for me,’ says Ms Lewis, who also won the defence nursing category. ‘That my work and the results I have had so far have been noticed is extremely touching, especially as I was put forward for an award by my line manager. Winning is the icing on the cake.’ Ms Lewis’s nursing career began in the Royal Navy. ‘My mum was a nurse who managed care homes, so nursing is in the blood,’ she says. After qualifying in 1993, she became a leading nurse on a male surgical ward at the Royal Naval Hospital at Stonehouse in Plymouth. Three years later, she left the navy to concentrate on bringing up her children. On her return to nursing, she worked in hospices in Manchester,
SUMMARY
Rehabilitation is vital for servicemen and women who have complex injuries, with pain relief often crucial to its success. ‘It is a juggling act,’ says Sarah Lewis, clinical nurse specialist in pain management at the Defence Medical Rehabilitation Centre at
22 month 00 :: vol 00 no 00 :: 2014
Southampton and Portsmouth, with a spell as a Marie Curie community night nurse. But Ms Lewis found that working nights disrupted her family life, so in 2002 she jumped at the chance to join the department of pain medicine at Portsmouth Hospitals NHS Trust. Initially appointed as a part-time research nurse, a few months later she moved to a staff nurse position, eventually becoming clinical nurse specialist and nurse manager in 2010. It was one of the consultants she worked with who spotted the advertisement for the post at Headley Court and asked whether she had seen it. A visit to the centre confirmed that this was a place where she could thrive. ‘I remember thinking you could just drop me here right now and leave me, because this is where I am supposed to be.’ There had never been a dedicated nurse-led pain service at Headley Court before. ‘At first there was resistance, with some saying: “What do we need a pain nurse for?” But I have proved my worth – through general interference! – and become accepted,’ Ms Lewis says.
Sarah Lewis, a clinical nurse specialist in pain management, is Nursing Standard’s nurse of the year. The prestigious award recognises her innovative work with injured servicemen and women, creating bespoke pain management plans that put patients in control. Author Lynne Pearce is a freelance journalist
NURSING STANDARD
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Before her arrival at Headley Court, little time was given to assessing patients’ pain and the approach to relieving it was often unco-ordinated. ‘It was all a bit hotchpotch, with people doing different things,’ she says. She began by assessing what already happened and how she might begin to complement it and bring cohesion. Among her initial discoveries was a pain pathway, but the document was 280 pages long, which limited its usefulness. Today it has been replaced with 40 user-friendly pages. Patients who have been identified by clinicians as having issues with pain are now sent to Ms Lewis for a thorough assessment. This results in a
three months after their arrival. ‘This has a big impact and their families see it too,’ she says. Alongside cognitive impairment, some pain medication can also adversely affect sexual functioning. ‘It is something I ask about,’ says Ms Lewis. ‘It is important. These young men may already have to live with the trauma of losing a limb and to not be able to perform sexually feels like something else that has been taken away from them.’ Medication can also be problematic for those who are living with chronic pain. ‘In these cases pain can be particularly complex, with many different neurotransmitters involved,’ explains Ms Lewis.
bespoke management plan and a medication review. The pain service also provides psychological interventions, such as mindfulness and cognitive behavioural therapy. ‘Pain management is a team event and everyone plays their part,’ says Ms Lewis, who can see up to 40 new patients each month. ‘I see my role as the chocolate in the marble cake. I am there to bring it all together.’
Heavy medication
Patients present with a variety of injuries, from spinal problems or sports-related musculoskeletal disorders to conflict trauma. ‘Most come to Headley Court six to eight weeks after their injury and may still be receiving treatment four years later,’ says Ms Lewis. She says patients often arrive heavily medicated to manage their pain. Unfortunately, some medication severely affects cognitive function, dulling the patients’ senses and making rehabilitation harder. Whenever possible, Ms Lewis reduces patients’ medication by up to 50 per cent, about
NURSING STANDARD
‘If you try to block them all, the patient could end up a zombie.’ Instead, she uses a variety of alternative approaches, tailored to each patient’s needs. ‘I have got the box of tools and I assess what they need.’ The results have been so impressive that her suggestion that Headley Court becomes a pain centre for the forces is being seriously considered. But it is the individual stories that often mean the most to her. ‘I had one patient who said that before his accident, he had been a bronzed Adonis looking forward to strutting his stuff through the summer. Then he was severely injured and told me he felt like a piece of rubbish. ‘We improved his pain relief, and it has been like switching the light back on. He is not out of the woods just yet, but he is making eye contact now and the smile is back. ‘When you see patients who have been in severe pain, walking around, smiling and with a completely different demeanour about them, that is so rewarding. That is why I love my job’ NS
MARK HAKANSSON
I AM THE CHOCOLATE IN THE MARBLE CAKE. I AM THERE TO BRING IT ALL TOGETHER
Digital subscribers can watch a video of Sarah’s work on their page-turner edition may 14 :: vol 28 no 37 :: 2014 23
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Sarah Lewis: ‘Winning is the icing on the cake’
Headley Court in Epsom, Surrey. Although she has been in post only since August 2012, her work has already made such an impact that she has been named Nursing Standard’s nurse of the year. ‘Just being nominated is an immense honour for me,’ says Ms Lewis, who also won the defence nursing category. ‘That my work and the results I have had so far have been noticed is extremely touching, especially as I was put forward for an award by my line manager. Winning is the icing on the cake.’ Ms Lewis’s nursing career began in the Royal Navy. ‘My mum was a nurse who managed care homes, so nursing is in the blood,’ she says. After qualifying in 1993, she became a leading nurse on a male surgical ward at the Royal Naval Hospital at Stonehouse in Plymouth. Three years later, she left the navy to concentrate on bringing up her children. On her return to nursing, she worked in hospices in Manchester,
SUMMARY
Rehabilitation is vital for servicemen and women who have complex injuries, with pain relief often crucial to its success. ‘It is a juggling act,’ says Sarah Lewis, clinical nurse specialist in pain management at the Defence Medical Rehabilitation Centre at
22 month 00 :: vol 00 no 00 :: 2014
Southampton and Portsmouth, with a spell as a Marie Curie community night nurse. But Ms Lewis found that working nights disrupted her family life, so in 2002 she jumped at the chance to join the department of pain medicine at Portsmouth Hospitals NHS Trust. Initially appointed as a part-time research nurse, a few months later she moved to a staff nurse position, eventually becoming clinical nurse specialist and nurse manager in 2010. It was one of the consultants she worked with who spotted the advertisement for the post at Headley Court and asked whether she had seen it. A visit to the centre confirmed that this was a place where she could thrive. ‘I remember thinking you could just drop me here right now and leave me, because this is where I am supposed to be.’ There had never been a dedicated nurse-led pain service at Headley Court before. ‘At first there was resistance, with some saying: “What do we need a pain nurse for?” But I have proved my worth – through general interference! – and become accepted,’ Ms Lewis says.
Sarah Lewis, a clinical nurse specialist in pain management, is Nursing Standard’s nurse of the year. The prestigious award recognises her innovative work with injured servicemen and women, creating bespoke pain management plans that put patients in control. Author Lynne Pearce is a freelance journalist
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 14, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
Before her arrival at Headley Court, little time was given to assessing patients’ pain and the approach to relieving it was often unco-ordinated. ‘It was all a bit hotchpotch, with people doing different things,’ she says. She began by assessing what already happened and how she might begin to complement it and bring cohesion. Among her initial discoveries was a pain pathway, but the document was 280 pages long, which limited its usefulness. Today it has been replaced with 40 user-friendly pages. Patients who have been identified by clinicians as having issues with pain are now sent to Ms Lewis for a thorough assessment. This results in a
three months after their arrival. ‘This has a big impact and their families see it too,’ she says. Alongside cognitive impairment, some pain medication can also adversely affect sexual functioning. ‘It is something I ask about,’ says Ms Lewis. ‘It is important. These young men may already have to live with the trauma of losing a limb and to not be able to perform sexually feels like something else that has been taken away from them.’ Medication can also be problematic for those who are living with chronic pain. ‘In these cases pain can be particularly complex, with many different neurotransmitters involved,’ explains Ms Lewis.
bespoke management plan and a medication review. The pain service also provides psychological interventions, such as mindfulness and cognitive behavioural therapy. ‘Pain management is a team event and everyone plays their part,’ says Ms Lewis, who can see up to 40 new patients each month. ‘I see my role as the chocolate in the marble cake. I am there to bring it all together.’
Heavy medication
Patients present with a variety of injuries, from spinal problems or sports-related musculoskeletal disorders to conflict trauma. ‘Most come to Headley Court six to eight weeks after their injury and may still be receiving treatment four years later,’ says Ms Lewis. She says patients often arrive heavily medicated to manage their pain. Unfortunately, some medication severely affects cognitive function, dulling the patients’ senses and making rehabilitation harder. Whenever possible, Ms Lewis reduces patients’ medication by up to 50 per cent, about
NURSING STANDARD
‘If you try to block them all, the patient could end up a zombie.’ Instead, she uses a variety of alternative approaches, tailored to each patient’s needs. ‘I have got the box of tools and I assess what they need.’ The results have been so impressive that her suggestion that Headley Court becomes a pain centre for the forces is being seriously considered. But it is the individual stories that often mean the most to her. ‘I had one patient who said that before his accident, he had been a bronzed Adonis looking forward to strutting his stuff through the summer. Then he was severely injured and told me he felt like a piece of rubbish. ‘We improved his pain relief, and it has been like switching the light back on. He is not out of the woods just yet, but he is making eye contact now and the smile is back. ‘When you see patients who have been in severe pain, walking around, smiling and with a completely different demeanour about them, that is so rewarding. That is why I love my job’ NS
MARK HAKANSSON
I AM THE CHOCOLATE IN THE MARBLE CAKE. I AM THERE TO BRING IT ALL TOGETHER
Digital subscribers can watch a video of Sarah’s work on their page-turner edition may 14 :: vol 28 no 37 :: 2014 23
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 14, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
