Spinal Injury Nurses Association
Annual Spinal Injury Conference
17th Annual Spinal Injury Nurses Association Conference The 17th Annual Spinal Injury Nurses Association conference was held at the College of Nursing Burwood NSW. As in previous years the conference attracted a high standard of presenters with a broad range of experience providing care for clients with spinal injury.
On each of the two days 30 people plus speakers attended the conference. Participants travelled from overseas, (New Zealand- North and South Island), interstate (Northern Territory and Tasmania) and across NSW (Dubbo, Newcastle, Wollongong and Sydney).
Day 1 commenced with Neil MacKinnon, Manager, Service Coordination for the Life Time Care and Support Authority of NSW. Neil provided an overview of the scheme and information on how clients can access the scheme. The scheme provides lifelong treatment, rehabilitation and attendant care for people who have a spinal cord injury, a moderate to severe brain injury, multiple amputations and serious burns or blindness from a motor accident in NSW. The session generated a lively discussion regarding eligibility criteria and the assessment process for clients to enter the scheme.
Julia Shepherd, Community participation Coordinator, Community Participation Project followed on with a presentation on the outcomes of the evaluation of The Community Participation Project (CPP) which is a joint initiative between the MAA and DADHC that works to improve the community participation of people with a newly acquired Spinal Cord Injury (SCI). The Project involves a community participation coordinator working collaboratively with the injured person, their family and support networks. Initially plans are prepared encompassing a broad range of goals such as social, family, work and leisure. Planning begins usually when the person is still in the rehabilitation unit and continues once they are discharged to address short and long term issues. Central to this approach is support for family members. Most plans focus on hospital discharge and associated immediate needs. Considerable exploration of current systems is undertaken including housing, home modification, transport, personal care and other supports.
Marcus Stoodley, Associate Professor of Neurosurgery, University of New South Wales, Neurosurgeon, Prince of Wales Hospital & Sydney Children's Hospital, provided an excellent presentation on syringomyelia that was both informative and entertaining. He defined syringomyelia as any abnormal fluid filled, (cyst), cavity within the spinal cord which can occur from 3 months to 36 years following injury. The cause is unknown but it is thought to be something to do with the disturbance of CSF and can be associated with an array of conditions including spina bifida, disc protrusion, tumours and spinal trauma.
Steve Petrolati psychologist from the Drug and Alcohol Team in Wollongongpresented on Drug and Alcohol Issues. Steve asked us 'Why bother with D&A?' Post injury substance abuse can develop as a coping mechanism and can result in increased risk of medical complications, pressure areas, UTIs, depression, suicide, neglect of self care, re-injury, decreased life satisfaction, worse rehabilitation outcomes and seizures. Drug and alcohol use may be a life style issue. Steve stressed the importance of conducting a D&A assessment for pre and post injury use. He suggested using a motivational interviewing model and avoid confrontation and arguing with the client. Look at the pros and cons of alcohol use with the client. Ask them 'What are the good things about what you are doing right now? What do you like about your life style?' Explore the clients values and set goals from the values. Change takes time. Be prepared to take 'one step forward two steps back'.
Lyndall Katte, Physiotherapist with the Spinal Outreach Service presented on Respiratory Function after Spinal Cord Injury. Lyndall asked us to think about why we are concerned with respiratory issues. Respiratory issues are a major cause of mortality following spinal cord injury. The incidence of respiratory complications following SCI is also very high resulting huge costs to the health system. Lyndall discussed the importance of monitoring respiratory function, the effects of posture and seating and the importance of exercise. A reminder about the anatomy and physiology of respiration, lung function tests and treatment was also provided in the presentation.
Dr Andrew Chan and Dr Richard Lee from the Sleep Study Unit at Royal North Shore Hospital provided a comprehensive presentation on Sleep Aponea and Spinal Cord injury. Andrew and Richard provided information on the diagnosis of sleep apnoea, the treatment and management following diagnosis.
Lesley Brennan, Clinical Nurse Consultant and Alex Traill worked together to provide us with an informative talk on the benefits of 'Working Collaboratively'. Some of the benefits that they highlighted were early intervention, reduced hospitalisation, coordinated lifestyle/health issues, working on the community side and the physical side at the same time. Some of the things that they have achieved through working together are the Disability Care Service, Advocacy, Health Clinic, Spina Bifida Transitional Clinic, Pregnancy and Quadriplegia.
The afternoon finished with the SINA AGM followed by drinks and dinner at the Burwood RSL.
Day 2 Cathy Shorland Social Worker from the Spinal Outreach Service started the day with a presentation on Sexuality after Spinal Cord Injury. Sexuality is huge and complex and very individual. It is the central aspect of human life. Being supported through grief assists people to reconstruct their lives. Sexuality is a hidden loss that can impact on other aspects of life. Client readiness to discuss sexuality is individual. Introduce the topic and be willing to discuss sexuality with clients and significant others. Remember NO information conveys the wrong message.
Glen Stolzenhein, Clinical Nurse Consultant Prince of Wales Hospital, followed on with a presentation on Sexual Function. Glen reminded us that a lot of problems are the persons own perception of disability. Sexuality and sexual function issues can occur at any time post spinal cord injury. It can be some time up to 10 years post injury before people are ready to address issues of sexuality. Cathy and Glen reminded us that the information we provide on sexuality issues should be honest, relevant and factual and we should know when to refer on to other health professionals. Men tend to be overly concerned with erectile dysfunction while women are less focussed on their fertility potential post SCI.
John Hebblewhite provided an informative presentation on Freedom Across Australia which is a project of the Auburn Lidcombe Lions Club Inc. N.S.W. Freedom Across Australia was formed in December 1999 to continue and enhance a project commenced in 1988 at Ward 43 Lidcombe Hospital named ‘Travel 43′ to provide low cost holidays for Australians with severe disabilities. John encouraged us to dream dreams and think big and be persistent. John has taken many people with disabilities on trips around Australia with volunteer staff. Trips have included travelling to Gippsland, Northern territory, cruising the Murray River. The group completes three trips per year and volunteers are non clinical staff who share the learning experience with the participants.
Dr Julie Pryor presented on the research that she conducted on 'Anger Following Spinal Cord Injury'. Julie encouraged nurses to write and publish on rehabilitation and disability issues to inform undergraduate nurses on the subject. Anger following spinal cord injury is a significant issue as was demonstrated by the over recruitment of participants for the project. Twenty seven staff from one unit volunteered to be participants. Anger is a common experience following spinal cord injury. The two factors involved in contributing to the expression of anger include confronting the personal reality of spinal cord injury and the pre injury characteristics of the person confronting spinal cord injury. Almost anything can trigger an expression of anger, anything and everything, a compilation of things, the straw that broke the camels back. Staff found the expression of anger unacceptable. As health professionals we need to talk about appropriate ways of expressing anger.
Grant Nickel provided a presentation on Spinal Cord Injury and Psychosocial Barriers to Healthy Nutrition. Grant feels that a balanced diet is integral to maintaining health following spinal cord injury. He felt that there should be competencies involved in food preparation. It is a process to get fresh food, get it home and prepare it. It is a complex task. People with spinal cord injury/disability should do their own shopping to look at options and choices. They should go at least once a month. There are many factors that impact on following a healthy diet including healthy shopping and healthy food preparation. We need to consider the level of disability, do they live alone, what gender are they, what role do they play, do they receive food preparation assistance?
Charisse Turnbull, Occupational Therapist, Spinal Outreach Service, provided the final presentation titled Seating issues for Spinal Cord Injury. Seating is how you sit. We looked at seating anatomy and strategies for pressure relieving which include forward leaning and side to side leaning. Charisse provided demonstration of pressure cushions and pressure mapping.
The conference provided a great venue for sharing knowledge, learning new information and skills, gathering resources and networking over two days. We look forward to the 18th conference in 2008.