Spinal Injury Nurses Association

Overseas Spinal Nurses Visit

On 8 November a 'welcome dinner' was held at The College of Nursing, Burwood. The dinner was attended by the Patron and 25 friends and members of the Spinal Injuries Nurses Association, welcoming to Sydney, four spinal nurses. The College had generously sponsored the nurses in order for them to attend the 15^th Annual Conference to present their personal experiences of nursing patients with spinal injuries in their respective countries. The Conference itself was held over two days 10-11 November at the College.

The four nurses were Esther Daisy Joel, who is the department manager of the Rehabilitation institute , Vellore, South India; Rene Vincente E Espana ,who is head nurse, spinal/orthopedic ward at the Philippine General Hospital Manila; Misao Arimatsu, respiratory nurse therapist and Mihoko Nakamura team leader in pressure area management both from the Spinal Unit Fukuoka, Japan. Each of the nurses presented a 40 minute paper, which included a short introduction on hospital location, spinal/rehabilitation ward staffing and then the majority of their papers were on their specific nursing expertise and experiences with persons with spinal cord injury.

The papers were so very interesting and I am sure I speak for the Australian spinal nurses at the Conference that we should not grumble- we have it easy here. For example, our so-called problems with ongoing equipment issues for our patients, pale into insignificance when compared to patient equipment issues experienced by these nurses in their own countries.

From the nurses we learnt that road traffic accidents are the main cause of spinal cord injury in their countries. In India the next traumatic reason for spinal cord injury is from falling out of trees whilst collecting coconuts. Whilst in Manila 70% of spinal beds are taken by persons with Pott's disease, requiring spinal stabilistaion.

Both in Vellore and on the Manila unit when a patient is admitted to the rehabilitation ward, the ward also admits a carer. Usually female and a relative, this person provides all personal care whilst the patient is in the ward and then learns how to care for the person once they are at home if independence is not achieved. In Vellore this carer sleeps on a 'camp-cot' at the patient's hospital bedside and prepares all food for the patient, as the Hospital does not provide food; kitchens are available. One of the nurses at the Conference asked the question as to what would happen if the patient did not have a carer. This was seen as inconceivable by the Indian nurse, someone would always be available-such is the strong culture to care for their own.

In Fukuora in the acute spinal section alternate pressure air mattresses are not used, and are not available at all in Vellore or Manila, strict two hourly turns are routine. There are very low incidences of pressure area formation whilst persons are in-patient in the units. In Vellore and Manila there are no hoists, so all lifts, turns and transfers are undertaken by the relatives and staff using slide sheets. Eighty percent of spinal nurses working on the Manila unit are male.

An annual activity of the rehabilitation unit in Vellor is Mela. Every February over three days all discharged patients living within a 100 km radius return to the unit for "a program including medical check up, social activities, sports, self help groups and a chance to renew friendships". Multidisciplinary assessments, all tests, accommodation and food are provided free to all that come with their carers and /or families.

Snippets to share from our guests - the use of long thin plastic bags made for wet closed umbrellas, make excellent male urinary collection devices. A Foley latex/silicone catheter used for intermittent catheterisation lasts for months (the balloon never inflated). In Japan known as 'bird scrolls', graded party whistles whose paper uncurls when blown, used for testing expiratory function. The patient who when on long train journeys always sits on the sunny- side of the train so that he sweats heavily which then takes away the necessity of regularly catheterising. Two delightful mis-translations were the word 'gizzard' for 'stomach', and 'artificial anus bag' for 'colostomy bag'.

The delegates at our interactive Conference gained knowledge, insight and enjoyment from the overseas nurses. In turn, the four nurses will have benefited by mixing with us, swapping email addresses and listening to the other excellent Conference presentations. Apart from Conference participation, the overseas nurses visited the two Sydney spinal and rehabilitation units, also on their agendas was a visit to Spinal Injuries Australia Association, the Northcott foundation paediatric spinal outreach service and the Independent Living Centre at Parramatta. Time was also allocated for the obligatory holding of a koala, a City tour and a ferry trip on our beautiful harbor over to Manly. We hope that they take back to their respective countries knowledge and options to build upon, and happy memories all made possible by the initial sponsorship from The College and the good friends and members of the Spinal Injury Nurses Association who made them most welcome, and who showed them the sights and so generously billeted them here in Sydney .

Wendy Jannings
Publicity Officer, Spinal Injury Nurses Association