Using your voice to Get Loud for Legs! Because they matter…

Campaign week 12-16^th October. For patients and clinicians!

Have a look at https://legsmatter.org/legs-matter-week/lounge/ and put some of the events in your diary.

The Legs Matter Coalition has heard a mix of stories coming out of this ‘Covid Time’. Some good, some bad. Really good stories about how Tissue Viability Nurses have been impactful in their redeployment into community nursing. Also an increase in self-care – great, as long as people are given a supportive infrastructure.

So, the not so good? I heard that one clinical manager decided that at lockdown, compression bandaging was too much of a burden for nurses, so it was stopped – seen as non-essential. I would ask you, how is it possible for a clinical lead in community nursing to not understand the importance of compression? This led to an informal complaint but not to a Datix incident report describing the withdrawal of a therapy. Why would that be if not indicative of a culture of acceptance or an unwillingness to offend?

So the time is right to Get Loud for Legs! The tide is turning, albeit slowly, on recognising the harm that is happening across the country for those with leg ulcers or wet legs. Slowly voices are being heard. There is a groundswell of change happening with the assistance from the National Wound Care Strategy, Legs Matter and all other societies working in this field. Would you like to join in and use your voice for change?

This is how:

Firstly, believe that change is necessary and that absolutely is possible. At a minimum, 25% of the new patients you see this month will still be with you in 12 months’ time, unless you get them into effective compression. This is evidence based but even after 30 years, little understood. High compression is the trick, it works, it heals patients and reduces your activity. #simples. But understand that those not being assessed or given compression therapy should be seen as patient neglect, however caring the nurse.

Should not wet legs with daily crepe be seen as a clinical incident? We know enough to know this can be stopped. The world view challenge: look at pressure ulcers. When I was a District Nurse we saw craters down to the bone. We were horrified then, but the system springs into action more quickly now. What changed in the system for reporting or accountability to open our collective eyes, that we now understand that this should be prevented?

Secondly, challenge the language and decision making. Bring critique to the situation where a patient is being managed for weeks with only padding and crepe bandages; this is non-therapeutic care. What is the reason for this?  If they have been labelled as non-compliant, identify the relationship of this belief to hours of fruitless visits and their painful life. Who made that decision? Why can’t it be changed? Challenge yourself: partner up with this person, provide an action plan that involves building up the compression with confidence and see the change! This can create a ripple effect in the team, especially when they see the frequency of visits reducing.

Thirdly, read and explore. Take up the enormous number of free webinars on offer, follow the references and take up formal education in this field. Knowledge will give you the power to create change. You cannot ‘unsee’ harm or pointless ineffective care. Do not be a nurse who says to their patient, ‘I know this, I have been managing leg ulcers for years’. That is dangerous territory, especially as we know we have a UK-wide problem here. Listen and learn!

Bring your voice to service delivery.

Share the Lounge events with your team and patients. Tell them that all the patient information leaflets can be downloaded too. https://legsmatter.org/legs-matter-week/lounge/

Become a champion of Legs Matter!

Patients and clinicians need you to be part of this change!

Alison Hopkins
Chief Executive, Accelerate
E: alison.hopkins2@nhs.net