My role as CGD Adult Clinical Nurse Specialist for chronic granulomatous disorder (CGD) brings a fresh set of challenges each day. Contact with patients can include just a quick chat and catch up on the phone, provision of a listening ear or help in resolving clinical problems. An important question concerning any problem is ‘How fast does this need action?’ I use a simple Traffic Light Category system: red status requires urgent action (within 2-3 hours); amber needs immediate action (within 24 hours); green status is routine action (within 5 working days.)
I make a full clinical nursing assessment of a problem to decide the status. When I received a phone call from a patient reporting a pussy and bloody discharge from each ear, I asked the patient how the problem started, how long it had been going on and what were the signs and symptoms. The problem was ‘red status’ - requiring urgent action.
Using the patient’s CGD file, I checked his medical history before contacting Dr Ronnie Chee, the lead adult CGD consultant immunologist. We agreed a management treatment plan, requiring the patient to attend their local hospital urgently for a neurological assessment and CT scan of the head. I found the patient’s nearest hospital and confirmed the patient could go to ‘A and E’ immediately.
‘A and E’ departments have frequent delays and long waits. I am also aware of the lack of CGD knowledge within the medical community. I didn’t want either to be a problem for my patient! I referred him directly to the A and E consultant; I explained the diagnosis and management of CGD and stressed the urgent need for the patient to be neurologically assessed and scanned. I made sure the medical team had a copy of the CGDRT’s ‘A Short Guide to CGD’. We agreed the patient should present to the A and E consultant. The consultant warned the Radiology department of the need for a CT Scan.
Next, I reassured the patient that prompt intervention was in hand and told him the arrangements. At A and E, the consultant was there to meet him and provide immediate assessment and diagnosis. Happily, an abscess was ruled out and antibiotic treatment began for a severe ear infection. In collaborating with Dr Chee and the A and E consultant, unnecessary delay was avoided.
So you can see how useful it is to use the simple Traffic Light Control system! It enables me to act as gatekeeper for the patient, directing care in response to the seriousness of the clinical problem.
IMPORTANT NOTE :
The information contained on this website is intended only as a guideline, not as a substitute for medical advice. Always consult your doctor if you or your child has any CGD symptoms or concerns.
© 2001-2007 The Chronic Granulomatous Disorder (CGD) Research Trust
Registered Charity No. 1003425 email:cgd@cgdrt.co.uk
The CGD Research Trust is a member of the Association of Medical Research Charities (AMRC), the Genetic Interest Group (GiG) and an associate member of the International Patient Organisation of Primary Immunodeficiencies (IPOPI)
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