Fiona Saunders

Fiona Saunders

Retired Head of Continence Advisory Service, Nottinghamshire Healthcare NHS Foundation Trust and member of ACA Executive Committee.

Activity

  • Hi Marisa, thanks for you comments. If you are a member of the ACA you may be able to get a few upgrade to this course which would enable you to have access to the resources after the course is closed. Just wondered if you were aware of this and if it would help you. More information is on the ACA website www.aca.uk.com

  • Hi Claire, thanks for sharing this with us. It is really good to hear that you are reflecting on your practice and looking at treatment options.

  • Welcome to week 7, the final week of this course. Please complete the feedback survey at the end and tell us what you think about the course.

    We really don't have all the answers to bladder and bowel problems which are still often hidden. We need to continue to gain confidence to discuss and challenge, we don't want to loose the treatment versus containment...

  • Welcome to week 6, last week we looked at continence assessment, which is essential and fundamental to continence care. This week we are focusing on promotion and self management. We will be exploring and discussing some of the treatment options. Self management strategies can be very helpful with bladder / bowel problems. Please post your comments, Gill and I...

  • @TrishOreilly
    Hi Trish and Annette, please do what is best for you. Use your learning log or portfolio to assist and support you with your learning and reflection. You can use it as evidence for you continuing professional development. If you upgrade Understanding Continence, you will be able to continue to access this course after it has finished, there are...

  • Hi Trish, this is the reply I have had from FutureLearn:
    I have checked the links in week 1 step 1.4 and they all seem to be working fine. They link out to external portfolio tool options and then ask the learners to sign up or log in. Trish's browser may blocking her from accessing the websites. I do not believe this is anything to do with the FutureLearn...

  • @TrishOreilly Hi Trish, I have emailed FutureLearn to ask them to look at the links as they advised these portfolios. I hope they will reply soon.

  • Welcome to week 5 were we are going to focus on assessment. Assessment is essential and is the foundation of all continence care.

    We need to complete a thorough assessment to identify the underlying cause or causes and then to make a diagnosis, an accurate diagnosis is the key to a successful outcome.

    I hope you will enjoy this week and further your...

  • I agree with Josca, overactive bladder, especially OAB wet has a massive impact on quality of life and self esteem, it prevents people from wanting to go out as they are terrified they may wet themselves in front of other people.

  • Hi Kyoko, with OAB wet the size of the wet patch depends on how full the bladder is that the time of the unstable bladder contraction and how strong the contraction is, so it could be a lot, a bladder full, 400mls. For many people it will be less, as often their bladder's can small volumes, perhaps only 100mls. OAB wet is a very debilitating condition is the...

  • Hi Trish, sorry to hear you have had problems logging into you portfolio, which portfolio have you been using?

  • Hi Joe, there is a lot of information, especially in week 3, if you upgrade the course you will be able to continue to have access to this course run after it has had ended

  • I agree with you, a clear routine for toileting is will help to prevent problems.

  • I don't think Lasix would have helped Jean as she was in retention and the nerve supplying her bladder were not working effectively.
    Helping hydrated is definitely very important, often the one of the first things people do when they have a bladder problem is to reduce fluids which is likely to make their problem worse and increase the risk is a UTI as you...

  • If you are enjoying this course you may be interested in joining our E-conference on 24th and 25th May, please see the website for details www.aca.uk.com.
    Please take a look at the programme.

  • Welcome to week 4. We would really like to have some feedback from you all, we have added a poll at the beginning of this week, please tell us how the course is for you.

    This week the focus is on how our bowels function and what can go wrong. Bowel problems are rarely the subject of general conversation but they are more common than most people imagine. I...

  • Welcome to week 3, last week we focused on who the bladder works and now we will start looking at what happens when things go wrong and how this can affects individuals. As you will see there are many different causes of bladder dysfunction. I hope you enjoy this week. Please keep posting your comments and thoughts and share your learning.

  • Hi Sam, I hope you are able to consider making some changes. Perhaps some of you colleagues may be able to join this course also.

  • Hi Kyoko, stress incontinence and overactive bladder are different types of incontinence but individuals can and often do suffer from both these problems at the same time.

  • It has been good to meet you in week 1 and I am sure you will enjoy week 2. I find anatomy and physiology fascinating, it is so interesting seeing how systems develop and work. Understanding "the normal" is important, when we are trying to understand and explain symptoms and problems individuals experience, as we will do in later weeks. I am looking forward to...

  • Hi Sarah, great to have you join this course. We have a new run of this course which actually started on the 12th April, the new run will have new learners just starting, just wanted to let you know in case you would like to move across to the new run.

  • Hi Micini, we have a new run of this course which actually started on the 12th April, the new run will have new learners just starting, just wanted to let you know in case you would like to move across to the new run.
    Really great to have students joining and look forward to following you through the course.

  • Hello everyone and welcome to "Understanding Continence Promotion" course and thank you for joining. Gill and I am looking forward to the comments and discussions over the next 7 weeks. I am sure we will have an interesting mix of people with a wide range of experiences of continence issues, from both a personnel and professional perspective joining, and I...

  • Thank you for discussing this, we have an ACA Executive meeting next week and I hope we will have an opportunity to discuss this, other areas are having the same challenge with the present situation. Vaginal examination is key when assessing the pelvic floor power and teaching pelvic floor exercises. I found that feeling my own pelvic floor muscles helped me...

  • Hi Adrienne, thank you for sharing this us, it is great to here how you knowledge and understanding is developing. The role of the nervous system in bladder and bowel control is complex but like you say an understanding of this can really help when trying to work out what has gone wrong.

  • Hi Emily, thank you for sharing what you have learnt, like you I find the dementia detail fascinating and this knowledge is very valuable when completing assessments.

  • Welcome to week 7, the final week of this course. Please complete the feedback survey at the end and tell us what you think about the course.
    We really don't have all the answers to bladder and bowel problems which are still often hidden. We need to continue to gain confidence to discuss and challenge, we don't want to loose the treatment versus containment...

  • Welcome to week 6, last week we looked at continence assessment, which is essential and fundamental to continence care. This week we are focusing on promotion and self management. We will be exploring and discussing some of the treatment options. Self management strategies can be very helpful with bladder / bowel problems. Please post your comments, Gill and I...

  • Thank you for sharing this with us Jodi, I am sure you will gain confidence with making diagnosis and the skills you develop with vaginal examination will help with this.

  • Welcome to week 5 were we are going to focus on assessment.
    Assessment is essential and is the foundation of all continence care.
    We need to complete a thorough assessment to get the right diagnosis and identify what we can do to help the person recover bladder/bowel function.
    I hope you will enjoy this week and further your learning. We am looking forward...

  • Welcome to week 4. We would really like to have some feedback from you all, we have added a poll at the beginning of this week, please tell us how the course is for you.
    This week the focus is on how our bowels function and what can go wrong. Bowel problems are rarely the subject of general conversation but they are more common than most people imagine. I...

  • Hi Jodi, yes these symptoms are variable, individuals can experience overactive bladder at different levels of bladder filling, only 50mls or volumes of 250mls, if only small volumes the stream is likely to be poor. When individuals are experience "sudden urgency" and are "desperate" to void but can only pass a small amount, they often get the feeing that...

  • @GillDavey Thank you Gill and Gill, it is now updated.

  • Welcome to week 3, last week we focused on who the bladder works and now we will start looking at what happens when things go wrong and how this can affects individuals. As you will see there are many different causes of bladder dysfunction. I hope you enjoy this week. Please keep posting your comments and thoughts and share your learning.

  • It has been great to meet you in week 1 and to read your comments, please keep posting them. I am sure you will enjoy week 2. I find anatomy and physiology fascinating, it is so interesting seeing how systems develop and work. Understanding "the normal" is important, when we are trying to understand and explain symptoms and problems individuals experience, as...

  • Hi Nor, thank you for sharing this, it is great to hear that by understanding more about how the bladder and bowel functions you feel more confident as a continence nurse.

  • Hello everyone and welcome to "Understanding Continence Promotion" course and thank you for joining. Gill and I am looking forward to the comments and discussions over the next 7 weeks. I am sure we will have an interesting mix of people with a wide range of experiences of continence issues, from both a personnel and professional perspective joining, and I...

  • Hi Bridget, thank you for your feedback, I am pleased you have gained from doing this course. Are you aware that all members of the ACA can apply for a free upgrade which will give you on going unlimited access to the course, more details are on the home page of the Association of Continence Advise.
    Also can you help us? any ideas as to how we can advertise...

  • Thank you Alison for sharing your thoughts, I also feel that parents should take responsibility for potty training.

  • Hi Beate, thanks for telling us that the link in longer works, I hope this link will give you access: https://member.wocn.org/link.asp?ymlink=506943352

  • Hi Cristina, I have contacted a colleague in the ACA and she had suggested that the following information my help you:
    (athttps://www.ibdpassport.com/travelling-ibd/ibd-and-travel) that might help??

    Can't wait card for bathroom emergencies

    The European federation of Crohn’s and Colitis organisation (EFFCA)4 association website contains useful...

  • Hi Cristina, that is a really interesting question, I have just had a search on Google and the articles I have read are suggesting that if we squat at 35 degrees, this will create the best the anorectal angle (natural bend in the colon where it meets the rectum) to enable relaxation of the muscles and faeces to pass through with ease.
    This angle is more...

  • Hi Nor, I am pleased you are learning from this course, thank you for sharing this

  • Hi Keryn, men can do pelvic floor exercises, this is discussed in the week we look at treatments.

  • Hi Cristina, the website Emily refers to is:
    https://www.bladderandbowel.org/help-information/just-cant-wait-card/. I hope this helps.

  • Hi Neda, medications to help with bladder and bowel problems are discussed in week 6, I am not sure if you have reached that part of the course yet. Within the medication section there is a chart which I hope will provide the information you are looking for.

  • Hi Michelle, thank you adding this link, the article was easy to read and informative. I learnt several things from reading it, I was not aware how high the incidence of a stroke was with autonomic dysreflexia.

  • Hi Fiona, thank you for sharing the above, it is great to hear the news about one of your patient's.

  • The ACA is presently having discussions about moving the Conference on-line in view of the present situation with Covid. Please visit the website the keep up to date with this.

  • Thank you for your feedback Michelle, I am pleased you found the information useful and relevant.

  • Welcome to week 7, the final week of this course. Please complete the feedback survey at the end and tell us what you think about the course.
    We really don't have all the answers to bladder and bowel problems which are still often hidden. We need to continue to gain confidence to discuss and challenge, we don't want to loose the treatment versus containment...

  • Hi Charlotte, prevalence figures suggests that underactive bladder affects up to 45% of women (depending on the definitions) and the prevalence increases with age, increasing from the age of 70. The incidence men is lower.
    Underactive bladder is a common condition but is poorly understood and not well researched. I have attached a reference, i hope the link...

  • Hi Tracy, many people are troubled by bladder problems at night. Getting up several times at night needing to pass urine can affect the quality of sleep and cause tiredness in the daytime. Studies have shown that bed wetting in children causes sleep disturbances and can affect concentration in the daytime.

  • Welcome to week 6, last week we looked at continence assessment, which is essential and fundamental to continence care. This week we are focusing on promotion and self management. We will be exploring and discussing some of the treatment options. Self management strategies can be very helpful with bladder / bowel problems. Please post your comments, Gill and I...

  • Fiona Saunders made a comment

    Hi Charlotte,
    A loop diuretic such a furosemide may be prescribed in the daytime (often about 4pm) to help with nocturnal Polyuria – overproduction of urine at night. These work by increasing urine output during the day in order that your body doesn’t produce so much urine at night. I have seen this treatment work very effectively, it can significantly...

  • Fiona Saunders made a comment

    Hi Katie, thank you for your feedback and for the comments you have shared. I hope look forward to meeting some of you colleagues on the course.

  • Welcome to week 5 were we are going to focus on assessment.
    Assessment is essential and is the foundation of all continence care.
    We need to complete a thorough assessment to get the right diagnosis and identify what we can do to help the person recover bladder/bowel function.
    I hope you will enjoy this week and further your learning. I am looking forward...

  • Hello Eve, thank you for sharing the above, you will find that week 2 and 3 week focus more on bladder problems and causes and in week 4 we are looking at bowel problems and causes.

  • Hi Sheila, great to hear from you. Hope you have got back into the course.

  • Hi Claire, I have had a reply from FutureLearn, they suggest that you try to access week 4 by navigating to the 'To Do' section and click on week 4?
    If you are still having problems please post another message and they will investigate further.

  • Hi Claire, I am sorry to hear you have not had access to week 4 of the course, I am not sure why. Thanks for your message. I have sent an e mail to FutureLearn requesting them to investigate why. Hopefully this situation can re resolved very soon. Please post another message if you still have problems.

  • Welcome to week 4. We would really like to have some feedback from you all, we have added a poll at the beginning of this week, please give us feedback about how the course is for you.
    This week the focus is on how a person's bowels functions and what can go wrong. Bowel problems are rarely the subject of general conversation but they are more common than...

  • Welcome to week 3, last week we focused on who the bladder works and now we will start looking at what happens when things go wrong and how this can affects individuals. As you will see there are many different causes of bladder dysfunction. I hope you enjoy this week. Please keep posting your comments, thoughts and ideas.

  • It has been great to meet you in week 1 and to read your comments, please keep posting them. I am sure you will enjoy week 2. I find anatomy and physiology fascinating, it is so interesting seeing how systems develop and work. Understanding "the normal" is important, when we are trying to understand and explain symptoms and problems individuals experience, as...

  • Hello everyone and welcome to "Understanding Continence Promotion" course and thank you for joining and I am looking forward to following your comments over the next 7 weeks. I am sure we will have an interesting mix of people with a wide range of experiences of continence issues, from both a personnel and professional perspective joining, and I hope we can...

  • @YvonneGall Thank you Gall

  • The urine passed first thing in the morning is a darker yellow colour (concentrated), compared to urine produced in the daytime, which a pale yellow/straw colour ( dilute). This happens because antiduretic hormone is released at night time acts on the kidneys to reduce the production of urine during sleep.

  • From my experience, many older people can learn and cope very well doing intermittent catheterisation. The "teaching" of intermittent catheterisation is key, a discussion about the advantages and disadvantages of intermittent catheterisation and step by step guidance and support to learn the procedure by motivated and knowledgable teacher are important.

  • Dear Yvonne, thank you for your feedback. We would love to use it to promote the course on the FutureLearn website and in our newsletter. May we have your permission to do this?’
    If you are in agreement, please can I ask you how you would prefer to have your comment attributed to you, using your profile name, YG, or anonymised, eg Anonymous or A previous...

  • @WendyM Hi Wendy, thank you for your reply and for your support to promote this course. Please can I ask you how you would prefer to have your comment attributed to you, using your profile name, WendyM, or anonymised, eg Anonymous or A previous learner on this course.

  • Hi Wendy, thank you for your feedback. We would love to use it to promote the course on the FutureLearn website and in our newsletter. May we have your permission to do this?’

  • Hi Winifred, thank you all the comments you have posted throughout this course and I am pleased you enjoyed it. I have been trying to follow up with Future Learn about your mark of 98%, I presume you were expecting 100%. I have been asked to check with you that you marked all steps as completed?

  • Hi Nicola, thanks for your comment on our course. We would love to use it to promote the course on the FutureLearn website and in our newsletter. May we have your permission to do this?’

  • Hi Lynne, thanks for your comment on our course. We would love to use it to promote the course on the FutureLearn website and in our newsletter. May we have your permission to do this?’

  • Thank you also, from me, for joining this course, it has been inspiring following and sharing your comments, conversations and hearing about what you have learnt and reflected on. Please share information about this course with friends and colleagues.

  • Are aware that it is "World Continence Week" this week?
    I have just been forwarded a link and I thought you might find the activities interesting: https://sneakpeekwcw20.org/
    Each day covers a different set of subjects around continence to mark world continence week. You can access the days that have already gone Mon-Thursday as well a preview what is till...

  • Agree with you, many people I have taught have amazed me. For ladies identifying and visualising the urethra can often be one of the biggest challenges.