2012 marked the 20th anniversary of the formation of ESNA.In that time the organisation has expanded from an initial handful of pioneering epilepsy nurses to the two hundred and forty or so that make up its current complement. ESNA is now recognised both nationally and internationally as the leading voice of epilepsy nursing in the UK. Its views influence health care policymakers and the organisation has been at the forefront of efforts to establish the necessity of an epilepsy specialist nurse as part of a comprehensive multidisciplinary service.
ESNA holds a biennial scientific conference which this year was hosted by the well appointed Nottingham Belfry hotel.Delegates were treated to an outstanding series of platform presentations from both medical and nursing leaders in the field. Generous sponsorship from a number of pharmaceutical companies, most notably Eisai and GlaxoSmithKline made the conference affordable for delegates without the need to compromise on venue or content.
The Sunday afternoon sessions began with Prof Matthew Walker and Dr Sunny Philip delivering a generalised epilepsies symposium. Prof Walker took delegates candidly through the proposed new International League Against Epilepsy (ILAE) epilepsy classifications while Dr Philip looked at syndromic classification and the thorny issue of when to withdraw medication. A further paediatric specific session was held on day two when Dr Robert Robinson gave delegates an overview of catastrophic encephalopathies.
There followed a neuro-oncology symposium presented by Dr Doug McCorry and Prof Garth Cruickshank. Prof Cruickshank presented work in progress to examine whether Valproate might be a useful tool in modifying tumour progression as well as treating resultant seizures.
Much of the first afternoon was given over to nurse led care innovation. Malissa Pierri presented her work which examined different healthcare models in the UK,America and Australia.Nurses in all three countries were at the forefront of patient care,streamlining the patient experience from first seizure through to diagnosis and treatment. Service delivery varied enormously between the models but the crucial role of the epilepsy specialist nurse was evident across all three. Each country’s nurses were clearly working at an advanced level and Malissa’s talk dovetailed nicely into a presentation on what is arguably the greatest step forward in epilepsy specialist nursing since its inception. Doctors in particular, with their rigid development programme find it very difficult to work out the level at which an individual nurse is working as the majority have very similar titles (usually a play on the phrase ‘epilepsy specialist nurse’).Yvonne Leavy presented a framework of adult epilepsy nursing competencies which for the first time sets out what can be expected of a nurse working at novice, competent or expert level. Competencies for paediatric epilepsy nurses have been around for a few years but conference heard that they are in the process of being updated. Brand-new competencies for epilepsy nurses working in the field of learning disability are also being developed and are scheduled for launch later this year.
At this point, conference indulged itself in a little nostalgia. Carina Mac and Lorraine Reynolds were both epilepsy specialist nurses in the early 1990s (incidentally both are still practising although Carina has a managerial role these days) and are founder members of ESNA.They took delegates on a light-hearted look back at the organisation over the last 20 years with plenty of photographs illustrating the ageing process and questionable fashion sense!
The evening began with a drinks reception followed by an excellent gala dinner punctuated by awards ceremonies for the best poster in conference and the ‘achievement in epilepsy’ (ACE) awards.The biggest cheer of the night was reserved for Ena Bingham, epilepsy specialist nurse from Belfast who has recently received an MBE for services to epilepsy and who was made an honorary life member of ESNA.
Day two opened with a transient loss of consciousness symposium. The diagnosis of epilepsy can be extremely tricky and the differentials between it, non epileptic seizures, vasovagal syncope and cardiac causes of loss of consciousness were covered by Dr Richard Grunewald and Dr Sanjiv Petkar.The theme of nonepileptic seizures was to be taken up later in the day by Catherine Crow with a fascinating overview of conversational analysis which examines how patients with different diagnoses describe their seizure episodes.
Their presentations were followed by an examination of the treatment of seizures in the accident and emergency department.Prof Tony Marson gave delegates an overview of the recent national audit of seizures management in hospital (NASH) while Vicky Myson presented an audit of an innovative nurse led first seizure service operating in Cardiff.
Nurses are always keen to learn about approaches that improve seizure control. In common with many conferences, a session was given over to ‘rational poly-therapy’.This title can be a poisoned chalice for speakers but delegates pretty much universally praised Prof Mike Kerr for his rather unique stance with an emphasis on demonstrating to patients both the knowledge of the practitioner and the theory behind combining antiepileptic drugs with different modes of action.The message was not so much innovative treatment but rather innovative presentation.
The day concluded in somewhat unusual style for an epilepsy conference. Mr Doug Feeny is a barrister specialising in medicolegal cases. He used two hypothetical case scenarios involving people who have epilepsy but also lack capacity to illustrate current legislation and considerations that all practitioners need to be aware of when planning the treatment and management of people with epilepsy.
The ESNA conference 2012 represented a celebration of epilepsy nursing in the UK.Twenty years ago the handful of original epilepsy specialist nurses may never have really believed that there would now be an epilepsy nurses organisation with a membership of over 260 and a national voice in decisions relating to epilepsy care,or that both NICE and SIGN guidelines would identify epilepsy specialist nurses as integral to high quality care provision. That the organisation can now hold a conference of such quality is tribute in itself to the drive and determination of epilepsy nurses. It must also be recognised that this development process has received incredible support from our medical colleagues as evidenced by the faculty list from this excellent meeting.By working together,we can make the next twenty years even more successful to the benefit of all people with epilepsy.