An out-patient service for patients suffering from amyotrophic lateral sclerosis (ALS), the ALS-clinic, was established at the Department of Neurology, Haukeland Hospital, in 1990. The number of ALS patients who were hospitalised during the period 1990-1995 was 59, with a mean stay in hospital of 14.8 days. Eleven of the patients died in hospital. The ALS-clinic had 127 consultations during the same period, with a mean of 2.2 consultations per patient. Speech difficulties were the dominating problem at 26 of the consultations. 32 patients experienced feeding difficulties, and a percutaneous endoscopic gastrostomy was performed in nine cases. Respiratory problems dominated in ten patients, but only two of these patients wanted a home ventilator. Various assistive devices were adapted for 16 patients.
Prevention in nephrology is only possible with the cooperation of patients and their families. The nurse plays a considerable role in working with patients and is a major player in the team, responsible for follow-up of the patient, where the earliest interventions can help delay and sometimes avoid dialysis. The hypertension clinic is the beginning of a continuum until dialysis. This paper describes three clinics that are managed in the renal service and indicates how they contribute to offering optimal care to a renal population.
The authors describe an external crisis intervention service in a general hospital. This service is intended for a clientele presenting acute mental health problems, referred, in the majority of cases, from the emergency department. They present demographic data, diagnostic data, data on the factors precipitating the crises and data which can be used to qualify and quantify the clientele. In addition, they describe the therapeutic approach and the treatment philosophy, the number of follow-up sessions, and the guidance provided to the clientele after follow-up. Finally, the authors suggest prerequisites considered essential to the effective operation of a crisis intervention module in an external psychiatric clinic.