Exploring specialist nurse clinic appointments: supporting a person with multiple sclerosis to manage spasticity and spasms

Abstract

Background: Managing clinic appointments effectively and efficiently are a fundamental part of being a multiple sclerosis (MS) specialist nurse (MSSN). Opportunities to practice these skills can be limited, which can be daunting for nurses new into the speciality. Aim: This article explores the management of spasticity and spasms and how a MSSN can effectively use time in a clinic appointment to complete a holistic assessment and support people with MS (PwMS) to manage their spasticity and spasms. Method: Narrative methodology was used to synthesise insights from appointments in a specialist nurse clinic, where individuals with MS needed support to manage spasticity and spasms. The insights were constructed into a reflexive narrative and are presented in this article as one clinic appointment. Findings: Strategies for MSSNs to consider during their clinics and spasticity management practices are suggested. These include clinic preparation, verbal and physical assessments, measuring, timely referral to other multidisciplinary members and educating PwMS, such as educating them on the possible triggers that can exacerbate spasticity and spasms, the importance of exercise and stretching, and monitoring the effectiveness of symptomatic treatments, including drug interventions. Conclusion: MSSNs have a vital role in supporting PwMS to manage their spasticity and spasms throughout the disease trajectory. Developing expertise in effectively using time in clinic appointments will benefit the outcomes for PwMS, the individual nurse and the healthcare organisation.