6 C’ing my way through Nursing – Compassion

I recently had surgery and interestingly, during my last placement I cared for people who had the exact same surgery that I’ve just had. So naturally, I went to my pre-op thinking that I knew everything that I would need to know. On the day of my surgery, I knew in my head the exact order in which things would need to happen…admission, WHO safety checklist, consent, TED stockings, no jewellery etc.. multiplied by 3. Then sleep. Then wake up. Then recovery. Home.

It wasn’t that simple. I was in pain – did I want to press the call bell? No, I didn’t want the nurses to think I was making it up and that I was a trouble maker. I couldn’t get comfortable. I wanted another pillow. I wanted an orangey drink because I hadn’t drank or eaten for hours and water was just not going down too well with me. I was hungry but didn’t want soup because my hands were shaking and I was worried that I would spill it all over myself. I ate it anyway. I needed the toilet but didn’t want to cause a fuss and have to unplug oxygen, BP cuff, cardiac monitor, pulse oximeter etc.. off me to then have to plug it all back on so I held it in until I could no longer hold it in any more. My lips were dry and I wanted lip balm which I didn’t have so I just licked and licked them until they got sore. I was cold and wanted to put my own pyjamas on. My hair was a mess and I wanted it in a bun on the top of my head and out of the way but with all the various things I had plugged onto me I couldn’t get to my hair so I just sat there looking like a hairy monster. Not that it mattered much because I also couldn’t see anything – my glasses were in my bag.

When I eventually got home (after a longer than expected stay in hospital due to a reaction to anti-sickness meds) I had no idea what to do with my medication, or when I would have my follow up, or how long to rest for. I had no clue. I had been told all of this before my discharge but retained none of it.

I thought I knew what to expect. But I really didn’t. I thought that I knew what patients that I had previously cared for had gone through. Not really!

Here is the definition of compassion:

Honestly, I’m worried now. Would I have known what it was like to have this surgery when I was on placement I think I would have been much more attentive to patients. Not that I neglected them but now I’m not so sure that I was able to really empathise at the time. I’m not sure that I would have been able to alleviate their suffering just like the definition says without knowing what it was! I can’t possibly have every procedure and intervention known to man in order to know what it feels like for patients, so how can I be completely compassionate without really understanding?

These are rhetorical questions of course. I’m not sure I will ever be able to fully understand. But I can try. I believe that now I know what kind of questions to ask post-surgical patients and this is where communication is key. Maybe I can even apply them to all patients. I think it’s definitely work in progress but I’m grateful for the very personal experience and I hope that it will make me a much better and compassionate nurse in the long term.

Elective Placement in Peru – my placement area

Peru is very different to what we are accustomed to here in the UK. For starters, they don’t have the NHS. So, my elective placement was definitely guaranteed to be a million miles away from anything I could have encountered throughout my nursing programme at home. I was based in a private clinic called Clinca Peruano Suiza – a 14 (ish) bed elective and emergency treatment centre (You will see why the bed count is a little iffy further on!)

Being on a nursing degree programme, my elective placement very much focused on nurses and their practice so you will have to forgive me if I make little reference to other health professionals – who were clearly very much present! The nurses in Clinica Suiza differed from the nurses I have encountered so far for a number of reasons.

1. Firstly, they worked in a private clinic. In Peru, most people require private health insurance to access health services as public services, unlike in the UK, are scarce.
2. There is also a high patient to nurse ratio. Whilst the number of patients seen in total at the clinic is much lower than the average UK hospital there is only one nurse caring for all inpatients (which is usually around 14). There are also less nurses available for every doctor. In the UK, the average is 3 nurses for every 1 doctor whilst in Peru is one nurse for every doctor. In practice, this means that there are less nurses available for doctors to delegate work to.
3. Being a private clinic, nurses encountered a number of ‘predictable’ patient groups. Because of the need for medical insurance, or sufficient finances to pay for treatment, the type of patients seen at the clinic generally fell into the following categories:
   1. Firstly, Emergencies – so this covered anyone who did not really have time to decide how they are paying for treatment.
   2. Tourists – who were generally armed with several travel and medical policies and could therefore afford most treatments.
   3. And the third, the “wealthier” Peruvian who could afford insurance. Although it is all relative and they were still comparatively poor – actually around 58% of the population could not afford any medical cover whatsoever. It’s nice to have free healthcare eh?
   4. Interestingly, in the time that I observed these nurses, there were no patients seen with minor injuries. It certainly made an impression on me having spent a placement in A&E in the UK and having observed some of the complaints the people present with! I think Peruvians are savvier and self-care much more. There are pharmacies on every street corner probably proves this point.
4. Nurses at the clinic also managed and trained a team of nursing technicians. The role of a nurse technician was somewhere between a care support worker and an assistant practitioner which I’m not sure exists in the UK. At the clinic there was one nurse for every 3 technicians.
5. They also wrote their own drugs kardexes or prescriptions – under the supervision of the doctor but it was often the nurse guiding the pharmacist on the medication required. I think, this was again associated to the cost of treatment, as even syringes were ordered on prescription and charged for!
6. Finally, these nurses whilst they were non-specialised they were very highly skilled in general nursing, paediatrics and midwifery as the low number of nurses available required that they were all able to undertake any sort of emergency! So there was no need for them to study the branches that we are accustomed to here in the UK. Nurse education is also 5 years long instead of 3 such as in UK.

Of course, there are similarities and many universal roles that nurses have to take on in Peru that reflect the roles of the nurses I have encountered in placement in the UK. Assisting with ADLs, documentation, drug administration, advocacy, coordinating care and communication I think are all part of the global role of the nurse.

Communication was a funny one –  I speak Spanish fluently and expected that once in Peru I would be able to fully understand everything but I quickly realised that speaking the same words does not mean that you speak the same language. It is a much more complex relationship. The nurses that I observed did not often talk to patients directly, talking to the patient was seen as the traditional role of the doctor, who often spoke multiple languages. But nurses still acted as advocates for their patients and often offered clear and effective insight and feedback to the doctor in front of the patient. On one hand this could be a good process as it provides one single source of verbal information. On the other hand, this could make the patient feel that he or she is being talked about rather than talked to.

In terms of written communication, nurses in Peru used colour coding to note information – in blue pen for morning shifts, and red for evening shifts. The colour makes information stand out and seemingly more interesting to read!  The colour coding also continued in the drugs and nursing kardexes with procedures in blue ink and medications in red. Black pens were banned! I asked a number of times why blue and red were used and I’m not sure I ever got a straight answer – although perhaps I just didn’t understand it!

The nurses that I observed would  also often keep their distance and provide little therapeutic touch unless a procedure was required. Whilst this sounds standoffish, this detachment I think is very much a Peruvian trait – within their culture remaining at a distance is a sign of respect – a fact that was often misrepresented by nurses and mutually misunderstood by tourists!

Similarly, the tone and character of voice used by Peruvian nurses was also a little surprising at times. Peruvians use the diminutive form in much of their vocabulary. Imagine adding ‘little’ or ‘wee’ to every word in a sentence then multiply it by 10 and you are probably close to Peruvian Spanish. Whilst it can come across as a form of endearment and familiarity it can sometimes feels like this diminishes the urgency of illness and treatment. For example, a patient who had recently arrived in Cusco (which sits at an altitude of over 3200 metres above sea level) was advised that he was ‘lacking a little bit of oxygen’. Saturations were 52% and the patient was clearly suffering from dangerous altitude sickness! I’m not sure that was the most appropriate way to describe the patient’s condition!

Appearance was also an interesting concept! The nurses I observed wore scrubs of different colours to represent their status and were immaculately turned out. One thing I noted was that nurses in Cusco often wore long sleeves, coats and scarves during their day to day nursing practice. There was just no other way to manage….it was so cold even in the hospital as there is no heating anywhere in the city! It could be argued that this is an infection risk but I wonder if bacteria could even grown in those temperatures 😉 and who would convey a more effective and positive message? A warm nurse wearing appropriate clothing for the temperature or a shivering nurse with a snotty nose baring her elbows?  Nurses needs to evolve their means of communication, whatever they may be, in order to communicate in a manner that is adequate and relevant to their surroundings. I worked a number of night shifts and wore several layers under my scrubs to ensure I was somewhat warm. It was not pleasant!

But that wasn’t the worst thing. I felt frustrated by the fact that patients were restricted on the care they could receive by the cover of their insurance policies or their finances, and often could not afford the treatment they would rather have, but instead, had to have the treatment their insurance dictated. Often going without vital medication. However, the doctors were very open and only suggested treatments or investigation they

felt were necessary.  Nurses in Peru faced very conflicting and difficult situations as they were often bound by a strict medical model rather than the holistic nursing model we aim for in the UK. Nonetheless, in my experience they were able to provide effective and prompt care to the best of their ability. Indeed, the care a patient experienced was also very much affected by resources available as well as technology. Resources were tight. Nothing is Cusco was new nor shiny – much equipment was re-used multiple times, for example saline bottles were also used as ‘sharps boxes’. Actually, I found this very refreshing and resourceful – I never had once had that ‘what a waste!’ moment.

Going back to those beds….family involvement in Peru is expected, and in fact, an extra bed was always made available for family in the same room as the patient at the clinic. So whilst there were 14 inpatient beds, there were actually 28 once we counted the extra ones for relatives. I would imagine that if the hospital got very busy that those beds would then be used for patient care. But, the point to take is that the involvement of relatives and significant ones meant that not only did they take some of the responsibility of caring for their loved one but it also meant that the patient had support as and when needed rather than having to wait until visiting hours! This facilitated great individualised and inclusive care for patients, something that we strive for so much in the UK.

What I liked the most about the MDT in Clinica Peruano Suiza was that every member of the MDT was present during ward rounds. This included pharmacists in charge of dispensing medication, the admin staff in charge of updating the insurance companies, the surgeon if relevant, doctors, nurses and all technicians. This meant that all members of the MDT were updated and handover over to at the same time. Although I appreciate that this is possible in a small clinic and may not be feasible in a larger hospital, I felt that this enhanced the handover process and prevented information being missed ultimately ensuring that the best, most efficient and prompt care and treatment for the patient.

I mentioned earlier that nursing education in Peru is longer than in the UK. However, nurses not required to be registered so it could be argued that without a regulating body the quality of nursing care given to a patient could be affected – there are  however minimum educational global standards to be met  and from what I observed, the whole MDT worked together to ensure the right mix of knowledge and skills were available to provide effective and individual patient care at all times – calling upon in-house specialists and surgeons as needed to improve the quality of service through an inter-professional approach. But this can vary greatly between public and private health services. Public hospitals in Peru have been on strike since 13^th May 2014 and are only open to emergencies with most patients having to pay for private healthcare. This is a political move in support of improved terms and conditions for workers. It is greatly benefitting private clinics such as Clinica Peruano Suiza but at the great detriment and expense of the neediest patients whose needs are not being met by the very organisations and agencies set up to care for them. Could you imagine the NHS closing down for even one day? Me neither!

The lack of sanitation facilities and adequate water supplies in Cusco posed different priorities of care for nurses and the MDT, with communicable diseases and food and waterborne illnesses being much more common among the indigenous populations than the colonial societal groups – who were more likely to suffer from lifestyle and excess conditions such as diabetes, obesity and alcoholism. Similarly, nurses often had to consider tradition and religion in their patient care although this often caused conflicts of interest. For example, the use of coca tea is widely recommended in Peru by traditional healers for altitude sickness and patients were often reluctant to take medications as prescribed in favour of traditional cures! I heard many a conversation where doctors and nurses were unsuccesful in trying to educate patients on the use of medications in conjunction with more traditional remedies.

So…that was my placement area and the environment in which I spent my elective placement! Coming up soon…what did I learn?

Elective Placement in Peru – the arrival!

I have now been and returned from Peru and my elective placement, and although I realise that I haven’t quite finished my series of the 6C’s posts. I wanted to write about my experiences in Peru whilst they are still fresh in my mind. So I will return to those posts at a later stage!

I have to stay the trip to Peru did not start well. I I originally chose to fly from Heathrow rather than from my home city of Manchester as flights were considerably cheaper at the time of booking and I figured that it would be easy enough to get to on the day. My lovely other half had offered to give me a lift and so we departed on what should have been a 3 hour journey about 7 hours ahead of my time to make sure we were not late and also to allow us some time to stop for a coffee and breakfast etc. As soon as we got onto the motorway the traffic slowed down… then it stopped altogether… and then we realised that the motorway had in fact been closed due to a major accident. We travelled around 15 miles in 2 hours and then spent almost 2 hours on a diversion to the next open junction. I was convinced I would not make my flights and would miss all my connections. I tried to call the airline multiple times (on their premium ‘helpline’ numbers) to see if I could get later flights. However whilst I would have been able to get later flights to Lima, the capital of Peru, there were no flights to my actual destination, Cusco, for the next 4 days, and so it was either get my scheduled flights or reorgnaise my entire trip! It was very stressful and I cried a lot of tears. I worked so hard to pay for my trip and I put so much effort into planning every single day of my Peruvian adventure that the idea of not being able to make it or having to miss some of it was breaking my heart.

But, my fabulous other half of a driver got a very grumpy and emotional me to Heathrow and I ran out of the car with my luggage hoping that I would still make it in time. I don’t even remember saying goodbye or thank you. I just ran.

As I ran into the terminal I grabbed the first airline representative that I saw. I explained. I apologised. I begged. My flight was due to leave at 12.15 and it was 11.13. This very nice representative told me it wasn’t a problem, that the flight would close in a minute and she would get me checked in asap. I am ashamed to say that I actually pushed in front of a very very long queue of people for passport security (for entry into the US), for check in and then for passport control. But thank you to that very understanding and lovely airline representative I was sat on the plane waiting to leave by around 11.45. I made it!

I first flew to Miami and I was welcomed by this sign which I thought was a nice little touch considering how stressful the start of my journey had been, but also how the kindness and love of people had got me there in the end! The rest of my trip was long…very long…around 35 hours in total I think! I flew from Miami to Lima and then Lima to Cusco – where I arrived to very rainy and cold weather!

Peru is south of the Equator and so I went during their autumn/winter, but supposedly dry season. Whilst all my friends were enjoying the heatwave of the UK or were going to their elective placements to hotter and sunnier climates I was wrapping up myself in 5 layers of clothing, woolly hats and gloves!

On arrival at Cusco I was met by Angelika, my placement coordinator and we took the smallest taxi in the world to what would be my home for the next 3 weeks – Kyuki Do Wasi – I don’t know if the name means anything specifically. I asked a few times but no one seemed to know!

Kyuki Do Wasi (I don’t know if the name means anything specifically. I asked a few times but no one seemed to know!) is a home for teenage mums. Peru is is a very poor country with little or no social care to help vulnerable people. This home was really set up to help young girls who need a bit more of a helping hand in caring for their babies in a safe environment. The youngest was 14 with the oldest being 17. I miss them, and I miss their little ones too. They were typical teenagers for the most part, moody but also incredibly humourous and playful. The girls always called me Señorita Ruth…and it made feel very respected and also very special! Many people, including other volunteers, referred to them as ‘the teenage mums’ all the time but I didn’t like that. I felt that they were still girls first and foremost and still needed nurturing as individuals and not just treated as mums.

So, that’s my arrival in Peru! Next blog…placement!

2013 – what a year!

I’m currently in the middle of tidying my flat, to make room for my Christmas pressies but also for all the stuff that I will no doubt be collecting in the next few months. I’m a little bit of a hoarder I think and I want to start the new year with a clean and tidy flat and as a result, I hope, a clean and tidy mind too (ooooh I’m not insinuating that I otherwise have a dirty mind…you know what I mean!)

Whilst tidying I have come across lots of reminders of the last 12 months, and I feel a little bit nostalgic now. I’m not really very sure whether to make another list of resolutions for 2014. I did pretty well with last year’s list…and frankly, I had such an astonishing 2013 that I am a little concerned that I will crash and burn like a lead balloon if I try and top it. On reflection, I’m not sure I have ever had a better, more productive and accomplished year! I have written about some of these before, but this is a more definitive list now that the year is over so it’s ok…haha!

January – The first month of the year was a bit of a funny one really. I’m not sure I enjoyed it very much. If I did I can’t find much evidence of it! What I do remember though is that I was exhausted for the first few days following NYE at Disnleyland Paris and I also remember that as part of my new year resolutions, I got my first part time job to do alongside my nursing course. I have been doing the job of an outreach ambassador for widening participation for a year now and I absolutely love it. I get to meet young people who aspire to go into higher education and my role is to advice, guide and inspire them to do so, but really, they inspire me and remind me that hard work, enthusiasm and passion is everything you need to achieve your goals.

February – Completed my very first Nursing placement. At the time, I found it very challenging. In hindsight, and in comparison to many of my other placements, it was probably the best first placement I could have had and in fact, I now like it so much that I often return to the same practice area to do agency work as a support worker. During February, I also attended a research conference about Neurofibromatosis and encountered so many incredible people who manage under the most difficult of circumstances every day. I was so taken by them that I made it my quest to learn more. I was subsequently able to arrange a few days with the genetics team at a major hospital to better understand the condition and its impact. I believe in making the most our of every contact and opportunity and would I have not attended the conference, I wouldn’t have got to learn as much as I did during those few days. I intend on writing a reflective piece on my experience when I pull my finger out and stop procrastinating! My favourite little dude was also born in February, it’s lovely being ‘auntie Ruthie’ even if I don’t get to see him very often.

March – Busy month! I did my skydive for The Together Trust and raised a whooping £500 for the charity. It felt like a very long day but I thoroughly enjoyed it and not only was it for charity, but it was also one of those things to tick off the proverbial checklist. It is not every day that you can say you have jumped out of a plane at 14,000 feet just for laughs. In March I also went to watch Girls Aloud on their final tour and was mightily disappointed with Sarah Harding’s pants performance….the others were good though and it was fab to spend time with my girls! During March I started my application to work as a support worker…little did I know that it would be another 5 months until the recruitment process would be complete! Better late than never I suppose and I am making good use of the flexibility now. It was also the month that my first blog for national nursing magazine was published.

April – Visited my favourite little dude for the first time! I hadn’t seen his mum and dad for a very long time so it was amazing to catch up! For the first time, I attended the Royal College of Nursing Congress and it was fantastic. I hope to go again next year and soak up the atmosphere and the debates! I have no idea what else I did in April. I must have been catching up on my sleep or revising for exams. Probably a combination of the two! Clearly it was a lovely quiet month which I have no doubt was well needed at the time.

May – Celebrated my birthday! I do love birthdays. We went for lovely Spanish food and then for cocktails. It was a lovely mix of people from my previous work, past jobs, current uni course, family and loyal friends. I could not have asked for more! May was also the month that I found out that I was to become the first ever student nurse to have won an essay prize from the College of Medicine. I came joint third. I have never been so surprised and shocked! It had been a while since I had written a proper essay and whilst I always enjoyed writing, I can’t say that I ever expected to win. I also attended the Student Nursing Times Awards with university and could not have been prouder to have been present when MMU won best nursing education provider of the year. Well deserved! I also became a Student Quality Ambassador sharing quality initiatives across the NHS and university to improve care and service delivery.

June – Went to see my grandma is Spain and spent the whole time there ill with flu. But nonetheless it was lovely to see her. I made a promise to her that I would try and see her every year and I will try my best to honour that promise. On my return from Spain, still suffering with woman flu, I attended to College of Medicine Annual Conference to pick up my essay prize certificate. I spent my prize money on car repairs because that’s just how cool I am and how i roll 😉

July – Started my second placement of my first year which I absolutely loved. My mentor was brilliant and I felt like I could finally be a little bit useful… it was a great feeling! During this month I also found out that I had come first at another essay competition. This was even more of a surprise because I had entered it on a whim. I’m forever grateful for all the support that I got from the teaching staff at university. In particular one specific lecturer, who is always willing to read my work, critique my writing and provide feedback so that I can push myself further each time. I tell her how much I appreciate her taking the time to help me but I’m not sure she realises just how much it means to me. I also attended lots of other nursing related workshops and conferences. I’m not sure if other student nurses do the same but I find them invaluable to keep up to date with current issues and challenges. 

August – Completed my last placement and all my work for the first year of my nursing course! Yey! One down, 2 to go! After months and month and months of dealing with the recruitment process for my agency job, I finally received my uniform to be able to book shifts as a support worker in my local hospital. This has proven to be a real life line for me. It has given me even more confidence out on placement but has also helped me out quite a bit financially. I can pick shifts as and when I want them which really helps. In fact, as I’m writing this I’m trying to figure out how long I have before I have to go and nap in preparation for a shift I have tonight. For me though, August was probably the highlight of my academic year. I won the University’s  Ede & Ravenscroft Prize for Academic Excellence. Out of 40,000 students in my university, I was one of only 2 winners of the prize in 2013. Well…. if that’s not a slap in the face for anyone who thinks that my hard work is pointless and unrewarding then I don’t know what it. I’ve said it before and I will say it again, I will not lower my standards and refute success to please those who are narrow minded and old fashioned enough to think that nurses cannot be equally academic and practical. I am. Here’s is proof. So there.

September – Attended the wedding of year in Texas, USA. I had such an amazing time and met so many incredible people. The hosts could not have been more accommodating and I miss them terribly! I will never forget how much my legs were sweating as I stood by the altar waiting for the bride – it was a little hot! but I’m not one to complain about the heat.. I love it! Also passed my first year of nursing and started my second year…which to be honest is a bit strange – I’m a little unsure on whether I’m enjoying it or not. I’m working just as hard and keeping my head done so I’m taking that to mean that I’m as passionate as ever about nursing and I’m just as dedicated to doing to best that I can.

October – I think October was mostly spent settling back into uni after placement/holidays. I also spent it campaigning to become a Delegate for the National Union of Students. I won alongside another 8 delegates and that means I get to go to a big conference next April to vote on issues which affect students. I’m particularly proud that I managed to get enough votes considering how notoriously difficult it is to reach and engage student nurses, and also considering I was not on campus at the time, nor anywhere near the hub of the elections. I’m specially proud that i managed to extend the elections after finding a glitch in the voting system… I ain’t letting anything stand in the way of my votes! Democracy and all the jazz 😉

November – Another crazy charity event! This time, I did a fire walk (walked on hot coals) and it was a fun night out! Two of my friends joined me in the fun and we had lots and lots of supporters who came to cheer us on! . During November I also found out that my first paper has been accepted for publishing (Perez-Merino, 2013) Yes Sirreeeee! I’m an author! Will keep you posted on when it’s out in print 😉

December – Started my first placement of my second year in probably one of the most demanding and fast-paced practice areas you can think of. It’s a tough one for me I have to admit, but I am surprising myself at how much I am learning and how quickly I am picking things up. I certainly don’t feel like a complete novice but I do feel out of my depth….but…onwards and upwards! It’s an amazing learning opportunity and I am making the most out of it. I celebrated Christmas with loved ones and cooked a huge Christmas meal. This has been one of the most relaxing, and simply lovely Christmases ever. I hope it’s a sign to come! can get, and in fact, have created a funding page just in case anyone wants to help me along. http://www.gofundme.com/5yti6s author! Will keep you posted on when it is out on print. I also booked my elective placement to Peru. I’m a little nervous about it because it’s so far away but I’m sure that I will have an incredibly time. Now I just need to buckle up and pay it all off. I will need all the pennies I can get!

So that’s that for 2013, I’m sure there are lots of other things that went on that I have not written about..that doesn’t mean they weren’t as important, or as fun or as meaningful. It just means that those memories are kept in an extra special holding place 🙂 or they may just not be appropriate for public consumption…..

Happy New Year! I hope 2014 brings all my readers and followers all the happiness, laughter and love in the world xx

Elective Placement booked…Peru here I come!

I’m completely trying to avoid doing any uni work today so I thought I would update my blog. Great idea eh? I suppose that I’m still talking/writing about uni and nursing so that counts as directed study…yes? Yes.

In any case..I wanted to tell you a little about my exciting news!

Throughout our nursing education pre-registration, we spend 50% of our time on placement…you know…doing hands on stuff and applying all that lovely theory into real life situations. We are allocated placements based on the requirements from the Nursing and Midwifery Council with the aim to get exposure to different (by no means all) areas of nursing (community/acute/medical/surgical etc…).However…during our second year as student nurses, we are given the opportunity to arrange our own placement. This is what we refer to as our ‘elective’. For us, this can be anything from 2 days to 4 weeks and so long as there is a nurse involved, it can take shape as almost anything… we can go to a mental health placement, paediatrics  military…you name it! The world is our oyster! It’s a great opportunity to get exposure to nursing areas which we may not otherwise experience, or, if unlike me, you know what type of nursing you want to be practicing upon registration, its a great chance to test the waters in that particular area.

As the title may suggest. I have booked my elective placement! I decided to go to Peru and you know what…I am so excited!! It may sound like a bit of an extravagant trip away, and well, it is definitely a once in a lifetime opportunity, but the point is, I have the opportunity to do it so I am! Here are my reasons for choosing my placement and Peru:

– I speak Spanish fluently and I think that, as future nurses, we have to be resourceful and use every skill that we have. I want to develop my language skills and learn clinical/medical terminology in Spanish. I don’t think that my ability to speak the same language will make it much easier. I don’t purposely like to make things difficult to myself, but I do like a challenge. The Spanish spoken in South America is very different to the Spanish spoken in Spain. It is my view that even when you speak the same language (irrespective of accent/vocabulary/dialects) there are always communication issues and barriers. How many times have you misunderstood what someone else was saying in your own language because of tone/body language? So no, it won’t be easy but hopefully, it will mean that I’m a little bit more clued up on what’s going on if I can understand what’s being said.

– Why Peru and not Spain? Well, I lived in Spain for 11 years and I visit one or twice a year. I wanted a change of scenery. Once I have been to South America I will have been to every continent in the world with the exception of Antarctica. That can be next on my hit list. I also wanted to move away from the luxuries we enjoy every day and go back to nursing essentials. By that I mean the luxury of free health care and complete accessibility to services at our doorsteps. I’ll be going to placement in Cusco, a city in southeastern Peru, near the Urubamba Valley of the Andes mountain range, where there is a real lack of quality health care that is affordable. 

– My degree is in Adult Nursing, so I wanted exposure to family and children’s nursing. My placement will be at a small hospital that specialises in meeting the needs of families and children in Cusco and the people from the outlying areas of Sacred Valley. The hospital specialises in family medicine, children, some preventative health care, and  provides specialised clinical services in areas such as general medicine, gynecology, pediatrics, neurology, obstetrics, dental, and more depending of the specialist available. They also have a small infirmary, day emergency room, triage, well baby care, and psychological care. They clinic see around 150 to 180 patients daily. Are you jealous yet?

– I wanted to go on my own, and somewhere that wasn’t going to be full of students…I don’t mean that to sound like I would have hated it if someone else would have come along with me but I wanted it to be a brand new, fresh experience for me…so I avoided places where everyone else was going (Tanzania/Sri Lanka/Nepal). Haha! 

– I was not willing to pay through the nose for the trip. Word of warning…yes..you may want to go to a third world country with the aim to make a difference and go back to basics but many of the companies out there that will help you to make that happen will make an immense amount of profit doing so. I chose to ignore those bigger/better advertised companies and go with a not-for-profit humanitarian organisation. That was my preference. I get the same support (with the exception of a branded t-shirt and scrubs) but I know that I’m paying at cost plus making a small donation which goes directly to my placement and host family…not lining some fat cat’s pockets.

– Finally….if I’m going to go far and away, I wanted to go somewhere with lots of things to see. Cusco is the site of the historic capital of the Inca Empire and was declared a World Heritage Site in 1983 by UNESCO. I aim on visiting Machu Picchu and the Sacred Valley and if I get a chance, Lake Titicaca too. 

 

I know that I am extremely lucky to be in a position to be able to go abroad, and all the way to Peru, for my elective placement. I know that some people simply can’t afford it, and I also know that there are people who have other commitments which makes a placement abroad impossible…I also know that you don’t need to go abroad to make memories and to feel fulfilled, so if you are in the process on organising your elective placement, just base your decision on things that will make you happy and develop you personally and professionally and you will be fandabidozi!

…but if you are reading this wondering how on Earth I can afford it, please know that I can’t, not really..but  I’m working super hard and making a lot of sacrifices, mostly because I know that it will be one of the most rewarding experiences of my life, and that no matter what, I will never forget it. You can’t put a price on that! 

Ps – if anyone would like to buy me some scrubs I would be very grateful! I also need a camera….if you don’t ask, you don’t get!

 

If only there was something I could do…

I’m watching the news and I’m just so upset at the images coming through from Oklahoma. I just wish I could go to help. I felt exactly the same when the Boston bombings happened and after the Bangladesh factory collapse, after the Sandy Hook shooting…and  after every other major disaster in the last 10 years. I. Just. Want. To. Help.

I really feel events like that. Whether natural or man-made (if there is such a concept). I’m not really sure why. It’s not just a news story to me…it just flabbergasts me that so many people’s lives can change so drastically in seconds through no fault of their own. You could potentially argue that we have upset Mother Nature and that Man (and I’m using that in the most generic of terms) simply gets in the way of natural phenomenons, or you could argue that Man has caused many of these disasters, but even if that’s right, surely the victims themselves didn’t cause such catastrophes, and even if they did, surely they don’t deserve such consequences? It is harrowing.

Over 8 years ago, I remember watching the scenes following the 2004 tsunami on TV (if you’ve seen The Impossible – that’s the tsunami I’m referring to). I  remember the death toll increasing by thousands every time I changed channel. 280,000 people just gone. I can’t even picture that many people. Can you? I remember feeling like a £10 donation, as well intended as it would be, just wouldn’t fill the complete sense of helplessness that I had. I remember feeling like I wanted, could and would help. So I did and I went and I helped. I built houses, worked in orphanages and helped in refugee camps.

I feel like that now. I. Really. Want. To. Help.

But then I remember that I’m doing my nursing course. I must not forget that in just over 2 years I will (hopefully) be well on my way to becoming a qualified and registered nurse and you know what that means? It means that maybe, one day, I will not only be able to help but I will be able to make a real difference. I may even save someone’s life. Imagine that!

Sometimes I wonder if I would be any good working for some form of humanitarian organisation such as the Red Cross or Médecins sans Frontières. In the midst of chaos. I think I would feel my most useful in emergency situations like that….but then, there is so very much that needs care and attention at home that I think I would feel a little guilty if I didn’t try to help those closer to me first. Could I do both? Do such jobs exist? I guess I don’t really have to look into it now but I’m more sure now than I have ever been. I want to be a nurse. I want to help. I want to make a difference.

I just wish there was something I could do right now.

 

Time is flying! Nearly birthday time again!

Where the heck has the time gone? I can’t believe that this time last year I was days away from my big birthday party and now….guess what…I’m days away from my 20-and-11th birthday! I have had such a good year – full of upheaval and lessons (both from the university of life and from award-winning Manchester Metropolitan University) with plenty of topsy-turvy and exhilarating moments; I have met some wonderful people, and ‘lost’ (on purpose) a few not so wonderful people…but wow-wee, I wouldn’t have changed any of it for the world!

Just a few of the things I have learnt during the last 12 months:

– It is never ever too old to do anything – you will get old no matter what, so choose to live your life well! Just ask the amazing man who decided to study nursing at the age of 74! Or, the awesome 93-year-old skydiver!

– There are far too many medical/clinical/anatomical words that look and sound that same that mean entirely different things. This will not help me in my anatomy and physiology exam!

– Be honest – life is definitely the longest thing you will ever be involved in, but  according to popular belief, life is also too short, so, don’t use up energy to a) blatantly lie  – you will get caught out eventually, and b) not do/say what you really mean for fear of hurting others – anyone worth their salt will gladly accept your honesty, even if it means that you have to say no…but then again, don’t say something mean and horrid and caveat it with “I’m just being honest”. That’s cruel.

– Owing a sphygmomanometer and a stethoscope will only be exciting for the owner. Poor unsuspecting bystanders will not often appreciate having their blood pressure taken repeatedly…On this note, trying to manually take your own blood pressure is really hard.

– Don’t wear too much make up – your skin will be very grateful, and you will  be very happy when in years to come, people don’t believe how old you are (ahem), you will also save lots of money; and when you do wear make up, people won’t recognise you…surprise!

– The NHS has possibly the longest recruitment process in the entire universe (and potentially beyond but I can’t prove that).

– On the above point, I strongly believe we are incredibly lucky to have the NHS and I’m utterly proud to be a student nurse in such a system. Nothing is perfect but by golly we have it good!

– Also on the above point (I won’t continue with this “above point” malarkey I promise) nurses work really flipping hard. Unfortunately and regrettably, sometimes bad things happen and some nurses let the side down – they are the exception to the rule. Nurse bashing must stop. Nurses need to stand up for themselves more!

– Don’t go on faddy diets. Eating healthily is much much better, easier and cheaper – it does help to have friends who are wonderful nutritionist (thanks K!) but even if you don’t, eat salads and veggies every day and less of the processed, frozen and tinned foods! (Whilst on this subject, don’t smoke either…it’s gross…and it smells…and that is coming from an ex-smoker!)

– Seek out new challenges! Slight contradiction to the point above about being able to say no… but…don’t be afraid to say yes! Really! What is the worse that could happen? So much goodness has come out of me saying yes to brand new and challenging opportunities! Who cares what it is! Just give it a go.

– Studying nursing does require some level of artistic skills – you try to draw the brain with all its lobes/ventricles/centres…not easy!

– Always work by your own standards and let others work by theirs. Otherwise you will get into all sorts of conflict that can lead to a whole bunch of really awkward and uncomfortable situations. In some cases you will be right, in others you will be wrong, but in most you will just be.

– If people want to follow you, they will….a good leader will capture the imagination of his/her peers and will be able to easily influence.

-Sock buns are mini angels in disguise 😉

– And of course, just to confirm, I am absolutely love nursing! I have spent the last few months at uni recuperating after my previous placement and we are currently in exam (procrastinating) season…but… I cannot wait to go back out to placement! I will be both in acute and community settings (remember I’m not allowed to say exactly where due to confidentiality) for 10 weeks from June until September! Wooohooo! Lovely patients to look after!

Of course, none of this would have been possible if my wonderful university would not have believed in me, seen potential and given me a chance…and for being so incredibly supportive, Manchester Metropolitan University have won an award for Best Nursing Education provider! How cool is that?! I officially attend the best university for nursing. I have never been so proud to be part of anything before! Don’t we look good?

Why volunteering is invaluable

I have spent the past few days frantically trying to mobilise my fellow students nurses to stand with me to lobby the government’s recent proposals for student nurses.  I am so upset that the government have not only failed to listen to the recommendations from the Francis report but also that the priority has been deemed to be student nurses and Health Care Assistants. Where is their research? Why have they not even considered that fundamental care can be learnt through so many other channels?

What about family carers? Do they not have the caring and compassionate skills needed to nurse?

What about those who freely and tirelessly give their own time to raise awareness for an endless number of conditions? How much more selfless do they need to be in order for them to be considered to have the essential care values?

What about those, like me, who worked in a completely unrelated field; who volunteered at every opportunity to raise funds so that others could be given the same opportunities; and who through wanting to make a difference to others and their quality of life decided to jump ship, and go into nursing. Do we not care?

I am a full time student nurse, I work 14 hours shifts, just like many many nurses. I also work part-time to fund my studies and I am a HUGE believer in volunteer work. These are some of the reasons why everyone should make time to volunteer (in no particular order):

1. It is incredibly rewarding. You will not only get to spend time with people who are facing or have overcome incredible obstacles and challenges, but you will also spend time with people who have freely given an immeasurable amount of time and support to help. You will feel inspired, humble and grateful to be in a position where you can also make a difference in your local community or further afield…whether it is volunteering, raising awareness or fundraising, it shows empathy, kindness, compassion and a commitment to ‘give back’.
2. Volunteering provides an opportunity to meet people and be involved in causes which you may not otherwise be exposed to during placements. Most placements will be specifically catered towards your branch and whilst it is an NMC requirement to have some exposure to other branches, volunteering allows you to get hands on experience and a working knowledge of areas which your course may not otherwise provide. This is invaluable in understanding nursing in a wider and holistic context. It is empowering!
3. It is a great for networking. The more people you meet in different areas, the more doors you will open for yourself. You may find that your interests sit in something completely unexpected and if that’s the case, you will already have the contacts to potentially pursue your dream job! This shows assertiveness.
4. Volunteering is completely flexible. You can choose to volunteer one hour per week, one hour per month or longer. Days, evenings or weekends. You could choose to assist in an online support group, help out at a day centre or coffee morning, befriend, run a marathon to raise awareness, or even do a skydive to raise funds. Whatever suits you! This shows the ability to be flexible, adaptable and also dependable – definitely skills which will come in handy throughout your nursing career.
5. It is an education in itself. Volunteering is the ideal way to find out what you’re really good at and to gain new skills. Do you want to be a future NHS leader?  Fundraising for a charity event and confirming sponsors displays leadership, negotiating and influencing skills. Are you interested in a Research position? Volunteering to carry out telephone questionnaires and collate the information shows great communication and analysis skills. Do you want to work in palliative care? Volunteering as a befriender will provide excellent working experience. Are you just passionate about a cause? Using social media to raise awareness counts!

There is something for everyone. Do you want to stand out from the crowd? Do you want to make a difference? There’s no two ways about it…get involved, volunteering is invaluable and don’t let anyone tell you different.

Update on New Year’s Resolutions

It is just over 3 months into 2013 and I just wanted to check in with my New Year’s resolutions. I want to make sure that I really do achieve them all this year! Or as much as I can anyway! So, here we go:

1. To survive 6 weeks of nursing placement  – completed! I survived my first nursing placement and lived to tell the tale. I’m looking forward to my next placement starting in June. Although right now I’m enjoying uni lectures and a bit of a normal routine.
2. To toughen up a bit. In progress….not sure I will be able to fulfill this completely in a year!
3. To keep on top of my uni work so that I am not rushing towards deadlines. I’m going to partially tick this off because I finished my first assignment 2.5 months before it was due and handed it in almost 2 weeks before the deadline. I think maybe I should rephrase this to study so that I am not revising until the last minute!
4. To pass my first year of my nursing degree. In progress! Fingers crossed.
5. To raise enough sponsorship to do my skydive for the Together Trust – big fat tick! I raised a massive £500 plus £90 gift aid thanks to the amazing generosity of my sponsors! I also had an awesome experience. Thank you everyone!
6. To be an awesome bridesmaid x2 – I think I’m doing really well on this…even if I do say so myself! I have my flight booked for this year’s wedding all the way in Texas and I have been to my very first Wedding Fayre with next year’s bride…she even got a little gift from me as a treat!
7. To learn to park my car properly. Erm……..
8. To get a small part time job – Yes! I actually sort of have 1.8 part time jobs at the minute…. The first is as an outreach ambassador for widening participation in higher education which is super interesting and gets me involved with lots of schools and career events. 0.5 of a job is my monthly writing column which is unpaid but that doesn’t matter to me. I feel very privileged to be allowed to write for a real magazine! The 0.3 job is with NHS Professionals. I have a conditional job offer for care support work but am currently 2 months into what I expect to be a 6 month recruiting process!
9. To start buying myself flowers again and restart yoga and/or zumba – Oooooh I haven’t started this yet! I forgot all about it!
10.  To be strong and stay positive no matter what and not let anyone make me feel otherwise – In progress!

So that’s it! I’ve made quite a lot of progress really! Woooooo! Lots more happening this year I’m sure! I will keep you all posted not to worry 😉