6 C’ing my way through Nursing – Competence

I say competence but really I mean incompetence. That’s how I feel today. I feel pretty pants.

Yesterday was entirely different. Yesterday I attended a COPD simulation session at my Trust and actually did pretty well – I managed to remember hellomyname is….I did my ABCDE assessments and incorporated all of my 6Cs into my care. I even managed to squeeze a brief intervention in there and encourage smoking cessation to my ‘patient’. I was pretty chuffed. Yesterday I went home from placement thinking that I could really do this nursing thing. After all my doubts and tribulations, I believed in myself. Yesterday I felt pretty competent.

Today however I feel the opposite.

Today, I took our a cannula for a patient who I knew was going home. Said patient proceeded to leave the ward without their discharge documentation and take out medication. She wasn’t my patient, I was just trying to do the nurses looking after her a favour and take it out so they had less to do. I don’t know if the patient took the removal of the cannula as a sign that she could go home. I don’t know if its my fault. I don’t know if that makes me incompetent but it feels that way.

Today, I took a shivering patient’s temperature (36.8), just like I always do, by holding one of those fancy infrared thermometers against their forehead and said patient proceeded to then spike a temperature (37.9) half hour later. The patient’s partner told the nurse in charge I had held the thermometer about 2 feet away from the patient. I’m sure that these thermometers do not work at a distance, and I’m even more sure that it wouldn’t have recorded a normal body temperature at all held so far away. But still, I don’t know if it was my fault. I don’t know if I did something wrong. I don’t know if that makes me incompetent but it feels that way.

Today, I also had my mid-placement review. All my competencies signed off except one. I should be happy I suppose. That leaves me the next 3.5 weeks to focus on one competency. Care of an acutely ill patient. The only problem is that it is not getting signed off not on the basis I haven’t been involved, but on the basis that the placement area itself doesn’t really care for acutely ill patients (elective day case) and therefore I’m unlike to experience it in the next 3 weeks. There was no attempt to get me to explain how I could care for such a patient. There was no attempt to run through my COPD simulation yesterday which covered exactly that. I had no chance to explain all my previous acute placement, for example A&E, which have given me more experience in acutely ill patients that almost any other areas of care. I know that I have the knowledge I need for the level that I’m at. I just feel like I won’t be given the chance to prove it. don’t know what it all means, but it doesn’t feel great. It makes me feel incompetent.

I wonder if competence and confidence are always so closely linked that it is near impossible to seperate them. I wonder if today I have lost my confidence and that’s why I feel so incompetent. Or I wonder if I really am not as competent as I think and my ego has taken a bit of a hit. I really don’t know.

But is confidence always a good thing? I don’t know if I would rather have days like today when I sit back and really reflect in my own competence and doubt or always be confident and self-assured.

I have met nurses and students who are super confident, who do not accept any form of critique and who appear slapdash, but they come across as always knowing what they are doing. Is that better or worse than having occasional self doubt? I think the answer, as with anything, is that everything should be in moderation. The good comes with the bad and vice versa. I just wish the lows didn’t have such a demoralising impact on me. It’s a vicious circle isn’t it? I’m not sure where I am in this bo – but today I really feel like I’m in the ‘Need Help’ Category.

I hope next week will be better, I hope that I will be able to feel confident and competent again.

6 C’ing my way through nursing

The title of this blog entry is probably a little cryptic, so let me explain.

Back in 2012 (before I started my nursing course) in light of some of the most horrendous scandals to hit the NHS, the Chief Nursing Officer of England (Jane Cummings) set a 3 year vision and strategy that would include 6 specific action areas to ultimately deliver  and implement Compassion in Practice (CiP) at all levels of our National Health Service. These areas are:

1. Action area one: Helping people to stay independent, maximise well-being and improving health outcomes
2. Action area two: Working with people to provide a positive experience of care
3. Action area three: Delivering high quality care and measuring the impact
4. Action area four: Building and strengthening leadership
5. Action area five: Ensuring we have the right staff, with the right skills, in the right place
6. Action area six: Supporting positive staff experience

I’m sure everyone will agree that all of the above are vital if the NHS is to meet the expectations of the very people which rely on it, . But…they are a little wordy aren’t they? They don’t really roll off the tip of your tongue. So to help with that, the 6 Cs were created – the 6 Cs encompass the ethos of the Compassion in Practice strategy and cover:

1. Care
2. Compassion
3. Communication
4. Competence
5. Commitment
6. Courage

Again, I’m sure you will agree that they above qualities are essential in Nursing and Care staff. Nonetheless, there are people out who are not quite convinced that the 6Cs and the CiP vision will make any sort of impact. Some people believe that the 6C’s are a gimmick, and that nursing staff should not need to be reminded of the 6Cs to do their jobs….and to a certain extent, they are perhaps correct. Health professionals should not need to be reminded that they are in fact in caring professions. However, there are many examples out there of a lack of compassion, as we are frequently reminded of by the media, so something needs to change. My view is that something is better than nothing and I am an avid fan of making change happen and not simply sitting down and complaining about it.

The 6Cs act as a prompt, as a reflection model and as a really really good reminder of what Nurses are fantastically good at. They should be used to celebrate achievements, to show how there is no other profession quite as unique and rewarding as nursing, and to remind us all of why we do what we do (whether qualified or not). They are not – in my view – a tool to metaphorically beat people up with nor are they a framework on which to blame bad practice or culture.

So, in light of that, I want to dedicate a blog entry to each of those 6 Cs and I want to start this blog with Courage – keep your eyes pealed for it!