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.

First Day of Second Placement

Can’t really remember if I have mentioned it before, but even though Nursing is now a degree, student nurses do actually spend 50% of the course in practice. Working. For free. I wish people would give the whole “too posh to wash” and “too academic to care” rubbish a bit of a rest. It’s a bit boring now and achieves nothing. Student nurses nowadays do more minimum training and more learning than ever. 

I digress.

As part of placement, we are assigned a mentor. Our mentor is always a qualified nurse charged with teaching us nursing skills (not just clinical skills) and ultimately responsible for deciding whether students are fit and able to progress to the next level of nursing or not. Each week students must complete at least 37.5 hours. Yep, that’s full time work. In general, student nurses should work the same shifts as their mentor or at the very minimum 40% of their hours must be with their mentor.

So (I’m getting there…I do have a point, honest!), whilst most of my fellow student nurses started placement on Monday, I had to wait a little longer, until Thursday, to start placement. My lovely mentor wasn’t working until then and because I’m doing long days (14 hour days) with her, I don’t need to work as many days to make up my hours. So there you go. The time finally arrived! Yesterday I completed my first 14 hour shift of my second placement.

As per the norm, I can’t say exactly where it is due to confidentiality but in contrast to my previous medical placement, this is a surgical placement. Faster pace, more staff and well…just different. But brilliant. I noticed a few of things as soon as I got to my placement.

1. I am now much more confident to be wearing my student nurse uniform. I sort of feel like I deserve to wear it now…like I have earnt the right I suppose! Not that it ever felt wrong to wear it but it didn’t feel natural at first. It does now….and I love it! I’m not really sure why that is. Maybe I’m more confident in general, or maybe the last 9 months have proven to me that I CAN do this and I now feel more secure in that knowledge, or maybe it is the fact I have lost over 16lbs in weight and my uniform now fits better, or maybe it is because my uniform has now been washed 100 times and no longer feels like cardboard! I’m not going to over-analyse it too much (as you can probably tell). It feels good and that’s that.

2. I have remembered things from first placement and lectures. Nursing education (and Nursing in general for that matter) is so so intense. It is a hard course and it’s frustrating when people underplay just how difficult it is. There is so much information to remember and it is undoubtedly overwhelming. So imagine my surprise when I realised that I actually remembered much (not all) of what I had been previously taught. Now…to build on that and learn more! Hopefully it won’t be ‘one in, one out’ when it comes to facts and skills!

2. I’m much more assertive. My previous placement was 10 weeks long. This placement will be split into 2 completely different areas with 5 weeks in each area. 5 weeks doesn’t leave me with a lot of time so I’m determined to really seek out every chance I get to learn new skills and I’m no longer scared/worried to ask.  I don’t necessarily mean going on spokes all the time but definitely jumping at the chance to do new things, learn new skills and develop existing ones, and just in general, get involved as much as possible! Just in case you think I’m talking in riddles and you are wondering what the heck a spoke is… spoke placement = time spent away from the main placement on a related field. This gives students more of an idea of multi-disciplinary team working involved in the care of a patient. For example if on placement in a ward specialising in diabetes, a student could potentially do a spoke with a dietitian, a diabetes specialist nurse, a podiatrist etc. Thankfully, my mentor seems to ‘get me’ completely and understands what I want to get out of placement and is already very kindly on the case.

[Serious geek alert]

Talking about people understanding me or ‘getting me’. Am I the only person out there who loves Eurovision? I realise it was a while ago but the reason I mention it is because I have the whole compilation on my iPhone and I listen to it all the time. It keeps me sort of sane. Though I appreciate the irony in using Eurovision and sane in the same sentence. 

I like singing and dancing along to songs I don’t understand the words to. I don’t let language get in the way of a good tune! I take after my mum. Also, I don’t really stop at Eurovision…I’m a genuine lover of Europop. Join in! Here are some of my favs! 

509 million hits on this surely means I’m not completely crazy?! I partly blame my zumba class for this one…

Eurovision 2013… erm….I like it and that’s what matters.

A German man-band! what else is there to say? I understand the words to this one…and I don’t mean the English words at the end. Don’t know how I found it. YouTube special!