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 – 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!

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.

Peru is nearly here!

Woowwwweee! Time is flying! In no time at all I will be making my way across the world to do my 3 week placement in Peru! I’ve had a request by another blogger to write a guest entry about organising my trip to Peru so I’m saving all my exclusive info for that particular blog which I am hoping to link here once it has been published on t’internet but I wanted to write something for myself on how I feel about my trip so that I can: a) vent b) clear my head c) have something in writing that I can reflect on once I come back from my mahooosive trip! d) keep you all wonderful (nosy) readers in the loop 😉 Anyone who knows me and knows me well will also know that I’m quite ballsy and that I’m not usually phased by the idea of travelling on my own, or in fact, doing anything on my own. I mean, I go to the cinema on my own sometimes and that’s seen by many as a quite the adventure! But I am starting to get nervous and I’m not very sure why! If I look at it rationally:

• It will not be my first time flying, I have flown so many times that I have probably lost count. In big planes, smalls ones and some only marginally bigger than my head.
• It is not the first time I have traveled alone. Sometimes I prefer it! Less arguments and no compromises needed 🙂
• It is also not the first time I have flown long haul..and no, 8 or 10 hours on a plane is not long haul for me. I’m talking about trips over the 15 hours mark.
• It is not the first time I have been to the Americas.
• I have traveled abroad for work many many times before (this is how I have managed to do all of the above).
• I speak the lingo. Plus I would also be quite happy talking to a wall so the thought of talking to strangers is not really that scary to me.

But, if i think about it:

• It will be only the second time that I will be flying super long haul (by that I mean over 24 hours flying)  in economy. Ooooh the joys of being a student and not having company expenses to pay for the luxury of space!
• The furthest south I have been in the ‘Americas’ is Mexico or Cuba  (whichever is furthest south) and I have never been to South America. This was sort of the point of going to Peru in the first place as I am a big fan of visiting new countries but still – it’s a big deal!  I have got myself a Peru travel guide to give me a few tips and pointers before I travel!

• I speak Spain Spanish and not South American Spanish – which is really quite different. So I speak the language but I don’t. You could argue that I have a better chance at getting my point across than many others , you could also argue that I also have a better chance at putting my foot in it. I also have no idea what it will be like to speak ‘Nursing’ in South American Spanish. But….I have got myself a lovely book to help me along. I just need to actually sit down and read it now!
• It’s for ‘work’ (or elective placement if we want to be pedantic)  but not work that I actually know how to do. When I used to travel for business I knew what I was doing for the most part. This is totally different. I am still learning and there is real people with real illnesses in a foreign country involved – that has to warrant a few nerves right?
• Although big things (like travelling for hours on my own) don’t phase me, the little ones (asking for directions, finding the bus stop, trying to figure out currency change) do make me feel a little unsettled. I don’t know why, it’s just one of those funny anxiety things that I have always lived with! So that will be fun.
• It will be autumn – everyone keeps saying “ooooh you will have a lovely tan when you get back” No, I won’t. Peru is in the southern hemisphere and it will be autumn. Cuzco is also at the edge of the Amazon and whilst I am not going in the rainy season, temperatures do drop to around 4 degrees at night (Celsius not Fahrenheit for non-metric readers)
• I also feel quite stressed at the timing of my placement. I will be away for 4 weeks in total, including travel time and a stop over to visit my lovely friend in Dallas. That probably doesn’t sound stressful but when I land home I have 3 days before I go on holiday with my other half. In those 3 days I will be getting ready for my bridesmaid duties at the wedding of the year, finishing a presentation for uni and packing for my holiday! Once I return from holiday I have my summative presentation all about Peru, my end of second year tutorial, and also, more packing for my trip to Spain to see my granny. The thought of all the packing and unpacking is making me want to cry.

So yeah…I’m getting a little nervous about it! I also still have so much to do!:

• Buy my luggage – I have a very specific type of bag in my head that I want to take with me. One that is kind of like a rucksack but on wheels.
• Decide whether to take iPad full of films and things or stick with simple Kindle and e-books.
• As above but  iPhone vs simpler phone.
• Sort out a gift for my placement and host family.
• Make doctors appointment for my travel check – including vaccinations if I need any. I’m pretty sure I have everything I need.
• Book my Machu Picchu trip.
• Arrange meet and greet on Skype with host family and mentor.
• Pass placement here in the UK – otherwise I won’t be allowed to go to Peru – no pressure!
• Oh yeah, work my pants off so I have the moment to get most of the above!
• Read my guidebook and phrase book.
• Print out all my documents.
• Pack.
• Start my presentation so that I don’t have to do it all in those 3 days after I come back from Peru.

So much to do! So much to do! I better get on with some of it!

6 C’ing my way through nursing – Courage

As I mentioned in my previous entry. I want to write about each of the 6Cs (have a look at my ‘6 C’ing my way through nursing’ entry if you want to know more!)

I wanted my first entry to be about Courage – for no other reason than a couple of events this week have really made me reflect on why people do certain things, and in turn, why I do the things that I do. Worth pointing out that in my view (and you may disagree here) there is a very distinct difference between being courageous and being reckless – though I accept that different people see things very differently. Nonetheless, I like to think I am the former and not the latter. So here goes….

When I resigned from my previous job, people said I was making a rash decision; a whim they called it. Those who knew me little were surprised at my new career choice. Those who know me best reacted with “about time” comments and those people were simply full of admiration. How many people do you know who are stuck in a rut? It may be work, it may be the house they live in, it may be a relationship, it may be financial worries or all of the above! It may even be you – reading this now – who is feeling like that..and how many people have the courage to make change happen? How many of all those people have the courage to change their circumstances? As it stands, I have met a lot of nurses and student nurses who have found that courage. Every single one of the people I have cared for are courageous people. They have courage to carry on; to keep trying; to keep smiling.

Take Dr Kate Granger, she’s a GP diagnosed with a very rare and terminal cancer. I have been very lucky to have met her, and can honestly say I have never met anyone so honest, open and courageous…unafraid to fight for what she believes in. She has fought tooth and nail for our NHS and to raise awareness of the value of person centred care and she has continued to do in the little time she has left. She has talked openly about her experiences in hospital as a patient and offered much valuable feedback on how we can improve further. Not as a means to devalue the NHS but in order to make it even better than it already is. This includes her ‘Hello, my name is’ campaign – encouraging all health workers to introduce themselves to patients as a matter of course. She’s a boat rocker and one of the very bravest.

Then, take the Daily Mail <sigh>….. I really wish I could remain objective when writing about such a sensationalist paper. This week, it published a story about Dr Granger’s campaigning. They didn’t really listen, they didn’t understand and without any consideration to Dr Granger turned HER story into one of disappointment and despair – Kate Granger is nothing like that. She is positive, encouraging and ambitious and the Daily Mail have broken her heart…but she has picked it back up, and has vowed to continue all her hard graft. What an inspirational lady.

What do you think? Who is courageous or who is reckless? Does it depend?

The thing with courage is that people think that a heroic act is needed in order to be courageous. I’m not sure I believe that. I take courage as I take risk. I weigh up cost vs benefit. Most of all do this in our daily lives anyway. To have a salad or a pizza. To drive or take the bus. To hang the washing out when its cloudy or not. To drive those extra 5 miles with the petrol warning light on or not. They are all decision that we make daily and risks that we take each and every day. They are all rational and calculated risks for which we accept the consequences. In my eyes, courage encompasses the ability to accept responsibility for the consequences of our actions – possibly to the benefit of others and not ourselves – and to do it regardless, much like Dr Granger does each and every day.

How would you define courage? Dictionaries not allowed.

Sometimes I wonder how people like Dr Granger do it. Where do they find the strength? I aim for the same bravery or course. Whether I will get there it remains to be seen! I don’t often say no to a new opportunity or to a challenge. If you have never seen the ‘Yes Man’ with Jim Carrey I would certainly encourage you to. I may have mentioned this in previous blogs but its a great film and incredibly inspiring. It is only because of this ethos that I have taken advantage of opportunities as much as I have. I don’t wait for other people to try things out first. I don’t wait for encouragement or coaxing. I like breaking down barriers and I’m not afraid of a little hard work to make it happen. I have to admit that  recent experiences would suggest that hard work and success offend people, and they get really angry. I’m not very sure why but it makes no difference to me whatsoever. I truly believe that THERE ARE people out there with no agenda. I work hard because it’s the way I am made and to ask me to do something less than my best would go against everything that I believe in.

Because of this, I spend a lot of time reflecting on things that I have done and said and I try to rationalise all outcomes. I get happy, I upset, I pick myself up and I carry on. I do that almost constantly because I am so self aware that I analyse almost every single one of my moves. I am my biggest critic, as most people are. But I try to not give myself a hard time if I am wrong even if it takes a lot of effort and energy to let things go. This is incredibly difficult to put into practice – but I do try!

I understand that when I write this blog and publish it to the Universe that I make myself vulnerable by opening up myself and my thoughts and inviting feedback. I understand that the power of the internet means that whilst I open up to all my readers, that in turn my readers are able to hide behind an internet persona without consequence. The internet, or the freedom of press and speech (see the Daily Mail for example) gives people courage to perhaps do and say things that they would not otherwise do or say in ‘real life’. I know it certainly gives me courage to write things I would normally reserve for my ‘Dear Diary’ moments. In spite of that, I continue to do what I do, I continue to publish blog entries.

I don’t really want to apologise for the long entry. I feel that it is important that we are all self aware of our actions and whether you are in a caring profession or not, consider the 6Cs in every day life. In the context of this post perhaps you could consider, are you courageous or reckless? Does it depend? And if so, what on?

 “Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen.”  Winston Churchill

“Courage is grace under pressure” Ernest Hemingway

 

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!

Have I really not written anything since January?

Oooooops, I haven’t updated this blog for a while, have I? Since January in fact. I recently received that comment on this very blog! It was very well timed… the day I received it I had just been mentioning how guilty I felt that I hadn’t updated my blog for a loooong time and how  I just needed to find the time from somewhere to write. Well….I got the time and the motivation that I needed and here I am!

So, in reference to whether I really really haven’t written anything  since January the answer is both yes and no. I really haven’t written this blog since January but that’s because I have been super super busy writing and doing all these other bits and bobs!

– I had to finish my last placement in A&E and with District Nurses – after spending endless hours writing patient notes, care plans, referrals, handovers, discharges etc.. my motivation to write blogs goes walkies! That’s understandable isn’t it? I know that my intention when I started writing this blog was to update it weekly, or more frequently than that.. I can’t really remember to be honest but I must have been deluded,  just cannot manage that at the moment.  I hope that if nothing else, my blog is an online record of all the opportunities that are available to student nurses if they are able and willing to grab them with both hands…and well.. I’m sort of too busy doing that to have the time to write about it all!! I really didn’t expect that the world of nursing would be so flipping exciting and full of wonder! I want to make the most of it all whilst I still can.

Anyway, back to my list of things I have been writing and doing!

– Writing a 3000 word assignment whilst also in placement – imagine all of the above, plus having to muster the energy to also research, read and read and read and critically appraise (contrast and compare) evidence and write an essay. Sounds like hard work, doesn’t it? It was, it was tedious and it took over my life for a good few months.

– In addition…I have also been writing approximately 25 x 1000 word reflective essays for my portfolio – this is in addition both to placement and to my assignment! That is a loooooot of words! It hurts my brain writing reflections…having to be open and honest and self-aware of your own feelings and behaviours is a lot more difficult than you would think! Ignorance is bliss as they say but alas, not in nursing! For good reason too.

– Writing, reviewing, modifying and re-writing my first ever journal article! Watch out world! Author Ruthie has landed! I originally submitted my article in November last year, and it has been updated every time I had feedback for reviewers, sub-editors and editors which equates to around 10 re-writes in total. Frankly, it looks nothing like the original article now but I hope someone enjoys it nonetheless. I am so super proud and cannot wait to be able to reference myself in an article – because I am sad like that 🙂

– Writing notes, reading, watching videos and revising for my one ginormous exam of the year. “That’s all you have?” I hear you say! Yes, that was all I had…one single exam that covered 18 hrs per week x 9 months of work, on any part of the human anatomy and physiology, on anything on major chronic and acute conditions out there. Easy peasy lemon squeazy. No? Exam was actually ok, although I did have a few head scratching moments but it wouldn’t be an exam if it wasn’t a little challenging!  Will find out in the next week or so if I did enough to pass!

– Oh yeah, there is the small matter of attending uni full time too! And also working, I have two part time jobs…which reminds me! I work so so so so hard that guess what? I am the best super hardest worker at my uni:

So you know….sorry that I haven’t written my blog in a while. I have been a little preoccupied! I will try my hardest to do better.

Sometimes I wonder how I will cope doing all this when I qualify – working full time, shifts, having a life, sleeping, eating (though incredibly I always find the time to eat, several times a day, every day- my weight is testament to that!). But then I realise that when I qualify I won’t be working full time, studying, volunteering, writing journal articles and working another 2 part time jobs at the same time. Having a full time job may actually be a little easier – plus I’m sure the pay will soften the blow somewhat 🙂

Chat soon! I promise 🙂

 

Neeeeee nawwww – my day out with the ambulance service

Earlier this month, I was lucky enough to spend the day with the ambulance service – that is, I got to spend a day driving  (I wasn’t the driver)  – aka sitting –  in an ambulance.

When I originally applied to spend a day with the service, I was really excited…all those accidents and traumas and exciting things to see and do!  As time got closer, I was much more apprehensive, and actually, not really looking forward to it…not sure why! That feeling was made worse by the fact that we were specifically told by the organisers not to phone the ambulance station prior to our day with them, but to just turn up on the day, with our documentation. Just like that.

This is unusual as we are always advised to do the opposite prior to a placement, in order to let placement know we are coming along and give them a chance to prepare and us a chance to ask any questions. I would have liked to have asked about what to wear (warm clothes? layers?), what to bring (fob watch? thermometer? pen and paper?), and where to park. I just wore my student nurse uniform in the end and extra layers. I took my PAD (Practice Assessment Document) so someone could sign my hours and I used Google Streetview to try to figure out where to park. Thank goodness for assertiveness and the internet! I felt like I had achieved something incredible just by turning up on time. Go me.

I was also a little apprehensive because after my 12 hour shift with the paramedics, I had to go straight to placement for a 7 hour twilight shift until 3 am. This made my working day just under 21 hours long. Not doing the twilight would have meant being out of sync with my mentor’s shifts for several days and/or being down on hours so I did not feel like I had much of a choice. It felt ok – it was a busy day but I think that’s better when you have a lot of hours to work! It goes quicker  – plus the lovely paramedic gave me an energy drink to keep me going!

So how did it go?

It was much much better than anticipated. The ‘crew’  (that’s not street talk, that’s what the paramedics are referred as!) did not know I was coming but were welcoming and friendly. Much more so than some nurses at some placements actually. I went out on an ambulance (or van/bus as it’s better known) with a paramedic (D) and with an EMT 2 (A). I hadn’t actually realised that not everyone who drives an ambulance and attends 999 calls is a paramedic. In fact, only about 50% of the men and women in green who attend emergency calls are paramedics. There other 50% are comprised of Emergency Technicians (EMT 1) who are the most junior, and Senior Emergency Technicians (EMT 2). Currently all EMT 2s must top up to be a paramedic but there is no ‘upgrade’ route for EMT 1s. They are all extremely professional and competent, you won’t be any lesser cared for if one attends and the other doesn’t – there is just a small difference of the types of treatment and medications that EMTs can give – plus only paramedics are registered  like doctors and nurses – EMTs are not.  Interesting stuff eh?

We attended a number of calls – though no road traffic accident or serious incidents or traumas. My experience is that, believe it or not, the scary/exciting stuff really only happens on a daily basis in Casualty/Holby City/Grey’s Anatomy/ER. Most of the real life 999 calls generally relate to chest pain (possible heart attack, angina), shortness of breath (asthma, chronic obstructive pulmonary disease), general weakness and unwellness (mostly in older people), abdominal pain, and then anything from collapses to sore hands.

What did I do?

Observed mostly! I had an Observer’s jacket so it was really quite obvious what I was doing there! I helped carry the equipment which made me feel quite powerful actually. I cannot image how big and mighty the police feel carrying all their bits and bobs! I also helped with vehicle checks such as medication counts, stocking it with blankets, sick bowls etc.. and I did most of the observations of vital signs, including manual BP and blood sugars. I was a little rusty at doing manual blood pressures but found myself cracking it again in no time! I was also in charge of doing the 12 lead ECGs. I’m really quite good at doing these now since I do many of these every day in my current placement. I don’t really know how to read them but would be able to see if someone was having a heart attacvk which is the most vital thing. I also learnt a new skill…my main responsibility for the day was working the tail lift 🙂 Up…and down…..up…and down…. When I wasn’t doing one of those very important tasks I was doing the most critical thing of all and I was talking to patients and comforting them.

I was tempted to ask if I could have a go at driving the big ambulance but I resisted. The ambulances can be automatic or manual and as part of core training, all crew members  get driving skills lessons which they must pass but from what I gather it is quite intense so  I doubt A & D would have let me drive anyway! I did however, get to press the button which switches on the blue lights and the sirens .That was fun! I didn’t get to go on the Fast Response cars so I have no idea what they do – other than attend really serious incidents which require an extremely fast response (get it?) …for example, someone losing consciousness.

What have I learnt?

Well, as I mentioned before,  not everyone in an ambulance and wearing green is a paramedic but I will continue to refer to them as that in this blog for now…too many words otherwise! Not that it matters because they are all super skilled and brilliant, though I suppose it matters to them….anyway! They also have a lot of responsibility – from getting to the right place quickly to carrying out accurate assessments –  and managing to do all of that with silly drivers doing silly things all over the place; and then having to climb up trillions of stairs because the lift doesn’t work; or not being able to get into the property and having to phone the police to force entry etc… Much like District Nurses, working in other people’s homes can be challenging, but paramedics also have to deal with other unusual or difficult to reach places. Their work can be anywhere and in general, the crew rarely know exactly what they are going to – the triage (initial assessment) which comes through on the ambulance system is really not very in depth….and yet, time is of the essence! How stressful is that?

There is also a loooooooooooot of waiting around. If the crew decides to take someone to hospital, the crew must stay by their side until they are handed over to nurses and doctors. So if there are no beds in hospital for the patient, then the crew go nowhere! Imagine spending your entire shift standing in a corridor in a hospital with a poorly patient and not being able to go and help anyone else. How frustrating that must be.

So, all in all, I had a super brilliant day and now that I understand just how much they do, I intend on being extra understanding and nice (not that I wasn’t before). You should do the same, if you ever need the ambulance service  – for an emergency that is – please be nice! They do an incredible job and we should all be very grateful that gone are the days when we have to be carted off to hospital in the local mechanic’s van.

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!