6 C’ing my way through Nursing – Care

Care. Such a little word with such a huge meaning. My last post about competence/incompetence was a little downbeat I admit. I don’t really feel much better this week, as other things have happened that have made me feel more … Continue reading →

6 C’ing my way through Nursing – Communication

Next post in the 6 Cs series!

Communication – one of those buzz words. Found in every job specification, every soft skills workshop and every CV. But really, sometimes I wonder if we always have the time to communicate properly, or even, if we sometimes remember that not everyone knows what we are talking about.

For example, this week I got some new inhalers for my newly diagnosed asthma. It’s not very well controlled at the moment and they have been trying me with all sorts of things. It turns out that I shouldn’t really be taking my Ventolin/Salbutamol (blue/rescue/reliever) inhaler more than 3 times per week if I am also taking Clenil (brown/steroid/longer acting) inhaler. No one told me that. I remember asking how often I could use my blue inhaler and my other GP said as often as I needed it. So I did. I didn’t realise that ‘often’ was limited to three times per week. This is what I thought it meant:

often

ˈɒf(ə)n,ˈɒft(ə)n/

adverb

adverb: often; comparative adverb: oftener; superlative adverb: oftenest

1. frequently; many times.

   “he often goes for long walks by himself”

   synonyms:

   frequently, many times, many a time, on many/numerous occasions, a lot, in many cases/instances, repeatedly, again and again, time and again, time and time again, time after time, over and over, over and over again, {day in, day out}, {week in, week out}, all the time, regularly, recurrently, continually, usually, habitually, commonly, generally, ordinarily, as often as not; More oftentimes; informallots; literaryoft, oft-times “he often asked after you”

   antonyms:

   seldom, rarely, never

Perhaps not then! So…  cue a very surprised GP and even more surprised moi when I explained how often I used my inhalers. Now I have a pink one – to replace the brown one but not the blue. I have no idea why and I can’t remember if my GP told me. I just know that I very obediently picked up and paid for my prescription without really asking anything.

I’m surprised at myself really. I think I’m quite assertive and I don’t really see myself as needing any sort of extra assistance or support with my meds.  I normally ask a lot of questions and don’t really accept the status quo if I don’t understand it. But it does make me realise how much we all trust and rely on ‘experts’ without question.

During placement I ask any questions that I don’t know the answers to and when it comes to patients I try to gauge the patient’s understanding and knowledge and explain things in their own terms as much as possible. But now that I am the patient and ‘on the other side’ I’m double guessing myself – am I really communicating as well as I could and should be? Are my patients going away from hospital as confused as I am about my asthma inhalers?

I have no doubt that my GP believed that he was being truly helpful; looking after me and ensuring I had the right inhalers to help me. Just like I do not think for a second that a lack of information or communication is ever intentional. I don’t think people intentionally withhold or hide information on purpose. Or do they?

But, I can’t remember if my GP asked me if I had any questions when I got my new inhalers. Nor did he show me how to use them – a bit of a faux pas seeing that it was a completely new type that I had never ever seen before (thank you YouTube for showing me the way). But then again, I’m not sure I would have known what to ask, and I don’t know if I would have asked even if I did now.

Of course, I know communication is not just verbal. It also includes body language, tone, eye contact and gestures. But I wonder, is communication between the health professional and patient really about exchanging information (in whichever format that may be)? Or instead (or in addition to) is it an exchange of power? That’s what they say, isn’t it? Information is power.

Do we, as health professionals, not communicate properly or hold on to information for fear that the patient will run away with it and we will no longer be in control?

Or perhaps we are worried that they will no longer needs us? We need them! Otherwise we wouldn’t have a job!

Do we not willingly communicate for fear that we will not understand the response?

Or that we will not have the time or resources to deal with the response or questions that our own communication and information triggers?

The above reads like a bit of a riddle and I suppose communication in itself is a bit of a mine field. Most of us think we have the necessary skills to communicate adequately. I think I do. Sort of. Though I have to be honest and admit that the more I write this blog the more unsure I am that I’m getting my point across and communicating effectively! So I will leave it there..until next time!

Here is a quick picture that made me smile! I thought it was apt 🙂

 

 

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?

Good things happening!

So…where have I beeeeeeeeen?

Well, since the last post I have been very busy (as usual) and have had amazing things happening. Who said hard work doesn’t pay off. I don’t believe in doing anything half heartedly and it sure is paying off for me!

Following the end of placement, we had some OSCEs assessments. OSCE stands for Objective Structured Clinical Examination and it’s basically when our practical clinical skills get assessed.We had to show we knew how to wash our hands (yes really – it is very important to know how to wash your hands properly to avoid transmission of infections!); how to move and handle loads and patients safely, which involved assisting to move a person from one chair to another; how to do Basic Life Support; and finally how to do Observations of vital signs such as pulse, temperature, respirations and blood pressure. I was so nervous! I practiced taking my own blood pressure so much that my arms where numb by the time I got to my exams. I was mostly worried about taking blood pressure because using a stethoscope can be a little challenging for me – one of the disadvantages of being partially deaf is that “amplified” sounds are still not quite loud enough for me to hear them properly…but I did really well and I passed it all! Yey!

We also had a mock exam for anatomy and physiology and considering I only did a couple of hours revision I actually didn’t find it too hard. I know that I answered a number of questions incorrectly but I will learn from them and for the real exam in May I will definitely study properly and focus more!

Talking about focusing, I’ve recently got contact lenses so I can now see all the time…it may not sound like a big deal but sticking things in my eyes (just like injecting patients with big needles) doesn’t really come naturally to me! It took me 45 minutes to put my contact lenses in the first time…Now it only takes about 5 minutes to put them in and less than 1 minute to take them out! Woooo! Progress! I have put my contact lenses inside out and have had them popping out…I won’t be doing that again! I have learnt from the above picture 😉 Most of the time though I manage to put them in without crying and wanting to scream and they are amazing! I love them so much…it’s like seeing everything in High Definition…which certainly helped when I did my skydive!!

Yep…the time finally came for me to jump out of a plane at 14,000 feet strapped to a burly man! It was amazing!!! I have to say that I really wasn’t nervous or scared! I’m not sure why because it is quite an extreme thing to do I guess but I was just excited that the time had finally arrived! Thank you so much to everyone who sponsored me who helped me get to my £500 target! For those who didn’t manage to sponsor me this time, don’t worry! I will ask you to sponsor me on my next challenge whatever that may be! Haha!

I’m starting to think of what I will throw myself into/out of next and I think I really really really want to go overseas for my elective nursing placement in my second year. I have volunteered abroad before and it was one of the best experiences of my life and being able to do that again but on a nursing capacity sounds completely and utterly incredible! I’m thinking Africa or South America since I haven’t really been to either. I’m really getting into all this nursing and philanthropy stuff!

Which reminds me, a little while ago I mentioned that a nursing magazine had picked a topic I had suggested for a new article…well….it’s gone above and beyond that and now the very same magazine has picked me to write a monthly blog for them! I can’t really believe it. I love writing and I love nursing and now both of those passions have come together and my articles have been published! Isn’t that amazing?? It’s going to be fun keeping this blog updated as well as my monthly blog – wish me luck! See if you can spot me below!

AND…there’s more! A few months ago I was asked by my university to support their bid for a number of Student Nursing awards, including Nurse Education Provider of the Year, and I wrote a testimonial about the university and my course….. and guess what?! Uni has been short listed as a finalist for the second year running! I’m so happy that I contributed towards such an incredible achievement! I hope we win…and if we do, I will be there to see it first hand because I have been selected to attend the awards ceremony in London as a student nurse representative! Oh yeah, oh yeah, oh yea!!! I don’t know what to be most proud of…the fact that Uni has been shortlisted again, which shows how brilliant it really is or the fact that I’m getting to experience all these amazing new things because I’m really getting involved with everything I can and putting my all into it… it just shows how much it means to me and how passionate I am about making the most out of every opportunity!

‘Do or do not…there is no try’ ~ Yoda

Placement Numero Uno – completed!

Wooohoooo! I survived! I have no words to really describe how it feels to know that I have passed and completed my first nursing placement..and that I am still in one piece (ish). For me, this placement has been as much about gaining experience as it has been to prove that I CAN do this. Point proven I think! Not only can I do it, but I can do it really well!! No one needs to tell me that in so many words – I am very proud of myself for what I have achieved and just as proud of my friends who are also going through the same things. Being a student nurse is hard. Really hard…..but I did it! I still have a lot to learn and a lot of things to experience but I’m making progress and that is certainly what counts.

Looking back to my first day I simply cannot believe how much I have learnt and how much I have seen. I have worked early shifts, late shifts, long shifts, weekend shifts and night shift.  It has been 9 weeks of working full time…some days a mere 8 hours, other days a mammoth 14 hours with only 5 hours sleep in between shifts. I have laughed and got shouted at. I have been scared and nervous. I have washed, brushed, shaved, bathed and showered (myself but mostly others). I have cried and wiped more tears than I ever hoped. I have helped patients to the toilet more times than I will probably visit the toilet in a year…if not longer. I have fed food that I wanted to eat myself.  I have washed my hands until the have been red raw, sore and peeling.  I have seen medication being administered in all shapes, sizes, forms and through a range of different routes. I have learnt that bodily fluids are wide-ranging and far-reaching (trust me!). I have met staff who have inspired me to work hard and reach for my dreams. If I have seen it, I have documented it. If I have documented it, I have filed it. If I have filed it, doctors haven’t read it (joke…sort of). It has been tiring and exciting….

Just to give you a final idea of what my placement has entailed:

• Admissions
• Personal care, including oral and eye care
• Bed making
• Recorded observations of vital signs and charted updates
• Repositioned patients and updated chart
• Checked pressure mattresses
• Recorded fluid inputs/outputs
• Recorded diet intake
• Removed cannula and updated relevant documentation
• Daily weights
• Supervised administering of medication including intramuscular injections
• Updated Nursing notes
• Physiotherapist referral – e.g.  after falls
• Occupational Therapist referral – if input required for Activities of Daily Living
• Social worker referral – if assistance required at home/Nursing or Residential home
• Speech and language Therapist referral – if non-responsive/refuses diet and fluid
• Dietician referral – if non compliant with diet e.g. diabetic
• Specialist care referral – diabetic specialist, Parkinson’s specialist, podiatrist etc..
• MRSA, C-Diff, CPC testing
• Given enemas
• Blood sugar monitoring and administering of insulin with subcutaneous injections and sliding scales of insulin
• Last offices
• Pressure, Mobility, Falls risk assessments
• MUST (Malnutrition Universal Screening Tool)
• Mobility, Shortness of Breath, Catheter etc.. care plans Care plans
• Discharges, including transfer letters and booking transport
• Bladder scans
• ECG

It has been…everything! I think I have felt possibly every emotion and every feeling and as I am sat here trying to explain I’m finding it very hard to pin point specific experiences that I have enjoyed more than others. I know I have learnt a lot, I know I feel much more confident as a student nurse, I know that I will keep going and keep working hard and I know that it will all be worth it in the end! I know it’s going to be challenging and that much chocolate will be needed along the way…..

My head is so full of stuff! I am sure that in no time at all I will miss patients and the dynamics of placement. I’m sure that I will recall instances that will make me wish I was back there again. I have had an amazing learning experience and I definitely have to be appreciative of that…Right now though, I think I will enjoy the 12 week break back at uni and being able to do other stuff and maybe even be a little social again! Even if that involves preparing for practical exams and mock exams…

Wish me luck!!!

Night shifts….goodness me!

I was going to start this post by apologising for not having written for nearly a month but then I realised that I have started almost every recent post in the same manner so I won’t apologise…just take it as evidence on how incredibly hectic a nursing course is….. 

I have been SUCH a busy bee going to placement, doing my assignments, preparing my portfolio and doing a little bit of studying when I wasn’t too tired or sleeping…but not to fear…there will be a few new posts coming your way!

Sleep. My darling sleep. Oooooh I was starting to forget what you were! As part of my nursing degree I have to do 150 hours of night duty by the end of the 3 years. University does not really recommend for first year students to undertake night shifts but I thought I would try it out anyway so I could experience the full 24 hour cycle of care on my placement and start chipping away at the night duty requirement. I did 4 nights and my goodness….I won’t ever forget them! I’m still trying to catch up with myself.

Night shifts in my area of practice run from 8.15pm to 7.30am and are very different to day shifts for many reasons. We have one break to be taken any time from around 1am to 5am and I have to say it is a little strange eating sandwiches and a Pot Noodle at that time of night/morning! The wards are obviously a lot darker which gives it bit of an eery atmosphere…and also, it actually gets a little chilly in the middle of the night! I never thought I would say that but it is true! There are also a lot less staff around and some even take a nap whilst on their break….so it is extra super important to work as a team during night shifts. The feel of a night shift is less haste but more intensity.

During my night shifts I unfortunately experienced a number of bereavements. Anyone who has read my ‘Heartbroken’ post will know I really did not deal with it very well the first time round and I was in fact inconsolable and heartbroken….I was so worried that it would be a side of nursing that I would never be able to cope with. However, on these occasions I am beyond proud that I managed to control my emotions and focus on the patient rather than myself. It wasn’t easy. It was really really hard to keep it together. But at the same time, being allowed to do Last Offices (laying the patient out ready for the Chapel of Rest) has been a privilege and very spiritual and I think it has really given me a different outlook. Being born and passing away are the two things a person will only ever get to do once in a lifetime so for me, it is an absolute necessity to get both moments absolutely right. I am grateful for being allowed to be part of it.

I also experienced my first, and hopefully last, absconded (escaped) patient from the ward…he ran, out of the fire escape, into the darkness, fully clothed and with most of his belongings. Luckily hospital security found him before the police came but I can honestly say that it was a very worrying time for all sorts of reasons…you just don’t know if they are confused, alert, hurt or safe..the unknowns are just overwhelming! The relief of the patient’s return was immense…having to then sit and watch their every move whilst they are threatening to do it again definitely kept me on my toes!

I also, fortunately or unfortunately (which ever way I look at it), worked with a nurse who I most definitely would never ever ever ever ever want to be like. Throughout my placement she has referred to me as “student” and made no effort to learn my name or address me by the fact that I am a person with an identity other then being solely a student. Nonetheless, I sort of let that go on the assumption that perhaps she sees so many students that it is just the way she deals with all the changes. However, her behaviour during one particular night shift was so incredibly disappointing and upsetting that I’m really a little confused about the whole episode! I’m not going to say exactly what happened because I am still trying to process it and figure out what to do but needless to say it mortifies me to think there are nurses out there who act like that..though I really feel like I should emphasise that this was only ONE nurse during ONE shift, out of all the nurses in the ward who are the most caring and compassionate people around. Every workplace has its problems and I think it would be a little naive and irrational to jump on the “let’s demonise all nurses” media bandwagon. Nurses are awesome and they work so hard…don’t tarnish everyone with the same brush please……I’m just appreciative to have met her so I can remind myself on how not to be.

It wasn’t all sad or upsetting or frightening – there were many funny moments too including various patients getting into other patients’ beds, falling asleep on chairs and on toilets and also many opportunities to improve my clinical skills – I carried out my first intramuscular and subcutaneous injections whilst on nights shifts and they really were not as scary as I thought they would be!

So…over all… Yes, as a student, working nights it is definitely challenging and having a good mentor to work with and support you is incredibly important and yes, sometimes things get a little wild and it can be upsetting, emotional, scary and very overwhelming but for all that, nights are for the most part, a little more peaceful and they also provide opportunities not available during the day. It can be hard to stay awake and alert when your body is telling you to go to sleep and your eyelids feel like bricks but I also got a chance to talk to the other staff and patients and find out a bit more about them…it was a bit like a bonding session I suppose and I felt much more involved in patient care throughout the night…Working nights shifts has definitely been a totally different learning experience but a very productive and insightful one at that. Good luck to any student nurses out there coping with  night shifts! I can’t say I would always recommend working nights but I would most definitely recommend to give it a go to understand just what a patient, and the staff, go through in a 24 hour day.

 

 

A Day in Placement

I haven’t written in sooooo long! I was starting to feel terribly guilty for not updating my blog but I have been so busy with placement and getting myself a little job that I really just haven’t had time to sit down and be sufficiently focused to write.

One of my New Year’s Resolutions was to get myself a part time job…and I have! not bad considering January has not even finished yet.  It is a flexible working job as an Outreach Ambassador. The role involves engaging with young people from under-represented groups such as those whose parents didn’t go to University, disabled students, and those who have been in Care. Basically I will just get to talk about my own experiences and challenges and hope that it inspires young people to progress onto higher education.  I’m not committed to specific days and times which is brilliant because it should make it a lot easier to fit around my nursing! I think it’s a great opportunity to work in the local communities and encourage others to get involved in something I’m so passionate about…education, education, education! It opens so many doors and the world is limitless when you make use of all the services and opportunities available to you. I’m looking forward to my first event, whatever and whenever  that may be!

So, back to placement. Working shifts is REALLY hard! I have never really worked shifts before so this is a first for me! I much prefer either the early shifts (7am-3pm) or simply a long shift (7am-9pm). The late shift (1pm-9pm) is horrible! I still wake up at 5am and then I meander about just wishing the hours away until I have to go to work. The day just drags and drags and drags. I’m sure some people may appreciate the late start to sleep in and do some shopping or get some other chores done in the morning but it just doesn’t work for me!

Anyway, since I’m using placement as an excuse to not write my blog, I figured the most appropriate thing to do would be to describe a typical long day for me….here it goes!

5.30 am – Alarm goes off, time to get up…..the light gets switched on immediately so I don’t sleep in! Once ready, I walk to the bus stop, usually with a giant cup of coffee in my thermos mug (courtesy of my previous employers!). I could drive into work but I don’t yet have my parking permit for my placement area and I am not paying the extortionate parking rates every day!

7.00 am – Will have already been on placement for around 15 minutes but this is when the handover happens between the night staff and morning staff. Phone starts to ring.

7.15 am – Help the Healthcare Support Workers to sit patients up ready for breakfast. Do any washes which are needed and can be finished before breakfast arrives. I like to wash people’s hair and give them the option to shave, brush their teeth etc… Before breakfast I also do any checks of blood sugars for anyone who is diabetic… Answer phones and patient’s buzzers.

8.00 am – Breakfast time! Help feed anyone who requires assistance. Diet and fluid is so important in a person’s recovery! Reluctance, avoidance or inability to eat or drink can be symptomatic of many conditions so it’s important to keep an eye on this and offer whichever support needed. Answer phones and patient’s buzzers. Start hourly monitoring of patient’s comfort and pain and document.

8.30 am – Join the tail end of the morning medication round with the nurses so I can familiarise myself with the drugs being given, the doses and practice my basic drug calculations. Answer phones and patient’s buzzers.

9.15 am – Continue to help the Health Care Support Workers with making beds, personal care, transferring patients. Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

10.00 am – Start the morning observations for patients who are scoring in the Modified Early Warning Score system – in other words, patients whose vital signs (temperature, respirations, oxygen levels, blood pressure, pulse rate) are outside the average ranges and who are therefore to be checked at least every 4 hours. Any one scoring 3 or more, needs to be brought to the attention of the doctors immediately and monitored at least hourly. Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

11.00 am – Break time! I get half an hour.

11.30 am – Help to roll, turn or sit up anyone who requires help before lunch arrives. Very important for pressure area care to ensure those who are not fully mobile are being checked, transferred and rolled at least every couple of hours. Answer phones, buzzers, fax social worker referrals, follow up with social workers, handover to occupational therapist, and handover to physiotherapist. Continue to document hourly monitoring of patient’s comfort and pain.

12.00 pm – Give out the dinners. The hot food trolley comes onto the word and we all help give out the hot food. It usually smells pretty good and makes my tummy rumble! Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

12.15 pm – Lunch time! Again, help anyone who requires assistance with eating and drinking. If no one requires help I will join the lunch medication round so I can practice my pharmacology knowledge a bit more! Answer phones and patient’s buzzers.

1.00 pm – The afternoon staff start so it’s time for another handover. Generally if I’m doing a long shift there will be no nurses to handover to but the Health Support Workers still need the handover to understand the mobility and hygiene needs of patients. At this point the ward is very busy with both the morning and afternoon staff still on shift with the doctors doing their rounds. Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

1.15 pm – Write nursing notes (kardex) for the patients who I have nursed throughout the day. This would include details of any observations recorded, whether medication has been given and/or taken as prescribed or refused, diet and fluid intake, mobility and hygiene and any assistance given. If needed, I will also update the ward file with any referrals, test results etc.. Answer phones and patient’s buzzers.

2.00 pm – Start the afternoon observations for patients who are scoring in the Modified Early Warning Score system since the morning. Visiting hours also start and I spend some time talking to families and visitors. Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

3.00 pm – Lunch break! I get another half hour. The morning staff also finish now. If I was doing an early shift I would also be going home at this time….but…no rest for the wicked! I’m here until 9pm! Continue to document hourly monitoring of patient’s comfort and pain.

3.30 pm – Help to roll, turn or sit up anyone who requires help. Answer phones, buzzers, fax social worker referrals, follow up with social workers. Accompany patients to various other departments such as CT scans, x-rays, discharge lounge… so they don’t get anxious or confused. Pick up medication from the pharmacy. Go to the shop to buy magazines, snacks, drinks etc… on behalf of patients to make their hospital stay a little more comfortable. Take cannulas out and dispose of them safely. Assist with any wound dressings which need changing. Top up linen trolleys with clean pyjamas, gowns, nighties, towels, bed sheets, pillow cases and blankets. Top up ward cupboards with more soap, pads, wipes, toothpaste, hair combs. Talk to patients and any family members or visitors still on the ward. Before dinner I also do any checks of blood sugars for anyone who is diabetic… Continue to document hourly monitoring of patient’s comfort and pain.

5.00 pm – Dinner time! The hot food trolley comes back and we give the dinners out. Generally the dinners are a little smaller than the lunches but they are still pretty good. Fish, chips and mushy peas is my favourite! I’m led to believe the vanilla ice cream is also delicious. I also help with any feeding needs. Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

5.30 pm – I join the evening medication round with the nurses. Most medication is given in the morning or at bed time but it is important to have regular medication rounds, particularly for antibiotic and pain killer medication and if intravenous fluid or infusions are prescribed. Answer phones and patient’s buzzers.

6.00 pm – Dinner break for me! Another half hour. My feet start to hurt by this point.

6.30 pm – I start the evening observations for all patients, not just those who are scoring in the Modified Early Warning Score system. All patients must be assessed at least every 12 hours. Any scores will increase the frequency of this. Visiting hours also start at this time so the evening observation round normally takes me a while longer, not just because all patients must be monitored but also because I also stop and chat to all visitors, even if it’s just to say hello and ask if they have come from far. Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

7.30 pm – Update nursing notes (kardex) for the patients who I have continued to nurse throughout the day. This would include details of any changes recorded since the morning, observations taken, whether medication has been given and/or taken as prescribed or refused, diet and fluid intake, mobility and hygiene and any assistance given. If needed, I will also update the ward file with any referrals, test results etc..Sometimes I also update the handover documentation. Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

8.00 pm – Night staff start their shift so the third handover of the day begins! Answer phones and patient’s buzzers. Continue to document hourly monitoring of patient’s comfort and pain.

8.30 pm – Help the night staff to get anyone into bed who wants to go to sleep already. Tidy bits and bobs, get rid of any confidential documentation that I may have in my pockets from the day.

9.00 pm – Home time! Bus doesn’t get me to my destination until around 9.40pm and I then have a 20 minute walk so by the time I am home it is at least 10 pm and I am a little tired! Food is not often a priority, but bath and sleep is! I get all my things ready for the next day, make my lunch and go to bed! Night night 🙂

So that’s it! That’s my day! I’m tired just writing about it!

I have to say that I can see why some people drop out of a nursing course after their first placement. It is very hard work and sometimes not entirely pleasant. I have experienced shortages of nurses and healthcare support workers first hand. I have even experienced agency and bank staff walking out after “misunderstandings”  which further increases the risk of being unable to meet patient’s needs. It can be upsetting and demoralising BUT I am happy to say that I’m not likely to be giving up any time soon. I love and respect the people I care for and work with so much.  In the past week alone I have been given comments such as:

“I am so glad I met you, you always come back when you say you will” – Patient A

“You are the only person I have seen smiling today, it has made my day, thank you” – Chaplain

“You have a trusting face, you are doing so well” – Patient B

“First year? You’re doing brilliantly” – Patient C

“Thank you so much for your help” – Nurse

“Thank you so much, we really appreciate it” – Ward Manager

What more can I say?!! The rewards are so totally worth the hard work!

Here we go again…

Second post in less than 3 days! Goodness…what’s going on! Someone would think I was poorly, or trying to avoid doing some reading, or even bored!

So here we go with the New Year’s Resolutions! It’s taken me almost a week to think of them but better late than never, right?:

1. To survive the next 6 weeks of nursing placement (and my next few placements after that!) without bursting into tears again. Or at least, to make it out of the ward before crying in the comfort of my own home. That would be sufficient. Let’s not be greedy.
2. To toughen up a bit. I think I’m too soft and too sensitive…it’s hard to change after 30 years of being this way though. Maybe I should just accept that I will always be too soft and too sensitive? Yes…maybe that can be my resolution. Accept myself as I am. I have to accept everyone else as they are… so I should probably stop beating myself up for my imperfections and just be glad that I am here and healthy…plus who wants to be a meanie hard-ass nurse anyway.
3. To keep on top of my uni work so that I am not rushing towards deadlines. I have never left anything to the last minute in my life but I’m adding this just in case – you never know! Life has a bad habit of getting in the way when you’re busy making plans….better to be prepared than sorry!
4. To pass my first year of my nursing degree. Pleeeeeeeeeeeeeeease!
5. To raise enough sponsorship to do my skydive for the Together Trust – an amazing charity which supports children and young people with disabilities and autism.
6. To be an awesome bridesmaid x2 – Thank you Kate and Emily! Even if the weddings don’t happen in 2013 I’m sure there will be lots of planning and preparations to get on with! I’m so excited!
7. To learn to park my car properly. I have been lucky so far but I don’t think it will always be possible to park across 4 spaces or in a drive or simply to dump my car on the road.
8. To get a small part time job – I probably could manage with lots of scrimping with my student loan and NHS bursary but I like treats. Not just for myself but others too. I like buying pressies and little surprises for people. It makes me feel all warm and fuzzy inside when I help them rip the wrapping paper open. I also would like to go abroad to  South America or Africa for my nursing elective placement in Year 2 of my degree and that costs a lot so need to save up!
9. To start buying myself flowers again and restart yoga and/or zumba – this is part of the point above but I think it warrants its own bullet point. It’s so important to save up a little bit of love and care and treats for yourself!
10.  To be strong and stay positive no matter what and not let anyone make me feel otherwise – I have got this far, and I will keep moving forward. So there.

I think 10 resolutions is a nice round number so I will leave it as it is! In less than a year’s time I will be coming back to this and hopefully be patting myself in the back for having accomplished most, if not all of my resolutions.

I didn’t feel that it would be necessary to write that I want to be happy for the year – everyone should aspire to be happy most of the time and to make those around them happy too – maybe not all the time though because it’s just not normal to be super happy all the time and no-one likes a smug (I think I just invented a new noun) 😉 we all need a bit of a pants day to appreciate all the awesome ones! But we also all need good caring people around us and the odd strange one to remind us of what we want and don’t want.  Maybe that can be my bonus resolution – to be thoughtful and appreciative of those around me and not take them for granted and hope that other people will have the same regard for me.

My first resolution concerns placement. I’m flabbergasted! After 3 months of studying the basics of anatomy and physiology, the foundations of care and clinical skills and the 3 weeks of staggered placement and lots of reflection of practice….this is it! This is what it has been building up to. Starting from tomorrow, for the next 6 weeks, I will be working full time, as a student nurse in my local hospital. That means that the next 6 weeks my life will be dedicated to 5am wake up calls, 14 hour shifts, throbbing and burning feet, washing and ironing uniforms, packing lunches, and lots of flowery smells and interesting sounds. How could I not be looking forward to it? I am counting down the hours!! Hurry up and get here!

I wonder if any of the patients that I cared for before Christmas will still be there or will have already gone home. I love each one of them so much. Each one has their own individual story and they are amazing in their own way. I hope they managed to go home and get lots of love and hugs from their loved ones. Not just because it has been Christmas but because home is where the heart is and that’s where everyone deserves to be. I feel so lucky to have already met such wonderful people. They inspire me every day. What more could I possibly ask for.

Happy New Year and Thank You

I wish you all the very best for 2013! I have my fingers crossed that all your hopes are fulfilled and all your dreams come true!

What a year 2012 was…so much happened! I went back to work after being poorly for a few months, I applied to uni to be a student nurse and got my place soon after, I moved house, I turned the big 3-0, I quit work, I started writing this blog, I started my nursing course, I completed the first 3 months of university, I had a wonderful Christmas, I went to Disneyland Paris to welcome the New Year and now here I am!! I survived 2012! Woohoo! Lots of other things have happened in between but there is just too much to mention! There have been lots of laughs (mostly at my expense!), lots of tears and lots of reflection. Every little and big thing has contributed to one of the most challenging, fulfilling and best years of my life! Long may it continue!

I’m very grateful for everyone who has taken the time to read my posts and for all the amazing comments that I often receive through this blog, facebook or twitter. I am particularly humbled for all the supportive comments following my last post. It was tough to write and even tougher to reflect on it but you all helped me through it and for that I will be eternally grateful.  I guess that’s the spirit of my writing.To write from the heart. I am frequently asked why I started writing and people often express surprise that I am so open and candid with my posts. I have to say that I don’t generally write for an audience…I just write what I feel and what I’m thinking in the hope that:

• I won’t offend anyone
• Someone out there may be able to relate to what I am talking about (if they are able to understand my ramblings!).
• It may help others to reflect on situations and not be scared to express themselves
• It may encourage others to write

Aside from writing and collecting snowglobes I don’t really have many hobbies.Unless I count sleeping and eating that is…They are definitely my two favourite pastimes  I think I would like to try out a new hobby for 2013 but I’m not quite sure what…I have dabbled with zumba, swimming and yoga in the past and I obviously tried hiking in 2012 but clearly I’m not very good at that, and whilst I know that hobbies are not about being good at stuff, it would be lovely if I was able to do it fairly confidently and without feeling completely inadequate or falling into holes. Wikipedia suggests things like fishkeeping and metal detecting as some options (http://en.wikipedia.org/wiki/List_of_hobbies) but I don’t really fancy those. I quite liked the sound of gongoozling until I found out what it was. Back to the drawing board!

Talking about hobbies and collections… a little bit of bad news…one of my snowglobes has broken, not sure how a snowglobe can break sitting on a shelf but it has (sorry mum!) but good news is that I treated myself to one from Disneyland so I guess it balances out 🙂 Out with the old, in with the new!

Thank you for a wonderful 2012. Happy New Year and all the best for 2013, I have a good feeling about this year!

Heartbroken

Up since 5am. Worked for 14 hours. Cried for 4.

Heartbroken.

I hope you know that I tried my best to give you a comforting send off. I kept you as warm as I could in that bear hugger that all other patients were jealous of. I know it probably got a little annoying that I kept sticking that thermometer in your armpit. I’m also sorry that I kept clipping the Sats probe on your ear. Even with constant oxygen I still couldn’t record a reading and I needed to keep checking. Your family came to see you. They love you very much. They cried a lot and showed you pictures of the family and talked to you non stop in between kisses and hugs. I asked if you were in pain. You said no. I sat by your side almost every hour of the day. You started to shut down when nurse told you to let go if that’s what you wanted. Your blood glucose levels didn’t improve. Your breathing slowed down. Your temperature dropped even more. I stopped feeling a pulse. I called ward sister. I counted your last breaths. You left us.

I will never forget you. My heart aches for your loved ones. I’m crying for fear that you left feeling some form of discomfort, or pain or loneliness. I hope with every ounce of my being that is not the case.

I was just one of those student nurses that kept hanging around you the last few days. I hope you’re in peace now my beautiful sleeping angel. I held your hand for as long as I could.