Common myths you may hear as a student nurse

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1. It doesn’t matter what degree classification you get. 

In the grand scheme of things, it’s true it doesn’t matter what classification you get. As long as you pass and are signed off as competent, you will qualify and receive a pin. BUT if you want to go on and do further study like a masters, the chances are you will need a 2:1 at least. This is where degree classification does matter. There is no shame in aiming high and wanting to achieve something which you know you are capable of.

2. Every day will be amazing and you will love every minute.

This might happen. But there’s also the chance that you will have ‘off’ days or a negative experience which will make you doubt/question everything. I know, I’ve been there. I didn’t talk about it and it made me doubt my decision for a long time. I felt useless because I was struggling and everyone around me seemed to be loving every minute. If you feel this way, talk about it. Others will feel the same you just don’t realise it.

3. You must work on a general ward for at least a year before specialising.

NO.

Want to work in the community? Go for it. Critical care? You can. A&E? DO IT! If you know you want to work in an area that isn’t a general ward and they accept NQN (which more and more areas do now) then go where you know your heart lies. Why ‘settle’ for a job you know isn’t your first choice when your dream job is waiting for you to grab with both hands?! Yes you will learn transferable skills on a general ward, but the skills learnt in other areas are usually very different to the skills learnt on general wards. Each area has its own strengths and skills to be learnt, all of which can be transferred to other areas if you decide to change direction later in your career.

4. You can’t work around your degree.

You can, I do. I HAVE TO. Always put uni/placement/deadlines above picking up a shift. And always be careful of doing too much and ‘burning out’. Your uni may have rules about how many hours you can do a week, so if you have a 30 hour uni week you may only be able to work 18 hours around that. You don’t need to work in healthcare, it’s beneficial to keep care skills up to date but you spend enough time on placement that this shouldn’t be an issue. You can have any part-time job as long as it’s flexible enough to fit around uni/placement.

5. You can’t be yourself on social media.

You can. Be mindful of abiding by the code and maintaining professionalism/confidentiality, but if you want to tweet about your favourite tv show or sport then go for it! It’s great to get to know the personalities behind the student nurse ‘tag’ and you can make some wonderful friends through social media and shared interests.

6. You must spend every waking moment reading, researching, working etc.

Yes it’s important to read around assignments and research up coming placements. But you need to remember to take time for yourself as well. See your friends, go to the cinema, go for a run. Something completely unrelated to nursing, give yourself a break regularly. Take care of yourself.

7. Male nurses are gay.

This is one I hear time and time again and it’s simply not true. Yes some male students/nurses will be gay, just like some female students/nurses will be. But there are also many who are not. Don’t assume someones sexuality based on the job they do, its outdated and stereotypical. Plus, someones sexuality is nobody’s business unless they choose to share it with you, assumptions can be damaging and hurtful.

8. Nurses are only nurses because they are not clever enough to be a doctor. 

If I wanted to be a doctor, I would have been a doctor. Many of us are clever enough to be doctors but didn’t want to be. Yes they are both careers within healthcare, but the roles are very different. Gone are the days where nurses are just there to help the doctors, they are recognised in their own right now. The care that nurses provide is just as vital to a patient. It’s insulting to hear someone say you chose your career path because you’re not intelligent enough for another one.

9. Your cohort will be amazing and you will all be friends for life.

Your cohort will be full of people just like you, student nurses trying their hardest to succeed. You will make friends and those friendships may continue after uni. But you will not like everyone. This is the same in any situation in life, yes you will be friendly towards people but you don’t have to become best friends with every person you meet just because they are a student nurse too.

10. You will always be supernumerary.

Now this may not 100% be a myth and in a majority of placement areas you will be supernumerary. Just be aware that if you feel your supernumerary status is not being implemented then you should speak to someone about it. There is a difference between helping HCAs and assisting with the ward routine, and constantly being used as a HCA/extra pair of hands with no learning opportunities or mentor guided time.

11. You cannot be good academically and on placement, it’s one or the other.

I’ve heard this on many occasions and even had it directed towards me more than once. There is no reason you cannot excel in both areas, many people do. It’s another outdated view that you can only be good academically or in practical situations, not both.

Let me know if there are any other myths you have heard!

Love,

T x

How to survive group work as a student nurse

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“This module will include group work”. Something that I’m sure many of us dread hearing at university. This may be because you prefer working on your own or because you’ve had a bad group work experience before. Group work brings different personalities together and these can sometimes clash, I’ve compiled a few tips to help get you through the group work and out of the other end smiling!

1. Make sure everyone understands the assignment 

When the project is first assigned, the most important thing is to make sure everyone understands what is needed and when by. Making sure all group members are on the same page early on is essential to good group work. Get to know a little bit about all the group members and where they feel their strengths will lie within the project.

2. Spilt up tasks and create a team 

Once you’ve determined what people’s strengths are, you can use them to make your project a success. Some people may be creative, some may enjoy writing, some may prefer to present the presentation (if this is part of your task). If you can split the work up evenly between yourselves and utilise everyone’s strengths, it makes the whole process run a lot smoother.

3. Encourage participation 

Sometimes during group work, it’s easy for people to feel as if their ideas are not valued or are not being listened to. Always try to encourage members to talk about their ideas and if you don’t agree with them, try to say this in a non judgemental, constructive way….so explain why you don’t think that’s the right idea for the project or what you could change slightly to make it the right idea. Trying to compromise on ideas is always better than saying no outright. Challenge opinions respectfully and always be open to other members’ points of view.

4. Communication

Communication is key to group tasks! You will never have a good group work experience unless you communicate. Stay in regular contact with group members and keep everyone up to date with anything that is happening. I’ve always found creating a WhatsApp or Facebook chat group is an easy way to keep group work chat in one place. Try to meet up regularly as well, having a message group is good but messages can often be taken in a different manner to which they are meant. Meeting up as a group is good for brainstorming and developing the project.

5. Don’t try to take charge immediately 

I get it, some people are naturally ‘leaders’. Try not to be the person who walks into group work and immediately tries to take charge, this can cause problems within the group from the start that may be hard to rectify later on. Everyone within the group should be equal and often one person ‘taking charge’ is great for organisation but when there is more than one person who wants to be the ‘leader’, this can often lead to clashes. Everyone should work together to ensure the project is completed. A ‘leader’ may naturally emerge throughout the weeks, and that is a much better way than someone assuming they will be from the start.

6. Pull your weight

It can be easy during group work for someone to take on a lot of the tasks and for others to not do much. This isn’t fair on the other members and can often lead to resentment. If you are assigned a task within the group, keep up with the work for it and have it completed by the relevant deadline date.

7. Picking your group

If you find yourself in a situation where you can pick your own group, you think ‘great! I can be with all my friends and it will be great’. Whilst it’s nice to be in a group full of friends, it may not be right for you. If you’re the kind of person who likes to be organised and your friend is a last minute type of person, being in a group together may not work for you. Try to be in a group with people who work like you and you may just find that you enjoy the process!

8. Recognise why group work is used 

Group work may feel like a pointless task at times, but there are many benefits to it. You can improve communication skills that you already have and work with a variety of different people. In first year, group work is a great tool for getting to know other people in your cohort. Group work can help with team building and collaboration skills which we will all need when we start our NQN jobs. Other skills you can develop are problem solving, time management, delegation and confidence in your own knowledge.

Love,

T x

 

 

Common equipment used in critical care

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Monitor – Every patient requires a monitor which allows for continuous monitoring of observations. These include blood pressure, heart rate, respiratory rate and oxygen saturations, CO² and temperature can also be added on to the monitor.

Ventilator – A ventilator can assist patients’ with their own breathing, or completely take over the control of a patients’ breathing. This allows their body to rest and recuperate. The patient will either have an endotracheal tube or a tracheostomy. A tracheostomy tube allows the patient to receive full support whilst awake. If the patient has an endotracheal tube, they will be sedated.

Arterial line – An arterial line is inserted into an artery and this enables constant monitoring of blood pressure, through being connected to the monitor. They also allow access for frequent blood samples and ABGs. The arterial line can be inserted into the radial, brachial, femoral or pedal artery. The most common ones I saw in critical care were radial ones. The arterial line is sutured to the skin to keep it in place.

Central line – A central line is an intravenous line, inserted into one of the larger veins in the body. They are mainly used for administering medications, IV fluids are also given through central lines. Central lines are usually inserted into the jugular vein, but they can also be inserted into the femoral or subclavian veins.

endotracheal-tube-500x500Endotracheal tube – This is a plastic tube that is used during mechanical ventilation. The tube is inserted into the patient’s trachea, often the tube will be cut to a size recommended by the Dr carrying out the intubation. A bougie may be used to guide the insertion of the tube. Once inserted, the tube will be attached to the ventilator via ventilator piping. There is a cuff on these tubes that will be inflated to prevent movement of the tube, cuff pressure is checked regularly to ensure there are no leaks.

Indwelling urinary catheter – All patients within critical care will have a urinary catheter in place. This is to ensure accurate monitoring of urine output for the patients fluid balance records. Urine output will usually be recorded every hour.

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Vas Cath – A vas cath is a specialised central line that is used only for dialysis. Placed in the jugular, femoral or subclavian veins. I only saw one of these in my time on critical care and it was placed in the femoral vein.

 

Product_PicWindow_Carefeed-AdultNasogastric tube – This is a flexible tube that is inserted through the nose and down into the stomach. The NG tube can be used to provide nutrition via a ng feed and to administer certain medications. The NG tube is aspirated regularly to check if the patient is absorbing the ng feed and to test the ph level of any aspirations collected. The position of the NG tube should be checked and recorded regularly by measuring the length of the tube visible. Before using the NG tube, the guide wire should always be removed.

tracoe-twist-ref-301-tracheostomy-tubeTracheostomy tube – A small tube placed into a hole made in the neck, allowing access to the trachea. A tracheostomy is used when a patient is being weaned from ventilator support. These are temporary and will be removed when the patient no longer needs them. The inner tubes are cleaned every 4 hours.

Intravenous infusion pumps – Used for any medication that is administered through a central line. The amount of medication infused every hour is recorded on the fluid balance chart. These are the ones used in my trust, others may vary.

 

Let me know if you’ve seen any other equipment on your critical care placements!

Love,

T x

 

 

Acidosis and Alkalosis

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You can read my post about ABGs here.

Respiratory Acidosis

Respiratory acidosis is caused by poor alveolar ventilation. This leads to the retention of CO². Causes can include asthma, respiratory depression and COPD.

An ABG would show:

ph level

CO²

Respiratory Alkalosis

Respiratory alkalosis is caused by excessive alveolar ventilation, also known as hyperventilation. This causes more CO² to be exhaled than usual. PaCO² is reduced, causing the ph level to increase. Causes can include anxiety (panic attack), pulmonary embolism and pneumophorax.

An ABG would show:

ph level

CO²

Metabolic Acidosis 

Metabolic acidosis can occur due to increased acid production or decreased acid excretion. Can be caused by things such as diabetic ketoacidosis and Addison’s disease.

Metabolic Alkalosis

Metabolic alkalosis occurs due to a decreased hydrogen ion concentration. This leads to a rise in bicarbonate. Can also occur directly due to an increased bicarbonate concentration. Causes can include vomiting/diarrhoea (gi loss of H+ ions) and heart failure or cirrhosis (renal loss of H+ ions).

Below is what an ABG would show for metabolic acidosis and alkalosis:

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Love,

T x

 

 

 

A guide to ABGs

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ABG is an abbreviation for arterial blood gas. ABGs are performed by taking blood from an artery instead of from a vein. ABGs are performed to give an accurate measurement of ph, oxygen and carbon dioxide levels within the blood. They are used to check the function of the lungs and how well they are able to move oxygen and remove carbon dioxide.

To begin to understand ABGs and be able to interpret them, you need to know the normal ranges:

  • pH – 7.35 – 7.45
  • paO² – 10 – 14 kPa
  • paCO² (carbon dioxide) – 4.5 – 6.0 kPa
  • HCO3 (metabolic) – 22 – 26 mmol/L
  • Base excess – -2 to +2 mmol/L
  • O² sats – 94-100%

 

paO² – partial pressure of oxygen

This should be >10kPa (kilopascal) on room air in a healthy patient.

If patient is <10kPa on room air – patient is hypoxaemic (lack of oxygen within the blood)

If patient is <8kPa on room air – patient is severely hypoxaemic and in respiratory failure, CO² would be looked at to determine type 1 or type 2.

Ph level – acidity/alkalinity of the blood 

Acidotic – <7.35

Alkalotic – >7.45 

The smallest change in the ph level can have detrimental effects on the human body. The causes of a change in ph level can be respiratory or metabolic. Changes in ph are caused by a CO2 imbalance (respiratory) or a HCO3 imbalance (metabolic). Co2 and HCO3- act as buffers to keep the ph level within its normal range.

paCO² – partial pressure of carbon dioxide

paCO² is the respiratory element of an ABG.

The chemistry behind respiratory acidosis/alkalosis follows:

CO² binds with H2O and forms carbonic acid (H2CO3). This is acidic, causing the ph level to decrease below 7.35. If the patient is retaining CO², the blood will become more acidic. If the patients’ respiratory rate is raised, CO² will be ‘blown off’ meaning there is less CO² in the system than usual therefore the blood becomes more alkalotic.

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HCO3- (Bicarbinate)

HCO3- is produced by the kidneys and ‘collects’ acids (H+ ions). It is a byproduct of the body’s metabolism.

When HCO3- is raised, ph level is increased due to a decrease in H+ ions (alkalosis).

When HCO3- is low, ph level is decreased due to an increase in H+ ions (acidosis).

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Base Excess

Base excess is another marker of metabolic acidosis/alkalosis. It is the amount of acid that must be added to each litre of fully oxygenated blood to return the ph level to 7.40 and to gain a paCO² level of 5.3kPa.

If the base excess is high ( > +2mmol/L) = this indicates higher than normal HCO3- within the blood.

If the base excess is low (< -2mmol/L) = this indicates lower than normal HCO3- within the blood.

Compensation

Respiratory acidosis/alkalosis can be metaolically compensated. This is done by increasing or decreasing the levels of HCO3-.

Metabolic acidosis/alkalosis can be compensated by the respiratory system. This is done by retaining or ‘blowing off’ carbon dioxide.

You can read more about acidosis and alkalosis here.

Love,

T x

 

Information researched through critical care nurse, on Geeky Medics, Oxford Medical Education and from medical textbooks.

 

 

 

 

Common medications used in critical care

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I often see posts from students who have received placement allocations in critical care and are wondering what to read up on. Here are a list of the most common medications used in critical care that I hope others may find useful.

Sodium Chloride 0.9% (also known as normal saline) – every patient will usually have this on ITU, it is a source of water and electrolytes. Used for replenishing fluid and restoring/maintaining the concentrations of sodium and chloride ions.

Hartmanns fluid – used to replace body fluid and mineral salts. A mixture of sodium chloride, sodium lactate, potassium chloride and calcium chloride in water.

Propofol – sedation used in ITU for critically ill patients on ventilators. Propofol is given continuously via IV infusion.

Alfentanil – used as an opioid analgesia. Suppresses respiratory activity in patients receiving invasive ventilation. Acts within 1-2 minutes and has a short duration of action. Often used alongside sedation such as Propofol.

Noradrenaline – a vasoconstrictor used to treat hypotension. Norad is administered continuously via IV infusion into a central line.

Atracurium – a muscle relaxant used to paralyse. Dose is calculated on patients’ ideal body weight, not actual body weight. Able to be used in patients’ with hepatic or renal impairment due to the way it metabolises. Atracurium relaxes the vocal cords to allow intubation.

Vasopressin – often used as support for other vasoconstrictors, such as norad.

Ranitidine – reduces gastric acid output. Ranitidine is mainly used to stop stomach acid coming up from the stomach while the patient is under anaesthetic or sedation. It can also help to clear up infections within the stomach, when taken with antibiotics.

Remifentanil – used for sedation. Has a shorter onset duration than Alfentanil. Remi is often used overnight for patients who are not quite ready for extubation.

Digoxin – is a cardiac glycoside which increases the force of myocardial contraction and reduces conductivity within AV node. Digoxin helps make the heart beat with a more regular rhythm. Digoxin is used to treat atrial fibrillation.

Quetiapine – antipsychotic. Used for the treatment of ‘mania’ episodes.

Haloperidol – antipsychotic. Mainly used to ease agitation or restlessness in elderly patients.

Furosemide – diuretic. Used in critical care to offload a large positive fluid balance or if the patient is not passing an adequate amount of urine per hour.

Aminophylline – used to treat reversible airway obstructions.  Aminophylline is usually given via IV infusion and is used to treat the acute symptoms of asthma, bronchitis, emphysema, and other lung diseases. Will often be given to patients who become ‘wheezy’ if nebulisers do not appear to be helping. Aminophylline belongs to a group of medicines known as bronchodilators.

Clonidine – used as a sedative agent when weaning patients off stronger sedation.

Tinzaparin –  an anticoagulant used to prevent blood clots in patients with reduced mobility. As the patients in critical care are often sedated and bed bound, all patients will be administered tinzaparin or a variant of this.

Antibiotics – The common ones used are Co-Amoxiclav, Tazocin, Meropenum and Clindamycin.

Love,

T x

 

Information was collated through talking to consultants, critical care nurses and further research through the BNF.

 

 

A day on ITU

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The shift pattern on ITU is the same as the shift pattern on HDU (You can read my day on HDU post here) :

Long day: 07:15 – 19:45

Nights – 19:15 – 07:45

Just like on HDU, there is no ‘typical’ day on ITU as every day can be different from the next. Below is one day that I experienced on ITU.

07:15 – 07:45 – During this time, we received a handover from the nurse in charge. We then went onto the ward and received a more detailed handover for the patients we would be looking after that day. This included details about why the patient was admitted and followed the A-E approach with a few extra sections. This handover also included any planned interventions for that day, such as x-rays or planned transfers. On ITU, the staff nurses’ have 1 patient each for the whole day (1:1).

07:45 – 10:00 – The nurse in charge checked the resus trolley and ventilation trolley to ensure all the correct equipment is present, working and within the expiry date. The staff nurses completed bedside equipment checks such as ensuring the equipment alarms are operating, checking the oxygen and suction points were working and checking the infusions to ensure there is enough left to last a couple of hours. In ITU, there are also ventilator settings and alarms that need to be checked to ensure they are working correctly. After all these checks, the patient was assisted with personal hygiene needs and repositioned. Pressure areas are checked and patients on ITU are repositioned 4 hourly, with pressure areas checked on each reposition. Everything is documented on the daily observations chart, an A3 sheet with information on both sides. All observations, fluid input/output and re-positioning is documented on there. The patients have a drink and breakfast if they are able to eat.

10:00 – 12:00 – Usually between this time, the consultants and nurse in charge will do a ward round. They discuss each patient and what the next step of their medical plan should be. Sometimes this will be a new medication or a change in ventilator settings, depending on how the patient is responding to their current treatment plan. Sedation holds may begin around this time to allow the patient to have time to respond, sometimes the patient is not ready to fully break from sedation so the sedation may be restarted and a sedation hold attempted the next day.

12:00 – 18:00 – Again it’s hard to fully describe what happens in the afternoon as every day is different. Obs are usually completed hourly on ITU, they may be 2 hourly if the patient is self ventilating and being transferred to a ward. Obs on ITU include fluid input and output. Fluid input includes any medications given by IV or through a NG tube. Fluid output includes blood taken and NG tube aspirations as well as urine output. Every hour the balance is recorded so we can see if the patient is in negative or positive fluid balance. Equipment checks are carried out once again throughout the afternoon to ensure alarms are still functioning correctly.

Patient observations are monitored closely and medications/oxygen can be adjusted accordingly. If a patient is responding well to ventilation, the ASB rate, PEEP or oxygen % may be adjusted to see how the patient manages. Extubation may occur if the patient is responding well to treatment but this will be planned in advance and discussed in the days leading up to the decision. ABG’s will be taken and the results recorded on the daily observation chart, as well as the patients medical notes.

New patients can be admitted from surgery, A&E, HDU or other wards.

18:00 – 19:15 – Daily notes are completed for the patients we have been looking after. The daily handover sheet is updated ready for the handover to the night shift team.

19:15 – 19:45 – Night shift arrive and the nurse in charge gives a handover covering the whole ward. The night shift team then come onto the ward and receive detailed handovers for their patients.

Love,

T x

A day on HDU

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My first placement of year 2 is 6 weeks on ITU/HDU. At Derby university in second year, we have two hub placements. One is for 6 weeks and the other is for 12 weeks. We also have a spoke placement where we spend 4 weeks.

The shift pattern at my placement is:

Long day: 07:15 – 19:45

Nights – 19:15 – 07:45

There are 1/2 days but I won’t be doing any of these during my placement block.

There is no ‘typical’ day on HDU as every day can be different from the next. Below is one day that I experienced on HDU. Other areas/trusts will vary and I would love to hear about your typical days on placement!

07:15 – 07:45 – During this time, we received a handover from the nurse in charge. We then went onto the ward and received a more detailed handover for the patients we would be looking after that day. This included details about why the patient was admitted and followed the A-E approach with a few extra sections. This handover also included any planned interventions for that day, such as x-rays or planned transfers. On HDU, the staff nurses’ usually have 2 patients each for the whole day (2:1).

07:45 – 10:00 – The nurse in charge checks the resus trolley and ventilation trolley to ensure all the correct equipment is present, working and within the expiry date. The staff nurses also complete bedside equipment checks such as ensuring the equipment alarms are operating, checking the oxygen and suction points are working and checking the infusions to ensure there is enough left to last a couple of hours. After all these checks, the patient is asked if they would like to have a wash and a fresh gown. If the patient declines, they are re-positioned and a skin check completed. Everything is documented on the daily observations chart, an A3 sheet with information on both sides. All observations, fluid input/output and re-positioning is documented on there. The patients have a drink and breakfast if they are able to eat.

10:00 – 12:00 – Usually between this time, the consultants and nurse in charge will do a ward round. They discuss each patient and what the next step of their medical plan should be. Sometimes this will be a new medication or transfer to a ward such as respiratory or stroke wards, depending on the patient.

12:00 – 18:00 – It’s hard to fully describe what happens in the afternoon as every day is different. Obs are done hourly or 2 hourly, depending on the patient. Obs on HDU include fluid input and output. Fluid input includes any medications given. Fluid output includes blood taken as well as urine output. NG tube aspirations are included in the fluid output also. Every hour/2 hours the balance is recorded so we can see if the patient is in negative or positive fluid balance. Equipment checks are carried out once again throughout the afternoon to ensure alarms are still functioning correctly.

Personal care needs are met as needed and re-positioning is carried out regularly if the patient is unable to do so themselves. Patients observations are monitored closely and medications/oxygen can be adjusted accordingly. Equipment may also be changed if needed, such as changing a patient from a nasal cannula to an oxygen face mask. ABG’s may be taken in this time and the results recorded on the daily observation chart, as well as the patients medical notes.

New patients can be admitted from surgery, A&E or other wards.

18:00 – 19:15 – Daily notes are completed for the patients we have been looking after. The daily handover sheet is updated ready for the handover to the night shift team.

19:15 – 19:45 – Night shift arrive and the nurse in charge gives a handover covering the whole ward. The night shift team then come onto the ward and receive detailed handovers for their patients.

Look out for further blog posts in my HDU/ITU series!

Love,

T x

Why do I blog?

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I started blogging around 17 months ago and originally I planned to use it as a journal to keep a record of my time at university. I didn’t think that others would be interested in reading my content. After releasing a few posts, I realised that a few people might actually want to read my blog, so I decided to write about things during my time at university that other student nurses may read and find useful for their own journey to becoming a qualified nurse. When I started blogging, there were very few UK based student nurse blogs available to read. Now there are many more available and this is great as everyone has different experiences and placements during their time as a student nurse.

I enjoy blogging as it is a good way to arrange my thoughts and write about the different things I’ve learnt. I like to write posts about the different placements I have so that other students who receive the same placement allocations can start them knowing a little more about what to expect.

My favourite posts to write are my ‘top tips’. I have had a lot of fantastic feedback on these types of posts and I really enjoy collecting my tips and writing them into a post that hopefully other student nurses will find useful. So far I have written top tips on being a first year student nurse, first placement and assignment planning but watch out for more!

Blogging is open to everyone and you can write about whatever you want to (protecting confidentiality and abiding by the NMC code is a must throughout). You can discuss your opinion on current affairs, health related news stories or something you have experienced on placement/at work. Blogging is also a great tool when it comes to reflection, you can write your thoughts down and share them if you feel comfortable to do so. You can write in whatever style you prefer and blogging is very informal compared to academic writing, I’ve found that writing blog posts can give a little bit of a release during assignment writing.

I would encourage student nurses and qualified nurses to blog, there are so many of us out there who would be interested in reading your posts and you may just fall in love with blogging like I have!

Send your blog links for me to follow and let me know why you enjoy blogging!

Love,

T x

Receiving a new placement allocation

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February 18th 2018 I was on a night shift on my year 1 hub placement. At midnight, my first placement allocation of year 2 was due to go live. I nervously logged on around 00:30 to find it said access denied! I was so disappointed to not be able to see my placement allocation, it said it was a medical ward but did not have the name of the placement area, at this time I thought it was just mine saying this. I kept refreshing the page throughout the night but it didn’t change. The next day, I realised that all my cohort had the same message. After some emails and phone calls to the placement team from other students, we were told it would go live the next day.

Later on that evening, I saw a Facebook status from someone in my cohort about their placement allocation. I was so nervous to log on again and check as there were a couple of areas I would have preferred not to have been allocated due to them being similar to my first year hub. I logged on to the placement allocation area and it was there.

I HAD BEEN ALLOCATED ITU/HDU FOR 6 WEEKS!!! 🎉🎉

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I was so excited, this was an area I had hoped to receive as a placement but didn’t think I would. After the excitement, the usual doubts set in. I was worried that I would be at a disadvantage having been in a community hospital for first year. I didn’t think I would have the knowledge necessary to have a good placement on an acute ward, especially one as specialist as ITU/HDU. I had two weeks at university between being on placement as a first year and going back to placement as a second year. I wondered how much more knowledge I would be expected to have being a second year on placement.

I walked in on my first day and I was terrified. I felt so overwhelmed, I had no idea what any of the machines were for or how the paperwork was filled in. I was worried I didn’t know an acute ward routine and that I would have a bad placement. My mentor was lovely and put all my worries to rest straight away. They do not expect you to know the machines or the routine as you’ve never been there before. She talked me through the daily checks and morning routine. There was a NQN on my first day as well and she was great at making me realise there’s nothing to be worried about and that even if you’re qualified and choose to work on ITU/HDU, you won’t know everything and it is all a learning curve. During my first shift, comments were made to me about applying to work there once I qualify and these have since been mentioned on my following shifts as well, so I must be doing something right! The feedback from my mentor has been positive and I feel like I know the routine a little more now. I am a quick learner so I seemed to pick up the paperwork side of things quickly and by lunchtime on the first day, I was completing the hourly obs on my own meaning my mentor could concentrate on other areas of patient care.

On my first night shift, I was drawing up a vial of Pabrinex and managed to get it all over the floor and myself! Luckily, my mentor and another staff nurse had a good laugh about it and that put me at ease. They said everyone manages to get it on them once during training, which was a relief to know I wasn’t the only clumsy one! I had 2 weeks on HDU and I am now doing 4 weeks on ITU, I have followed my mentors rotation. At my trust, the staff nurses employed on ITU/HDU do a rotation, they spend 8 weeks on HDU and 16 weeks on ITU.

I seem to have fitted into the team really well and can definitely see myself applying to work there, I just need the job to appear on NHS jobs now 😊

Do you know where you would like to work yet? Let me know!

Love,

T x