*Book Review* Notes on a nervous planet

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img_2948A few weeks ago I reached a breaking point. I was done with social media, done with looking at other people and questioning why I wasn’t like them. I tweeted about it and amongst the replies, @EnigmaGirl81 told me I needed to read this book. I had seen previous books of @matthaig1 but hadn’t read any so this was my first experience of his writing. I ordered the book the next day and waited for it to arrive. Amazon delivered it quickly and I sat down to read it.

 

The book is described as being a ‘personal and vital look at how to feel happy, human and whole in the twenty-first century’. It was written based on Matt Haigs’ experiences with anxiety and panic attacks, linking what he felt to the world around him. Matt includes many honest recollections of his own experiences’ and coping strategies, which I’m sure many people can relate their own anxieties to. 

There are a number of sections but it was the section on social media that really resonated with me. I have spent hours and hours scrolling through Twitter and Instagram, comparing myself to other student nurses, to other girls and wondering why I couldn’t look like them. I’m 30 years old and having self-esteem issues because I don’t look like the streams of girls looking perfect on Instagram, so how do 15,16,17-year-old girls feel?! I’m more than aware that the pictures are sometimes filtered and edited but that doesn’t stop me comparing myself to those girls and wishing I looked more like Kim Kardashian and less like me.

In the book, there is a chapter where Matt Haig asked his Twitter followers – ‘Is social media good or bad for your mental wellbeing?’ and one tweet, in particular, I really related to. 

@deansmith7 I can find myself comparing my behind-the-scenes footage (loneliness, anxiety etc) to people’s highlights reel (socialising, success etc). I know it’s not a true reflection of their lives but it can still get to me. 

People choose what they want to post online, so it’s natural to only choose the good moments. Posting the pictures where you look your best. discarding of the 50 other ones you took before you were in just the right angle for the perfect selfie. Talking about the good days and achievements, leaving out the rubbish days or ‘failures’. 

Life appears to have become a daily struggle to validate ourselves through the likes and comments from other people. 

I would recommend this book to anyone, a perfect manual on how to navigate the modern world and to keep your own head. Funny, honest and real – Matt Haig is a fantastic author with a unique writing style. 

There are so many quotes in the book that I could include, but here are a few of my favourites:

  • We are all connected to each other but we often feel shut out.
  • In a world of a million distractions you are still left with only one mind.
  • In an overloaded world we need to have a filter. We need to simplify things. We need to disconnect sometimes.
  • Accepting where you are in life makes it so much easier to be happy for other people without feeling terrible about yourself.

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This is my favourite page 👌

 

 

 

 

You can purchase Notes on a Nervous Planet here.

Love,

T x

 

 

How to start blogging

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There have been some great blogs appearing recently on twitter, influenced by the 30 day July blogger challenge (@BloggersNurse) and the @WeNurses #70nursebloggers. I often see people asking how they can start a blog or for advice on what to blog about so I thought I would compile another one of my top tip posts around getting started as a student nurse blogger!

1. Choose your blogging platform

There are a number of free blogging platforms out there including WordPress and Blogger that are easy to use and can be personalised to how you want them. When you have been blogging a while, you could purchase a new theme or your own custom site address but for starting out the free ones are great.

2. Create a name

Try to choose something original and relevant to you. I chose student nurse and beyond because it describes where I am now and also allows me to carry on blogging using the same name once I qualify. There are some great blog names out there and you can really inject your own personality into them.

3. Personalise your blog

You can choose different themes and colour schemes to make your blog stand out. If you are a dab hand with graphics, you can design your own header or you can use one of the preloaded ones on the blogging site. I had my header designed by a friend and it gives my blog a personalised edge. Upload your own photos to give your blog a personal feel as well.

4. Create your first post

If you are a student nurse starting a blog, I would recommend blogging first about why you decided to start your nursing journey and why you chose the branch you did. This gives the reader an insight into you and helps to create a rapport with readers. Your posts don’t need to be too long and can be written in an informal style.

5. Read other blogs

Reading other blogs can help you to see different writing styles and what you may like to write about. If you see a topic on someone’s blog that you would like to write about, credit them within your post. It’s fine to take inspiration from other blogs, everyone does but people spend a lot of time of their posts so try not to just reword their posts to present as your own. Use your own skills and talent to create original content to you.

6. Don’t rely on a schedule

My advice would be to not put pressure on yourself when it comes to regular posting. Some bloggers post regularly and some don’t. Whatever works for you and your own schedule is good! Sometimes you can feel pressured to post once a week and it’s an added worry when you get busy and cannot manage to post that week.

7. Enjoy blogging!

I love blogging and find it really enjoyable to write, I like creating my top tip posts because I can give advice from my own experiences and if it even helps one person then that is fantastic! I personally stay away from commenting on political nursing issues but other bloggers comment on these really well (@Ewout1985, @CharlotteRCN, @JeepersMcCoy, @SchofieldRosie to name but a few). You can write about whatever you want to, but be mindful to maintain confidentiality at all times and to remain professional within your writing.

8. Don’t worry about the readers

It can take a while to build a regular readership on your blog, and even if you write a blog post to find only 5 people have read it it doesn’t matter! Write your blogs for you and if other people find them useful/interesting then that is a bonus. Blogging can soon become a ‘chore’ if you’re constantly writing to try to please other people.

9. Share your post

Promote your blog on social media – Twitter is a great place to share blogs! Some useful # to pop on your posts are: #nursebloggers #WeStNs #studentnurse

10. Continue blogging!

So you’ve got your first post out there and you really enjoyed writing it! Now carry on! Blog about your uni experience, your placement areas, your personal opinions, anything you want to write about.

If you want more information on how to start blogging, pop over to @WeNurses on twitter where there are some useful infographics to get you started!

Share your blog links with me as I love to read new blogs 😘

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

 

 

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

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