The mentor that changed everything

0

This post does not by any means suggest that my other mentors haven’t been amazing, because they have. I have been extremely lucky that every mentor I have worked with up to now have taught me so much and have always been fantastic to work with. There is just one mentor who changed everything for me.

Rewind back to the end of year 1, to me receiving my first placement allocation for year 2 and seeing HDU/ITU. I hadn’t been on an acute ward in my training yet and I was starting my acute experiences in one of the scariest places, A&E being another one that fills me with dread.

I spent weeks panicking (a common occurrence with me as you will know if you’ve read my other blogs 😂) and worrying that I really did not know enough to be trusted with this kind of placement. I was going from year 1, in a placement that I was actually quite confident in due to previous experience to my first acute ward. I did not have chance to visit the unit before starting placement so I walked in ‘blind’. The first thing I saw was all the machines and I must have looked terrified because one of the NQNs said ‘It’s not that scary once you get started, don’t look so terrified you will be fine!’. I met my mentor and she took me into handover. From the first moment she was welcoming and kind, I instantly warmed to her and felt a little less nervous. I picked up the handover sheet and was convinced it was in another language, I didn’t understand half of the actual handover and worried that this would happen every morning.

I started my placement with 2 weeks on HDU, so the ratio of patients is 2:1. My mentor started by showing me the crash trolley and the airway trolley. We then moved onto the bedside checks and the observation charts. By lunchtime, I was feeling confident enough to record the observations myself and my mentor was happy for me to do so. The next week passed so quickly and my mentor knew so much, the knowledge she had blew me away and I remember thinking to myself that I would never know all the things that she knew. At the end of my second week, I had 2 weeks annual leave for Easter. When I returned, I was on ITU.

I asked over and over if I was doing ok, if I was where I should be and was doing everything I should be. I was doubting myself as I always do and thought I didn’t know anything. My mentor encouraged me all the time to complete skills that she knew I could do, she had faith in me and taught me things that have since come in very handy on my other placements. The day she told me I was having my own level 2 patient in ITU, I remember thinking no, no way I’m not good enough. This is not happening I will mess this up big time. And guess what? I didn’t! I felt confident in the bedside checks and the observations, she provided me with support and encouragement and actually made me believe that I can do this. The next few days passed and I became more confident with everything, using my own initiative to complete tasks that I could do. Then my mentor said I was taking care of a level 3 patient. WHAT?! No, no thank you I do not know what to do and the ventilator scares me to death 😂 Of course I wasn’t on my own I had her supervision but I was allowed to complete tasks by myself, keep track of medication times and assess changes to care based on ABGs. She pushed me to make decisions based on my own knowledge without ever making me feel ‘belittled’ if I didn’t know anything or needed to check something.

Before this placement, I had absolutely no faith in myself at all and thought I wouldn’t make it as a nurse. This mentor completely changed my way of thinking. She showed me so much support and encouragement that it was impossible to continue doubting myself. She taught me so much and I genuinely think that if I become even half the nurse she is, I will be very lucky. She constantly made sure that I was feeling comfortable and gave me every learning opportunity, involving me in ward rounds and procedures such as intubations and tracheostomy procedures. I felt welcomed from day 1 and completely fell in love with the place, which is partly due to my mentor and the faith she had in me. The feedback she gave me made me cry and I always look back on it if I’m doubting myself and feeling low. To reiterate, I can say that I’m very lucky and all my mentors have been fantastic and I’ve learnt so much from them all, but there was something different about this woman. In 6 weeks, she took me from a nervous second year student believing she would never be a nurse – to a semi-confident (only because I’ll never be fully confident!) second year knowing that she could do this and that there was a good chance that she would qualify! I now feel slightly jealous of anyone who receives that placement in the time we have left on the course 😂

Let me know any stories you have of mentors like this!

Love,

T x

Common equipment used in critical care

4

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.

download

 

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

 

 

Common medications used in critical care

1

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 HDU

1

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

Receiving a new placement allocation

0

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!!! 🎉🎉

17062ca8-7b9d-4d3a-8ecf-9be9793ee0da

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

Changing years: Expectation vs reality

0

Being a student nurse is often about change and particularly transition, time seems to fly and when you’re told in the very beginning that time will fly, you may not believe it. But the longer you study, the more you realise that this is exactly the case. And now in the face of dissertation and nearing the end of my training, first year seems so far away, but it has passed in the blink of an eye.

Through this process, I’ve had a lot of questions. Some of those times, I’ve been fortunate to be able to catch another student nurse on placement about what I can expect from my future in nursing, but part of the time — I haven’t known what to expect and it has felt like entering into the unknown.

Sitting down with Toni, a second year student nurse, we decided together to do a mini Q&A on what to expect, from the eyes of someone who has been in her position.

Q. I have achieved good grades in year 1 and I’m worried about keeping up the same standard in year 2 now that they count towards the final degree classification. Is there a big jump from level 4 to level 5 academic writing?

The expectations shift a little, level 4 is often a descriptive form of writing and this year you will be expected to analyse your description more, to understand why you are saying that, from what the evidence base is telling you and to consider why pieces of information can contradict each other. In second year, I learned more about how to effectively appraise my evidence, before I reference it within a piece of academic work.

It isn’t a huge leap, the word level probably makes it sound more scary than it is. You will be guided by your lecturers, the library staff are always available for support. Your writing won’t necessarily change, rather you’re developing on the foundations that you’ve laid in your first year.

Q. I had a brilliant community hub placement in year 1 that was mainly elderly patients and I wonder if this had put me at a disadvantage coming into the acute hospital for my next placements. Will I be expected to know so much more in year 2 placements than I did in year 1?

I had a similar experience of moving from a year in the community in second year, to a placement in ITU in third year. I felt like a fish out of water! I found it was important to communicate these feelings with my mentor, to explain that my memory needed jogging about working in a hospital as I’d lost track of routines and schedules.

Placement in the community does not put you at an disadvantage, instead you learn a separate group of skills to what you may now develop going into a hospital. These skills are highly applicable, they are still nursing skills that you can utilise in any placement. For me it really just boiled down to grasping the new routine.

You will be expected to develop from first year, but that isn’t a bad thing. It’s a gradual thing. Your mentors will guide you, you will evaluate yourself as you learn more throughout the year.

Q. Almost every time I see a post on social media about year 2 it is negative, are year 2 blues really a ‘thing’?

I think this is something that we often end up a bit blasé about. Being a student nurse is a journey of highs and lows. There have been times when I’ve felt frazzled by my course, others where I’ve just known it’s perfect for me. I think the blues comes from the idea that you’re quite a distance from the beginning, but also a distance from finishing, so sometimes it feels like you still have so much to do.

My advice for this is to talk to your peers, your mentors, your lecturers. Look after yourself, practice good self-care. I always found it helped me to reflect on why I wanted to nurse in the very beginning, always go back to the start. Second year is hard, particularly emotionally, but a cup of tea and a chat can go a long way.

Q. The workload in year 1 appeared to be manageable with assignments launched early on in the year with 5-6 months to complete them. Is the workload more than year 1?

On reflection as a third year, where I have had OSCEs and I’m working on my dissertation, I do feel now that my second year workload was more manageable than this year. However, the pressures do increase and you will be balancing assignments while on placement, but this helps you to learn time management skills that are ultimately essential to life as a registered nurse.

This was a really tough part for me! Balancing moving up a level, placements, reading further, they all took more time. I cannot stress how important time management is to a successful nurse education. It’s hard work, but with good management it is manageable. Lecturers will not set assignments to be cruel, they set them to meet competencies and they set them with due dates that are manageable. It’s about taking control of your time, your education and what you want from it.

I found that in second year that I was able to explore my own interests a little more in my assignments, being able to choose an assignment focus from several case studies and following one. This is a good opportunity for you to identify the gaps in your knowledge and fill them, often also helping you to discover what areas of nursing you have a passion for.

Second year is a journey, I thoroughly enjoyed it. Enjoy the time you have, manage the time you have, remember why you started and remember that you’ve come so far. First year is completed and you are entering the next stage of your education.

Good luck for this year!

Love,

T & A x

The reality of being a student nurse

0

I’m just starting second year and thought now would be the perfect time to describe what being a student nurse is really like. Being a student nurse is a mixture of emotions and achievements, I’ve had amazing days and some days that were not so good. But I have survived year 1 of 3! Have a read of the following realities that I have discovered during my first year.

You won’t believe people when they tell you it’s hard work. 

Now I don’t want to put anyone off but this degree is hard work. There’s no other way to describe it. That’s not me saying it is more work than any other degree, I have only experienced one so can only comment on this one. You will have assignments to complete and exams to revise for, it’s easy to get caught up in university and placements then before you know it, it’s the week of the deadline and you haven’t even started. During placement you will be doing 37.5 hours at least, with assignment work on top. Include any extra paid work you have to do around uni/placement to live and any extra reading/research for placement and you suddenly have very few hours of free time for yourself.

Shift patterns.

You will be expected to work shifts covering 24/7 care. You will be doing nights, long days (12.5 or 14 hour shifts in some placement areas) and you will be expected to do weekends. There are very few placement areas that are Mon-Fri 9-5 so if you had this idea in your head, forget about it now. I’ve had 3 placements up to now and none of them have been 9-5. Get a good pair of shoes because you will be on your feet a lot.

Social life? Remind me what that is again.

Some people may disagree with me here but you will struggle to find time to have a social life. I have been to events and nights out in my first year don’t get me wrong, but it has been few and far between. And every time I have felt guilty that I’m not at home doing something towards university work. Friends that are not on the same degree or at university may not understand how busy you are and that you can’t see them for weeks on end, I’ve lost touch with a few friends because they don’t understand that you really cannot see them for a few weeks because you’re snowed under and that it’s not just an excuse.

Even if you have healthcare experience, you will relearn the core care skills on placement. 

Don’t feel disheartened if you start your first placement and you are working with the HCAs for a few weeks. Your mentors will expect you to learn the core care skills when you start your placement, even if you have years and years of care experience. You can read my previous blog on the phrase “too posh to wash” here. You probably won’t be giving out medications or doing ‘nursey’ things for a while.

You will have doubts. 

There will be days where you wonder why you are doing this. I had a fantastic first year but I still had plenty of days where I thought about quitting and going back to full time work. These were silly moments and I wouldn’t have quit, but you will find out who you can rely on to have a proper rant to and who will talk some sense into you on these occasions. Your support network will become a lifeline so keep a good one around you.

You may struggle financially. 

My bursary and maintenance loan cover my rent and my diesel to uni/placement. I have to work outside of the degree because I wouldn’t be able to do it otherwise. I try not to work much when I’m on placement but this means I have to work a lot during uni weeks and annual leave weeks. The current student finance situation may be more positive but there have been months where I haven’t had money left over after bills/diesel. It will all be worth it in the end! If you can work around the degree, try to save a little bit each month to cover you in case there are months where deadlines are due or placement is busy and you can’t fit any shifts in. Try to join the bank or NHSP at your local hospital as you can then pick and choose shifts around your availability, Sunday shifts and nights are the best paid so you could do a few of these a month.

Prepare to be emotionally challenged. 

There will be days where you are absolutely elated, and days where you are so worn down you cry at the tiniest thing. You will experience many firsts throughout your training, some positive and some negative but each one will be a learning curve. You will experience end of life care and the death of a patient. You may experience having to be involved in CPR. If you encounter situations that overwhelm you or challenge you emotionally, your mentors are there for support. You can also talk to your peers and university support teams. It’s ok to be upset and overwhelmed, these are natural human emotions so don’t be afraid to show them when appropriate.

You are supernumerary. 

Please remember that you are not counted in the staffing numbers. If someone rings in sick or is moved to another ward, you are not there to cover for them. Yes everyone gets involved with care and the tasks on the ward, but you should never be used to replace a staff member that isn’t there. You are within your rights to speak to someone if you feel you are being used within the numbers and not as a supernumerary student. Most placement areas are fantastic and won’t pose this issue.

Being a student nurse is often fantastic. I have experienced so much within my first year and I’m excited to see what second year brings. Time really does fly and imagine how good you’ll be feeling at the end of year 3 when you are qualified and waiting for your pin to arrive to start as a NQN. If you do experience times when you are struggling, please remember to talk to someone about it. Don’t bottle those feelings up as you are not the only one feeling that way.

Love,

T x

 

 

End of year 1!

0

I can now officially say that I am a second year student nurse! There have been times throughout this first year that I thought I would never be able to say that, I haven’t found the assignments to be particularly challenging but I have doubted myself in every way possible this year. Is my writing good enough? Am I good enough on placement? Will I ever have the right amount of knowledge to qualify?

I’m sure these are thoughts that a lot of us have had and will have again throughout the next 2 years of our journeys!

I am excited to get started with year 2 and get some more assignments, it seems like forever since I had anything to research and write about 😂 Although I may not be saying that once I get the dreaded research assignment!

My first placement of year 2 will be on ITU/HDU for 6 weeks, with 2 weeks annual leave in between. However, I won’t be off for the 2 weeks as I will be working at my bank job. I do have a visit to Harry Potter Studios to look forward to on the 6th April though!

I have so many expectations for second year, mainly due to what other students have said and things I have read on Internet forums. I am worried about the year 2 blues (although I worry about everything as you will know if you follow me on twitter, so that is nothing new 😂). I know I have a fantastic support network around me to get me through if the year 2 blues do hit.

I doubted myself so much at the beginning of the course and I still do now,  it’s a confidence thing and I think I’ll always be the same. I’m not the kind of person to admit to feeling like I’m good at something and would always rather play my skills down instead of shouting about them. Despite some amazing feedback from both my year 1 placements, I still have doubts about my abilities. I can see how much I have grown throughout this first year though and hope to continue to grow throughout year two.

In year 1, I achieved grades between 70-98% and would love to keep this high standard up throughout year 2 now that the grades start to count towards my final degree classification. I make no secret of the fact that ideally I want to qualify with a first so I need to keep focused on that goal.

During first year, my future focus has shifted from ward work as I now feel this is not where I can see myself in the future. I still have a passion for cardiology though so I’m keeping my fingers crossed for a placement on the cardiology ward at my placement hospital. My next placement is something completely different to my year 1 placements and I am excited to get started on there.

Let me know how you found year 2 and if you have any tips for me 😊

Love,

T x

*Book review* Clinical Placements

1

Clinical Placements by Kirstie Paterson and Jessica Wallar (edited by Kath MacDonald) is part of the pocket guides for student nurses collection of books. These are little pocket-sized books that aim to provide useful information to student nurses. Subjects such as intensive care, general practice, older person care and many other areas of nursing are currently under development so please look out for them in the future!

The foreword of the book discusses how the book came to be written and can be seen below. It was written by recent nursing graduates, reviewed by students and checked by a clinical supervisor.

62995340-3C7F-4141-9FFE-10F5EAE760BF

There is a list of common abbreviations which I know I would have found so helpful before starting placement as the first time I looked at a handover sheet it appeared to be in a different language!

There are four sections to the book: Getting there; Settling there; Being there and Moving on from there.

a65987ba-acf6-4853-b42b-01162fb77e2f.jpeg

  • Getting there includes tips for preparing for your first placement, information about the NMC code of conduct and guidance on social media usage.
  • The settling there section talks about your first day, how to work with your mentor and how to improve your communication skills with the team and patients.
  • Being there is about your time spent on placement and the common assessment tools you may come across within your placement area. Personal safety on placement is covered and drug calculations as well.
  • Moving on from there includes a fantastic FAQ section featuring common questions I know a lot of student nurses will have thought about.

Throughout the book there are links to the NMC code of conduct and handy pages around patient assessment tools such as NEWS and Waterlow. These would be useful for any student nurse on their first placement. There are also spaces for students to make their own notes.

image

I would recommend this book to anyone starting university as a student nurse soon, I haven’t seen a book of this size with this much information in before, it is small enough to be kept in your pocket or your bag during placement shifts to be used as a guide should you need it. It is also a great read before starting placement which would help to alleviate any of those nerves around starting a placement. The book is designed to make placements more enjoyable and less stressful – I would say it definitely does this! It would be perfect for first placements but would also be handy for students further into their training to keep as a reminder guide.

If you would like to purchase this book, you can find it here. The book is currently priced at £9.99 and published by Lantern Publishing ltd. You can also purchase direct from Lantern Publishing here.

Self care

0

You may hear this term and think what is self care? To me self care is about looking after yourself and making sure you regularly take time to do things that you enjoy. Sometimes it’s easy to get caught in a placement/uni and sleep cycle with very little else. It’s important to take time for yourself to recharge and refresh. How can we look after our patients if we don’t look after ourselves first? Here are the things I do for self care 😊

  1. I try to have one day a week where I have no plans and can just relax, catching up on tv or reading a book. This is not always easy around uni/placement/work but I usually have at least an afternoon off.
  2. Taking a long soak in a hot bath with a face mask on. I like to do this as it relaxes me and helps me to destress.
  3. I like to have at least 6 hours sleep on a night as I feel rubbish throughout the next day if I don’t. If I can have more than I do as it gives my body that extra bit of rest!
  4. You are not being selfish if you recognise that you need a day to yourself or you just can’t reply to that text/email right now. There is nothing wrong with taking time out to care for your mental wellbeing, sometimes you need the time away to concentrate on you. Don’t feel guilty if you need to rearrange plans or you turn your phone off for an hour.
  5. Step away from social media. This can sometimes be easier said than done, but even if you just ‘mute’ negative people it can have a positive effect on your social media time and your outlook.
  6. Calling a friend for a quick chat. It really helps to know that support network is there. Talking about things other than uni/placement helps to take my mind off any worries I have as well.
  7. Making plans for the months ahead. I always feel better if I have something to look forward to that isn’t uni/placement. D7B5D714-7624-4A8F-B55F-9F8CB9C4AF06I have a Harry Potter Studios tour, live WWE wrestling show and a live autopsy booked in already for this year 😊.
  8. I enjoy exercise (even though lately I haven’t done enough of it!), it really helps to brighten my mood and makes me feel more energetic afterwards. It is also a good destresser.
  9. Music. I love listening to music and Spotify has been a lifesaver. From cheesy 80s dance to pop punk, there is something on there for every mood.
  10. Gin. Gin is always the best part of self care. Cheers!

DBE2457D-2CAE-408D-BC58-C68F651AE669

 

Love,

T x