How to use Discord

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As you may have seen, I have created a server on Discord called the Student Nurse Academy. This server is for all student nurses and newly qualified nurses to get involved with. There are text chat rooms where you can ask advice and support on things such as assignments and placements, allowing you to receive real-time support from other student nurses. You can also chat socially with other student nurses from around the world! I know that many of you may not have been on Discord before so I have created this step by step guide on how to use it that I hope you will find useful!

  1. Create a Discord account – download the app on your phone or computer and choose a username (you can change this later on). Remember to verify your email to allow you full access to the servers chat rooms.
  2. Customise your account – you’ve verified your email address and now you’re good to go! Add a profile picture of your choice and connect apps such as Facebook or Spotify if you wish to do so! blog picture 2
  3. Join the server – you can join the server through the invite link, this takes you straight to the introductions chat for you to tell us a little bit about yourself! Your servers will appear on the left hand side of the screen.blog picture 1
  4. Start chatting! – join one of the chat rooms on the left hand side of your screen and write a message. All the chat rooms are text chats, except coffee club which is a voice channel. You can jump in there and chat with other student nurses, kind of like a big Skype call ūüėā¬†If you don’t feel comfortable using the voice channel, stick to the text chats! If the chat names appear in bold, this means there are messages in there you have not seen.blog picture 3
  5. Build friendships – the main aim of this server is to bring student nurses together and to create friendships. Asking for advice is important and a part of this server, but gaining a support network is the main aim. You can chat about anything you want to in the general chit-chat ward, from what pets you have to what Harry Potter house you belong to (I’m a Slytherin for anyone interested ūüėā). I’ve made many friends through social media and want to help make this a possibility for other student nurses.

Why not use Facebook/Twitter/Instagram like we are now?

I wanted to create an area where student nurses can just chat, a little bit like a Whatsapp group but without needing to share your phone number with ‘strangers’. Twitter/Facebook/Instagram require a little bit of work from yourself to start conversations, you need to post a status, tweet or picture for people to interact with, that’s if your friends see them with the current algorithms. Here on Discord, you can just jump into a chat and join in. Discord is a safe place where you don’t even need to divulge the university you study at if you do not wish to. Discord is easy to use and you don’t even need to receive notifications if you’re easily distracted like me. Pop in and out of the chats whenever you want to and interact with people. You can @username to direct a message towards a specific user and react to people’s messages. You don’t even need to download an app, you can just use this when on a computer through the web interface.

Feel free to ask any questions you may have!

Love,

T x

You must work on a ward…..

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This age-old narrative is rearing its head again and again. ‘I want to work in the community but people say I must work on a ward for at least a year’, ‘I want to specialise as a newly qualified nurse (NQN) but some say I should work on a ward first to hone my skills’ and such nonsense is heard and seen every single day in university or on social media. I feel that statements like this are dampening the dreams of student nurses for no real reason.

NEWS FLASH!

There is no reason to work on a general medicine ward first before moving on to another post if you do not want to. Yes you will develop your skills as a NQN and build your confidence during your preceptorship. BUT…the skill sets used in areas such as the community, in a GP surgery, theatres, a nursing home or in specialist areas such as critical care are very different to the skill set used on a general medicine ward. Contrary to belief, you will not ‘de-skill’ going into these areas!

So you spend a year on a general medicine ward and then move to the area you actually want to work in…and guess what? It’s like starting over again. You need to develop all the new skill sets and hone the ones you already have to your new area. Why not cut out the middle man and develop these from the beginning of your time as a NQN?

We spend a long and hard three years at university…why should we ‘settle’ for an area we know we don’t actually want to work in when we have fallen in love with an area that is right up our street? As a student nurse, or even a qualified nurse, the world is our oyster and we can apply to work in most areas now as a NQN, so if you have dreams of working in an area like critical care or a GP surgery there is nothing stopping you. There are more and more areas accepting applications from NQN now and I can only see this increasing in the future. If general medicine is your thing that’s fab, but for a lot of us working on a ward is not what we want to do and that’s fine as well. You are at work for a large portion of your week, why spend the time unhappy?

I am often criticised for wanting to go straight into critical care, I hear things like ‘it’s too specialised you’re not a good enough nurse as a NQN to work in such a specialist area’ or ‘why would you want to start in a place like that when you could spend a year on a ward first’. Working on a general ward is not for me, I’ve known this for a long time and it won’t change. Yes critical care is still a ward, but its a different kind of routine and style of nursing to general medicine wards.

Don’t be afraid to talk about where you would like to work, if someone attempts to shoot you down don’t feel like you need to explain yourself. The most important thing is finding the job that suits you and if this is in an area other than a ward, hold your head up high and know that you are making the right choice for you. Ultimately this is all that matters.

Nursing is not one size fits all and that’s the real beauty of it.

Love,

T x

Quantitative Research

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Quantitative research is used to answer questions that have numerical value answers. Quantitative research is also used to establish cause and effect relationships  between variables.

Quantitative research designs

  • Randomised controlled trial –¬†considered to be the best design to establish cause and effect relationships. Key features of a RCT include a treatment arm/group and a control arm/group.
  • Quasi-experimental –¬†similar to RCTs with no randomisation.
  • Cohort studies –¬†follow a predetermined sample group to measure the incidence of outcomes. The purpose of cohort studies is to link an exposure to an outcome. Purely observational with no intervention from the researcher.
  • Case control studies –¬†the retrospective form of a cohort study. Individuals with the desired outcome are chosen, with the researcher attempting to discover the exposure that the outcome can be attributed to. Highly prone to recall bias.
  • Cross sectional studies –¬†used to determine the prevalence of an outcome within a specific group. Often conducted using surveys, cross sectional studies are common in healthcare due to being cheap and easy to conduct.

Types of data collection within quantitative research

  • Biophysical
  • Pre-existing data
  • Observation of behaviour
  • Self-reporting

Strengths and limitations of quantitative research 

Strengths:

  • Data can be interpreted using statistical analysis
  • Can establish cause and effect relationships
  • Computer software available to analyse data – saves time and helps to minimise risk of human error
  • Easy to replicate and generalise

Limitations:

  • Do not reflect real life due to the high control applied.
  • Reductionist – simplifying complex situations into simpler versions
  • All confounding variables cannot be controlled
  • Lacks breadth within data

Terminology associated with quantitative research

  • Internal validity – whether the results are based on the intervention or an unknown variable.
  • External validity/Generalisability – how well what is being measured can be generalised to the wider population.
  • Confidence interval – usually expressed as a percentage. Represents how certain the researchers can be that the mean for the entire population would fall within the identified range.
  • Hypothesis – a theory or idea that needs to be tested.
  • P value – a measure of the strength of evidence against the null hypothesis. a small p value < 0.05 indicates evidence against the null hypothesis, this is then rejected and an alternative hypothesis developed.
  • Independent variable – the variable manipulated by the researcher to measure its effect on the dependent variable.
  • Dependent variable – what the researcher is interested in measuring in the study.
  • Confounding variable – an outside influence that can affect the results of a study.

 

Love,

T x

 

Qualitative Research

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Qualitative research aims to answer questions about individual beliefs, opinions and experiences. The data collected within qualitative research is in text form and is used to grasp emotions and attitudes – essential to person-centred nursing and healthcare in general.

Qualitative research designs

  • Ethnography – where researchers seek to understand a group experience, focusing on behaviours and norms within the selected group. Often used to study social relationships between humans. A key feature of ethnography is the long-term study of participants, with the researcher both observing and participating within the group.
  • Grounded Theory – where there is no available theory for the topic, the researcher attempts to create one. Grounded theory is used to generate new theories around practice and understanding within healthcare, making it one of the most popular forms of research methodologies used by nurse researchers.
  • Phenomenology – aims to understand the lived experience of individuals. Can be described in two ways: descriptive phenomenology (credited to Edmund Husserl) or interpretative phenomenology (credited to Husserl’s student, Martin Heidegger). There are slight differences between the two, you can read more about those¬†here.
  • Case study – based on in-depth studies of an individual or group. Case study research is seen as highly flexible and often uses multiple methods of data collection.

Types of data collection within qualitative research

  • Interviews – can be structured, semi-structured or unstructured.
  • Focus groups
  • Observation
  • Diaries

Strengths and limitations of qualitative research 

Strengths:

  • Ability to explore the cultural and social aspects of living with an illness or disability.
  • Rich, detailed data is collected and analysed.
  • The structure of qualitative research data collection can be flexible, allowing the researcher to follow any tangents that arise within the study if needed.
  • Smaller sample sizes are used, possibly maintaining low financial input and being completed quickly in some cases.
  • Allows for greater understanding of patient care experiences.

Limitations:

  • People’s opinions and experiences are hard to replicate as they can differ over time and in different situations – due to this, findings are subjective and context bound, making them hard to transfer to other settings.
  • Lacks rigour and credibility due to focusing on individual beliefs and experiences.
  • Can be time consuming due to the amount of data collected and analysed.
  • Researcher/interviewer influence on the participant.
  • Results do not have any statistical representation.

Terminology associated with qualitative research

  • Credibility – representation of the truth.
  • Transferability – would the findings apply to another individual within the same context?
  • Dependability – if the research was conducted again, would you achieve the same results?
  • Confirmability – results are able to be traced back to the data collected.
  • Reflexivity – the questioning of one‚Äôs attitudes, values and prejudices and to appreciate how these could affect the outcome of the research.
  • Rigour – overall quality of the study ie strength of the research design, how well it fits the original aim etc.

 

Love,

T x

 

Research methods – common terminology

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Here are some of the most common terminology used that it would be useful to understand for your research module.

critical appraisal – examines the practical application of research, assessing how valid and relevant it is to the practice area.

intervention fidelity – how well an intervention is delivered as intended

generalisability – attempting to apply study findings to settings/contexts other than the ones they were originally tested in. Applies to quantitative research.

transferability – how findings can be transferred to another setting/context. Applies to qualitative research.

standard deviation – the spread of results occurring around the mean. For example, the mean age of participants may be 40 with a standard deviation of 25 – 55. Often represented as S.D. A smaller S.D is preferred as this shows a small spread of data around the mean, a large S.D shows a wide spread of data, meaning it is less reliable.

confidence interval – usually expressed as a percentage. Represents how certain the researchers can be that the mean for the entire population would fall within the identified range.

hypothesis – a theory or idea that needs to be tested.

null hypothesis – no significant difference apparent between two groups.

alternative hypothesis – results are the result of a difference between two groups.

p value – a measure of the strength of evidence against the null hypothesis. a small p value < 0.05 indicates evidence against the null hypothesis, this is then rejected and an alternative hypothesis developed.

quantitative – research where the results are numerical such as statistics, percentages etc. Studies cause and effect relationships.

qualitative – research where the results are text based and may follow themes. Includes thoughts, feelings, descriptions etc.

mixed method – where researchers use both quantitative and qualitative data within the same study.

rct – randomised control trial.

randomisation – making something random ie the allocation of participants into a treatment or control arm. A good way of minimising the risk of bias.

treatment arm – where participants receive the treatment/intervention. Characteristic of a rct.

control arm – participants receive no treatment/intervention or they receive a placebo. Characteristic of a rct.

internal validity – whether the results are based on the intervention or an unknown variable.

external validity – how well what is being measured can be generalised to the wider population.

independent variable – the variable manipulated by the researcher to measure its effect on the dependent variable.

dependent variable – what the researcher is interested in measuring in the study.

Reflexivity Рthe questioning of one’s attitudes, values and prejudices and to appreciate how these could affect the outcome of the research.

homogenous sample – when participants have similar or identical traits ie same age, gender, employment etc.

heterogeneous sample – where every participant has a different value for their characteristics ie different ages, gender etc. Indicative of diversity.

blinding – where participants or researchers are prevented from knowing which intervention group participants are allocated to. Can be single blinded or double blinded.

T-test – used to determine if there is a significant difference between the means of two groups.

bias – a form of error that can affect the outcome of studies.

triangulation – using more than one method to collect data. A way of assuring validity within the research.

primary research – new research studies, carried out through experiments, trials etc.

secondary research – analysis or interpretation of existing research studies.

cause and effect Рwhere one event (the effect) is the result of another event happening (the cause). Randomised control trials are the best method able to establish a cause-effect relationship.

 

 

 

Let’s talk about second year blues

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If you’d asked me in the summer months about second year blues, I would have told you that it was a little bit of a ‘myth’ and that if you kept yourself organised you would be fine. I even wrote a post containing tips to survive second year¬†. My first module of year 2 was Research Methods and is often described as the worst module of the whole degree at my university by previous cohorts. I fell in love with the subject and wondered what everyone had been making all the fuss about. I achieved 95% in the assignment and genuinely thought I was set for the year…I couldn’t have been more wrong.

Autumn came and the second year blues hit me like a train. I lost all motivation to complete work and began leaving assignments until close to the deadline date, something I don’t do because I get stressed easily and not being organised is a trigger for me. My assignments were not up to my usual standard because of this and still I sat confused and upset when the results were released and I hadn’t achieved anything like the results I was used to. Instead of spurring me on to complete work early like I usually do, a rubbish result (or so I thought at the time) knocked me for six and I continued with no motivation wondering what the point was. I completed another assignment and submitted, knowing it wasn’t my best work but believing it was good enough to stay within my targets. Results were released and I was ready to quit university altogether that afternoon,¬† it was my worst result to date and the feedback felt brutal. I spent that weekend in what felt like a hole, at the end of my tether with this whole experience and genuinely thinking about leaving. I’m not ashamed to admit that I’ve had more negative days than positive days in year 2, I can probably count the number of truly positive days on one hand if I’m being brutally honest.

Second year blues are real and should be discussed more. It’s not enough to preach on and on about positivity, staying positive etc, because it really isn’t as simple as that. It’s hard to remain positive when every single day at university feels like a knock to your confidence, when you leave placement everyday wondering if you will ever really know enough to be a nurse and when every result makes you question whether you’re even intelligent enough to be doing this degree. I’ve lost count of the amount of times I’ve cried in the car park after a placement shift before setting off to go home, just from doubting myself and a decision I’d made that day or because I didn’t know something that I really feel I should by now.

My first placement of second year was amazing, I spent 6 weeks with the best team and felt like I knew what I was doing even though it was out of my comfort zone. I thrived in an area that is extremely specialised and that I was terrified of before I started. When I began my second placement of year 2, it all unravelled. I like being out of my comfort zone, but this was a whole other level. I knew nothing. And that’s not me being dramatic, I genuinely knew nothing. I was an adult branch student nurse, walking into neonatal having never really held a baby before, let alone cared for one for a 12.5 hour shift. Everything was so different to adult branch, it was like starting the degree again with no previous experience at all. I enjoyed the placement and my mentors were fantastic, but I spent the four weeks thinking I wasn’t showing my full potential because it was so different to what I’m used to and it completely threw me. I started my third placement of year 2 having lost all the confidence I’d gained from my critical care placement and not even knowing if I wanted to be a nurse anymore.

Year 2 has just felt like one knock after another and I will be glad to see the back of it. I have 8 weeks left of placement before year 3 starts and I’m excited to get back onto the ward and gain some confidence back ready for year 3. In all honesty, I still don’t feel 100% myself and if it wasn’t for certain people this year I don’t think I would still be at university now because I couldn’t have coped without them.

If you feel like you’re struggling at any point, reach out to someone. It doesn’t need to be a lecturer, it can be a friend or someone in your cohort. Even find someone on social media who you can confide in, don’t bottle it up like I did. I felt embarrassed to admit that I was struggling and keeping quiet for so long probably hasn’t helped the way I’ve felt for the past 4/5 months. I don’t think the ‘positivity brigade’ help at all, as much as they may think they are doing good, it’s hard to go on social media and see positive things all the time and no one talking about how hard things can actually be. I’m not saying people need to be negative nellies all the time either, but it’s about time we all started to show the real aspects of our experiences within this degree. Not just the highlight reel of achievements.

Love,

T x

Second year is the worst….or is it?

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I’ve seen so many posts about how bad second year is and how difficult it can be, I am 6 months into second year now and thought I would share my top tips on how to make it a little more bearable!

  • Start work as soon as you get it. Gather references for the assignments before you start them as this helps when starting to write.
  • Remember how far you have already come. Think about your first day and how much you have learnt/changed since then. Write a list of achievements from year 1 that you can look back on.
  • Plan things throughout the year. I found this helps the time to pass a little quicker if you have things to look forward to.
  • For research modules – make sure you fully understand the terminology as this will help you when completing the assignment.
  • Take everything you hear from previous cohorts about assignments with a pinch of salt, you may really enjoy something that someone else didn’t.
  • Placement pre-reading. Placements will expect you to have a little more knowledge this year so pre-reading is a must.
  • Take on your own patients. Even if it’s only one patient for that day, take responsibility for their care (within the limits of what you can do with mentor supervision). This really helps to build confidence and third year responsibilities won’t seem as daunting if you have been doing them through year 2.
  • If you’re struggling, reach out to someone. Your personal tutor, another lecturer, someone on social media. It doesn’t really matter who it is just make sure you open up to someone, don’t try to manage through on your own if you feel you are struggling.
  • Get hold of a book on critical writing and thinking. The step up to level 5 writing can seem huge but it’s really about being able to say why something is done the way it is, wider reading and being critical in your thought process. I can recommend these two:
  • Take time for yourself. This is important in any year but do the things that make you happy. Self care can really help when you’re feeling fed up!
  • Chip away at assignments bit by bit. I start mine as soon as they are available and chip away, doing an hour or 2 a day if that’s the only time I have. Before you know it, the assignment is completed and it’s just the final checks you need to do.
  • Reference as you go! I say this all the time but with critical thinking comes more references, the last thing you want is to get to the end and have to find all 50+ of your references again to get them on your list.
  • Take on board previous feedback from year 1 and speak to lecturers about how to successfully write at level 5, they may have little hints and tips that will help you.
  • If you have to work around university, try to keep at least 1 full day off a week for assignments and yourself. You may even be able to join the bank at your hospital trust now, allowing more flexibility with shifts.
  • Try not to be disheartened if your first result is a drop compared to your first year grades. This can happen with the step up to level 5 writing, ask for guidance and really pay attention to your assignment feedback.
  • Try to save a little money each month, student finance drops in year 3 so saving a little bit during year 2 will help fill the gap.
  • Make sure your referencing is up to scratch, I have found this book really helpful for referencing (there is a website as well). Referencing tools are great but I prefer to create them myself then I can be confident that any errors are down to myself and you actually learn how to reference when you do them yourself.

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  • Keep up with your car maintenance, this may seem obvious but if you use your car a lot for uni and placement, wear and tear can occur faster than through doing normal mileage. The last thing you want is to be sat on the motorway waiting for the AA! (Other breakdown recovery companies are available ūüėā)
  • Email your assignments to yourself or save them on onedrive/google drive/a USB stick. Again, this may seem obvious but if your computer breaks or your work doesn’t save, you risk losing all the work you have done towards an assignment.
  • Keep in touch with your friends during placement, this kept me going through long shifts and weeks on placement.

Let me know if you have any other good tips for year 2 ūüėė

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 ūüėė

Love,

T x

Common equipment used in critical care

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Monitor РEvery 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 РThis 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

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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 Рis 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.