The Beauty of South Wales

Ok this is not really a post, I just wanted to share a picture with everyone. This afternoon I decided to take a trip up to Pontsticill reservoir, just on the outside of the Brecon Beacons. Whilst I was up there the sun was setting slowly and I managed to take some really nice pictures looking across the lake. You can see these in full from my facebook page but it really shows the beauty of where I live.

September Updates & Nursing Department Conference

Just a quick post tonight, to go over a few things including an update on news from the RCN since I received my update for September tonight. Those who have read my twitter/facebook updates over the past few weeks will have known that this month the department of Health were due to release a new consultation on the NHS Bursary scheme for students. This consultation has now been released and is available from the department of health website, it is basically attempting to iron out any problems with the current system and to give enough financial support to enable applicants from all backgrounds to apply into a healthcare profession. It is an important document that will hopefully see an increase in financial support from the NHS to students who apply to study a course leading to a career within the NHS. The document also outlined five options that will be continue to be looked at which included continuing on the current scheme meaning that when the NMC implements the change to a degree only profession, students would go to the lower-financial option which is means tested. There is also an option to look at taking the current diploma financial option of non-means tested bursaries and applying it to all student when the change to degree is made. One that I believe that should be considered heavily within this consultation is an option to apply the minimum wage to healthcare student on placement. As I said above this document is available to read in full from the department of health website  http://tr.im/yOkl

you will also be aware, if you read my twitter/facebook updates, that the NMC launched their new guidance to Nursing & Midwifery student this month which will have been sent out to universities or available from the NMC website. I will also post a link at the end of this section of where you can get the document from. Similar to the old document, this one explains a bit about the NMC and what it does. It also touches upon fitness to practice a major part of the Nursing profession as well as remembering the importance of personal life. A major part of this new guidance though is the NMC Code which we are all obliged to follow. As you read this I have not long received these documents myself so have only really flicked through. If you are interested in seeing this new document it is available here  http://tr.im/yOmJ

Finally, I just want to mention quickly about the Nursing department conference that takes place in London next month. I sent an email to the RCN Student Coordinator Laura King earlier to ask to be considered for one of the funded places at this conference as a member of the Association of Nursing students. This would be a fantastic experience. This conference looks at the context of quality care and best practice but there will also be a talk on whistle-blowing highly considered to be a dark subject in the NHS but a very important one in the safety of our patients.

So what was supposed to be a quick post has turned out to be a normal-sized post after all. Hope you enjoyed reading this post and if there are any queries feel free to contact me.

Children with Diabetes excluded from extra-curricular activities

This post was supposed to be up this morning before I went to work but I ran out of time so here it is now. This week there was an article in the Nursing Standard that reported on children of school age who have diabetes being excluded from certain school activities. It stated that schools do not usually want the extra responsibility in caring for children with diabetes on overnight trips or in activities that can affect their blood sugar levels. This has seen children being excluded from Physical education and extra-curricular sporting activities which in the long-term would really benefit the condition. Adults with diabetes are encouraged to under-take regular exercise to ensure that they have a steady blood sugar level and to prevent the onset of cardiovascular disease. preventing children from undertaking physical education can help these other complications come on quicker later in life. The article spoke about children also be made to take responsibility for their own health from an early age, this can have psychological complications later on in adulthood as their childhood will have been cut back. It also spoke about the child’s education suffering as they would need to leave classes early in order to take insulin prior to lunchtime. The RCN has now launched a guidance to increase awareness of multiple injections and pumps in order to prevent children leaving class early. so this was just a quick post really on something that caught my eye when I was reading through the Nursing standard. hope you liked this post and I shall be posting again shortly.

Back again

It has been a while since I last posted on this blog. The main reason being that I kept forgetting about it and the fact that I have been away from my training for the summer break. Now though I return ready for the start of my second year after the first year went quite fast, faster than I thought it would go at the beginning of the year. So here I am a second year student and two more years before I become a registered Nurse.

So a recap on my first year of training. Last year started with weeks and weeks of anatomy and physiology lectures which provided the backbone of the first year of Nurse training. This is usually the same with most universities in the UK that offer Nursing as a course. This was stressful period as we would have about five or six hours of anatomy and physiology in the build-up to our exam.

The other main module we had during the first year looked at Nursing assessment as well as the core-elements that apply to healthcare such as the sociology and psychology which would aid future assessments of patients. We also had sets of clinical skills as well as biology lectures putting detail into what was learnt during the initial anatomy and physiology lectures in our other module. This taught us about the physiological elements of breathing, sleep and other physiological elements that made up our system.

The clinical skills sets taught us about what we would be expected to carry out on the wards as registered nurses once we qualify. This involved learning how to take routine observations on patients such as blood pressure, respiratory rates, pulse, temperature and early warning scores. We also covered manual handling sets informing us how to keep ourselves from injury in placement but also how to transport patients safely from one spot to another. It was also an important element to re-do basic first aid in the case of any cardiac arrest incident out on the wards. We were also taught about how to monior fluid levels correctly and perform bowel care. In the second set of skills we went deeper into the basic nursing tasks that we would be performing out on the wards such as oxygen therapy and administration of medication. Overall I think the first year went well I passed everything and am now looking forward to starting my second year in two weeks time!

So I have had my timetable for my second year now and it looks quite interesting. It looks like the main module this year will be teaching us how to care for patients who have complex needs such as learning disabilities or maybe complex conditions that may leave them in a critical condition. I must admit that I am looking forward to this module as it will be interesting to learn how to care for patients properly. It sounds as this module will also be a build-up to my fourth placement at the end of year two where by I will be placed in an area caring for patients who may be in a critical condition. this could be intensive care, coronary care unit or maybe even just accident and emergency. That should be a brilliant placement.

Ok so next is the second part of interprofessional practice, a module that I really enjoyed and received a high mark for last year. This year the university is sending us to Bath to take part in a conference with other health and social care students such as social workers, occupational therapists, physiotherapists and this year we also meet up with third year medical students. this should be a great two days and I am really looking forward to it. Like last year as well this year we will be doing clinical skills sets that will teach us what we will be expected to perform out in practice. this year we will be covering injection techniques, female catheterisation, cardiac monitoring, airway management, suctioning as well as more manual handling refresh sessions.

So yeah this should be another great year and I am really looking forward to it. I shall now end this post as it does seem to be quite long. I shall be making more posts over the course of this year.

Patient education as part of their perioperative experience

Hey again, another post and my first of July. Over the past two days I have been visiting outpatients clinics and pre-operative assessment clinics to see what the early stages of a patients perioperative journey is like, and also from the outpatients perspective what happens once a patient has been discharged. I have to admit it was a fascinating experience and has given me nearly an full picture of what happens during the patients hospital journey and what happens following discharge. On Tuesday I attended outpatients and pre-op assessment. During my morning in outpatients I met up with a range of patients that had been discharged over the past few months who were initially admitted for knee, hip or foot surgery. I was observing the role of a Physiotherapy specialist who has a very interesting role within the healthcare team. This involved assessing patients post-op to see how their recovery is going and how the surgery has benefited their everyday lifestyle. I linked this very closely to my experience of seeing a total hip and total knee replacement last month and how a normal leg looks almost a month after surgery. It was interesting to see the end stages of treatment and how the surgical wound would have healed. I had not really spoken much about my experience of observing very talented surgeons replacing knee’s and hip’s, I have to admit I have always really wanted to see a total knee replacement operation as my father is due to have one over the next few years. I had seen the operation previously through online surgical videos but it did not at all relate to seeing it up close. I had understood knee surgery for a while but seeing and having the surgeon explain the procedure to me as he was going through was very fascinating indeed. Basically an excision is made from the bottom half of the Femur and the top half of the Tibia where the knee joint is actually connected, from here the surgeon pulled the patella (kneecap) to one side to start work on the arthritic joint. The surgery which took about two hours involved using a tool to cut away the arthritic parts of the femur and Tibia before testing trial parts which will make up the new joint on the knee. Once this is done he would cement the metal prosthesis to the knee to make the new joint. Many people mock the ability of those who choose to become Orthopaedic surgeons but to be honest I feel that they are extremely talented to perform a procedure like this. During the afternoon session  I attended pre-op assessment. During this session I observed the role of nurses and healthcare assistants who assessed patients prior to their surgery. This involved looking at their blood pressure, temperature, respiration rates and oxygen saturation as well as performing an ECG to make sure the heart was functioning properly. This is an important element of a patients journey as it makes sure that the patient is fit for surgery and makes sure that any initial complications are avoided. Today I attended plaster-room which again was an interesting experience. I met many patients who came in to have sutures removed or new casts fitted which would allow support for their legs or feet. In the afternoon I attented a patient education class run by occupational therapists which answered any questions patients may have prior to their operation. This was an amazing service provided by the trust as it eases the stress and anxiety of patients and makes sure that they are well informed of what will happen before the operation, during the operation and after the operation. Overall the past two days has taught me a lot about the patient jouney during their perioperative journey.

June 28 2009

Hey again, as you will be aware of by now I am a proud member of the Royal College of Nursing and enjoy promoting it to new and current students where ever I go. On the 17th I attended a student conference up in Watford which I have said in previous posts was a very interesting day and made me want to get more involved within the student section of the RCN. Every other week I attend a work-based learning session within the University that aims to get students thinking about their practice and develop new techniques to help deal with situations out in practice. This is our second block of work-based learning as it shadows practice placements. During this block the group facilitator has allowed for the sessions to be student led enabling us to share our practice and knowledge with our colleagues. Tomorrow I have volunteered to feed back on my visit to Watford and what I learnt during that session. This I feel is another great opportunity to promote the RCN to my colleagues within the group. I personally find that the RCN is a great tool to use within students pre-registration training, as I have said on previous ocassions the RCN now hosts over 700 full journals to all members which are fantastic for professional development or essay writing. There is also a fantastic opportunity to share knowledge with experienced nurses, newly-qualified nurses and other students on the RCNs discussion boards. I have found on many occassions that asking questions on these boards have enabled me to get further understanding on a particular topic. If you are a fellow student Nurse reading this post today then please check out www.rcn.org.uk as it will really add a boost to your training.

Learning Disabilities week

Today marks the start of Learning Disabilities week, this week aims to promote the rights of people with learning disabilities and to ensure that their needs are met. As an healthcare professional I feel it is my duty to have some involvement with this but due to me currently having strict hours out in practice I will have to show my immediate support online. The main campaign this year looks at getting more changing toilet facilities in public places for people with learning disabilities. Over 230,000 disabled people across the UK are being denied the right to do everyday things and access their community because standard accessible toilets do not meet their needs. Without Changing Places toilets  – with a hoist, changing bench and plenty of space – disabled people are forced to stay at home or carers have to risk changing their loved-ones on dirty toilet floors. This is unhygienic, degrading and undignified.  There are currently only 85 Changing Places toilets across the UK. This is unacceptable. Please show your support by going to the Mencap website and signing the petition to call the Government to install suitable facilities within towns and cities across the United Kingdom. E-mail your MP to ask for support from them as well as your local councils and try and make change happen. We take advantage of being healthy everyday, we take advantage of having the facilites that allow us to complete our everyday activities, people with learning disablities suffer because they do not have the facilities. Please show your support.

RCN Student Conference Watford 2009

Last week I attended a student conference up in Watford as part of the RCN’s group of student events across which has now ended. I did post about two weeks ago about my expectations of the event which turned out to be better than I imagined it would be. When I arrived I was signed in and given a cup of coffee and a free copy of the Nursing standard. The first part of the day then Gillian gave a presentation about CV Techniques and preparing for interviews which was specifically aimes towards third years but it was really helpful because I am currently putting together a CV. We then had a presentation from Lynn Young the RCN Primary care adviser who talked about the serious-ness of the swine flu pandemic which was very interesting but I think she came over a little bit strong at times in regards to pushing the message that there will be a massive upsurge of the flu in the autumn and we need to be ready. The next bit had to be my favourite part of the day. It was a very moving and sobering story by the Author of “who cares” Amanda Steane who talked about the catastrophic events leading to the death of her husband. It really made me think of the importance of fluid balance and how things can take a turn for the worst very quickly. She also brought copies of her book along so we were able to buy it and she signed it for us . After Lunch we were made to think about dignity and its affect on patients. This was very good as there was like a mini-discussion then about how we would feel about certain elements of care. Then senior lecture Jim Blair from Kingston University spoke to us about how we treat people with learning disabilities and made us think about how our actions can have terrible affects on them. This was very interesting indeed and I am now considering taking Jim up on his offer of volunteering to help with the special olympics over the summer. As I said it was a brilliant day and something I would definatly be interested in doing again. But now I need to step it up a notch, Congress is a definate for me next year!

Change must happen now!

It has pleased me a lot to see Labour slump to a catastrophic defeat in the European elections recently. I still consider myself to be massively undecided in terms of my political views but I have become increasingly frustrated at the continuous failures by a Labour Government who I now believe are making us a laughing-stock across Europe. It was frustrating enough that New Labour and the Liberal Democrats pushed forward the Lisbon treaty without consulting the general public. This treaty would have signalled the end of British Independence. I am sure that I am not the only person who is completely against this. There has also been continued talk over replacing our currency with the dreaded euros, this treachery will also remove our Independence. I have on many occasions denied claims that I had become a Torie but would like to claim that I have turned to the Conservatives in hope that we can regain our European reputation which is in tatters after many years of Labour rule. The recent row over MP’s expenses has also left the reputation of the British political system in tatters, this needs to be addressed, the general public have begun losing faith in politics something that can not be allowed to happen. This signals the end of New Labour with Labour losing many MP’s over these rows. Mr Brown’s attempts of creating a new cabinet I am sure will not last. I believe that as soon as Labour call the next general election, their term will be over. This can certainly be backed up by the recent defeats in both local council elections in England the UK-wide European elections. In Europe Labour dropped to third behind the Tories and the UKIP with only 15.7% of the vote a drop of 6.9%. In the local elections they finished third as well with not one overall council win losing 291 councillors whilst the Tories gained 244 councillors. I sincerely hope that this truly is the end of New Labour as we need change now!

Nursing Documentation & Post-op recovery

My second placement in my pre-registration training has really taught me about the importance of thoroughly documenting everything that is involved within the patients care during their hospital admission. More importantly during this placement due to it being mainly surgical instead of medical is the use of pre-operative documentation and post-operative documentation relating to the care and recovery of an individual patient. Documentation is a major part of Nursing and does involve heavy loads of paperwork on regular occasions but if done correctly can result in a quick recovery for the patient as well as a good standard of care. I have noticed from my own experience that I lack a good understanding of Nursing documentation but aim to use my time during my second placement to bring together the elements of essential care and the relevant documentation that will involve the complete care of an individual patient. Today I picked up a few books from the University Library on planning care and what to look out for pre and post op in relation to the patients recovery and possible implications that will restrict the immediate recovery of that patient. This includes obvious possible complications of any surgical procedure- haemorrhage of the wound site and an increase in blood pressure. I personally think that it is also important to watch out for signs of pyrexia which could highlight possible infections at the wound site or at other places in the body. One of the key issues post-op is that the patient is recovering to normal such as returning to normal blood pressure if that was affected during surgery, normal temprature for the patient, normal oxygen saturation levels and a normal resperation rate for the patient. It is also important to make sure that the patient is able to pass urine and take in fluids, not being able to urinate post-op could indicate that there may be a lack of fluids in the system. Monitoring pain levels post-op is also a very important element of post-operative recovery whereby the pain score chart is usually used. This is where the patient would rate their overall pain from 1-3 with one being mild pain and three being severe pain. This also relates heavily to the analgesic ladder whereby a score of one would probably highlight the need for paracetamol, two bringing the need for paracetamol, codeine and iburoprofen and in the case of severe pain all three plus dosages of morphine. It is also an idea post-op to monitor signs of the general anasthetic wearing off, this can take a few hours to go completely as patients would feel drowsy and tired for a few hours post-op. This however also depends on the individual patient. In the cases of epidural injections it is important to ask a patient a number of times post-op if they are beginning to get sensation back in the area affected usually the toes. If the patient is not a day-case and the surgery they recieved was major such as total knee or hip replacements then care plans come into effect in order to monitor patients overall recovery and reduce the risk of any further complications prior to discharge. One of the most important care plans for major operations is that of pressure-ulcer management and prevention. In patients who have those major operations they could be immobile for long periods of time even if they have begun working with the physios. Pressure ulcers can form within a few hours and can be very painful for the patient. This also has other underlining issues such as constipation or loose stools due to immobility. I hope you have enjoyed todays post which shows my current understanding of post-operative recovery.