Phase 5

Happy New Year to you all!

Hope you all had a wonderful Christmas break (if you managed to have one!)

I am now back to my other home and once again, revising and writing my assignment.

Its 2500 words on people with a learning disability and their health needs.  It has taken far longer than my other ones have, due to the amount of research i have had to do and the lack of research i've then come across! But i am getting there.

I have organised revision sessions in the library with the others from my group and i've lost count of the amount of messages concerning referencing i've had!

I am looking forward to getting back to phase 5, we now have 20 weeks left of teaching contact time. It seems so scary to think 20 weeks left of teaching for my whole degree. It's flying in!

This phase we are covering various topics in relation to learning disability, including genetics, behaviour, communication and the criminal justice system. So i am looking forward to that.

I also have my next placement so i will be eager to start that too!

We should be able to go to the local genetics lab if possible, depending on access and staffing etc.

But this phase should be interesting as we get down to the nitty gritty so to speak of learning disabilities, how they occur, why and how we can then help those people. 

Its nice to see how everything is slowly coming together too. 

I shall hopefully be posting an update at the end of the week in what we have covered in practicals, my portfolio and all things such as that. But it doesn't seem like we are in long before we are once again back out on placement. 

The pace does seem to be quickening and there is a lot more expected of us now we are almost half way through our second year (wow!)

Hope you're all doing well and i'm keeping my fingers crossed for all you new applicants! 

Placement 4 - Complete

So i have finished placement 4 and it has been amazing!

I have noticed a massive difference from first year to second year. 

I have had a lot more responsibility this placement and i have been expected to do a lot more on my own intitative.  

In this placement; 

I completed patient admissions; discharges; signed in and out medications; been responsible for patient belongings; ive changed beds; set up beds for patient arrivals; i have been able to meet the children's parents and families; i was able to complete their documentation, complete body check and risk assessment forms; i was able to do day and night duty shifts; administer medication; do pharmacy orders; set up feeds via pumps and administer boluses; monitor nutritional intake; the list goes on...

I was also able to go in with the children to one of their schools. I organised this myself after speaking to school staff.  I wasnt able to spend time with the school nurse as the nurse also had students with her on placement in there.  However, I wanted to spend time in the classrooms and see what happened day to day with the children and how the teachers and the school adapted to each child's needs.  The school was amazing and have also offered me to go in again any time if i need any help or want to observe any more lessons.  I was also fortunate enough to see them competing a dress rehearsal for their Christmas play. That was incredible!

Each child was involved and had done their own play for each group of ages, or classrooms due to the size of the school.  Some groups used video cameras to film and create special effects, some made some incredible props (a Dolerean, giant backdrops and jellyfish to name a few!). The children and the staff were amazing and i really couldnt fault them.  They were very welcoming and only to happy to help me with my portfolio.  I would love to go back at some point! 

I am now in the community for my next placement so I will be really looking forward to that.  I should be able to do assessments, be responsible for a case load and look after patients from admission to discharge.  This placement I have just finished should hopefully have prepared me for such!

I hope everyone has a good Christmas and A Happy New Year and I shall look forward to hearing how you got on with applications!

(I shall be enjoying a break home and then straight to the library for finishing me essay that is due in when im back)

Revision and assignments....the life of a nursing student.

Placement 4

I have now completed two weeks of placement and I have really enjoyed it so far! 

I have been on night duty these two weeks so I have also been able to learn the layout of the building and familiarise myself with the stock room and the various health and safety checks etc that happen every day.  

I have also had time to read through the client's care plans and admission files to learn how the nurses admit and discharge patients and what it is that is needed.  This has allowed me to begin my care plans that I am needed to do, as my mentor on placement assesses these before they sign me off for the placement. 

I have also been able to set the child's enteral feeds up and run these through their pumps.  Many children tend to use the Kangaroo Joey pumps.  

Giving Set

Kangaroo Joey Pump

These are fairly easy to set up and some children will have these in a special backpack so it can be connected and running while they are out and about or in school. 

Many of the children will have their enteral feeds in the morning as well as school, and each school has a school nurse (that is also often learning disability trained) to set these up, oversee administration of any medication through their PEG tube or Mic-key button. 

A Mic-key button can be different sizes for the size of the child and these are assessed and changed on a regular basis as the child is still growing.  

A PEG tube fitting.

Positioning in a child.

                            A Mic-key button                                        A Mic-key button in a young child.

The locking system when attaching a giving tube.

I have pushed bolus feeds and bolus hydration through their Mic-key buttons as well as their medications.  Most medications are liquid, but some need to be dispersed in sterile water.  For the dispersible tablets, my mentor taught me to try and place the tablets within the syringe (by taking the plunger out).  Place the plunger back in as far down as it will go, then place the syringe within the sterile water and draw this up. Instead of placing the tablets in a medicine pot, dispersing the tablets in there and drawing up, it means you don't lose any of the medication from transferring from pot to syringe. Very clever idea and saves some time too!

I have also been fortunate to carry out my first female catheterisation on a young child too.  This young girl has intermittent catheterisation so it was not an indwelling one that I carried out.  The procedure to do so was quick and painless for the child.  

An intermittent one is similar to self catheterisation where you only insert the small catheter and the urine flows into a toilet bowl, pad or kidney dish for example.  As this was a child whom also had a learning disability, this procedure is carried out by the nurses. 

An indwelling catheter procedure would be similar to this;

There are plenty of videos available on YouTube and you will do this in practical classes within university too. A male catheterisation is much easier than a females, so try and get the practice if and where you can! 

I will be writing up my care plans this week (I have a draft of one done!). My mentor will be able to go through these with me and then I will be able to finalise these for my final week where I have my assessment with my mentor.  

So thus far, it has been a valuable learning experience.  I am hoping I am able to go into the schools soon and out with the children when I on my day duty. 

Hopefully I shall keep you informed! 

And don't forget, learning disability nursing is amazing.  All ages, all abilities and best of all, the greatest patients! 

Phase 4 done and ready for placement!

I've completed phase 4 and im just about ready to head out on placement! 

This phase we have learnt the history of learning disabilities, the nursing and caring aspect. We have also covered catheter care and female catheterisation, our basic life support, venepuncture and communication and nursing frameworks.

It has been a quick six weeks and we have done a lot of theory around law and legislation of learning disability nursing.  It is important to know and we have covered the holding powers of the learning disability nurse in relation to mental health and learning disabilities too. All of these topics are important to learn and cover as once we are qualified, we will be expected to know this and to be able to put it into action should we need to for the welfare of the patient.  

I now have an assignment to concentrate on as well as my care plans that we have to write while on placement this year.  Each placement we are required to do them to put into writing what we may have learned as well as what we will need to know for when we do qualify.  

There has been a big jump this year from last year, and we are expected to build on what we learnt last year and put that into practice along with what we are learning this year.  All of this then leads to enquiry based learning.  This is where we are expected to learn and be able to say why we are doing what we are doing and what evidence is there available to say that that action is the best one to take.

A lot more responsibility this year and a lot more to learn! It has been a fast paced 6 weeks and we have covered quite a bit, especially when it comes to the law in nursing! 

For my next placement I will be in a children's respite unit and I am really looking forward to it.  There should be a lot to learn as it is children with learning disabilities and they may have complex medical needs that will need nursing care.  So this should hopefully be a great learning opportunity and a great way to learn a lot more clinical skills.