Learning Curve

I've now completed 2 out of 6 weeks of placement! 

And I have learnt so much. It has been up and down, busy, tiring and so much fun all at the same time. 

So what have I done this week? 

I have;

Completed a medication drugs round. 

Completed multidisciplinary notes, care notes and analysed blood results. 

Tested urine using urinalysis dip sticks.

Weighed a patient. 

Completed clinical observations and recorded these on a NEWS chart (under observation, then independently).

Taken a finger prick blood sample to test a patient's blood sugar levels then given insulin via a subcutaneous injection (again under observation as insulin is a medication).

Supported the patients with relocation on the ward. 

Helped transfer patients. 

Administered medication (under observation) via a PEG (percutaneous endoscopic gastrostomy) tube. 

Signed in controlled drugs (again under observation). 

Organised the clinical room.

Photocopied notes.

Answered phones.

Supported patients with dental visits.

Received injuries from patients.

I have enjoyed it all!!

I have essentially been kept busy! It has been a very busy and quite a long week. 

But I have loved every minute of it.

It has such a learning curve this week and I cannot thank the nurses enough for the advice and the support they give regarding my learning. I have also met other staff, from the domestics who clean everywhere, the transport bus drivers, the ambulance crew, the support workers, patient's family members, the administration staff, the doctors and I'm sure others in the upcoming weeks. 

It is important to remember that you may gain confidence and feel comfortable in your role, but never get too comfortable that you let your standards drop. You are there to be assessed and monitored in upholding the profession as well as your university. Your mentor may ask for feedback from other staff you have worked with and had any contact with when they are not on shift with you.  You do not have to work every shift with your mentor but it does help.  It has been stated to us that we have to work 40% of our shifts with our mentor. Luckily, my placement have been really understanding and flexible when it comes to student's shifts. They have us in when they are in, when they think it would be useful for us and when we are able. As they are used to having students in as well, the patients have been more than understanding and usually cooperative with us. 

I say usually as this is a hospital for those with learning disabilities. It does mean that they often have mental health needs and very challenging behaviour.  Due to this, I have been scratched twice now and the patients have actually drawn blood. Now I am not trying to scare you off, but I guess somewhat this is a hazard of the job! It shouldn't be, but due to the nature of the patient's disabilities and mental health needs this may happen.  Nursing students are supernumerary. This means we are never to be left on our own with a patient, always observed and never treated as an extra staff member. This is so you can gain the most out of your placement and learn as much as possible. So as I was scratched, this was witnessed and documented.  It's only small and it will heal! 

As for my other achievements this week.....

I used these...

And I analysed a urine sample that a patient was willing to do with the use of a commode, to look at various aspects and report back to the nurse in charge and the doctor.

And this is what you look for.

 

I then was able to draw up liquid medication into various sized syringes and administer these via a PEG tube. For those who have never dealt with a PEG, the picture below should give you an idea. These are usually in place for people that have no swallowing reflex left or have severe swallowing difficulties.  Usually it is a last resort after all other methods, such as the use of thickener in fluids, has been tried.

I am lucky in that I have experience of PEG tubes before.  More so than some of the nurses I work with. This goes to show, as you go through your training and into your career, you find your niche of where you want to work. So regardless of the branch of nursing you will do, you will always meet a nurse who will have knowledge and skills that you or another nurse does not. This is because you become specialised in your area.  You develop your knowledge and skills and you can hopefully progress within this area.  

For keeping records, a NEWS chart is a National Early Warning Score. This enables health professionals to see when a person may be at risk of deterioration. 

As you can see, they are self explanatory but it is worth reading up on these as a lot of hospitals will use them.  The table below shows the scores and how these will then tally up to give you a final score. The higher the score, or if they score 3 in any one area, then the more at risk the patient.

(All images have been taken from Google images)

Next week I have my midway review with my mentor. The week after I am hoping to do night shifts so I can see how things work at night.  The medication orders and ward organisation are done at night with it being a lot quieter. I am also hoping to get a lot of work done during the night, looking through the patient's Kardex, and looking at how all the medications are organised and how they are ordered through the hospital pharmacy. 

My mentor suggested the night shifts will be very useful for me and will also allow me to do night shifts that we are needed to do each year (3 in year one).

I am really looking forward to the next few weeks. I feel like my confidence has grown already and that I am always learning new skills. Placements are invaluable and I have to thank the staff and patients for being so accommodating. 

Tip for the week?

Be quick on your feet, and make sure those shoes are comfortable!