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. 

Halfway through Phase 4....

So I have now finished my first 3 weeks out of 6.

Then I go to placement 4....Yes 4!

It is honestly flying in and I struggle to know where the time has gone!

Just wanted to update you on what we have covered so far.

We have managed to cover a lot in evidence based nursing, looking at different types of research and searching for research papers. We have then recapped our nursing models, but gone in to greater detail about the relevance of these within the learning disability field and then how we can apply these when assessing and assisting those with a learning disability.

We have also had our practicals, where once again we were assessed informally on our basic life support and what to do should we ever come across an unconscious patient.  We then covered the emergency trolley and its contents.

We looked at the different types of airway (which I have covered in a previous post) and how to assist the doctors in inserting and maintaining an airway. We will go into greater detail about this soon when we cover tracheotomies and how to suction these to maintain a palpable airway.

We have also been able to cover a lot of nursing care and nursing models within learning disability nursing.  It has been a fast few weeks and straight away it was discussion about placements and our assignments.  It is also important to maintain our skills and keep these up to date where we can.  

Very short post, but these 6 weeks are a lot of theory behind learning disability nursing, assessments and care plans and health facilitation. 

A good book to read on this is;

This book has a lot of theoretical information in it that is very useful for learning disability nursing.  
A lot of what we have covered has recapped last year's lectures and then gone into further detail.   For example, we covered Roper, Logan and Tierney last year.  We have then gone into further detail about the model this year covering Activities of Daily Living.  There may be 12 listed, but in learning disability nursing, you can cover up to 15, including mental health and personality.  This is especially important if the person you are looking after may be non-verbal and / or have difficulty communicating.  This ensures that those reading their care plan have as much information as possible to help facilitate good, all -round care for the individual.  
A very short post, but I don't think there is a lot for me to write without sounding like I am writing an essay or lecturing you! 

And classes are under way...

So second year has officially begun!

First week has flown by and we are straight in there.  Last year we had welcome week as our introductory week and then although it was very full on and very quick, there was still that little bit of leeway and understanding if we were struggling with finding things or learning how to search the literature and so on. 

This year...

It's more or less, you've been here a year now and you have completed your placements and your assignments and been successful. So, keep it up, kick it up a gear and head down.  We have been given our structure for the year and what we will be covering. 

As this year we really focus on our field, i'll give you an idea of what we will be doing...

• The background and history of learning disabilities, the principles of such etc
• Legislation covering learning disabilities
• Behaviour
• Mental Health
• Communication (including Makaton)
• Supporting and Promoting Optimum Health
• Maternity
• Play
• Alternative Therapies
• Multiple Complex Needs
• Criminal Justice System
• Nutrition 
• Partnership Working

Then in our practicals, we will be covering:

Basic Life Support

The emergency trolley

Venepuncture

IV Fluids

Tracheotomies

Suctioning

O2 Therapy

Spirometry & Peak Flow

Catheterisation

This is just for our first semester for our practicals, so I'm not too sure what we will be covering after Christmas! 

But hopefully that gives you some indication of what us as learning disability nurses can cover and will need to know.  Every university is different and will teach their own courses in their own way. But we all need to cover what the NMC states as minimum standards for when you graduate.

The pre-education standards for nursing education are available here on the NMC website. Scroll down to page 31 where you can find those specific to learning disability nurses. 

There is a big difference in what each field is learning, but we all still have our evidence based practice lectures together which cover research and why we need to keep up to date with our training and our reading as we progress through out our careers. 

It is great being back, but we already have our first assignment titles, our exam periods for next year and what it is we need to be focusing on!

On the up side however,

I have my ticket for Positive Choices!

There are a few of us going from my university from the different years of the learning disability course.  So I am really looking forward to going. Some have even booked their flights and accommodation already! So it will be good to see some of you there and put a face to the names of those who have emailed and tweeted me etc.  

So I will be looking out for you there!

I am also officially a member of my nursing society committee too so I am already being kept very busy. A lot of it this year is about being an amazing juggler, so much so I should maybe take up a role in the circus.  As I have mentioned previously, I am a member of St John Ambulance. So I have been keeping up with that as well.  That has taught me a great deal that I may not cover in university or that I will. 

So it is great revision, if nothing else a lot of good fun out on duties and always surprising people when they see a woman driving an ambulance (!) Yes...I still see some shocked faces at that - in 2015! 

Hope everyone is loving their courses so far and keep up that hard work. You know how hard you have worked so far to get where you are.

The Beginning Of Second Year

Hi everyone!

After a lovely summer off, I'm back!

Back to my blog, and back to second year!

I passed all my exams and my assignments. I enjoyed a summer off (well, I worked) and it's good to be back in university.

Now it'll start to sink in a lot more as the work steps up a gear and we are expected to amalgamate all we learnt in first year with everything we are learning in second year.

Its not like some other courses where once first year is passed you don't worry about it too much, we still need to know all that and more! 

This year we will be covering all things learning disability.  This year all fields branch off and are in the individual classes specific to our field. Of course this is great for my course as there are only 30 of us! 

So we are all getting to know one another and have a great relationship with our lecturers as they know us a lot more as individuals as there are so few of us compared to the other fields.

I am looking forward to getting started this year but it is also a little nerve wracking.  We will be on placements with first years and be expected to guide them.  We are expected to know the evidence and the rationale behind what we are doing a lot more; evidence based practice is a big thing in nursing these days! 

We will be picking up our portfolios in the coming weeks and we will be able to collect our new epaulettes for second year for our uniforms. We should also find out our placements for November too. 

Sadly, there has been yet more people drop out of the course over the summer.  This, unfortunately, is the reality of this course.  No one ever said nursing would be easy! Or that it is definitely for you.  Having looked back over the past year and realised how much we have learnt (even when you think you haven't!) it is astonishing the pace in which we learn. 

Good luck to everyone starting this year. As always, enjoy it and make the most of it!

What Does A Learning Disability Nurse Do?

Hi everybody,

Hope summer is going well!

I have been working a lot and putting this to good use and gaining more experience in the learning disability field.  It has been great to see other services where I am, both private and for the trust.  

I wanted to do a post on 'what do learning disability nurses do?' I have received a few emails about this and I frequently find myself explaining this to people I meet who don't fully understand either.

So let me begin by directing you to a few websites that you may have already come across:

Nursing Times

NHS Careers

Prospects

While these websites are very useful and do help to explain, it always helps to hear first hand of what a learning disability nurse does.

Our lecturers are learning disability nurses and their jobs are very varied from one person to the next.  One of ours is a community LD nurse.  They will travel from one individual's house to another, assisting with attending appointments, checking on their welfare, helping to administer medications, taking blood, checking their clinical observations; for example their blood pressure, weight, temperature.  They will also liaise with other health care professionals by making appointments and referrals to those who may need it, such as physiotherapy.  

Another lecturer will do a similar sort of role.  However, they also attend many conferences, organise trips for students to visit, they visit old patients they met when they were a student, (!) write journal articles and do research and will also meet with the local government in relation to health needs and legislation etc for those with learning disabilities.  They provide their input, but also act as an advocate for people with learning disabilities as well as their families and carers.  

Of course, these individuals are also lecturers.  So they support us as students, they help to grade our work. They provide advice and they teach us.  

The role of a learning disability nurse is so varied it is hard to pin the description of what we will be able to do when we graduate to just one thing.

So what does a Learning Disability Nurse do?

Well, that is dependent on the area you work in and what your role is within that area, similar to the other branches of nursing.

However, as a Learning Disability Nurse, you are using the skills and knowledge you have gained throughout your time in university.  Examples of this could be assessing your patients for their care needs and deciding if another health care professional needs to be involved.  It can be assessing the person's health, monitoring their clinical observations.  You could help to make their last moments of life more comfortable by administering medications (prescribing if you go on to do that course).  You can be changing tracheostomies, inserting and changing PEG tubes, assessing airway needs and managing in recovery, the list goes on.  Most of all, you are working in a holistic manner to ensure that the individual is able to communicate their needs and wants. You will be educating others to what your patients want and need.  You will be educating them on what your role is and why people with Learning Disabilities deserve specialised care just as every other individual out there does.  As I have stated in previous posts, someone with Cystic Fibrosis will have a respiratory nurse helping to care for them, someone with heart failure will have a cardiac nurse. Thus, a person with learning disabilities will have (or should have) a Learning Disability Nurse. 

A learning disability nurse can work in such a variety of areas and roles.  Once we graduate, we can work in; 

• schools, 
• prisons, 
• acute mental health areas, 
• theatres and recovery, 
• the community, 
• residential settings, 
• care homes, 
• day centres, 
• neuro rehabilitation
• criminal justice
• macmillan
• assessment and treatment
• custody suite health service
• child development service
• children's hospice 
• acquired brain injury
• rehabilitation
• challenging behaviour teams
• forensic care 

And this is just to name a few!

The possibilities are endless when you are a nurse. As a Learning Disability Nurse however, you have so many doors open it could be hard to choose!

It is so difficult to give advice to those who cannot decide if they want to do learning disability nursing or not.  

Personally, I think it is something that just becomes you.  You may have never thought about it (I hadn't - I was wanting to become a teacher). Then, there may be that lightbulb moment and you may wonder why you had never thought of it sooner (mine was Camp America, a camp for those with special needs). Whatever you decide, remember that at the end of the course, you all graduate as nurses.  That means we work together and we have one common goal - to ensure our patients are looked after and that we are doing the best we can for them. 

As Learning Disability Nurses, we are able to work with people who are newborn, we can work with those people right up until their last moments of life.  We are able to use our skills to be flexible and change to adapt to the individual and their care needs.  It is an amazing thing to be a learning disability nurse.  Not just because you are caring for them, but because you are able to provide that holistic care and be their advocate.  You can ensure that your patients get the care they deserve.  You will act as their voice, you will fight their corner, you will be proud of their achievements, but most of all, you will be their nurse. 

And what could be better than that? 

Results

Hey!

Hope everyone is doing well!

I have finished placement and I have received my final year results! 

And in case you have not guessed by all the exclamation marks I am over the moon!! 

It was what seemed like a very long day of having our results put online one by one.  Forever checking the university portal to see what we had! 

I think that was the most stressful thing about the exams! 

It was a very long day and our last result was not up until about 6pm. So you can imagine everyone's frustrations.  

There were a few students who failed an exam or assignments so they are redoing them in August.  There has been support from the tutors for them and then practice questions placed online for them to go over and hopefully assist with their exams. 

Anyhoo, I am so glad it is all over and done with. I have submitted my portfolio from placement and our OSCE results had to be stapled in there too. I also included drawings that I was given from students on my placement too (no names on them). So once that is marked by my tutor and then sent off to the exam board to be ratified then that is me done. We then have to register again in September to say we are returning and then our timetables and new modules will be placed online.  

I was so very happy with my results that I did a little happy dance around the house! 

So now I am going to enjoy a summer off.  I will be volunteering and doing duties with St John Ambulance to keep my clinical skills up.  I also have been driving the ambulance as well, so I will be studying for my test in that to then hopefully drive under blue light conditions.  I am also going to be working for the agencies that I am registered with, so I will be working in a variety of settings there too.  I find this not only helps with your clinical skills, but also helps in finding your feet in different settings and boosting your confidence.  It is just important to remember that although you can do things as a nursing student, when working, you may not be able to.  So always work within your remit and competencies.  

Enjoy your summer everyone, I will be back with a few more posts during, just not as regular as term time! 

Year 1 - Complete

Hi one and all! 

I have finished my final placement of year 1 and it has been amazing.

I had a great last day! We had a chippy takeaway, cake, juice and chocolate cake. Amazing.

I will really miss that place.

In six weeks, I was able to accompany the students on outings. I was able to assist with making decorations for the summer fete. I was able to run an art class which was super fun to do! I was able to assist with personal care. I was able to discuss oxygen therapy for seizures. I had so many learning opportunities.  

I went to epilepsy training ran by a RNLD and she was amazing in helping to go over the training and then assist in how we would write nursing care plans and assessments.  I know we have to do this next year so I was able to discuss this with her and gain some very useful information about this. The RNLD was in the process of writing up a nursing assessment for a new student starting at the centre, so I was fortunate enough to see how the process works of introducing the student to the centre and seeing how they settle.  They are assessed to see which room they would like to go in to and what activities would suit them.  They are then also able to look at the student and what assistance they may need in the centre and how they will get to the day centre, so their likes and dislikes of travelling and any requirement are also looked at in regards to buses and other students in proximity to them. The staff are then also looked at to see if they need any extra training, for example if the student has a PEG or a stoma or a tracheostomy.  This enables the students to attend the day centre and feel as included as possible.  The RNLD would then also train the staff where needed and formulate action plans and in case of emergency plans for the student and the staff.  

I was also able to then talk to the Speech and Language therapist who comes to the centre to work with the students.  I was able to see how she works with different individuals and I was also permitted to take part in a swallowing assessment for a student.  Listening to that with the stethoscope was a fantastic learning opportunity too. I then had the chance to look at the equipment that some students use, including apps on tablets that are very good for interactive learning. The technology out there is amazing, but the waiting list for assessments and access to some pieces of equipment is quite astounding. 

 We do have pages in our portfolios in each placement where we can get another health professional to write in it, so the SALT was able to do this for me.  I was then able to put this in that I had taken part in the various activities with the other health care professionals.  

The placement also allowed me to learn more about people with learning disabilities who have dementia.  I was able to support an individual who has been greatly affected by her dementia and is increasingly needing more support in the day centre.  Her care meetings would look at this, and how best to support her so she still enjoys coming in to see everyone as she has been attending for many years now.  The staff were able to facilitate her leaving a little earlier so she was not extremely tired by the time she returned home. 

I was also taught how to knit by several of the students! I thought this was amazing, they were so patient with me and so eager to help.  They were also amazing at giving advice and were brilliant in helping one another.  The relationships between the staff and the students are incredible and it is nice to see that there is that support and that trust amongst everyone.
I also learned that on an almost daily basis I would be getting hugs, my hair played with, my bum tapped, I would get asked how my family and pets were doing, the students would even bring in cardboard boxes or treats for my pets too! 
In many places I have been, many people worry about professional boundaries and this can seem a little closed off to many with learning disabilities as they may not understand this.  Especially for those who have no contact with any family. So the only close proximity or touch they may have, is with staff.  If I have learnt anything in one year of nursing. It is this.  It is okay to give someone a hug.  It is okay to laugh and cry with them.  It is okay to be there for them.  That's what nursing is about.  Of course, you still have to remain professional and you still need them boundaries.  However, we are all human.  And all of us like to have a hug when we feel bad or for someone to just offer a shoulder to cry on and an ear to listen.  It is all about striking the right balance.  

I am sad that my first year has come to an end, but I am so exhilarated and thrilled too! 
It means I am one third of the way there! 
It also means that I have learned a lot, I have experienced so much and more importantly, I have used that to ensure that I will be a great RNLD. 

Midway through Placement

I have now finished my third week of placement and it has been great. 

In the day centre they had a summer fete for all the students where their carers and family can come in to meet everyone. Despite the weather looking a bit iffy (rain, wind and sunshine) it ended up a really nice day.

The summer fete was a little fete that the day centre holds every year. There are many stalls that the students have crafted things for to sell and the staff have assisted with. Their families and friends donate things that can be sold and the students help man the stalls if they so wish or can just go around looking and buying and taking part in the activities. 

We had a tombola, hoopla, arts and crafts stall, sweet stall, badge making, flowers and even an opportunity to throw wet sponges at staff standing behind a frozen board (or just take a photo!)

This was made by staff, it looked amazing.

Here is me and an adult nursing student from another university modelling the board!

It was a lovely day where we had a band in playing music, a barbecue and plenty of snacks.  It is a day the students really enjoy and can look forward to. It marks the end of their classes in the day centre before the summer scheme begins. 
Half way through our placement we have a midway review so we can discuss with our mentor what we would like to achieve before we finish and how we have found placement so far. I have focused on communication and improving my Makaton skills in this placement as our students range from profound and multiple disabilities (PMLD) to more higher functioning and independent students. I have been able to make myself a folder containing lots of Makaton information that I have able to do from resources provided by the centre then from the Makaton website.

Here is a sample of the Makaton information I have that may come in useful as a nurse!

Summer scheme starts next week and I am really looking forward to that. All of us nursing students will have the opportunity to accompany the staff and students on outings around the local city and just beyond.  I've been told the activities include a city tour, a trip to the local cat and donkey sanctuaries, a trip on a boat, bowling, cinemas and many more. 

So I am looking forward to that! 

Of course I won't be able to upload any pictures of the students but I shall try and take photographs of the activities.
So far it had been such an amazing learning experience and I have been able to meet adult nursing students that have been very active in learning about learning disabilities and the various conditions and syndromes that can present in people with learning disabilities. 
Active learning is the best kind of learning! 

Learning Disability Week

It's Learning Disability Week! 

15th - 21st June 2015

What does a learning disability really mean?

So...

What does a learning disability nurse do?

Please see the above link for an interview with Helen Laverty, a Learning Disability Nurse and lead lecturer at the University of Nottingham. 

Learning Disability Week is all about raising awareness of Learning Disabilities.  Not just the term as such, but those individuals who have a learning disability.  The term Learning Disability is fairly recent.  In other parts of the world, you may hear the term intellectual disabilities.  Some years ago, you may have heard the term mental retardation, or retarded.  This is deeply offensive today, but back in the 1960's (yes only a short time ago) it was the norm.  Even mental retardation was considered  politically correct and replaced terms such as idiot, feeblemindedness and freak.

Learning Disability Nursing is about recognising that those individuals have just as much right as any other individual to having specialised nursing care.  As I may have mentioned previously, just as there are respiratory nurses, cardiac nurses, oncology nurses etc, then there should be learning disability nurses.  Each individual has the right to health care, and that care should be the best possible for them.  If there are nurses that are specialised in that field and that can ensure those people have access to that care so they are looked after then why not? 

It is important that you as a Learning Disability Nurse ensure that their care is the best that they can have and that those around them can help with delivering that care. 

For Learning Disability nursing, there are Twitter chats that take place on a regular basis. 

If you are not on Twitter, see the website here for a transcript of previous Twitter chats.

For a guest blog, please see this post on the Mencap page. If you think you may recognise her, it is because she has been on our television screens a lot recently! 

I have always loved my chosen field of work. Since I entered Learning Disability Nursing I have found not only has my passion increased for the branch of nursing that I am doing, but that I have learnt a lot in my first year of doing Learning Disability Nursing.  I am now one third of the way through to becoming a qualified nurse.  In this time, I have been able to get to know many health professionals involved within the field.  I may sound biased, but I do not know of any other field that is so prominent on social media and in helping one another!

I have found Learning Disability Nursing to be so enlightening for my own education and learning experience.  I have learnt a lot from those service users (or clients), I have been able to champion Learning Disability Nursing in many ways. I started this blog not for myself, but to raise awareness of what Learning Disability Nursing is.

With Learning Disability Week 2015, I hope that not only do we get out there what Learning Disability Nurses do, but that those with Learning Disabilities can still face discrimination and inequalities on a daily basis.  If you are reading this, then chances are you have seen this or know about this.  We can all advocate for those who cannot speak up for themselves.  By saying no to inequality, by saying you will listen, by telling others to be patient, by showing others by example, you are making a difference.  By educating others on what a learning disability is, you can help to end discrimination to those with a learning disability.

When I began writing this blog a year ago, I never envisioned I would know what I do today or I would be where I am today.  However, I am here. I couldn't be prouder of my patients / students / service users / clients / and what they have taught me. 

As I progress, both in my course and in my knowledge of learning disabilities, i find myself more and more aware of those out there who need our support and help as learning disability nurses.

 In relation to this, i have written a guest blog post on the BMJ for Learning Disability Week. 

You can find it here.

So what can you do for Learning Disability Week? 

Speak up! Shout it from the rooftops you are proud to know about Learning Disabilities and that you do what you can to help any individual wanting to know about learning disabilities and how to help those who may have a learning disability.  It is an amazing branch, it is life changing. It is full of surprises. Most of all, it is a branch I love and a branch of nursing that I feel so privileged to be studying. 

Final Placement of Year 1

Hi all!

I have finished two weeks of my final placement of year 1 already!

It has been amazing.

For my final placement I am in a day centre for adults with learning disabilities. The day centre is brilliant. There are a big mix of students in their abilities and likes and dislikes.  As it is a day centre, I do not have the opportunity to do clinical nursing care, but it is still nursing care all the same.  

So far I have assisted with personal care, eating and drinking and assisting the students (this is what the service users prefer to be called) in activities. 

I have been able to see the students take part in cookery activities; art; snoezelen; music therapy; sensory activities; going to clubs outside of the day centre and soon there will be summer activities as part of summer scheme.

The day centre is big and there are over 150 students on the books.  The students are lovely and so very welcoming to us nursing students! 

There is such a range of learning disabilities and syndromes that the students have, so it has been invaluable as a learning experience.  My mentor has also been able to give me information on the syndromes and how this may affect the students physical health as well as their mental health and well-being.  Each student has a care plan in the day centre that is put together by the centre staff and a learning disability nurse that comes into the centre.  The students may come from referrals or be transitioning from children's services to adult services.  

Each student comes in for short periods to begin with so they can get to know the centre and the centre's routine.  They may go around various rooms to decide which they like better or they be allocated a room depending on their needs and wants.  Each room has different student in it, with differing activities that it is centred around.  I am in a room that does a lot of arts and crafts and hands on activities. There are other rooms, for example, IT (Information Technology), skills and sensory.  There are various rooms and the students have the opportunity to have taster sessions in the other rooms and take part in activities in them.  

I am on placement with 3 others from my cohort so it has been nice being on placement with others that we know so we can all help one another.  It also means we can share knowledge of the room we are in for when we see the other students around the centre.  

I have also had the opportunity to talk to another nursing student who is on placement there as part of their 'out of field' placement.  

Recently, I was able to take part in a focus group for the NMC in relation to the nursing course, the structure and what we were happy or unhappy with.  It did come up that many people are confused about what we do as Learning Disability Nurses. Many of us felt that for those that are having their out of field placements, they should be in those challenging behaviour settings or those who may also have mental health needs.  As there has been some students from other years that said they have heard remarks that Learning Disability Nursing is not hard, or it is like being a 'glorified baby sitter'.  Of course, placements come down to a lot of things, but, by saying such things as the aforementioned, those people are creating inequalities.  Therefore, we want people to experience the challenging part of learning disability nursing.  Not so they may see us as Learning Disability Nurses in a different light (not all people have this view, just a small minority) but so if a person with a Learning Disability is admitted to A&E, or has to use what we may deem as mainstream services, they are given the appropriate level of care for them.  The staff will have a greater understanding and the individual with the learning disability will have a less stressful hospital stay or less waiting time, or even just a more understanding and knowledgeable practitioner in understanding their communication needs.  

So, if this day centre has taught me anything these past 2 weeks, it has been this;

Always get to know the person and be patient. 

Individuals with learning disabilities are amazing people. They may need extra support or they may need a helping hand every now again. 

And more often than not, you'll learn a lot from them! 

Exams!

Hi to all!

As I am sure you can appreciate it has been a very long two weeks of exams and revision. My last exam is tomorrow and then I start my final placement on Monday. 

It has gone so quick and it has been hectic to say the least. It has not been the most easiest of weeks and we have this one last exam to go. 

But I am very glad that I have put the work in and revised as I went as it has helped a lot with exams. 

We have had four exams, plus our OSCE's, which takes it to 5. I found out I passed my osces which I am over the moon with! Those who failed had chance to resit the following week, so hopefully they have now all passed. 

We then had chance to collect our marks to see percentage wise how we had done in our osce exam. This is then stapled in to our practice portfolio. This allows our mentors to see how we have done in our osce to ensure we have been assessed as competent in our clinical skills. 

We have then had our mathematics exam, which was our nursing drug calculations. This was assessing how to correctly calculate the correct dose of a medication, whether it was in tablet form, liquid or injection. We had to demonstrate our working out using the correct formulae. Then we had to work our the answer and demonstrate how to measure this out using a syringe, medicine pot or number of tablets.  This was all completed online using a special program that has been designed for nursing students. 

It was very good to use until several people got confused or their work wouldn't save! Never trust technology I say...

Again, just a little tip for revision. 

Know your learning style. 

I am a visual learner. It took me years to suss this out! But once I realised, I have discovered that watching anatomy videos on youtube, redrawing diagrams and rewriting notes in a different format and using colour codes really helps. I have also purchased some anatomy posters from the internet and stuck them on my walls in my study. Looking at them has really stuck in my head. I have used colour coding, drawings ( i'm not very good but it sticks in my head!) I have worked with others on my course to go through things and I have also redone tutorial work we were assigned. They don't just give you work for the laughs, trust me! This work has been a revision god send. I remembered a lot from doing the work for tutorials then going over it again for revision. 

If you aren't a visual learner, you may be more for lists or acronyms or poems or songs. 

Make rhymes from acronyms or lists, for example, 

7 at breakfast

12 for lunch and

5 for dinner.

(Spinal vertabrae)

Things like this make it easier to remember. 

I always remember dorsi flexion and plantar flexion from this.....a plant... grows in the ground....dorsi...dorsal fin, comes up out the water (like a shark).  Thus dorsiflexion is moving the foot upwards, plantar flexion is moving downwards. 

(Bet you wont forget that in a hurry!)

Your lecturers and tutors will always be willing to give a helping hand. They arent there to spoon feed you, but are there to guide you. University is about self learning and self discipline. Your university student's union will provide help, and you may also have a guidance centre which can help you on this also. 

Exams are tough and can be stressful. So remember to take time out and focus on yourself. Try and keep a regular sleep pattern too. It may be easier said than done, but if you're studying nursing, you know what you tell your patients also applies to you! 
I am now almost finished first year. I cannot wait to get this last exam done, catch up with everyone afterwards before hitting placement on Monday. Then it is 6 weeks before summer. 
Do you have any plans? Make the most of it. I shall be working full time, having a holiday then will start working on the pathophysiology we have to learn. It gets a lot harder in second year and from talking to them, it is the patho exam that they all struggled with. So any little head start helps. 
The life of a nursing student!