Epilepsy

This week we have had a lecture on epilepsy and I thought I'd pass that information on.

It's nice to see the other branches also learning about this as we are all together for first year; this week just gone and this upcoming week we are learning about autism,  learning disabilities and epilepsy. It's been nice as we have had people come in to speak to us with personal experiences of the aforementioned. It adds that sense of realism and many people tend to remember the lectures more when we have seen how this affects people up close. It's hard to not go away with tears in your eyes and feeling a little overwhelmed. It's important to remember why you have gone into nursing and why you have chosen the branch you have.  Unfortunately I still heard the comments..'aww they're so cute..' 'don't you feel sorry for them..' and best of all, 'they look so happy, that's nice.' 

For the student nurses that I overheard saying this next to me I had to say something. People with learning disabilities don't want you to feel sorry for them, they want you to treat them as equals. People with learning disabilities are often looked over in society and they are often not given the same opportunities as some people don't realise what they can do. These lectures hope to rectify these thoughts. It is shocking that a student nurse may think this, however these are people that may not have had any experience with people with learning disabilities or may have just arrived out of school.  It is these next 3 years that will educate those and will change their outlook. 

For our epilepsy lecture we heard from someone who spoke about the troubles that came with having a family member have seizures and how difficult this was for all of them.  It was memorable and it was very informative. I will not say much more than that to respect the  confidentiality of those involved. However, it is amazing the way this person coped with their diagnosis and was able to live their life and graduate university to become an example to others. Epilepsy can be a very debilitating diagnosis for some people and can severely affect their quality of life.   Epilepsy can be mild to very severe. It can be controlled with medication, or that medication may have no effect at all, or  it may lessen the amount of seizures. I have had experience with friends having epilepsy and with clients I have worked with having epilepsy. I have seen how epilepsy can be so severe it can amount to brain injury where the person is needing round the clock care. It is so varied and so life changing regardless. It can be hard for someone when all their friends are learning to drive and they cannot. It's important to remember that epilepsy does not discriminate and can  affect anyone, including the family of those diagnosed with epilepsy. 

When it comes to those with learning disabilities being diagnosed with epilepsy this can be particularly difficult. The person may not understand the diagnosis and their family may feel guilty or burdened or scared or all of the above. Unfortunately, in people with learning disabilities they often also have epilepsy.  The prevalence of this is quite surprising. It is vital that this is diagnosed and treated accordingly. Even more important is communicating this to the person with the learning disability and epilepsy. This needs to be communicated in a way they understand and accept. It is down to the family,  the carers and you as a learning disability nurse that you can help them understand to the best of their cognition and abilities.
There are a lot of myths and misunderstanding about epilepsy. Especially when it comes to those with learning disabilities. Many think that this is just something that will happen and just get on with it. Yes the person  will continue to live their life, but it is vital that seizures are treated and that the person is able to enjoy their life. Early treatment can make the difference between life and death in some cases. 

See the links below for some more information on epilepsy.

Epilepsy Action
Epilepsy Society
Nursing Times NICE Guidelines
NHS - Epilepsy 

These websites are very informative when it comes to learning disabilities. Rather than me dictating facts and figures i thought i would give you the website to have a look yourselves. As no doubt about it, working with people with learning disabilities, you will come across epilepsy sooner or later! So it is worth trying to make yourself familiar with the different medications etc used to manage epilepsy. This includes the generic names and the brand names and the different forms it will come in. 

There is a lot to learn. Try and get a head start if you can.  

Mathematics and Drug Calculations.

So I've now completed another week of university! And by is it flying in!

Can't believe how quick it's going. We have our assignment in next month and an exam.  

We have had a maths test this week to see where we are in our mathematics and drug calculations.  We need to know this as we have an exam at the end of the year that we are required to get 100% in. It is a requirement that we pass this or we cannot progress into second year. It is vitally important that we understand the importance of good arithmetic and how an incorrect calculation can result in possible overdose and the potential death of a patient. 

Here is an example of the type of equations you may be asked to do when it comes to math papers:

Question 1

Convert 800 micrograms to milligrams

Question 2

Convert 1.06 grams to milligrams

Question 3

Convert 1850 mL to Litres

Question 4

Convert 100 nanograms to micrograms

Question 5

A client is ordered 50 milligrams of Aminophylline intravenously. 250 milligrams in 10 millilitres of liquid for IV Injection is available. How many millilitres will you administer?

Question 6

Digoxin 200 mg is prescribed
The stock available is 25 mg
How many tablets will you administer?

Question 7

A patient is prescribed 1500ml over 24 hours.
What percentage would be administered after 18 hours?

Question 8

A patient has a daily fluid allowance of 2000mL.
The patient has taken 60%.
How many mL is this?

We are doing ours online as the university is moving to doing a lot of things electronically. We are using a programme they have bought into so this should make things easier.  Maths is a daunting subject for a lot of people and it can be difficult for some people. But with practice comes perfect! Universities often have student support for you to practice maths. They may have tutorial classes and past papers to look at. If you struggle with maths then there is no time like the present to get revising and practicing your calculations etc. There are a good few websites out there that help with basic mathematics and then with the more nursing side of it, so more drug calculations etc. This will include working out the infusion rate, working out how much of a liquid you may need, looking at how many tablets or capsules you need to administer to make up the correct dose and looking at how to calculate medication according to the weight of a person (this is more applicable for childrens medications).

These websites are useful when it comes to learning and practicing drug calculations:

NHS Snap
BBC Maths
Drug Calculations
A Step by Step Guide
E-Book on Drug Calculations for Nurses

(Click on the links above)

Videos like this one here are also good for helping you learn drug calculations. The good thing about maths is that it doesn't change! It is not like writing an essay where there may be a few correct answers. So make sure you know your stuff when it comes to drug calculations. Very important for your patients that you get their doseage correct! It doesn't even warrant thinking about if you get them wrong. If you are ever unsure, ask another nurse. You are all there to help each other after all. 

Best of luck with your studies. There may seem like it is a lot to take in, but with a bit of patience and a bit of self-discipline, you will get there.
On those days you feel like giving up, remember how hard you fought to get where you are. Remember the sacrifices and remember the passion you have which has got you to where you are. It is for that that you will keep going. 

(All the above questions are available online and have been taken from various websites with a few numbers changed!)

The Struggles of Being A Learning Disability Nurse

I've completed my first placement and my first week back in lectures. 

We have had a tutorial where we have reflected on our placement and had chance to talk to fellow students about who was able to experience what in placement. 

It has been good to have that opportunity to do so. It has also allowed us to see the difference in placement areas and the different experiences that each of us had during our six weeks in placement. 

It did come up in discussion how some of us had struggled and had faced negativity towards the branch in which we are studying. 

It is disheartening that even today, in 2015, that we are still facing negative attitudes and opposition in studying learning disability nursing. I have even received some emails from readers of this blog in regards to this as well.  I had a interesting conversation in regards to a student's placement and how they had faced some nurses asking why they had chosen to do learning disability nursing and if they thought they would be able to succeed in finding a job after they graduate.

As I have previously stated, learning disability nursing is still seen as a small niche of nursing.  However, with the population living longer, reproducing later on in life and living riskier lives, we are all experiencing a different level of health and disease than we ever previously have in our modern day world. As you may have noticed, the Ebola outbreak has been onoing for a while now and this has taken many lives.  We are still not yet able to say if the vaccines they are trialling will even work.  It is hard to even say what may happen if the vaccines do not work.  There are also many more people suffering from conditions such as dementia and multiple sclerosis.  This is because we as a population, are living longer. Why do I mention this? Simple.  People with learning disabilities are living longer and are needing more specialised care.  The population of people with learning disabilities is ever increasing and is not going to diminish any time soon. So why are they excluded as a group almost in society? We forever see articles and media focusing on the ageing population and how elderly people may feel segregated and need care and help from those around them.  Why do we never see those with learning disabilities in the media like this? Why do we never see many people with learning disabilities in the spotlight? Perhaps those with learning disabilities are not aware. But maybe it is those around them who may not fight as much for them as for their elderly grandparents.  It has been, and may always be, a common societal view that the elderly are frail and need care and respect. We think of teenagers differently, we think of middle aged men differently.  It is these stereotypes that need fighting on a daily basis.

As a side note, I never experienced any negativity on my placement.  The nurses were very skilled, they were lovely and so very supportive.  They applauded me for doing learning disability nursing, however there was 2 nurses that even admitted if they could go back they would do adult as they like the hospital setting and many of those patients were being resettled into the community. In my placement I couldn't fault the nurses for this.  I personally would like to do community care and manage my own caseload. I would like to go on to do district nursing so I am able to do that extra training in catheter care, wound care etc.  I am not fully settled on that as I am leaving my mind wide open for the experiences I am yet to have in my nursing degree. 

It has been pointed out to me that there is a blog on the Mencap website of another student learning disability nurse facing negativity and opposition.  As I am unaware of where she is based this is difficult to comment on.  On the other hand, I can give my experience. 

On my placement I was able to give medication.  Once you qualify, it is almost expected of you to do this. This is why some universities have maths and english exams before they will even interview you. Medication calculations are important.  I was able to do PEG feeds, I was able to clean and dress the site. I was able to do body mapping charts. I gave injections. I was able to enemas. I completed case notes. All of this can be considered clinical care. Not one of my peers faced any opposition or comments in this, from other student nurses on other branches or people on placement.  Learning disability nurses are becoming more recognised and valued for their skills. 

It is becoming apparent that slowly but surely, it is being recognised that people with learning disabilities need that specialised care.  We need learning disability nurses to fight for those people with learning disabilities. We need people with awareness to make this known.  And I say we as a learning disability student nurse, we as people with learning disabilities, we as health care professionals and most of all, we as people.  I have always seen learning disability nursing as an amalgamation of all 4 branches.  In learning disabilities, you can work with pregnant women and their families, you can work with the newborn they just had that has been noted may have a learning disability.  You may work with children and assisting them in assessment and development.  You can work with teenagers, struggling with regular teenage problems or just trying to explain the process of puberty.  You may work those trying to move away from home and seeking help and support. You may work with those wanting to have a family. You may work with those going through significant trauma in their lives.  You may work with the elderly learning disability population.  You may work with those needing palliative care. You may work with those going through a bereavement.

See where I am going....? 

Learning disability nursing is not and will not be stuck to one area. You are working with people. People change, people develop. And most of all, people are people. Nothing is guaranteed.  Nothing is set in stone.  People with learning disabilities may just go through all the phases in life that the rest of the population go through.  It is all dependent on them, their needs, their assessment, their decisions and their wants.  So please never let someone tell you you cannot.  Learning disability nurses can do clinical skills. We can take blood, we can do I.V's, we can do B.P's, we can do dressings. All it needs is a bit of training.  Nursing is a career that you are always learning and are always adapting.  So if you want to do whatever it is within learning disability nursing, why can't you? Do well at university. Qualify. Find a nice job and a nice, supportive employer. Go on training courses. Never stop learning. And never stop fighting for and raising awareness of people with learning disabilities. Because odds are, they don't have the voice or the platform to do so. You do. 

Phase 2

Well first off let me start by saying Happy New Year to you wonderful people! Hope your Christmas holidays have been good and that you got everything you wanted! It has gone so quick I can hardly believe I'm now back at university.  It's been 8 weeks since we were last all together and sat in a lecture. Now it's time where the lecturers expect us to know a lot more and be a lot more clued up on things.  

Phase 2 is the beginning of my new semester at university. I have completed six weeks of class and six weeks of placement and it has gone so quick it is hard to get your head around it some times. 

I have enjoyed it all, but the pace is quick. It is so easy to fall behind and struggle on a course such as nursing due to how much you have to learn and in what seems to be so little time. Other universities structure the placement time differently so this may differ for you on your course. But ours are six weeks in and then six weeks out.  

I am looking forward to getting this phase underway and recapping what we have done last phase.  We then start to learn a lot more and a lot more in depth before we have an exam and then out onto our second placement.  I have looked at what is available on our university portal and what we will be learning. So over the Christmas holidays I have began to look and read over things and do my revision.  It is important you keep organised and keep on top of things, don't think I can stress that enough! I have completed my portfolio and handed that in.  I have also completed my travel form, made copies of all my receipts and handed my receipts in too. These are all in my placement module folder in which I have also kept the patient advice leaflets from some of the medications I was able to administer on placement.  These come in really helpful, especially when it comes to looking at medication management and administration, (we actually have a lecture and tutorial on that this phase). My receipts I have photocopied and handed in the photocopies with my travel expense form so I am able to claim back my expenses for my first placement.  

Luckily I didn't have to pay for parking at my previous placement so I can claim back the mileage. We are only able to claim one or the other (whichever is the cheapest).  For my next placement I am using the bus so I will just need to keep each bus tickets but I think I can get a months pass which will work out cheaper.  I will then keep the receipts for this as well so I can claim that back.  The organisation involved in this course is quite surprising at times! 

For my next placement, I am in a hospital setting again, this time I will be working with children.  This is a children's ward so it will be those with and without a learning disability.  I will be ringing them up closer to the time to see what I will need to learn and what is needed for the placement itself.  I have been able to find out that the ward is orthopedics so I'm sure that will be interesting! This placement is our alternative placement for each branch.  So each branch is doing a placement that isn't within their chosen field. I am glad I am on children's surgical.  Although within learning disabilities you work with both adults and children you may find you are with adults more depending on the trust you are in. I am looking forward to the learning again and the process involved.  Within nursing, you never stop learning.  I have spoken to a nurse that is a family friend over Christmas and she was also doing work before her family arrived that is to be submitted and she has been qualified over 15 years now! So there will always be something!