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 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!