Placement 1 - Finished!

I've finished my very first placement! 

It has been amazing. I have learnt so much and I have chance to do a lot. Massive thank you to the staff and patients for being so accommodating. 

I have loved every minute of it.

It's tiring getting up at 5.30am and working 13 hour days then having to travel home again only to be back on first thing some days.  But it is worth it. As per my previous posts, I have been able to do injections, enemas, peg medication, other medications, learn how to monitor and manage diabetes. I have had chance to meet with the speech and language therapist  (SALT), the aromatherapist, the orthotics team and the dental team. I have had chance to see multidisciplinary team meetings being carried out, I've seen how resettlement works for patients moving into the community from hospital and I have had chance to meet the doctors involved in the patient care. I have seen their admissions to other hospital facilities and I have had the chance to really experience patient care in hospital facilities for those with learning disabilities. 

I have thoroughly enjoyed it and learnt so much. My mentor was very understanding and helpful in my learning. I was able to shadow my mentor and they were able to show me various different aspects of nursing care. I was also given aims and objectives for my next placement from my mentor that we agreed upon together in my assessment meeting. I have an initial meeting with my mentor to agree on what I want to get out of the placement and if I have any additional needs. Then half way through we have another meeting to see how I am progressing and what I have gained from placement thus far. Then in my final week I had my final assessment. This involved answering 4 questions based on the care of one patient on the ward. We then have to assess ourselves using the Bondy Scale and the assessor uses this to then look at how we have progressed during our placement. 

This is all in our portfolios. This is handed in once we go back to university where our personal tutor looks through it. They look at any absences, any night duties completed and any issues we may have had. This portfolio is then given back with any feedback and then we take this to our next placement. The portfolio is to last for the 3 years we are at university so it's important we take care of it and do not lose it. As you will then have to find all your old mentors etc and get them to re-sign everything they have written. 

But I am now so glad to be off for Christmas.  We start back early January unlike other courses so it's a short time off but I will be enjoying my Christmas with family and putting my feet up. To say I'm tired is an understatement at this very moment in time!

Merry Christmas to you all. 

⛄

And is hope next year brings the good news you're hoping for! 

My Reading List

As I have wrote a previous post on my books that I had read in the run up to applying, I thought I'd update you on what books I do have now and ones that I don't but I have borrowed from the library and found useful.

In my first year at university, all four branches are integrated. We sometimes have the midwives in on the life sciences lectures but not often.  So we are all learning the same things this year.  Next year it will be different and we will get to know one another a lot more on the learning disability branch.  So our books needed have mainly all been the same until it comes to assignments.  We have all needed to do the same assignments this year but we are told in our assignments that we need to relate it to the branch that we are doing.  So that is where books unique to our branch will come in to it.  

The books I have used so far (in phase 1 / semester 1);

•  Anatomy and Physiology - Tortora & Derrickson

• Nurses! Test Yourself in Anatomy and Physiology - Katherine M. A. Rogers & William H. Scott 

• Health Promotion: Discipline, Diversity and Developments - R. Bunton & G. Macdonald

• Fundamentals of Nursing - B. Kozier et al.

• Nursing Practice, Hospital and Home - M. F. Alexander et al.

I have also read local trust policies and guidelines when on placement.  I have also kept up to date with the local, national and worldwide health news as this impacts us all.  These are in addition to the books I already have or have read mentioned in an earlier post. You can find that post here. However, if you need any help or are wondering about anything else you may think you want to get started on before you start university then please don't hesitate to get in touch. 

P.E.G's, Enemas, Injections and Medications.

I have finished week 4 of my placement, which means I am two weeks away from finishing.

I cannot get across to you how quickly this has gone and how much I have enjoyed every minute of it so far. 

I have been able to spend time in the office and get to understand how the off duty is done, how patient appointments are booked and attended, how transport is booked. I have been able to go to the dentist, I have seen the aids and appliances being made for people with physical disabilities and epilepsy. I have been fortunate enough to really get to know my patients and to be able to understand a lot more from being on a ward placement. I am very lucky in that respect as the others from my year (and branch)  are mainly on community or day centre placements.  I have also been given my next placement which I am really looking forward to. Again, I will be in a hospital setting but this time I am in a children's ward.   So I am sure that will be fun to blog about! 

So this week I have again managed to experience a lot! I was able to go see the orthotics departments where they make the aids and appliances for people.  This is where leg splints, helmets, body braces etc are all made. This is very interesting to see the work that goes into seeing the patient, obtaining their measurements, hoisting them if necessary into bean bags that can mould around their body shape and then making their appliance.  This can be anything from moulded wheelchairs, seats, to specially designed helmets for self-injurious behaviour or epilepsy where they would possibly fall against things on a frequent basis. The staff were able to show me how things are made and on what time scale and how this can help improve a person's quality of life.  It is amazing the work that goes into all these different things that many people may not even think about.  

I was also fortunate enough this week to be able to administer insulin again, so I am feeling confident with that as well as blood sugar level readings.  I have also been administering medications via a P.E.G tube on a frequent basis (again always under supervision).  I have also been able to ensure that controlled drugs are signed off and see how a controlled drug check is carried out by pharmacy staff who come in.  They check that 2 people are signing off the controlled drug at all times, that it is signed, name printed and dated when any controlled drug is administered.  With controlled drugs, protocol is slightly different compared to other medications.  Unfortunately, within healthcare, it is medication administration errors that account for a lot of statistics.  So it is so important that you are good at your mathematics and drug calculations.  It is something you need to do. 

I have also been very fortunate in being able to administer flu vaccines this week as well. I was even more fortunate that the patients consented to letting me do this as well. It has been a very good week for learning this week. The nurses have also commented on how well i've done and how confident I have been for a first year on their very first placement.  This is where I think it does help immensely having any previous experience within the field of nursing you are doing.  Of course, without experience you're learning from the nurses first hand and won't have any bad habits or routines after your previous experience. So it can work either way! 

I have also been able to administer an enema to a patient so I've felt very lucky being able to do that. This was a very first for me so I am glad I have asked every step of the way to do things, as I've done things that they wouldn't have considered me doing with it being my very first placement. The enema is very effective and works within 5-10 minutes for the patient and can provide immense relief for someone. Within palliative care there is a great need for pain relief and as everything begins to slow down, the bowel can get lazy and cease to work where peristalsis is concerned. The faeces are not pushed through the bowel. This results in constipation and can be very painful and uncomfortable for the patient. An enema provides relief from this. 

So this week I have been very lucky in my learning.  And I have enjoyed every part of it. It feels very surreal that I am nearly finished this placement. I have learnt this week that if you dont' ask, you may not get! Especially if your mentor is not on duty. 

Essay Writing

So I finally got down to beginning my first academic essay of my nursing career. 

It has to be in in February so yes, I have started it!

It is a reflective piece of writing on my time in placement so I have begun to formulate ideas and put them down on paper. From experience, I know many people would think my word limit (1500 words) is not a great deal and the essay should not take long to do. It shouldn't, if I didn't have to reference everything and research how my university and the School of Nursing like to have things written, as well as wanting to get a good mark. Any one can write 1500 words, but it's including what the markers want to see. 

This includes the size of the font, what type of font, the spacing (usually double), the margin size, if page numbers are needed, is my student number needed, it goes on! 

So that took up a good two hours of my time trawling through university web pages and my module handbooks to find out how things are to be done.  Of course I will also be asking those in the years above how things are to be done as well! 

So yes, essay has begun.  This is because as well as this, I have an exam in February.  I hand my portfolio in as soon as we are due back in January and then I have a lot of assignments and exams all in May. So it will be non-stop over the next few weeks. I am wanting to get as much as possible done however, just so I can have somewhat of a break over the Christmas period.  I definitely do not want to be worrying about getting my work done over Christmas instead of worrying about what to wear and who to get what! 

As this piece is reflective, I am going to use Gibbs Model of Reflection.  

(Image from Google images)

Gibbs model allows me to look at my time on placement and formulate and structure my essay.  I have a 1500 word limit so I have begun by doing my introduction then going into further detail.  I have found it best to start while I am in placement as I can then get the information I may need.  With it being reflective I am talking about what has happened while on placement, so I have needed to omit patient details and placement area details, just as I do on here.  I have replaced the patient's name with a pseudonym and I have followed NMC protocol.  I have found it very useful beginning while on placement as the nurses have been a great help.  They have also been able to help me regarding the patient.  As the patient has learning disabilities, I have had to talk to their named nurse and gain consent for me to refer to them in my essay.  This is due to the patient's lack of capacity in the ability to fully consent.  I could ask the patient, but due to lack of capacity, they would not fully understand the extent in to which I am asking.  
I have found essay writing a lot easier if I plan this first and write down key words of what I want to write about. I have then researched my topic and spent a lot of time in the library going through books, journals and articles.  I have then also spent time on placement reading patient care plans before I have chosen which individual patient I am going to refer to.  I have then also spoke to the other student I am on placement with to ensure I have referenced correctly in regards to the patient care plans etc.  I have also looked at local trust policies and guidelines in relation to the patient and their care.  
For a small essay a lot of work goes into it to ensure that you gain the mark you want to. Leaving it late, you quickly realise that the time goes quickly and you will run out of time to get your ideas down how you want them to. 

More often than not its the references that take time and a fair amount of your word count! So try to do them as you go along and it will make life so much easier. It's important to remember that you cannot do draft after draft asking your tutors to look over it and mark and re-mark it. This is university and it requires a lot of self discipline and your own work.