OSCE's

So I have had my OSCE's, or the Objective Structured Clinical Examinations

Hopefully you will find this link helpful...OSCE

Osce's seem to get everyone a little worried and nervous as you are performing so to speak rather than writing down on a piece of paper  or being sat at a computer.

I will say don't worry, but of course you will!

Not every university does these, and not all Osce's are the same. So it is best to see what your university does in regards to assessments.  My university did only have them in final year, but now we have them at the end of each year once again.  

This year, we have six stations, each assessing a different skill.

Each station is something many of us will have carried out on placement, depending on your placement of course! But we have learnt about them in theory in our lectures and tutorials, then we will have also carried out the skill to learn in our practical classes.

Our stations this year involved Basic Life Support, Oxygen Therapy, handwashing etc.

So it is important to know what you are doing! Not only for the exam, but in your career as a nurse. As nobody wants an incompetent nurse i'm sure! 

These stations are approximately five minutes each and there is an assessor sat in each one.  Sometime there will be Simman or a mannequin, other times there will be real live patients (actors).  However, regardless of whether or not your patient is real or not, it is imperative you interact and show confidence. Even if you are a bundle of nerves inside!  
The osce's are your chance to demonstrate your knowledge and competence in a given situation. It is important to demonstrate this so the university knows you can do this and you can show them independently away from your classroom peers.
Osce's are nerve wracking for people but they are over so quick that you may not realise just how little time you actually have.  It is good to show the skills you have learnt over the course of the year and to even have that confidence within yourself.  As a nurse you need to be confident within yourself that you can carry out those tasks.  Three years goes by very quickly, and before you know it you will be out on your own as a fully qualified nurse. 
So use those practical classes and placement as practice and gaining experience.  This will help towards your final exams at the end of each year, and once you qualify.

The osce's at our university lasted over 2 days, but you yourself are in and out within half an hour! Shortest exam you may ever actually have!
We did have that opportunity that if we had finished before the 5 minutes was up, we could step outside the station. If we then realised we had forgotten something, we could go back into the station and go over it or inform the examiner sat inside. As long as it was within the allotted time frame.

I get my results soon and hopefully I passed.
Just my written exams all coming up so it is a lot of revision to be doing now.
Luckily, having worked all year and even just doing an hour after classes most days or on the days it didnt quite sink it, has helped revision so much as I feel like I have retained a lot more than I thought I had!

So just a little tip when you do start. If there are those days where it hasn't quite sunk in, revise a little of it and go over it that same day or even the day after while it is still somewhat fresh in your mind.  Even if it is only for an hour. It helps immensely and will pay dividends when it comes to exam time! 

Dementia Friends

Recently, I have been made aware of a scheme called Dementia Friends. 

This a scheme aimed at all health professionals, in recognising and becoming Dementia Friends.

This scheme is all about raising awareness of Dementia, and how, as we are living longer, more and more people will be affected by Dementia. 

Dementia is difficult for some people to talk about. And it can be difficult to recognise the signs and symptoms of dementia.  However, through Dementia Friends, the various organisations involved are hoping that more people will talk about it.  They are hoping that through this, those with dementia do not have to go through it alone.  No one deserves to go through any difficult time alone, let alone a debilitating condition such as dementia.  

As I am sure you may know, there are varying forms of dementia.  

The links below will take you to varying websites with information on dementia. 

About Dementia

What Is Dementia?

Dementia

We recently had several dementia friends come into our university to talk about the scheme and what it meant.  Not just about what it is, but how this helps those out there affected by dementia.

Most people will know someone or have someone in their family or close friendship circle affected by dementia.  It may not be directly, but it will have affected them.  Dementia Friends is aiming to break down those barriers and unite all health care professionals (as well as others!) into helping those people affected by dementia.  Dementia can be scary for people and it can be overwhelming, So for those people they need to know they are not alone.  They need to know that there is support out there and people are not just standing by.  

Dementia Friends were amazing at coming in and educating us on the various ways you can help someone with dementia. It is important for us to know as health care professionals the difference you can make to someone with dementia just by having that little extra understanding through knowledge and awareness. 

For example, were you aware that with certain types of dementia, their colour awareness and depth perception is altered? So a black mat on the floor can look like a great big hole? So much so, the individual will not walk across it for fear of falling in. 

I would highly recommend anyone to attend these workshops and to be aware of those living in their communities with dementia. That little bit of help, such as walking across the mat first, or even moving it out the way, will make such a difference to that person. And that help will be appreciated. Not only by that person, but their relatives, their carers and those working with the person. 

Why cover this in a learning disability blog?

Did you know that people with Down's Syndrome are more likely to develop a type of dementia?

This extract below was taken from the Alzheimers website.

Down's syndrome and dementia

When people with Down's syndrome develop dementia, this is usually due to Alzheimer's disease. However there is a growing awareness that people with Down's syndrome can develop other forms of dementia.

Studies have shown that the numbers of people with Down's syndrome who have Alzheimer's disease are approximately:

1 in 50 of those aged 30 to 39 years

1 in 10 of those aged 40 to 49 years

1 in 3 of those aged 50 to 59 years

more than half of those who live to 60 or over.

These numbers indicate a greatly increased risk for dementia compared with the general population. Studies have also shown that in later life almost all people with Down's syndrome develop the changes in the brain associated with Alzheimer's disease, although not all develop the symptoms of Alzheimer's. The reason for this has not been fully identified. However, it is known that the protein that causes brain cell damage in Alzheimer's disease is produced from a gene on chromosome 21. People with Down's syndrome have an extra copy of this chromosome, which may largely explain their increased risk of developing Alzheimer's disease.

Please have a look at that website in relation to learning disabilities. Although these workshops were fantastic, I do believe that it should be discussed more in relation to learning disabilities and how this can affect those more, due to their learning disability. I have come into contact with a lot of people with dementia. And with those who have a learning disability and dementia, it can be difficult. Staff, carers etc may not have that training. They may find it difficult caring for that person. Understanding, coping, support, it is needed. And more importantly, the individual with a learning disability needs to know and understand what dementia is to them. 

Thus, as a Learning Disability Nurse, it is important you are aware of those with dementia, and how to support them. Those with learning disabilities and any type of dementia may need that extra support and understanding due to their differing communication needs or their cognitive capacity and abilities. This is why learning disability nurses are so important. 

And I may have stated this already, but please be proud of the career you have chosen and the people you support. You are their advocate, you're their voice. And everyone deserves, and has the right, to be heard. 

As it is known in Learning Disability circles, Together We Are Better. 

And together, we can be the change that is needed. 

Death and Dying

This week in lectures and tutorials we have been learning about death and dying.

I know some may ask, what is there to learn? But the subject of death is still difficult for a lot of people.  So much so that our lecturers put the information on our university portal page and also sent a questionnaire out to us to send to our tutors so that all parties are fully informed about our experiences and about what to expect.  We were also told at the beginning of lectures that if anyone feels that they need to step out then to not be afraid to do so. This may be because some may have recently experienced a death or may be going through something that is still quite raw to them.

In nursing, we unfortunately may see a lot more of death than some other careers.  It is very important therefore, that you know how to cope with this.  As a professional, you are expected to be professional, to be knowledgeable and to be there for the patient and their families.  It is okay to shed a tear or two with the patient's family, it is okay to have that sense of empathy. I don't think, however, that it is okay that you sit there and become so distraught that you cannot help them.  Do that in private.  However, as a nurse you are expected to be able to reflect on the situation and use that to help forward your practice. With the subject of death, this may be even more important.  You need to know how you will cope as a person, and as a professional.

The first time you as a student, or even as a qualified nurse, deal with the death of a patient, it will be hard.  Nursing students are always worried about 'last offices' that you may not cope or that you just don't feel comfortable. This is okay.  Talk to your mentor, your personal tutor, even family (bearing in mind confidentiality).  This is what they are there for.  It may not be easy, but it is something you will probably come across. Some nurses more than others, depending on area of work, will deal with this more frequently.   However, it never gets easier.

I am lucky enough that even when i worked in palliative care, i never personally witnessed a death.  I was always somehow, just around the corner, either arriving or leaving! I am interested though to see what happens after death and how other nurses deal with this.  On my last placement i was told that parents would often ask for help in taking photos of the deceased child, taking handprints and footprints and asking for help with the paperwork.  They may want to take the child home, they may not.  It all comes down to personal preference.  And as a nurse that is something you have to support the family with.

In class, we learned about end of life care, palliative care and how to raise the topic of end of life wishes.  There is no right way of doing this, so working with some experienced when you do come across your first death may help immensely.  As a student, it is a good opportunity to learn.  On the other hand, as a student you can step away and say you are not comfortable dealing with that at that present moment in time.  

Dying Matters is a good website to look around for help and information on the topic.  

When it comes to learning disabilities, there are different ways of helping your patients talk about and learn about death and dying.  There are different websites out there that can help as well as different organisations. 

PCPLD

Foundation for PWLD

The above links are just two websites i have come across when looking at how to communicate death and dying to people with learning disabilities.  It all comes down to that individual and their level of comprehension and understanding.  They may only want to talk to a family member or someone in a position of authority such as yourself.  It really comes down to knowing your patient and their needs and wants.  It is always worth thinking 'outside the box' when it comes to learning disabilities.  

This factsheet by Mencap is worth a read if you are looking at communicating death and dying to someone with a learning disability.  

Shockingly enough, there is not a lot of information or facilities when it comes to people with learning disabilities needing end of life or palliative care.  Many will be looked after by their family, or if they no longer have family around, then this will be amongst the elderly or in a general hospice.  These may be the perfect places for them, however, it may not be.  They may be frightened or scared or anxious.  The staff may not have the correct knowledge and/or training to help them in looking after someone with a learning disability that is palliative.  So this is a niche that really needs opened up.  So if you were looking at somewhere to make a difference when you qualify, this is it! 

Overall, don't be afraid to talk about death and dying.  It is not taboo. It is not scary. And it wont go away.  It is so important to let relatives know of your wishes, for example, when it comes to organ donation.  So just take a step back and think of those with a learning disability.  Do their relatives know? Does the individual know? Are they fully informed? When it does come to their end of life care, who will consent for them if they cannot? Who will make those tough decisions? 

There is a lot to think about when it comes to death and dying in relation to those with learning disabilities.  So all i can ask is this, 

Please be aware of your own knowledge and limitations. Then try to improve that.  As that person with learning disabilities may not be able to and will be counting on you to do the right thing for them at their most vulnerable point in their life.  Never go beyond what you know you can do. Always work within your limits. Ask for help if you need it. And be proud.  

You made a difference to that person in their last moments.  And that is the most privileged position to be in. 

Positive Choices

I thought as I am doing Learning Disability Nursing it is only fitting to write a post on Positive Choices. 

For those of you who aren't aware, it is a big conference for Learning Disability Nursing Students to attend.  It certainly looks amazing! 

Sadly I was not able to go this year, but I am trying to organise it next year with my lecturer.  I have been talking to the organisers online and they are such a lovely bunch of people! They are only too happy to help you out and are trying to promote and raise awareness that #togetherwearebetter.

There was a hashtag on Twitter for those of you who are on there about Positive Choices under pc15.  There are also many videos on YouTube from this year and previous years.

Downs Side Up 

Mix It

If you get the chance, go! I have heard nothing but good about this conference and how it is good to see just where your qualification can take you once you qualify.  As a nursing student studying Learning Disability Nursing, you may get your fair share of negative comments.  This will happen in all fields regardless.  I do think personally, this needs to stop. As we are all working to the same goal, to become a nurse.  To help others. To aid them, to assist them, to speak out for them.  No other group needs it more than those with learning disabilities.  If you have doubts, or feel offended, imagine how those with a learning disability must feel every day?

They need you to be their advocate. To be their voice and their support. 

Positive Choices is in Nottingham next year and I am already gathering information on who from my cohort would like to go, and perhaps other years too! 

This is done in collaboration with Learning Disability Nurse.  It is amazing to see the passion and the fight to change things.  And more than 10 years on, it is certainly changing.  This is why we need the new generation of nurses coming through to carry on making the change.  This is evident from the new campaign launched by students in the North East of England. 

We Are Human

Watching these videos, especially in the run up to exams, deadlines, and i suppose, for many of you, waiting to hear from your universities, reminds us all of why we have chosen the course we have.  Nursing is amazing. There are patients that will touch you, that will never leave your memory.  It is those patients that may have prompted you to apply for nursing, or may prompt you to make a change for future patients.  No matter what branch, no matter what university, you are going to become a nurse.  It is worth remembering that.

Through all the tears, heartache, stress and the hard times you will have throughout your course, try to take that step back.  It is important to look after yourself.  

Positive Choices was started by students, and is for students.  You never really stop being a student.  You will learn from your patients, and although they may not remember you, or your name, they will never forget how you made them feel. They wont forget how that amazing nurse changed their stay in hospital, or changed their relatives end of life experiences, or how you may made them comfortable.  

So, in looking at Positive Choices, all you have to do is look at the impact it is making.  The people that attend, not just the students, but those with learning disabilities, the families and friends willing to share their experiences.  From talking to others, when you go (yes when, not if!) you will laugh, you will cry, but most of all, you will learn and will make some amazing friends from it.  Learning Disability Nursing has and always will be my passion.  I want to make a difference, i want to make their voices heard.  Most of all, i want to ensure that now and future generations see that Learning Disability Nursing is AMAZING!

 Everyone needs a nurse, no matter what your prognosis, condition or otherwise. 

So make sure you tell your family, friends and partners that! Ha!