Wednesday 17 April 2013

Finally getting our hands dirty...or clean. Nursing Practicals!

Hey!

So this week we've finally been able to get started on the exciting things - practicals. Yeah!

Hand Hygiene

We began by learning about the importance of infection control and how to wash our hands, which I must say is not as easy as it sounds. They asked that we put some sort of lotion on our hands (which would show up as dirt) and then wash our hands as we normally would. Personally I'm a bit of a stickler for having clean hands so I wash thoroughly. Following washing we had to put our hands under an ultraviolet light which showed me that I had missed several places on my hands - the heel of my hand and under the corner of one of my nails. Yak! So, lesson number one is to chop off my long-ish nails. As awful as that is to me, they have to go!
These are the places where most of us missed, and in fact most people miss when washing. Not good when you consider how easily those germs can be passed on.
Anyhoo, we were shown how to correctly wash our hands so as not to miss any areas. Here's the sort of flow that we were shown to follow:


These posters are above most sinks in hospitals so really there is no excuse to "forget".

The nurse taking the session gave us a warning though that the constant hand washing can have quite a large effect on the integrity of our skin and given that I have quite sensitive skin, this is something that I will have to keep on top of. All of the hand moisturisers that I received for Christmas will come in very handy I'm sure (absolutely no pun intended there, ha!) :)

She also shared this with us:
It's pretty self explanatory but it's basically the main times when you should be performing hand hygiene whilst in practice.

De-escalation

We also covered different methods of de-escalation, so how to try to avoid aggressive behaviour and how to calm situations down. This was a bit of an odd session. It was very much common sense - calm tone, eye contact, open body language, etc. We covered some different scenarios and carried out some role play which seemed simple enough, however I don't feel that the session has equipped me to an extent that I would feel ready to face a similar situation. In fact I don't think I'll be ready until I'm in that situation  It's very much a case of everyone and every situation is different as well. Human emotions are always going to be a big challenge and I don't think I'll ever predict what may happen. I just hope I develop enough skills to be able to cope without curling up into the foetal position and calling for my Mam! :0/

First Aid

The next session we had was around First Aid, mainly focusing on shock, dressings and choking in babies, children and adults. I've been to several of these sessions before but it was refreshing that we actually got to practice the techniques on actual people (dressings by the way, not knocking someone on the back!).

First and foremost we talked about the priorities of first aid:

  • Assess the situation quickly and calmly
  • Protect yourself and any casualties from danger
  • Prevent cross infection
  • Comfort and reassure casualties
  • Assess the casualty
  • Give early treatment and treat the casualties with the most serious (life-threatening) conditions first
  • Arrange for appropriate help

I think the second point hit home the most for me. Although I'd be very tempted to trump on in there and try to help out, it's so important to ensure that it's safe for you first, otherwise what help are you going to be if you're in the same position as them?

Following this, we learnt about how to recognise a choking casualty and how to treat them, learnt how to distinguish between different types of bleeding and how to treat it, and finally identified the possible signs and symptoms of shock and how to care for someone in that position.

Choking:

We were shown the correct technique, which is very similar to the picture below. I must say though that we were told to carry out up to 5 blows. What is the point in continuing beyond 2 blows if the item is dislodged and the patient is fine after that? Sounds silly but it's true. We were warned about the final, drastic step also. If abdominal thrusts are used then we must refer the patient to A&E as it can cause internal bleeding/damage. We were also shown the techniques for children and babies which I must say was not a pleasant experience but one I'm glad I now know about just in case.


Bleeding and Dressings:

This part of the session seems a lot easier than it was in practice I can assure you. There is definitely an art to applying a bandage and a triangular sling, one which I need to practice...a lot! Mine was rather squint and my sling was not ultimately supportive so I think I'll be purchasing a couple of first aid kits and fluttering my eyelashes a bit to my partner. Speaking of him, after 3 weeks of learning how to be a student nurse he has now decided that I know everything and can subsequently tell him why his leg hurts, how long things will take to heal and the best action to take...after 3 weeks! Clearly not. Anyway, I digress...
Here's what we did:


Seriously looks easier than it is!

 Shock:

Finally we looked at the signs and symptoms of shock and how to treat someone with them. The most common include:

  • A fast, weak pulse
  • Low blood pressure
  • Feeling faint, weak or nauseous
  • Dizziness
  • Cold, clammy skin
  • Rapid, shallow breathing
  • Blue lips
We were advised that the faster the symptoms are recognised the better, which in some cases can be very difficult if there are a lot of things going on. Imagine being in a car accident and this arose...how would you react? How quickly do you think you would recognise this, if at all? Definitely something to ponder...


As a final thought, we were told that being a nurse will always be a part of our lives, both inside and outside of work. It is our responsibility now to help all of those in need where we can and at least call emergency services if required. It really does make you realise that nursing is definitely a vocation and not necessarily a "career" per se. And for all of the bad press that nurses have had recently, I'm still proud to say I'm a student nurse. I'm learning the right way and I came into nursing in order to care which is exactly what I intend to do for the next 40 or so years.

Thanks for reading!


3 comments:

  1. Love this post, sounds like you've had a very intense day!!

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  2. Hi Carlene,

    We did the same thing when we were learning handwashng, with the cream showing the 'dirt'....ours looked like glitter in the places we missed :)

    Also, it's interesting seeing the difference in our courses already, being in different countries and all.
    We have to have a nationally recognised first aid certificate (obtained through an external source other than the uni) before we can even start our nursing course.
    Thanks to the World Health Organisation, we all wash our hands the same way hahaha we have the same posters and 5 moments of hand hygiene guides here in Australia :)

    Also, at this early stage of our course we really haven't covered de-escalation. We do study mental health in the second half of our 2nd year though. However, there is a Mental Health First Aid course that we are able to take which gives us a nationally recognised certificate showing we have completed the 2 day course. It covers things like depression, anxiety, psychosis, substance misuse, suicidal thoughts & behaviours, panic attacks and aggression. So that should be interesting and so helpful, especially because we have our first clinical placements out in the real world in about 4 months!

    Student Nurse Lisa

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  3. Apologies for my ridiculously late reply. Thank you Project Nurse - it was a pretty intense day but all very fun to pull my head out of a book for a change.

    Hi StudentNurseLisa - I think our hand washing session used a product that had the word 'glitter' in the title so it may well be the same product. I was so disturbed at the little bits I missed - it really makes you think.

    It is interesting to see the differences between our courses. Thank you very much for taking the time to share this with me :) Are you studying General Nursing? I'm not sure how the Australian Nursing programmes work but in England you choose a branch - Adult, Children, Learning Disability or Mental Health and you specialise in that for 3 years. I know in some countries they don't specialise and are known as General nurses.

    I start my first placement in less than 2 weeks and am so sooo excited to get out there in the real world as a student nurse. Ahhhh! :)

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