A long overdue catch-up: What I've been up to, nursing placements, Bank HCA job and almost finished first year.

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I must say I have been extremely busy (usual excuse) and have a lot of catching up to do in the blogging world. So over the last 3 months (oops!) I finished my second placement and had 2 spokes, which are kind of like tasters in different areas of nursing. I've also had an essay, a Workshop and 2 exams, as well as copious amounts of placement documentation and research. I then started a Bank HCA job and of course trying to fit my life around all of this has been a challenge in itself. I'll fill you in on placements and my new job in this post and then I'll write a separate one about the assessments I've had as this post is already going to be rather lengthy!

Hub 2 - Medical Ward

Let's start with my second main (Hub) placement. I go back there again on Monday and am so nervous. The last time I was there was 27th September :O Getting back into the routine is going to be fun, but I just can't wait to get onto a ward and nurse again. Anyway, on that placement I was given more responsibility and began to administer medication (supervised of course). I also provided fundamental care in a much more confident way,  assisted with more medical procedures, took swabs, removed what felt like 100 venflons, carried out vital obs, completed admissions, helped with discharges, attended ultrasounds, CT scans and Xrays with patients, referred patients to other professionals (physio, occ health, dietician, etc.) and arranged patient transport. I've almost certainly missed out the other 1000 things I did. I swear, I'd get home after a shift and just stare blankly at a wall for an hour from exhaustion. Placement is blumin hard work both physically and mentally.  

Spoke 1 - Mental Health

My first 2 week spoke placement was in a rehabilitation home for people with mental health problems. I must say I was nervous about going as I just didn't know what to expect. I went for a visit prior to the commencement of the placement so that I could get my shifts and find out a little bit about the place but they didn't really tell me much and seemed a bit irritated by yet another student, bearing in mind I was their 4th of 5 students in an 8 week period. They were probably very fed up. During the first week I was a little reserved as I didn't know how to make myself useful. There seemed to be a lot of tea drinking and sitting around which when you're used to a hospital ward can be a bit of a shock to the system. I was constantly asking if I could help or do something and it took me a little while to realise that the main point was therapeutic presence. A lot of the residents simply loved having someone there to sit with and have a little chat, and by the second week I loved it too. I learnt how to knit and crochet and now have a bit of a penchant for it if I'm honest. I am clearly a granny at heart :D I thoroughly enjoyed supporting people with the things they loved doing such as nipping to the shops, cooking tea, going to exercise classes, baking, going to social events and for little walks. The whole experience totally opened my eyes to the reality that 99% of nursing is about just being with someone and helping them to be them again. I don't think that MH nursing is for me but I really did learn a lot from it and hope to learn more in the future. Some of the nurses and healthcare staff who worked here were the best I've seen. I hope to be like them when I qualify.

Spoke 2 - Health Visiting/School Nursing/Sexual Health

My second 2 week spoke placement was spent with health visitors and school nurses and I absolutely loved it. After the short time I spent there I think I might actually want to specialise in school nursing in the future. It felt so natural for me. My mentor was fantastic and gave me every opportunity possible. I spent an afternoon with the sexual health nurse in her clinic and seen some very interesting things. I also spent a day with the sexual health team in a high school to educate teenagers on the risks of STDs and hand out testing kits, as well as little treats for having taken a test (something that they never had when I was young!). They got free cinema tickets, headphones or undercrackers. I then spent a couple of mornings in schools observing inoculations which were really interesting. It was a very strange feeling to be back in a school environment and I felt very uncomfortable at first but it was nice to be seen in a different way, not as a student teacher but as a student nurse. I held the hands of those who were afraid, handed tissues to those who had meltdowns and distracted them from the injections. It was a really interesting experience even though it was a simple as giving injections. In my final week I attended a child safety meeting with a whole host of other professionals, from nursery nurses to social workers. It was a pretty stressful environment and really opens your eyes to the vast role of the nurse...and the importance of quality, accurate paperwork. Aside from all of these things I went along to lots of home visits with the health visitor which made me ridiculously broody. All of the cute little babbas and nervous/excited parents made it such a lovely experience. I loved being in the community and dealing with people in different settings. People are so different when they're not wearing hospital gowns! Unfortunately I ended up missing 2 days of the placement due to spending some time in hospital but did everything I could to get back given that it was a 1 time only placement that couldn't be made up. That's another story though and I'm fine now :) My report for this placement was glowing and my mentor said that I'd make an exceptional nurse. Yeah! :)

HCA Bank Job

As I said in a previous post I gained a job at a private hospital as a Bank HCA and had my first shift yesterday. It took them so long to organise a shift that I honestly thought it would never happen! But regardless I went and it was OK. It was a very quiet shift, not much going on. I've got another one tomorrow morning and I've been told it's usually manic so I'm looking forward to that. I also have an interview for an NHS Bank HCA post on Monday as I thought it would be really beneficial to gain more experience in an NHS based hospital too. I hope I get it!

Final placement - Hub 3 - Medical Ward

So like I said above I return to placement on Monday morning and couldn't be more excited about all of things I'm going to get to see and do. I've really missed it. The Ward Manager runs her own cardiac clinic and has asked me to spend the day with her when I go back which I am ridiculously excited about. She knows everything there is to know about the heart and it's a particular area of interest for me due to my sister's very unusual condition so I'll be taking a tonne from it I'm sure :) My mentor also said that she's going to increase my level of responsibility when I return (after I've settled back in of course) so that I'll be looking after a whole section of my own patients, eep! I'm so excited for this but unbelievably nervous also. This is going to be my final placement as a first year student nurse. Next year I'll be a second year nurse and feel so unprepared for that title.

How did you other student nurses find the transition from year 1 to year 2? 

My First Nursing Placement

I'm currently in the 3rd week of my 2nd block of placement on a general acute medical ward. The ward itself has 27 beds that are rarely empty and quite a high turnover of patients. There are 5 cardiac monitoring beds for patients who are most at risk. It is a very interesting ward to work on as patients come on with such varying conditions and I have learnt an incredible amount already, even after just 6 weeks. My mentor is a Sister on the ward and is obviously very busy but makes sure to give me excellent learning opportunities. I also have 2 co-mentors (staff nurses) who are brilliant and explain everything so thoroughly. I really think I have landed on my feet with this placement even if it is a fair distance for me to travel every day. The structure of placements at my university has changed recently and means that we have 1 Hub placement that we revisit over the course of the year and 2 Spoke placements in between. The placement I'm on at the moment is my Hub placement. I'm there for another 2 weeks and then back for 6 weeks in January. I have my Spoke placements after this placement where I will spend 2 weeks in a mental health environment and 2 weeks with a Health Visitor. These are basically to give us a broader outlook of the nursing career.

So when I first started reading blogs I was itching to know what student nurses do whilst on placement and at first I expected that people would be doing all of the nursey things straight away. Wrong. It makes A LOT of sense really as when you set foot onto a ward (which I had never done in a work capacity) it can be very daunting - alarms here, wires there, patients with life threatening problems, family who are anxious, staff running around, patients coming on the ward, other patients leaving, buzzers going...you get the picture - it's stressful! There is so much to learn that starting with the basic stuff, the fundamentals, is vital. So for the first 4 weeks of my placement (all of July basically) I spent in the role of a HCA (Health Care Assistant), learning from the resident HCAs, working with my mentor to understand the role better, getting used to the ward routine, learning how to take vital obs (BP, pulse, temperature, respirations, oxygen saturation, AVPU (alert, vocal, pain, unresponsive - basically that the patient responds and to what), blood sugar, passing urine and pain level (if any), reporting this back to a staff nurse if the patient had anything out of the ordinary, assisting with meal times, helping patients with daily living tasks (getting out of bed, toilet, shower, bed bath, dressing, etc.), bed making, restocking supplies, taking patients to different departments... the list is endless really. HCAs do a lot on the ward and basically keep it going. They have the most contact with patients and some of them can teach you anything you want to know. There are a few I have clung to on several occasions and they have taught me a tonne. Moral of the tale - stick with the HCAs ;)

Since I returned to placement after the Summer, my Mentor has given me more opportunities to broaden my experiences and is allowing me to partake in drugs rounds and slowly increasing my responsibilities, which I am thoroughly enjoying. I think the easiest thing here is to list the things I've been doing:

• Bed baths
• Showering patients
• Making beds
• Taking vital obs - completing NEWS charts (early warning system)
• Admitting patients onto the ward
• Completing documentation
• Dressings
• Watching procedures - Lumbar Puncture, Ascitic drain, Xrays, Endoscopy
• Assisting a Dr with an Ascitic drain - I put a sharp in a normal bin as I was so nervous...oops! I'll never make that mistake again!
• ECGs (heart trace)
• Serving food and assisting some patients with their nutritional needs
• Speaking to family/friends of patients
• Re-stocking supplies
• Tidying the patient's rooms/ward
• Taking BMs (blood sugar)
• Laying out a dead patient
• Drugs rounds
• Checking skin integrity
• Calling family regarding patients' needs
• Arranging transport for discharged patients
• Preparing IV solutions (e.g. 450g Tazocin with 20ml water, mixing then adding to 1000ml Sodium Chloride) and setting up the machine...under supervision obviously.
• Simple drug calculations
• Injections (4 and counting!)
• Observing Aseptic technique - Catheterisation and an aseptic leg dressing
• Observing an Occupational Therapist assess a patient and attending a home visit
• Assist in a cardiac arrest (SCARY!)
• Swab to test for MRSA
• Dip urine and sent samples to the lab
• Accompany patients to other departments (Xray, Ultrasound and Endoscopy so far) and observed the procedures
• Attend Medical Gas Safety and Syringe Driver Training
• Removing venflons
•  ...the most important one I've found - talking to patients.

I have come across a variety of patients on the ward, mostly elderly but some quite young. One girl was younger than me (around 20) and unfortunately admitted due to taking an overdose. That one was difficult. I love caring for elderly patients and to be honest before I started I was dreading working with elderly people. I think because of my previous work experience I expected it to be the same but the environment in a hospital is vastly different to that of a care home. I realise now how poor the care actually was in the home I worked in for a few shifts. This whole nursey thing doesn't half make you reflective!

I feel like I've dealt with all that has been thrown at me quite well and am adapting all of the time. I can feel myself learning and developing constantly, dealing with situations and people I never thought I'd have to contend with. All in all the best advice I can give to any student nurse is to just take things as they come and not expect too much. Every one learns at different rates and every hospital/ward/mentor is different in how they teach students. I have some friends on the course who did all I've done in the first month and at first I was jealous but after realised that taking things in my own pace leads to a better learning experience personally. Apologies if I've skimmed over things a bit. I've been trying to finish this post for ages and been a busy bee. If anyone reading this has any questions or would like any advice please don't hesitate to comment.

Overall placement came as a bit of a shock for me as well as my nails. They're usually coated in something sparkly but now look absolutely pants, short and plain. My toe nails remain overtly sparkly to compensate. Moral of the tale - make the most of holidays and paint your finger nails, ha!

P.S. I'm not sure if I mentioned this previously, but I applied for a Bank HCA job at a private hospital and heard last week that I got it! I'm very excited to get going.

Hope you're all well :)