My 2007

This is the end of the year and the end of my time as a student is drawing near. It will be another 29 days until I will be officially finished as a student Nurse (in case any of you were ever bothered I was/am a student at the University of Teesside, Middlesbrough). So, given that not only is this the end of the time as a student, I am also at the end of the year 2007. So, what was 2007 for me?

January
Nothing remarkable for the first half of the year as the first week was spent on annual leave. The second week was the return to the final placement of second year (Critical care placement) in the ICU. The week was spent with patients on my three shifts (though I cannot recall much now what happened). The week after was my final tripartite for second year. This I passed, I remember being very nervous about the second year one, and was sent out to a cardiac arrest in the hospital with the arrest team and thought that was less nerve racking. The 2 weeks after was on my elective with the North East Ambulance Service NHS trust. That was enjoyable.

February
The first 2 weeks were study time and I prepared my portfolio. They went in on the 19th and I started 3rd year. This was a time when the attitude changed with the university toward the student groups (from “oh, don’t worry you are only a student” to “Right, your managing bays and other students when you go out next”). It sowed and I remember I ended up being late two days thanks to traffic (some did not even make it in to university). I met my girlfriend this month.

March.
The portfolio passed this month. Not a lot to report for March.

April.
The semester continued with the addition of the independent learning module coming online. There was no a lot to recall, I did have a weekend in York with my other half, and records suggest I had the blog by now.

May
I was asked to hand in an essay and this was worked on while I queried the MITS which had been applied for. This was met with a stern look and a mark of 30. That was not good. Some of the modules drew to a close as the final seminars were had.

June.
I was kicked off the course due to the 30 mark for the essay from second year. Thankfully, I still had some old paperwork and approached the student union with a view to appealing against the decision. It was agreed that I had a case and the assessment review was put in. I immediately started looking for work and was accepted for employment in a call centre. I also joined St John Ambulance.

July
Back on the course on the 3rd. I got the letter which while written on the 3rd only reached me on the day I was being asked to go into the university to meet with the pathway leader and 3rd year module leader. This went OK and I agreed the date’s to submit essays (3rd August). The essays were worked on, till one module asked for submission on the 3rd which was not originally intended. This took some sorting out.
August

A new placement was on the infections disease and diabetes ward. This is well document on the blog.

September
The placement was worked through and the essays all passed. One later needed re-submission though this was the one which I was asked to write in less then a week.

October.
The internship placement began in a old division. I did get a bit downhearted by this at first by slowly it did get better

November
The tripartite and nights dominated this month

December
The application for jobs started in earnest this month as did attending st john ambulance duties having passed the members first aid course.

The end (Part 1)

I am a tad nervous at the moment. Ok, that's a bit of an understatement. "Absolutely bloody terrified" is strolling over in the right direction. At this moment in time I am passing by the scary house, around cape fear and into the calm lagoon of sheer terror.

Because this is the beginning of the end. Yes, on Wednesday, I am facing one of the biggest tests of my life so far. Namely, the final tripartite meeting of the internship. This is it. The big one. The terminal end of the Nursing course. In the meeting, I have to present evidence of Manual Handling, CPR, Venous Cannulation, Male Catheterisation, Venepuncture, IV drug administration, Fire lecture and so fourth. I am also required to pass 17 competencies and benchmarks as laid down by the University in conjunction of the NMC. I then need to submit with the portfolio, 2 learning contracts and a SWOT analysis (already done), a medicine log and all dialogue sheets. This is a daunting prospect. I mean, heck all final tripartites are bloody awful, but this is the daddy of them all. I can only hope my 4000 word essay on an reflective account of an episode of care nets a good result. I have gone from being the bottom of the nursing post as a first year and have climbed up the mountain which is Nurse training and I am now in the rarefied atmosphere of the summit.

Wish me luck!

my new world

Had the first day of the new placement start. This is a surgical ward with a few cardio patient and some medical patients under cardiologists. The past two days have been keeping me steady away with work but I prefer this to the wards where I was hectically busy on the few hours of the morning with hardly anything on the afternoon to occupy my time with the patients. While it is possible to use this time for reading policy documents and so forth I usually find that as soon as you do that, something crops up that takes may attention.

These have been interesting times though and there has been a wide variety of work to be done. I have enjoyed my last two days, busy as they are. The initial day started with a patient being preped and consented for surgery and taking them down to the operating theatre for the anaesthetic nurses to take over, and there were tow journeys made that day. I went back and dispensed the medication (under supervision). The bay was full of independent patients which makes a change, though there were more dressings and ECG's and hourly observations to be done, as well as referrals to be made for the discharge. After the morning was done with, I was given an orientation to the ward, and the sister gave a small fire talk and showed the location of the fire panels, extinguishers and so on so that's part of the fire talk out of the way. This may seem irrelevant but as the alarm kept going off it was needed to assess the problem.

The afternoon was spent co-ordinating the new admissions and doing the nursing assessment. Today was much the same, save for going to the cardio lab to watch a PCI (Percutaneous Coronary Intervention) being done for an angiogram. Had a few in for them today, one who took a few scans (with the appropriate referral), had several ECG's, Observations to do post op. As there were 16 admissions to the ward, I was over the bay that took some, and was doing the Nursing admissions for some patients. While I was asked to go on a break this evening while I was doing one Nursing assessment, I got the details down of the patient who manages independently and got around the time problem by filling in the form over a tea break. Had to take a venous blood sample today as well, first time in a while and that went fine with no problems. In the last 5 minutes of the shift, I did a BM, Did an aseptic dressing to a patients leg, and removed a venflon. Shows how busy I have been.

The only razor in the toffee apple of the day was that while 2 essays have passed, one that was supposed to have been MITS and extended has been thrown back. Bugger. This now means having to go in to see if they have accepted the extension of the essay with MITS (its a throwback to when they buggered me about) or if one part has been thrown back. Either way I am annoyed at the whole thing. I don't mind the MITS being refused if they see fit, I just with the university had not messed me about originally to bring about this situation. In saying that, my new average mark has been announced as being 58. Not that bad.

My big move

Saturday was the day when the ward moved from the second floor of the hospital to the ground floor. The ward now is the old CCU. Although it was my day off, I turned in for a few hours to help out. The move was simple in its outlay- move the patients, their lockers and the tables- from the bay, down the corridor, into the lift (which was kept open by the head porters and had notices on asking the public to use the other lifts due to the ward move), down the ground floor corridor and to the left into the new ward, then place the patient in the bay area which corresponded to where they were in the original ward. In reality, what happened was that the side room patients were in different side room numbers which caused some people to go to a different numbered bed, and to compound this there was no bed 13 (somebody was superstitious. I kid ye not, it went bed 11, 12, and 14 in the bay). What this meant in real terms was that for every one patient moved, three journeys were involved- one with two people (sometimes only one) moving the patient on the bed, one for the locker and one for the bedside tables. This took time, I moved about 8 patients in some role of the above categories. This was harder then it seems (which with going up the stairs after each run), not to mention taking equipment and supplies between the wards (hoists, dynamap’s-though not sure why as they always are buggered in my bay- chairs, crates with paperwork in were all moved by myself), as well as helping with the patients (buzzers still went off, medication was still given etc) as well as removing cardboard into a cage which was for disposal, taking chairs from the new ward to the ward where that was moving to, and taking the hot-lock for the patients meals down to the catering department with one of the housekeepers as the porters which were plentiful in the morning were talking about some finishing at 1pm, which they indeed did from which time it was impossible to find one for love nor money. I was remarked as being “always walking through the ward pushing something big and heavy” so at least people saw me doing some work (for a change- normally I was in the end so saw little of other staff). I also taped up the new bed numbers (a senior HCA took on the role of assistant ward clerk- and I, having micropore tape in my pocket was able to take on the job of affixing bed numbers, which helped gain an understanding of the ward layout which was handy when I took one of “my regular” patients back to their correct bed as we were all a bit lost with where we all were supposed to be.

I was knackered by the end of it all and had a splitting headache. Still, at least the ward manager thanked me for turning in which is nice. However, when I got home I checked my essay feedback. While I thourght at new essay feedback would show up as an added number, I checked under the original listing (which read Deferred) and it has passed with a good mark which I am happy with.

MY CELEBRATION

JUST HA THE NEWS THAT THE ESSAY THAT CAUSED ALL THE TROUBLE BEFORE HAS PASSED. THERE IS A WEIGHT OFF MY MIND!

My Helicopter

It was an interesting shift Friday, mainly because I was working with a different staff Nurse after mine phoned in Sick. Had one patient who was not very well, and another who was on the End of Life Care Pathway (EOLCP). During the course of the sift, I was doing the work of a HCA as there had been a sick call. I am by no means complaining of Nursing in the role of the HCA as often a Staff Nurse will occupy a floating role to do this, but the most exasperating thing with this is that I am supposed to be on management placement at the moment, but have had only 3 days of actually doing anything like that.

I did have a good shift though, I decided that a patient would be better off having assisted feeding as they were not managing well with eating or drinking (several changes of gowns had occurred by the time lunch had arrived so I was not taking chances). Took another bay's patient over to CCU, and had a mild bit of excitement when I went outside to phone my girlfriend up as there was a large RAF Rescue Helicopter on the Helipad, several Police cars and a Fire engine. I am not sure what it was all about but it looked interesting enough, especially as there was a TV crew filming..

Apart from that just had a jaunt up to a nearby city with my Girlfriend who wanted some shopping, and I have a few ideas for my Christmas shopping (which I will have to do early this year as last Bursary is in December). So, now need to crack on with the essays!

Time (and the lack of it)

Somebody else who's running out of time, today

Finally, I have finished two essays. One for Tuesday, and one for the 5th september, so it will be now simply a case of checking for typo's, double checking the reference list and making sure it all makes sense.

So now I have to write a 3000 word report up for palliative care in the community. There are two problems with this. 1) I have not got to hand the plan of a report from which I am supposed to write the essay to the structure of. 2) The tutor I need to speak to has an email address listed which no matter how I try it bounces back to me.

So, I have decided the easiest way to proceed is to get the two nearly done essays out the way and then focus all my energy between tomorrow and the 5th september on doing the report (I have the source references to hand so there will be some structure to start with and then all I need to to is to find other references as they are needed while writing). I am also awaiting the results of another essay which I am really wanting to hear back that I have passed.

There is only one problem with all the above plan. I am supposed to work 3 shifts a week. There is I know 4 days where I am off duty. The problem is that you then need to write the three day off as I am too tired to do much after being up at 5:30am for a shift that lasts 12 hours. Then there is the first day off which usually involves me catching up on all the sleep I have lost over the work days (I am terrible at getting off to sleep at night- I have done a few 12 hours shifts on only 3 hours sleep). So, you call that three days between now and the 5th September to get cracking on an essay. Good job I can work fast.

My defining moment

I once said that there was never any time where I felt that I have had that one defining moment in Nursing. Well, today was as near as I have been in a while. Today I was with my usual caseload of patients and all was proceeding smoothly. All the patients had their medication given, been washed, and were all in good spirits. I was to go for my morning break at 10am but after working through doing a flush and an IV line did not in fact start the 15 minute break until near 11am. I made my usual round of the patients, told them that I would be away from the bay but that the HCA would be keeping an eye on them. I make a point of this informal chat as it allows the patients to be aware of my whereabouts, and for me to know that they do not need anything in the immediate time.

Well, when I returned, all was well bar one patient who seemed a bit quiet. I was making another patient comfortable in the chair with the pillows when something made me take a look at the patient mentioned before and think "Somethings not right here". The patient looked a bit pale and seemed to be breathing heavily and rapidly. I went over, asked if they were OK and they seemed very distressed. They said that it was due to the new tablets they had had that morning (though this was several hours ago at the time). I was concerned that this could have been an allergic reaction so immediately started following the accepted protocol of laying the patient down, getting a set of obs and getting help. I got the patient onto their bed, got the dynamap which was next the patient, took a full set of observations, took down the information from the patient who was reporting SOB and chest pain. I alerted the HCA who put the patient on oxygen, and while I was doing the ECG the HCA called the staff nurse and the doctors to come down. All was well in the end, but it was one of those moments where the training really started to kick in. It was interesting to say the least.

Took the doctors ward round in the afternoon which was uneventful, though was the first one I have ever done which was a tad nerve wracking. In the afternoon I had a vist from the tutor in the essay which caused all the confusion who was really helpful. He said that considering the essay was bashed out that the standard was good. It would not pass at the moment as there was little mention made of the future implications of the subject, but said that if that was written in the same way as the rest and the current content tidied up that it would get well above 60 based on his opinion at the time (subject the change though).

My weekend administration

This is my last day off having managed to have the weekend off the ward. I am back on tomorrow. The weekend has been up and down. Was out for a few hours last night and went to see a mate of mine as well as my girlfriend, and have been trying to sort out paperwork. Unfortunatly I have cut it fine for renewing my library loans but I think I have managed to avoid going over (not that having to pay £2 is a big deal).

I have been trawling CINAHL and the British Nursing Archive for some articles for an essay and fine tuning the next two submissions.

I am tonight going to start to write up my letters for application to the NHS trusts for the January qualifying. I am not sure what to put in the letter but will have a think. The trouble is "Gimme a job" being written in a fancy way usually means trying to sell yourself and I am not normally that vain. The plan is to go to all the departments in the hosptial and put a letter into the ward manager, write to the local PCT and fill in a generic application form to approach on three fronts in my own area, then go to a hospital in the next county to ask for a job. I have been told that my grandparents are wanting to move to the other end of the county, if that happens then there is always chance that there can be application made to other areas as well which will be nice, and I also want to contact a private aero-medical firm where I know the operations director. Then I will search Nursing standard and the NHS jobs website.

Throwing coal onto the fire of pressure

There was mention of the two essays that has to be done for the theird of August. I was aware of there being two more essays which were to be handed in on the 5th September. Only yesterday I got an email form the module leader of one of the september hand in date modules and was told that they had recieveed email "Regarding the submission of the essay for the 3rd August".

I am not sure if this is one of two things:
1) The original submission date. The module guide never had this in, and we (the group I was in) had to ask. I remeber clearly people saying "5th Septmber the same as the other one".

2) A mistake based on the pathway leaders email casusing confusion.

Fortunatly for me, I had made a small start to the essay, and had written about 750 words of the 4000. After some quick reading and typing on all three, there is 941 words of the 1000 essay (less literature search), 3065 of the first 4000 word essay and now from the urgent writing of the second 4000 word essay, 2385 words. Phew. Now, I need to get offline, and get my laptop down to the PC repair shop as I am writing this to use by using "Safe mode".