My Finnegans wake

It was with mixed feelings that I was told that the internship placements were put up on the university intranet today. The result is that I am on my second choice, a cardiac surgery ward. Which I absolutely love as the heart is one of my strong fields. However, I am getting too far ahead, so leave me at 4:30 in the central corridor on my break being told this by another student and return to some hours previous when I arrived at 07:10. Today was on the ward, while my mentor was on duty I was allocated to another nurse to act as second nurse. There was one patient who began the day by telling me and the staff nurse to "Fuck off and don't come near me". We left him half an hour and were met with the same reply. As were the junior doctors. The consultant. Two ward hostesses. A physiotherapist. And a visitor. SO there was not a lot we could do. Still I did get the patients medication and observations done and was able to get the bed made and sort them out with getting washed and changed. Just never done it while being swore at before but hey.

I was trying to do the observations with the dynamap again which stopped working near the end but still managed to get my observations done albeit slowly. The day started with the slow fall down to being stagnated trying to square things up, but one I found the sats probe and the dynamap came back to life I was able to make a start on the observations once more. My two side ward patients were both discharged which eased the workload. There was a staff nurse from another department who was with one of my patients when I was covering the lunchtime. I thought it was odd that a visiting nurse would be dealing with the patient in the manner they seemed to be until I was able to deduce this was in fact a visitor and the patient was a relative. I was mildly taken aback with mild panic as I became acutely aware that here was not only a visitor, but one who was also my superior on the job. Thankfully they were very happy, and actually gave me a hand with them. I was able to crack on with the patients who were left. The staff nurse remarked that I had "worked very well" today which was nice (I have never worked in the same bay as the staff nurse in question who originally trained in 1966 and is about to retire!).

The afternoon drifted by slowly and while tiring has left me some time to think. Which is really starting to get to me as I am now comming full circle. The end of the course is comming up and I now look upon this with a mixture of thourghts. The initial one is a feeling of happiness that this whole course of three years is nearly done and this I can rest (I am feeling tired at the moment of the pressure) but also with the uncertianty which all in my positon are facing. Which is even worse for seeing the list, as there are quite afew people on the list from the same hospital as me which will all be fighting for position. And this is simply depressing as there is the rumor running around of the jobs which are going and of those who have been earmarked and the problems which the last cohort faced (60 people qualified but only 8 finding jobs), the future what this holds for me and of my girlfried and how they will fare.

This should be the time to be glad and looking forward to a bright and prosperous future career. However, I am left burt out, dejected, nearly reaching for the fluoxitine, and considering work in a call centre. This is not healthy.

Question

Is it really worth it anymore?
In another 9 hours the essay that nearly ruined my career will be submitted. I am hopefull that this will pass, but I have had such a hassle with this other essay that I am really worn. I am really tired of this all. I mean, where is the job at the end of this? There really is little prospect, I have always asserted that I doubt that there is a job at the end of the course for me (and many others). The third year has been a demoralising exercise and really I cannot take much more of the constant kick-in-the-teeth experiance which the course has descended into. Course, today is friday but heaven knows when my money will arrive, when hell freezes over or there is aerial bacon seems to be the two hot favourites at the moment.

Take the latest problem. I am being asked to submitt an essay today that is not infact due to be submitted until september 5th. I have mentioned this, and all I get is a terse reply saying to hand the essay in. Well, they want an essay in a week then fine, you get an essay in a week. So this will more then likely defer.

Then, I will go to the studnent union and kick off on the matter.
But, who will be made out to be the c**t?
Yes, well done you guess right.
I may be back on the course but I really am just past my mental tolerance level. Just when you think you cant go any lower some bugger comes along with a jackhammer to add a few extra foot.

Back in (in more ways then one)

Ah, yes.

We went a bit quiet back there for a bit, did'nt we

The last post was about the "30" mark. Yes, well I was withdrawn on the grounds, though I launched an assessment review and thay concluded that due to my personal circumstances at the time that I would be reterospectivly awarded mitigating circumstances for the module and re admitted.

So, that was a total of 27 days on the dole (well, from the 6th June).

So, what have I learned?
1) Appreciete what I am doing even more (though I love my job even more then ever now)
2) Always have a bit of self beliefe
3) A bit of fear is sometimes a good thing
4) You never write as passonatly as when your entire life rests on it
5) Im nearly £12500 overdrawn (Opps)
6) Boredom results in you making a website (www.freewebs.com/ambulancegallery)
7) That the most progress you can make with administration is in face to face meetings which are far more effective then the computerised/non contact system.
8) Deciding to join the St John Ambulance brigade was a good idea.

So, there we go. 3rd August for 2 essays to go in, and to start on the 6th August on a new placement in infectious diseases.

When it all went wrong, yesterday

Oh Buggery buggery f**k f**k.
Ah. Read the last post
Then consider the mark.
30.
30!
Bloody 30!
What in the name of steam powered buggery d'ya mean 30?

Thats what the essay got. The same essay which was referred twice before. That was awarded 30 before, though this time had a load more references. The complaint was the rational not clear. Not clear. I wanted pain management in palliative care to compare syringe drivers to subcutaneous morphnine to deterime the superior method as research. I was told to change it to "family involvement" and to use 3 papers from the part 2 essay (which passed).
Then the feedback complaned about the papers [already bouhnd to use as they were part 2] and the rational was "not very clear". Too bloody right it wasn't clear matey, thats generally what happens what you are left bewildered by conflicting information.

Soooooooooooooo...what to do, what to do, what to do.
Have compulsory withdrawl- Hope not
Re-do the work in a different form- Maybe (fingers crossed)
Re-attept (with MITS being in could be allowed)

In response, I have been to the local PCT to see what HCA jobs they have. One. In the community. Which needs a car. I have only this morning applied for the driving theory test. The deadline is tomorrow. Bugger.

Insomnia makes Student Nurse think: "Why, a culture of cynicisim may not be a bad thing now you mention it!"

I have no problems with the NHS as an idea, nor of its aims. It was responsible for the 23 operations I had on my hands, feet and mouth. That was the reason I wanted to be either a Doctor, a Nurse or a Paramedic. But what bothers me is the way that in the past few years the focus of the NHS has shifted from providing care which is intended for the benefit of patients, but for the finance of the NHS. The trust deficits have run into millions. One wonders where all this money has gone. If a trust has over-spent by £20 million providing patient care then this is fully justified. However, the biggest bug student nurse has on the issue is why the shortfall was not a) noticed sooner or b) Planned for in budgeting. Did the trust leave at 5pm one Friday all ship shape and on return at 9am the following Monday suddenly think "Crikey, £30 million in the red!". When the idea of foundation hospitals was initiated, I personally considered the financial penalties for low performing trusts rather odd. Should it not be that those who are struggling be given the extra funding to put toward investment in services to improve the outcome and service for patients while the better performing trusts be given an increase in line with inflation to maintain the standards which they operate at, but be given reward by placing of regional units and first choice of a new facility to be developed (with the attendant increase in finance to meet such investment and expansion). By having the questioning of any changes which have changes which hide ulterior motives, clinicians are best place to have a say on these changes and to ensure that the safety and the service which we offer are for the greater good for both the trust and the patients.

But when this system begins to fail, there is a huge impact. I remember back when I was more involved as an ambulance attendant the old agency agreement which was held with the former county ambulance service. My regular mate was once activated as an emergency team and the ambulance pressed into service for the NHS. On arriving in A&E, he overheard a county Paramedic mention about "Cheap work while we are on overtime ban". It was very clear, the agency agreement intended for when county was swamped was being used as cover for industrial action. It was swiftly terminated. The forth-coming weeks was busy and the service swamped, and it resulted in a death of a patient. I have never forgotten that event.
Now though, this has grown to record levels. I am a third year and should be ecstatic over the prospect of finishing university, planning for a lifelong career, looking forward to my graduation day when my family can see me gain my "cap and gown", and take another step down life’s great road and plan for what the future holds for me and my girlfriend (also a student nurse, on the child pathway). Instead however, I fear that I will be left with no job and fail to gain employment as a Nurse, have studied for 3 years for nothing but my certificate to show or face having to leave my area to find a job and leave all which I hold very dear: Family, friends, my dear girlfriend, have the headache of finding a home for my historic vehicle, change the address for correspondence for an organisation which I am a committee officer/Editor for, and have to pay for accommodation for the initial weeks (with what money though as I am heavy on the overdraft as it is). I understand that some trusts have to find ways of balancing the books but this really is not a healthy culture to have with staff. I am doubtful that I will gain employment which I am passionate about. In all placements had a great rapport with staff and patients, shown a high level of knowledge of both medical and nursing knowledge/theory, passed essays and have done well with that. I admit, I referred on a research essay, this was when I was going through a rough time and knew I would not pass the essay becuase of the situation, but that is an exception (I got nearly 70% for assessment at the end of year one, and despite the horrendous second year got slightly lower at a range of 50%-60% for essays). I am now pulling out all the proverbial stops to increase on second year and build on the sucess which came at the end and re-build my confidence, but this is the one dark cloud on the horizon: Job freezes.

Unless all health and medical professions work together, there is ever chance that students who have the potential to be good novice nurses, junior doctors, physiotherapists, Occupational therapists or Radiographers in the upcomming 18 months will be left unemployed. Unless the full reason for change is ever explained (and I mean without political unspeak), I cant help but think that thinking cynically may lead to the true reasoning behind changes.

Pre-registration delays?

Brilliant! Just when there were loads of problems such as trust freezes, slashed recruitment and the ever present worry that I would end up as a shelf stacker at Tesco*, the university have now decided that they also wish to weigh in along with the NMC. Before, back in the days when I was a first year, you only had to make up time at the end of your training if you had three weeks or more off during your training. Now, the powers that be have decided that all time off can has to be made up at the end of training. This is alledged to be "fair" for those who have turned in all the time. Yeah right. I was off over a 2 1/2 week period (Missed days though only recorded for seminar days n=11) in second year following a unexpected death of my families new arrial after just 10 days. During the flu season I caught a humdinger of the flu, and was off for two days. There are some in my cohort (I will not name names) who decided that certian modules were boring and did not turn in. Others were just lazy.

I was off because I was genuinly depressed and upset following a death, and the second time because I was too ill to attend. But now, despite filling in forms, applying for MITS on essays, playing catch up with work and informing the university on all that happened, despite having all good reasons for the time away, I am now lumped with the lazy idle students who did not want to turn in.

And can I make up some time while on Management and internship and count them as extra days? No, it all has to be at the end of the traning. All of it. That means that assuming I have to attend for 34.5 hours per week (or 36 hours on 3X 12 hours shifts), I have to now wait over a month to register. But the biggest gripe I have is the issue of timing. The statement is that days are to be made up, not the hours lost. This would mean that unless the time itself as opposed to registered days is worked, in effect for missing a 2 1/2 hour seminar, the suggestion is I have to therfor work a 12 hour shift. That means I would have in effect worked 9 1/2 hours more (less lunch breaks) on a ward then then time missed.

"Caring and supportive of students"? Yeah right.

*Tesco, on the basis they do seem like the state within a state these days. Of course, they could just be a supermarket.