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.

My patience trying patient

Given the fact that this morning it was raining quite heavily it was nice to be at work. Today was a return to the same bay where I was covering yesterday, though this time I was covering the role that is normally associated with the duty HCA (though I was not being used as a substitute, simply having the floating task as I had been joined by a male colleague student nurse who is an ex-HCA from the same hospital having served for 13 years in post). This was nice as I was able to undertake a few different tasks on the discharge of several patients in the catchment area of the ward for discharge by ambulance this afternoon. What made this even more unusually is that it was my dear old mother who was the ambulance crew who took one patient off another bay for us. I know that she has complained that she has gone up onto wards and has been told that a patient is in "Bay 2 bed D" which of course means nothing to the ambulance crew, or find that control send them too early for the ward staff and that the patients are not ready and/or need medication sorting out. Today, bar one patient was was handed to mother as pathology were causing delay, all ours were ready and waiting and also meant that several new admissions were sent straight into us which sped up other wards.

One annoying things is that the patients I had yesterday were starting to get a bit wearing by them wanting one thing, changing their minds, then wanting the original request before deciding they really wanted the second option all along. There was a few moments today when that was really starting to try my patients as there were some in particular where the effects are more behavioral rather then illness based. I was more involved in the observations of patients, and even did a manual BP today which is a rare thing (though the second one I have done on the ward).

The patient was shouting out nearly all day (I did investigate as initially I thourght it was one of my side room patients. The one thing that did get to me was that the person was repeating the same name over and over again which was the same as my own...definatly something haunting about hearing an invisable voice you thinks calling to you).

Still, cant complain as the day was steady and productive and cant really moan about that shift. Of course some of that steady and laid back gait which people thourght I was exhibiting today has a far more benigne reason. You see, I normally walk quite fast, but this morning I had to hurry as I thourght I was running late (I wasn't in the end but at the time I thourght I was). Anyway, I managed to make a small skin tear on my right heel, so anything over "moderate amble" speed meant the "Oh bloody hell thats stinging" pain sensation, so the net result was a gentle amble through the ward. This while done for my own comfort also made some think that I was taking a calm and collected approach. I must admit it was a bit more therapeutic then my normal "Mad man tearing on another errand" speed that sometimes is used. I think that we all managed to get the patients seen too with good personal care but also got through very smoothly. Now I am home, I am cracking on with two essays and the letter asking about jobs.

Finally bothered to write, this week

Ok,

I have done the tutorial of the essay on clinical decision maiking, had a bad dream the other night I failed the essay and was kicked out of the university, met my old mate from the ambulance, and have my old vehicle back on the road.

Stayed at my girlfriends the other night, and have been to the hospital twice to see her where she was working. Not sure when I will see her next as she's on 12 hours on a neonatal unit.

Tomorrow, I have been told its our CPR exam, though I have it down as cannulation. Odd.

So, thats it for the last few days.

Stranded in suburbia gives a glimpse of utopia

Having spent the past few days with my better half, I realised that a few days away from the daily slog can really do wonders for the soul, and make you feel a little less angry with the world. Easter was quite nice, I feel very happy with the world in general this evening.

But why? Well, I am ahead with most of my work, the reading list I have is being worked through, a few more photo's of old ambulances from Scotland have been emailed to me so that's another article written up, and even my old historic vehicle while still refusing to start now no longer seems to phase me.

Over at the Dr Rant blog, even the ever present threat of the MMC fiasco and the deeper troubles of the NHS seems almost again to be quelled in the blogs standing as the bastion against some of the more anarchic medical opinion.

Amazing. From screeching through the streets in ambulances, to pacing the floor of the hospital, against all this, Student Nurse feels all charged up and ready to return to the grind. Maybe the romantic [.sic] walks through leafy suburban bliss at sunset with my girlfriend has made me happy, perhaps realising just how much I know from all the years of study finally starting to pay off has provided a valuable ego boost. Or the overall reason? All the above, plus not having to return for two more weeks and a weekend away next Friday to boot.
Ahhh, happiness for a few hours. That's a rarity!

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.

Mindless Violence

The animal instinct to attack when its territory is invaded is one which you can almost forgive in terms of natural selection. However, when the human animal begins to fight for no reason other then a lot of beer looking for a fight and the rest of the body being prepared to go along with it, usually people end up injured.

Go to any club or pub, and I am sure they have a scoring system based on the number of hospitalised punters there are. Mostly, after being thrown out, and given a few calming kicks by the bouncers, they make their way to A&E. Do they act calm and polite? Do they heck. Reports of Nurses and Doctors being attacked (appart from being the lowest form of low) are nothing new, but looking at some figures, it seems the brainless nerks now seem to think Hi-Jacking ambulances are a good way to proceed as well.

There are many problems which workers in the NHS face at the moment, but what manner of man (or woman) sees it fit to attack the very people who are trying to help them? One wonders with the upcomming management placement and internship just how safe I will be when I hit the wards again.