Big night out? Partying all weekend? Having a social life…. not quite! My weekend is all university work and reading mixed in with my bank shifts. In case I haven’t mentioned it before, I have to work as well as placements and university to pay my bills. This isn’t a grumble… it sounds it haha! I adore my job! Sexual health and family planning 😍 absolutely love it. After 3 years and 3 months of being there, this is my social life. Seeing my work family and catching up.
So here I am, Saturday morning 9am, en route to work. I’m sat on the bus filling out my Asthma case study workbook for university. Every second counts when it comes to university study or work. I’ve just completed the COPD section in the book. That’s one task complete for next week ✅ amazing!
What. A. Week. On one hand I’m so glad to be back and see our group. It has felt like forever since I’ve seen everyone. Really good to catch up and see how everyone has got on during their placements and OSCE. On the other hand… a surprise 2 hour exam coming in September to prepare for and a new assignment launch! Arghhhh! Second half of the year is going to be so tough! BUT on saying this, I absolutely love this module. Health in Society and I get to pick my favourite area sexual health!!! So excited for that. So my assignment will be based on sexual health, relating to young people and the chlamydia screening. Done. It’s only just been launched and I’ve decided and even saved some websites for information! Too keen? Naaaah. Prepared. This is how you have to be throughout your nursing career all. Organised, prepared and ready for it. Along with positivity!
So… this exam. Oh my god. Firstly, I’m excited for it. Reason being, it’s all linked into actual health issues. So we will have an exam based around; Asthma, Stroke and Renal Colic. We have to know these things inside out, anatomy and physiology of it all. The drugs used, side effects. HOW and WHY the drugs work on certain areas etc. Which cells it affects… this is my downfall haha!! Trying to remember all this and the long wording of drugs and categories etc. Revision for September starts now! We have a virtual case study online that we have to complete. This is a simulated ward and we search info for the patient (Martha/asthma case) and diagnose etc. This is amazing to me! More interactive! This will really help me remember things if I can do and see it in front of me.
Thank god it’s over. OSCE – objective structured clinical examination. I didn’t realise how stressed I was about OSCE exams until the day of it. I have been revising so hard with physiology, practiced my practical skills for it. I’ve used everything available to me to remember it all and perfect it. The night before OSCE I had some terrible nightmares about failing the exam. One after the other. When I woke in the morning, this made me panic a lot more and I became so nervous for it.
The OSCE comes in 2 parts. The first was a physiology written paper at random, you won’t know which one you get so I had to revise the 4 systems: Renal, Respiratory, Skin and Cardiovascular. You get 20 minutes to complete it. My knowledge on the skin is far better than the rest so I was praying for that one! And luckily I got that one! 😀 I was so happy to see that written on the front when the lecturer put it down in front of me ready to start. I think i did enough to pass this. I know I got a couple of questions wrong, I labelled one part of the diagram wrong, it was all back to front and everything was in different places and I couldn’t remember the name for the one part of it. There was a multiple choice question that I think i got wrong too. All of the answers could of been right to me! But despite this, I think I’ve done enough to pass physiology part. 🙂 I remembered a lot more than I thought I would so I am happy with that.
The second part was the practical session. There was 2 examiners in the room. One is the ‘patient’ and the other one has the paper to mark you. I had 20 minutes to do a set of observations; blood pressure, pulse, temperature and respiratory rate. I had a whole list of things that I need to do. Gain consent, infection control, safety, communication, professionalism, know the ranges of all the average measures of my observations, introducing myself as student nurse and getting the patients preferred name.
I think I did enough to pass! I felt confident coming out of the exam. Both parts. But now I have had a couple of days to reflect back, I think I am thinking the worst now! What if I haven’t. What if my pulse was wrong?? What if the lecturer marking didn’t hear me ask for consent because I am quite a quiet person. The pulse was hard to read, I should of done it twice to double check it!! Instead I gave the first reading. I was so nervous during, its all one blur. I just hope I have done enough to pass. I will get my results on 14th July so fingers crossed!!
Overall view of my first placement is good. A great first experience and insight to the hospital wards. My mentor was a band 5 staff nurse who had been working the wards for years so her knowledge was amazing. In fact all of the staff working on the ward I was on were so knowledgable and really great at educating the patients on everything they asked. It showed confidence for the patient. It put the patients at ease and gave the patient confidence in the hospital, I know this because one of the things I wanted to do personally was get patient feedback about the ward, staff and the hospital itself. After all they are on the front line of it all, they hear and see everything and patient care is first priority. A number of patients I spoke to praised the ward and staff, they were highly impressed ‘especially after reading the bad press about the hospital’. The comments made me feel good about my first placement.
Main things that went well during placement:
My mentor allowed me to do things from a distance from her. This gave me confidence that she felt I was safe to care for patients.
Mentor encouraged me to use aseptic technique to change various dressings on wounds. This helped me use the skills I had learnt during university. I gained great feedback on this from staff.
I have leant the routine of the ward, MDT, basic care for patients, fluid and diet assessments, pressure area care, wound management, stoma and catheter care, observations (and very poorly patient observations), admitting and discharging a patient, visit to theatres to see an operation.
Used professional values and skills following BCU guidelines and the NMC code of conduct well and feedback has stated this.
Things that didn’t go as well:
Nightshifts. For me personally I didn’t feel I learnt anything or had opportunity to learn any skills during my night shifts. I had 3 nights in a row and sadly had to call in sick for the third one. It really altered my whole body doing nights, I was all out of sync, I couldn’t sleep in the day and i was physically sick. Being a proud person with punctuality this really disheartened me that I had to call in sick. But I had to for patient safety and my own safety.
I feel the ward was so busy, there wasn’t time to spend time with patients that really need it. For e.g, a patient with dementia, I feel they need a bit more support and someone to talk to on the ward.
On my first day I dropped a jug of water on the floor in the patients bay area, I will forever kick myself for this…. haha.
Now to revise physiology ready for my OSCE exam on the 8th June!! Argghhhh…..
So I’ve finally got round to blogging my results! I sat waiting patiently Friday for them to come through at midday…. 11.55, 56, 57, *whatsapp notification* university group ‘Our results were in early!’ Whoooo! So nervously I logged into my university account to check if I passed or failed. I’d worked soooo hard on this assignment I’d hate to fail this. PASS yay!!!!! Thank god!!! But I only got 55% which is a C grade. It’s still a pass but I’m really taking the 55% grade hard! I’ve read the feedback left on my assignment and I just need to double check a couple of things with the tutor that marked it as I don’t understand it fully. Hopefully whatever I was marked down for I can correct in my next assignment and aim for the higher marks.
It’s still gutting, knowing I worked so hard on it to get it perfected and only gained 55% but at least it’s a pass. No retake thank god.
Last week of placement this week eeeee. This 9 weeks has gone by so fast!! Fingers crossed I’ve done enough to pass this placement and move onto the second one.
Since being on this placement, we’ve had 2 training sessions on Tissue viability. An area I really love. It’s about preventing pressure areas / ulcers. And if there are any patients with them, it’s about how to manage the sore area and prevent it getting any worse. Stopping it in its tracks.
First, it’s risk assessment! So assessing each patient, dependent on; Mobility, nutrition and continence needs. Anyone that has anything affecting these areas we put a plan into place.
Then skin bundle; Which is a daily/ weekly check that has to be done on the patient, with a lot of tick boxes. Basically to check all of their pressure areas head to toe; head, nose, ears, shoulders, elbows, Natal cleft, Sacrum, Buttocks, hips, spine, knees, ankles, toes, heels.
Regular turning and repositioning; Anyone at risk should be encouraged and educated on repositioning to relieve the pressure from the area they are lying/ sitting on.
Nutrition; Making sure patients are well hydrated and eating a good balanced diet.
At risk? Anyone at risk, then we check their skin daily, reposition regularly 2-4 hours, put on fluid/food charts to ensure they are getting enough in them and add barrier cream to the skin to protect from pressure and moisture lesions.
If a patient was to come in with an ulcer or wound already, then there would be steps in place to monitor it, review it, do all of the above and if it is that bad then it would have a dressing to cover the wound and even packing it with various things! You do NOT want it to get to that stage. Horrible image coming….. Look away now if queasy.
So I’m half way trough my first placement! I have 4 more weeks left to go.
Today on my shift I got to do a pathway experience through the operating theatres yay!! Exciting stuff!! Prob not for some but I love it 😀
I went down with a patient from the ward and they did an ileosomy and wash out. Which is basically, cutting open the abdomen, washing out the old wound and insides around the organs. Cutting the abdomen slightly to pull through a small piece of the intestine so it sits outside the abdomen (to the right or left of the belly button) and a stoma bag is placed over the top for the faeces (pooh/ #2 however you wish to call it) to come out. The patient will learn to empty the bag themselves and take care of it 🙂 This surgery can be permanent or just temporary. I’m not sure which his is yet.
It’s very odd that after watching your patient go through surgery, how your mind alters afterwards. That patient became my patient. I wanted to make sure they were ok afterwards, constantly checking on them. Making sure they had enough fluids and comfortable. Free from pain. Checking the obs every 30minutes for 2hours and then onto 4 hourly observations. Seeing the surgery kind of makes you more empathetic towards the patient and what they’ve been through. The patient was great afterwards. Everything went well and they can now eat soft foods! Fantastic news.
For me, this was really great to watch. It’s surprising how big your small instines actually are!! 😮 It didn’t quite look real haha. Looked like fake parts from a movie or something. All in all, I enjoyed the experience. Would love to see more if I can!
Next thing to hear back from is my assignment results on the 19th May!! Urghhhh. I hope I’ve passed!
The second night shift was pretty similar to the first. Busy to start with but once patients had settled down there wasn’t much to do. I did my physiology revision and my practice placement book which was good. After my second night shift, I got home and tried to sleep and couldn’t! I managed about 2.5 hours sleep 😴 and woke feeling sick and exhausted. I unfortunately had to call in sick for my third night shift. I felt so guilty, even though I’m not counted in the numbers, I still felt bad for calling in. But I couldn’t physically do another one. I’d be unsafe to patients and myself! 😦 I much prefer the day shifts. Regular routine, plenty of sleep and a lot more to learn. I don’t feel I’ve learnt much from my night shifts other than how a night shift runs. But I’m glad I did it and I’ve now experienced the full 24 hour ward. I’ve done days, weekends, nights and bank holidays all on my first 4 weeks of placement. Another 5 weeks to go! 🙂 Then its exam time arghhhhh!
On the day, I woke up around 5.30am so that I could hopefully sleep later before my shift. I spent all morning thinking about this night shift. Panicking, worrying, feeling very anxious about it. Night shifts aren’t something I want to be doing at all. I’m no night owl. I love my sleep.
“I don’t know how I’ll cope!”
“Nope. Stop it. Positive thoughts. Happy ones!”
So I ate breakfast, ironed my uniform ready, got my bag pack together and prepared my food for the shift. 12:45pm I get into my bed, cover my head with the duvet to block the light but leave a tiny gap to breathe haha.
I actually managed to sleep a bit! 2 hours but I woke a couple of times. I finally woke before my alarm feeling more tired than I did before! Urghhh. I made my lunch. Hair and make up done. Dressed and out the door to catch the train. 17:05pm train to get me there in time for a 19:00pm start.
I arrive at 6.30pm and have a coffee to wake up a bit. I feel like a zombie today and the shift hadn’t even started.
7pm. Hand over
7.30pm. Assisted a patient to change after she had been to the toilet and got some over her night dress.
8pm. Removed a cannula from a patients arm.
8.30pm. Measured urine and documented. Did urine dip stick sample. Check for urine infections on a patient.
9pm. Repositioned patients that needed doing. Did observations (Blood Pressure, pulse, temp, resps and O2 levels) on patients.
9.30pm. Aspirated a patient (Using a syringe to drain out mucous/fluid from her nose tube). Documented it.
10pm. Patient obs again (she has to be checked every hour as she’s just had an operation and some of her results were a bit low last time).
10.30pm. Writing on the handover list online anything that needs updating.
11pm. Completed all fluid balance charts for patients. Obs again on my patient.
11.30pm. Check all patient documents are up to date.
12am. Obs on my patient again.
12.30am. Looking back for anything I’ve missed to let my mentor know.
1am. Assisted the healthcare assistant to change a patient and reposition him. Then assisted to reposition my patient and do obs again.
1.30am. Check fluid balance is up to date again, check catheter bags.
2am – 3am Break time. Chill. Eat.
3am. Obs again. “I feel so tired!! I sat and ate food and now I need sleep. Zzzzzz. Not long left. Come on!”
4am I seem to be wide awake again. More obs, assist patient to toilet/commode.
4.30am document notes. Check all fluid balance charts are up to date.
5am. All patient obs this time. And reposition patients that need it.
6am. My mentor says I can go early 😬 yay!! Sleeeeeep.
As soon as I left and entered the daylight I felt so tired. I felt the night shift take over me. “I was JUST fine?!” Haha. It’s crazy how the body works.
All in all, it seemed like a quiet night. In between patients I managed to fill my practice placement document and a little revision for my physiology. Kept my mind occupied I think. I was surprised at how fast the night actually went. I was expecting it to drag and I’d clock watch and hate it all. But it was OK. I wasn’t rushed off my feet, everything went smoothly as it could. All patients were comfortable and safe (minus me disturbing them for their obs). I don’t know what I was worried about after all.
Pros: Less busy, you can manage your time better and steadier to look after each patient properly. I prepared myself really well for the night shift, plenty of sleep, food and fluids to keep me going and only felt tired a couple of times for a moment and then I was great.
Cons: I don’t feel like I’ve had a life outside of the hospital. Work, sleep and back again. I have a long travel so makes the night even longer. Don’t see my girlfriend 😦 which isn’t good. Don’t like that I’m leaving her to sleep alone when we are used to sleeping together now. My routine is all messed up.
So I slept from around 7.30am until 14:00pm, woke a few times but managed to get straight back to sleep which was great. I woke feeling fresh?! Which was strange haha. Got my things together, made food and drinks for my next night shift, got my bag ready. On the 16:57pm train en route my second night shift! Wish me luck.