Diary of a Child Nurse

The final final countdown

2012-01-24T12:57:00.000-08:00

In less than two weeks I have my first shift as a trainee paediatric accident and emergency nurse. My exams are done (I think they went well) and my coursework submitted. So now it's just me, my copy of "Emergencies in Paediatrics and Neonatology", and two weeks of paper-pushing to make up the money to survive the next six months.

There are a few things about the coming placement that are stressing me out, so here we go:

I think I want to be an A&E nurse when I qualify, and have a whole career working in emergency nursing, but that idea is really all made up. I've never worked in an A&E an only know about my interest in emergency care from the more extreme experiences I've had in general areas. So maybe I'm going to be awful. And maybe I'll hate it.
I haven't been in a hospital for 8 and a half months. That is a very long time to have no practice or experience. The student I'm on placement with for the next 3 months has been working as a part-time health care assistant and I've been managing revenue and investigating budget deficits. So i have the steepest learning curve - within 3 months I need to go from knowing nothing and having no confidence to a competent and practical nearly-professional nurse.
I haven't been super well lately, so now will take my shattered and tired body into a mad, fast paced unit. Bugger.
At the end of the next 6 months I will have to exhibit management skills, clinical knowledge, care-plans galore. Right now I can't even remember to iron a shirt the day before.

I have high hopes for my next placement. I'm pretty sure it will go well, and I will be OK. I just can't get my head around how I'm going to get there from here.

Exams

2012-01-18T02:11:00.000-08:00

So, there is a lot I need to write about here. Loads is going on in my career and training right now, but I'm busy and stressed and having problems talking about it. SO! Here is the shortened version:

I'm about 6 months away from finishing my studies.
I have two exams, today and tomorrow, and then it all comes down to practice.
This blog was rated 30th on a list of top nursing blogs HERE. Sure, it's not a particularly pretigeous accolade but I'm surprised and happy with that.
Very soon I'll be writing more. In the meantime here is a photo of my new best friends:

It's official

2011-12-22T10:07:00.000-08:00

I am one exam, one OSCE, two short essays, one 3000 word essay and 24 weeks of placement away from (hopefully) being a registered children's nurse. This means three things, essentially:

I am considered to have many if not most of the skills needed by a children's nurse already.
I am likely to be capable of learning the remaining skills I don't have within 6 months.
I am terrified.

This year I have two 12 week long placements, which is great because it means I really get the chance to be part of the team. Our modules include management skills (running a real ward with real patients and staff who know more than I do :-S) and medicines administration. Best of all, the placements are in the two areas I was really interested in working this year, A&E and NICU.

I love the idea of being an emergency nurse; the environment suits my skills and interests and I'm generally pretty stable under pressure. Additionally I'm book smart and can generally multi-task pretty well. Right now I view the idea of being a Nurse Practitioner / Advanced Practitioner in Paediatric Emergency Nursing as my 'dream job'. Until now, though, I haven't worked in an Emergency Department and have no way of really gauging how I'll do, so this placement is either going to be reaffirming or a real eye-opener.

When I worked at the NICU last year I was thoroughly happy. Like A&E it's a fast paced, high stress area with loads to know, do, and remember. Because I loved it, I asked to go again and had my wish granted with my final sign-off placement being back in the unit I was placed in before. This is tough - I'll be there with our class's best student as she completes her studies and gets signed off and will have to shine on my own merit as a safe, competent, and professional nurse whilst dealing with the obvious comparison that she is, quite honestly, better than me.

This year comes with a surprising amount of pressure, stress, and anxiety - problems which will no doubt haunt me for the rest of my career. Aside from the negative words I can use here though, the biggest thought in my head is excitement. Soon I won't be reading and writing, I'll be doing. Soon, I'll be a nurse. A real nurse.

Wish me luck!

Jobsworth

2011-11-09T03:15:00.000-08:00

The biggest problem with my course is that we can spend as long as 8 months out of placement (because of the way dates line up / the length of placements). Whilst I enjoyed my summer break / spent it working and wishing the new term would start, and I enjoy classes and studying it makes for a long time when we're effectively de-skilling.

This year we hit placement as third year students. Third year student nurses are mere steps away from qualification. They're knowledgeable, confident and experienced, and they are pretty much capable of doing the job of a registered nurse, with appropriate supervision of course. When I finished my last placement I was feeling good about my practice. I was taking the steps from second year to third year in terms of my abilities and my confidence. When I start placement in January or February next year I'll have been out of the wards nearly 8 months. I won't have dealt with a patient or their family for that long, won't have hooked up an enteral feed, or taken BP from a squirming toddler, or even taken a temperature for that long.

I'm not saying I'll be useless when I get back to it. This is stuff you don't forget, and my knowledge base and skills are growing every minute I spend in class, but it feels emotionally like a set back. In my first placement I had a mentor that was often a little surly and stand-offish with me and embarrassingly I've only just realised that it was because she was nervous having to teach and having her own skills put under the spot light. Confidence in oneself is hard to find from nowhere, which is why, when students at my college go back to the wards it's staggered - 3rd years first, then 2nd years some weeks later, and finally 1st years. It's staggered so no one has to perform for their peers and settle into the new environment at the same time.

I feel awful that I never realised how my mentor felt, and that I was such an irritating student (I still am, but at least I know it now). So if you're reading this and preparing for placement take a read of this years top tips (and maybe last years too HERE) and stop worrying:

There is no shame in being new to nursing, new to a ward, and on your first ever placement. Have you found yourself stood by the nurses station completely unsure what to do? We all did that, and sometimes still do. It gets easier as you get better.
When the crash alarm goes off for the first time 90% of students freeze. Next time you might go and observe. Maybe after that you'll help somehow. You aren't expected to run a resus situation for a long while yet. My classmates and I laugh about how pathetic we were in these situations now, but it took this long before we were confident enough to even admit it to each other.
Listen to the news papers when they report on how nurses are uncaring. Then go out and make sure you're never that way. Ward culture can be tough, and some places will get you down. But placements are short and you should definitely not let it break your spirits or passion for helping others.
Don't feel stupid using a stethoscope, or a manual sphigmomanometer or any other tool of our trade. Some nurses don't believe that nurses should be skilled in that way, but it's out dated and most nurses and even other members of the team will help you learn.
When you do badly? Learning opportunity. When you do well? Learning opportunity. Everything in between? You got it!

The Student Nursing Times has some articles about placements (subscription only, for the most part, but some free articles too) that are worth reading. And once again - Enjoy it!

A new low

2011-10-21T09:56:00.000-07:00

For the first time since I started my course today I thought about quitting. I don't mean in a passing 'oh this is hard' way, but in a 'I really don't think I can do this' way. I feel worse about my career and my profession right now than I think I ever have, and the worst thing? I was left feeling this way after what should have been an interesting and enlightening days study.

I can't and won't talk about it here, but what I will say is that I found it incredible how little any of my colleagues in other branches of nursing know about what children's nurses actually do. I appreciate that it is a relatively small branch of nursing but surely we should all be taught what each other does. As I said, I'm sorry I can't say more and this is cryptic, but it would be inappropriate for me to rant here.

I won't quit, because I shouldn't and it wouldn't help, but I will come back to uni and make sure the staff understand that I'm not unreasonable feeling disappointed and hurt after today. It is very hard having confidence knocked out of you like that, especially in the final year of study, but what doesn't kill you supposedly makes you stronger and I'm too proud to argue that point.

A new approach

2011-10-13T10:23:00.000-07:00

This year we have a new lecturer, who hasn't taught our class before. She has an impressive background in nursing and has only just recently moved into the role of educator full time, so still has plenty of recent memories of the job. In class we were discussing skills that student nurses need to acquire and the point was made that many students feel embarrassed using a stethoscope to listen to breath sounds. Our lecturer put forward the idea that maybe it's nurses that hold themselves back, and not our medical colleagues.

Thinking about it, she's right. During medical school doctors learn how to assess a patient from top to toe, using a wide variety of techniques. Junior doctors invariably love percussing an abdomen or auscultating a chest and do so with no shame. These techniques should also be well within the range of all nurses. If we can't assess a patient then we can't treat them and we end up reverting to the "hand maiden" role of the past. But nurses don't auscultate often, and they don't like to take complex medical histories or so many other really useful skills.

In Holby City this week (I know, I know!) had all of the (medical) consultants meet with the Chief of Surgery, where he told them to make sure their staff were in order and working properly. They didn't mention this to the Chief of Nursing of course; it is presumed that nurses work for the big fancy consultant surgeons. In other episodes doctors have been shown organising nursing shift patterns, ignoring the senior nurses on the ward who would really do this. The media doesn't like the idea of competent professional nurses very much and would rather have us politely smiling at the big important doctor, but can we blame doctors for how de-skilled we feel? Do they step in and take over like in shows?

Not really. When I took my stethoscope out to listen to a child's chest my mentor was perfectly happy, and we listened together and talked about what I heard and the ward doctor was happy to compare notes just for my benefit. But the ward sister was not. I don't understand why, but I was made to feel quite stupid for wanting to assess an asthmatic child's breathing because I wouldn't be able to. In the same ward I was discussing blood values with a doctor when another nurse told me "I didn't need to know that, it's the doctor's job". I may not need to know it now, but I will eventually, and will it do me any harm to have one more way to understand my own patients condition?

Nurses don't always respect themselves and they certainly don't always respect ambition, and the combination frustrates me to no end. If all goes well I'll make it at least Nurse Practitioner (or maybe Advanced NP) level, and by then will be using every little skill that I could have picked up on the way. Doctors usually get embarrassed early on in their training by doing something stupid, but then they get teased and they move on fearlessly. Nurses rarely will risk being embarrassed so never know the joy of getting over it and moving on. What we all need is to accept that we aren't perfect and get on with being as close as possible.

Addendum - my hazing ritual.
One of our patients was being transferred to a more intensive unit that day. I called radiology to get a DVD of their scans, which I was told would take a while. After the retrieval team arrived I really got onto chasing them, and eventually was told the DVD was ready. I ran down to get it, collected it, and ran back. As I walked into the room, in front of every senior nurse and doctor on the ward it was pointed out that I had asked for the wrong patients scans. Very smooth, huh? (Oh, and after another run the radiologist burned me the right ones then and there, with only a little begging).

Scrubbing back in

2011-10-03T08:20:00.000-07:00

Only a quick post, partly to tell you the latest and partly to rant.

Last week I started back at uni for my final year. 15 weeks of studying, 24 weeks of placement, a few breaks, and I'll hopefully be a nurse. Our class has shrunk, partly the normal attrition associated with nursing and partly due to some leaving to take the degree rather than diploma to end their course. Despite meeting the criteria, for one reason or another, I chose to take the diploma so will be working towards slightly less impossible goals than some of my classmates. A blog about how this affects career prospects is yet to come!

At the end of their degree every student is asked to take the National Student Survey, a huge survey investigating the attitudes and experiences of UK students during their degree. Until it was made public that they were doing this many universities made it a mandatory part of graduating to complete the survey, but I don't know why; all students should be intrinsically interested in completing the survey.

You might presume they'd be interested because it allows them to improve the quality of their institution and help future generations, but I'm afraid that's not the case. Jobs are scarce and the quality of your uni education is just another areas that you can be judged by prospective employers, so students (certainly all that I've spoken to) feel a need to "big-up" their uni. If you say it was incredible then maybe it will rank higher and we'll get better job prospects.

The Survey is inherently flawed, in my opinion. I'll fill it in, and do so honestly, but that doesn't change how I feel about it. More and more young people have to define "doing whatever it takes" to find a job, and I'm worried that surveys like this are just gateway exaggerations...

Though I don't think that gateway exaggerations are a thing...

The Off Season

2011-09-04T06:51:00.000-07:00

Between my last placement this year, which finished in June, and the start of the next academic year in a few weeks time I haven't thought too much about nursing. I've got a job, and am happily wrapped up in the world of the 9-5. Or, at least, I thought that I was.

I feel very nervous about the upcoming year. I can't remember a time when I was feeling capable or competent in the job, and won't be back on a ward for another 5 months. The gaps between placement in the course provide ample opportunity for students to lose the confidence and self-belief that placements allow them to build.

The big problem is, there is very little that a student nurse can do to improve their confidence in the holiday periods. A part time job as a HCA (health care assistant) keeps them in a hospital environment but without the practical nursing side, which I think of as the difficult bit. Reading lots of books means that you either learn new things or reinforce old ones, but a list of conditions or care plans means nothing when your confidence is weak to begin with. Taking any other job will just provide your new employer an opportunity to lure you into the real world.

In the end the best thing I can think to do is accept that right now I don't feel much like a nurse and hope that the next term will build me back to some sort of starting point. I've always hated summer holidays at university because they're designed for people like me to fall out of the Uni loop and socially and academically backslide. This summer is just reinforcing that, but with a little luck I'll return to class with a bit less panic and a bit more "study" on my mind.

I've said this before, but now I'm saying it more anxiously!

Two years

2011-08-17T02:28:00.000-07:00

I have been training as a nurse for two years now. I have seen and done things that are incredible, scary and rewarding, often all at once. Additionally I have met some incredible people, both colleagues and patients, and this experience is steadily building me into a real nurse.

Right now I'm on my summer holiday, and I'm working a summer job to pay bills and fund next years study while trying to do some reading for next year. I don't feel like a student nurse, I feel like a normal person, and I hate it. My second year placements went well, I passed, and got good grades and a good review, and I am raring to go for my final year. Every day spent working in my office job is another I'm not learning to be a better practitioner and exactly as I hoped, this enforced break working in the real world has made me miss hospital more than ever.

Only another 6 weeks until I become a real student again, and I cannot wait, roll on third year!

My Hero

2011-06-21T03:31:00.000-07:00

Honest truth? I think Florence Nightingale sounds like a bit of a boring one. God's calling lead her to nursing, from a privileged background. The government helped he choose a team of nurses to go to the Crimean War and help wounded soldiers in a war that changed warfare and media coverage of war. She saved countless lives, changed nursing practice and is credited (although somewhat dubiously) with revolutions in sanitation during the Crimean conflict. She was undoubtedly 'good' and was certainly very influential in modern perceptions of nursing, but what she achieved is nothing compared to my idol.

Mary Seacole was born in Jamaica and learned a lot of traditional Caribbean medicine from her mother. She learnt modern nursing techniques whilst travelling extensively, including to Britain. When she went to the Crimean War it wasn't paid for by the government, it was self-funded. She nursed soldiers on the front line, whilst under fire until she was literally destitute. This woman, who history forgot for a century, did so much more for nursing in my mind. She was of mixed race and was a pioneer for Caribbean people in medicine, nursing, and so many areas.

Quite simply, you can keep you Nightingale and 'Lady with the Lamp' paradigm, because Mrs Seacole exhibits the real meaning of nursing. She threw herself into the care of others against any resistance, against danger and threats, and using modern and traditional techniques, because it was what needed to be done. The Crimean War was a watershed for western nursing, but Mary Seacole is the figure who makes me proud to follow the footsteps left behind.

Gender bias in nursing

2011-06-21T03:09:00.000-07:00

We've been through this a million and one times so I'll summarise: I'm a student nurse, who is also a man. Soon I will be a nurse, who is also a man. You may know us as "murses", but that's OK, most of us are cool with it.

A few nights ago, while sat around in the nurses office on shift waiting for my next feed to come up the discussion came round to careers in nurses. The general consensus was that there are career nurses who aim high early in their career and end up as bed managers or matrons, and there are job nurses who make it to ward sister at most and swap roles about to suit their lifestyle away from the wards. One of the nurses said that I was a career nurse and I asked why; she said that because I'm male I must be.

Full disclosure here: I have an eye on the prize. I know what sort of progression I want to make in my career, I know where I want to go, the types of jobs I want to do and how to get to the top in my chosen field. I'm super competitive as a student because if I'm capable of being top of the class then I see no reason not to be. These are all traits of career nurses and all traits that most nurses recognise in their male colleagues.

Nursing is a female profession. Around 90% of UK nurses are female, and that is especially noticeable in child nursing. I don't mind, actually, though it would be nice to work with more men sometimes. I'm a rarity and I know it. So many patients are surprised when I introduce myself as a student nurse, and so many keep calling me "doctor" for the rest of my shift whatever I tell them, that I know I'm seen as an anomaly if people realise I'm a male nurse at all.

So like women in the work place throughout a distressingly large portion of western history one could assume that being a minority will negatively affect male career prospects. The corporate bro-club of men promoting men is still in existence, so does the same thing happen in nursing? Apparently not. I expect to be successful. In fact, I demand it of myself. So finding out that despite what should be a handicap I can enjoy working against my gender will actually make my career easier as I strive to reach higher positions.

I feel entitled to a good career full of steady promotion opportunities, not because I'm a dude, but because I know my limits and I'm happy to ignore them and reach higher. I also feel guilty. Do male nurses really get promotions because of their gender? Will I? What does that say about my colleagues who are as good or better than me if I beat them because of an accident of nature? It's a funny thought, that even in a profession where I am more likely to be refused by a patient I can get ahead faster. I guess as I grow and progress I'll get to see where my career takes me and if I deserve it!

Learning curves

2011-06-06T08:59:00.000-07:00

By the time I graduate, in about 14 months time, I will be expected to be able to do the job of a qualified nurse because I will be one. Right now I am good enough to know all of my weaknesses as a nurse, but also to know which bits of the job I'm good at. In my current placement things have changed a bit; my last post about it complained I was doing nothing much, but since then I started work with my mentor and that has gone out the window.

My mentor decided that I'm wasting my time following her around, and I'll learn better by doing the job. So when patients are allocated she gives me her case-load and leaves me to it. Throughout my shift I do the job, observations, drug calculations, ward round, chatting with the patient and their family, feeds, everything. No longer am I doing odd jobs as I get told, but I'm expected to plan my own cares and prioritise my work load. The interesting thing is how hard she is working. Everything I do I know that I'm being checked up on, even though she's been nice enough not to make it obvious and shatter my confidence.

I'm learning so much from this way of working, you can only really learn to do it by doing it, and that's the chance I've been given. I'm exhausted, the shift pattern I'm working is taking it out of me and it's a lot harder to do the job when it's a bit out of my ability range, but by the end of this placement I'm pretty certain I'll be a big step closer to being a nurse.

That's pretty cool right?

Independence Day

2011-05-30T09:13:00.000-07:00

My current placement isn't like my previous ones. It's a general medical/surgical children's ward in a London hospital, sure, but there is one massive difference to what I'm used to. This ward is in an independent hospital, not an NHS one. And it is strange. Being a children's nurse is comfortingly consistent. I always say that one of the best things is that no matter how sick children are, they're still kids. They still want to play, to laugh, to do kids things. Being in this unit reminds me of that every day, but also reminds me of how working with children actually means working with families.

The ward isn't just for rich people, which I was told on my first morning there and have seen daily since.We see almost as diverse a spectrum of families as in any other unit, but we see considerably less of them, and for the most part for less time. The ward does a large amount of business in short surgical cases, so the majority of patients I have cared for have been with us for a single shift. This means that the skills of long term care that I developed in the neonatal intensive care are stagnating, but the communication and surgical care skills I want to gain are readily available for me to learn.

I find it frustrating that the better staffing ratio, the less intense patients, and the less complicated care, mean that I feel like I'm losing skills and confidence, but I know that focusing on that rather than the benefits to this environment is a mistake. Every placement is different, and this is absolutely no exception. I plan to take everything I can out of it, learn as much as I can and see as much as I can, and then get out of the private sector and back the NHS where I belong!

An interlude

2011-05-16T00:21:00.000-07:00

My in-laws live over in the USA, where things are sometimes very different in health care. Yesterday they emailed me over a Youtube clip of an advert shown on American TV that beautifully illustrates how it doesn't matter where you are, nurses are nurses. There are a few different ones but the clip below is, for obvious reasons, my favourite.

Full screen it, watch it, smile, and for all of the nurses that read this blog, enjoy how awesome we are for the rest of the day.

Another experience

2011-05-04T11:23:00.000-07:00

In the three years of my nursing qualification I will only spend six weeks working in the community, the last six weeks in fact. Nursing is moving towards a community model - more care is to be given in patients own homes or their local area by specialist or general nurses, rather than in a hospital setting. For this reason I feel like the six weeks were to little - I still barely know what services are available and have no idea how it's organised.

I will never be a community nurse, I don't think. I say never because I am aware that it can be fun to change your mind sometimes, maybe I will grow up and want to leave the acute setting one day? As I learn more and start to think about specialising into one area of nursing I realise just how important a knowledge of the health care provision within the community setting really is. To that end I've worked with loads of different professionals over the last six weeks of placement, and have seen many different approaches to health care.

Part of what we as student nurses do is to synthesise the practice of the nurses we work with and use their best parts whilst avoiding their worst habits. There are so many things that I have seen that I will certainly be using myself in my practice, and equally I have seen things, ways of discussing sensitive issues or assessing a patient, that I will gladly never copy.

Working in the community has been educational, fun at times, and interesting, but I cannot wait to put my uniform and clogs back on and hit the wards. Next stop - the Dark Side, working in a private paediatric ward. ONWARDS!

A quick one.

2011-03-26T04:35:00.000-07:00

Q) Why are student nurses so good at Aseptic Non-Touch Technique?

A) Because they aren't allowed to touch anything!

I have a possible future career as a stand up comedian, don't you think?

When the going gets even tougher.

2011-03-24T15:32:00.000-07:00

I lied. To the readers of this blog, initially, but I think I have now figured out that I lied to myself too. I said that I had learned from the death of my patient a few weeks back and moved on, which is mostly true, but I didn't factor in the way that it had shaken my confidence. Little wobbles are normal in training, especially for nurses, so I wasn't surprised to feel a bit off colour when I moved to my current placement working with a local team of Health Visitors. The problem is that right now I'm falling off the peak of my confidence completely. If they made Thrive Lines for this I'd be in the 5% grouping.

To be honest, that should be OK. I spoke with a colleague at the same stage of training as me this week who is feeling completely out of her depth on placement - an uncomfortable feeling but a sign that she is now good enough to assess her own practice. The problem I'm feeling is that I've lost my sense of adventure. The last new thing I was involved in as a student nurse ended with the patient dying. It is tragic and I feel guilt for obsessing over something I have no right to, but since then I haven't wanted to stretch myself. I'm happy to let the nurse I'm with do the talking, the measuring and weighing. When something I have knowledge about comes up I sit back and keep my mouth shut. Anyone who has been late out of class because I'm talking will understand how rare this is.

Simply I feel awful. I know it's silly but I feel like I've tried to extend my self and it failed, so now I'm sitting back and not risking anything. This isn't how I want to spend my career, and I know I need to shake it off, but I also know that this sin't how I want to spend my life. It's now falling into my life outside of health care, as small as that might be, and I'm not me. So I am formally saying that I recognise that this experience has damaged my confidence, and damaged my practice also, but I will be working flat out to get over it.

In the mean time, I think you should know;

I passed my neonatal placement.
I think I made a good impression.
I am working in the community for a few weeks and learning a whole new time of nursing practice. Finally the boring essays of this year have some context!

Working closely with death

2011-03-09T01:29:00.000-08:00

Most of the student nurses I know are like me. We walk a tight rope between being confident professionals and self doubting beginners. I've improved over the last six weeks. There have been confidence knocks and doubts but I was on an upward climb. I've been waiting for a delivery in the emergency theatre directly below my neonatal unit for weeks, but to no avail. It's one of the big goals of my placement, and I knew it would be an important experience. Luckily it finally happened. I held it together, fetched and carried for the qualified staff and helped in any way I could. And I saw a baby born in front of me.

After my shift I was buzzing. it was an incredible experience, and one that completely lived up to what I had hoped for. I was on a high. I started my shift at 7.30 last night, and just before I did one of the nurses popped in to see me and tell me something that would be better not being a surprise in a few minutes. The beautiful baby I had seen born less than 24 hours before had died during the day. It was unexpected, from a complication that whilst usually manageable wasn't due to the size and prematurity of this infant. And it hurt me.

I know plenty of patients who have died. I've sat with people before they went, I've worked to save lives that are all but lost, and never have I been hit like this. This was my first birth, the first miracle of mammal biology I had ever seen and I thought a landmark in my career. And he passed away, probably in pain and feeling fear.

Worse than all of this was the guilt that my presiding thought throughout my shift was "Was this something I caused?". I'm feeling this, but I also know that the team, myself included, did what we could and I cannot seek blame from myself to try and resolve how much this sucks. There will be another baby born in a minute, and another after and another after that. For me this loss hurts. For the parents it hurts infinitely more. For the parents of the children I continue to treat it isn't even a flicker. My job now is to learn and move on, just so long as I don't leave this baby behind.

Babies!

2011-02-05T00:33:00.000-08:00

One week down. I have washed my hands over 150 times in 5 short shifts, worn approaching 100 pairs of gloves. It has been a long, exhausting week, with not a huge amount of clinical time and lots of induction and training. Many of my student colleagues have told me they didn't enjoy their placements in Special Care Baby Units all that much. They reported that the staff didn't really accept them or want them there, and they didn't find the learning opportunities to be that good. I am very excited to say that I don't have that problem.

The nursing and medical staff on the unit are welcoming to the point that I feel inadequate, the level of training I've been given and support I've received can't be faulted and the unit itself is amazing (Yeah, we have our own MRI scanner in the ward, what of it?). I'm starting small, caring for the more well babies, getting involved in the paperwork and planning that are part of the career, but over the next few weeks I'm hoping to get involved in deliveries, newborn resus, High Dependency and Intensive Care patients, and maybe even get my own patient for a few shifts (under supervision obviously).

A lot can change in 5 weeks, but right now I'm finding myself really at home and my plans for where I want to work after I qualify are totally up in the air once again. In the mean time, I hope the students who read this are having a good time on placement, or will be soon, and for everyone else - stay well!

Pack it it.

2011-01-28T07:23:00.000-08:00

I like packing. Before a bike race I used to pack and repack my bag making sure that everything I could possibly need was in place and ready to go, and work is no different for me. So, three days before I head off to my first day at a Special Care Baby Unit I'm planning what I need and thinking how to pack it. Here is a not quite comprehensive list of what I'm bringing:

Uniform. Technically I'm going to be wearing scrubs the whole time, but in case I get sent somewhere else I want the option stored in my locker.
Shoes. 2 pairs, one surgical clogs and one black leather. A comfort and practicality thing, but I'd rather have the option.
Socks. Lots. I hate having cold/wet feet so will keep spares at work in case I manage to spill stuff down myself severely enough to soak my feet. Again.
Fob watch, x2. One personalised Mickey Mouse and one boring yet colourful silicon one.
Pens. Plenty.
Notepad (Pocket sized)
Pen torch, used 1000 times a day and rarely for more than finding lost stationary under desks.
Alcohol gel on clippy thing, for my unifiorm.
Stethoscope. Paediatric sized diaphragm and bell, natch.
Neonatology text book and dictionary.
Lunch, coffee flask, snacks. More Snacks. Snacks.

Can you tell I'm getting nervous now?

Tom

2011-01-14T07:29:00.000-08:00

I told you about my placements last year. I told you about the joy I gained from my Learning Disability placement, and how I feel that might shape my career. I want, as a little boost to my confidence before my exams in 3 days, to talk about a student on that placement who changed who I am a nurse.

Tom* has Down's syndrome. He is nearly non-communicative verbally. Meeting him at first he seemed closed off. No eye contact, verbal or sign language, he wouldn't recognise I was in the room. He likes his routine, and I quickly learned what that meant - when it was time to go somewhere he was up and on the way, unless he was told to when he sat and wouldn't move for love nor money.

After a few hours I realised that I was seeing him all wrong. Tom was communicating. He was communicating loud and clear and stupid me I didn't think to listen at first. When he got up, he was telling us that it was time to go. When he sat still he wanted to play a game that he played with his class teacher where he pretended to need a countdown to stand up. We understood the each other within a few days. He started walking with me to class and waiting for me when he knew I was meeting him somewhere. He had a wonderful sense of humour, and in a speach and language class we had great fun on our adventure around the campus in searh of a wig, which he wouldn't let me get away without wearing.

Three days from the end we went round the sports-day circuit (which he wouldn't do without a friendly face, me, accompanying him). After the 100yards race he kept going and, knowing he was a risk of absconding, I followed. I needn't have worried, he just wanted to see his family, and introduce me to them. I promise that you will never see a prouder parent than Tom's that day as he finished every event and posed for photos on his way round.

Before we finished that day I chatted with his mother. I explained that the highlight of my month at the school was working with Tom, sharing jokes with him, and becoming someone he showed his personality to. Choking back tears she explained that her son was about to go onto to further education - a residential school where he was to study skills of daily living. Before he started at the school she didn't know if he would ever be able to. She said how he didn't have an outward personality in the way he does now, that he was non-communicative, that he didn't want to walk with or be near people. In the years he spent with the staff and students I met he became a man that she never even dreamed he could be; a loving, kind and very very funny man.

When I'm down I look at the fridge magnet she gave me, with a picture of him grinning ear to ear, and I remember that even if I can't get my head round something or I'm stressing out, that the people are more important than my stresses. Tom is the patient that made me want to listen better, and connect. He is another piece in the complex puzzle of who I am now. I look forward to meeting many more!

The obvious answer

2010-12-23T02:50:00.000-08:00

In the UK there are four main branches of training that nurses can qualify through: Adult, Child, Mental Health, and Learning Disability. Choosing child nursing was easy, I love working with children and adolescents and I love working with whole families. The challenge came that there was one other branch of nursing that I was really interested in. I already wrote about my Learning Disabilities placement and said how much I enjoyed it.

Hopefully I'm heading in the right direction with my career. I'm really interested in congenital cardiac illnesses, which often form part of other illnesses that might predispose the child to learning disabilities. For my birthday I received a copy of the Contact a Family directory, my new favourite book (from my lovely outlaws [like inlaws but less official]). I've involved myself with learning from organisations like Mencap and CaF and I'm ready to carve myself a niche. I just hope that there is a way that I can fit all of my interests into my job. Maybe Special Care Babies is the way to go? There's only one way to find out.

This post comes down to one thing - I am excited to get back to work. I have coursework left, I have exams and OSCEs, and then I can get back to what I should be doing; learning everything there is to know about nursing as well as possible. Not long now.

Be Prepared

2010-12-06T03:38:00.000-08:00

With less than 2 months to go until I start my next block of placements the university issued us with the information we need to get ready. For our second year placements we get three 6 week periods, one of which is based in the community care system (which I don't know yet). This year I am getting to hit one of my biggest targets and also try something very new.

Trust4 will be a neonatal placement. A lot of people didn't enjoy these placements in the first year but I'm off to one of the best units in the city for 6 weeks and I'm excited. I have no idea what it will be like. I'm not sure about babies (they scare me), but it's important that I learn and I'm excited about this oportunity. I've looked at a selection of neonatal medical books and I'm looking forward to applying the knowledge I'm starting to develop in a real situation. Trust6 is something I never expected. Another General Paediatric ward, but in a private hospital. I like the NHS, as everyone who reads this knows, but it will be interesting to see what the differences are like. I'm nervous as always, but I'm also really eager to get started.

So far this year my grades have been good, and aside from a degree of frustration from returning to the classroom after placement I'm getting on well. All that's left now is some little exams and to thoroughly enjoy my placements, bringing me one step closer to qualification. Wish me luck everyone!

Critical care: A new nurse faces death, life, and everything in between.

2010-11-16T08:38:00.000-08:00

Theresa Brown is an oncology nurse in America. She qualified later in life, as her second career, and wrote the above book documenting her fall into the rabbit hole that is nursing. I found her writing through the New York Times weblog site, and was struck by how talented an author she is. She is, admittedly, a former English professor but still!
(Also, note they always refer to her with her qualification, R.N., after her name. As if nursing is a respected profession. This goes on my list of reasons to escape the UK).

This book is important for many reasons. I bought it on Amazon and started reading it straight away. The first chapter sucked me in, and reminded me about why I decided to go into nursing at a time when I really needed a bit of moral support. I haven't seen many other authors who can put the experiences that nursing gives you so eloquently, there's no easy way to describe what can be a dirty and demeaning profession, but Ms. Brown manages very successfully. She doesn't cover the details but makes them humorous, witty or moving, a serious feat when you spend all day emptying bed pans or trying to fight a hopeless battle against an illness.

I've leant this book to a few other nursing students, and am hoping to copy the first chapter for a few of my friends who I think will enjoy it at a time when coursework and deadlines make nursing school feel much less "nursing" and much more "school" than it should be. The amazon page allows you to read that first chapter online as a Kindle preview, and I recommend that you do. This book makes me want to write, this book makes me want to work, and this book makes me want to tell people that "I am a nurse, and I'm proud of what we do."

So you're going to be a student nurse?

2010-11-05T02:01:00.000-07:00

Part of the role that student nurses hold is to be a teacher and mentor to those students in lower years. On the ward I have been taught by more experienced students a few times*, and find it to be an invaluable part of the training experience. As such, as I get further through my training it is my role to take up education and support of students in lower years, or who have not yet experienced everything that I might have.

One of the best teachers I had on my first placement was a third year student, because I could learn the job of being a student nurse from her without the pressure of having someone qualified watching me (and scaring me half to death). As such I would like to wish any first year student nurses reading this well - you WILL be great, once you hit the ward. Here's some advice for you, that I wish I had been told before I started.

You don't need to be very good when you first start on the ward. Just learn how to take observations (and in paeds what to expect in different ages) and what they all mean. Knowing the patho-physiology of septicaemia isn't as important as spotting tachycardia and signs of distress.
Ask for help. If you're scared to ask the staff get advice from a more experienced student, or an HCA, or your mentor. People will judge you if you ask stupid questions, but only half as much as if you make a mistake because you didn't ask.
Ask to meet interesting patients. If you can, see what a meningococcal rash looks like, what a child with respiratory distress looks like, what cannulation is like. This stuff will be vital, and you can only get it from watching and remembering.
Keep notes. Nothing that could identify a patient or ward but things so you can look up things later. I kept a textbook on the ward to cross-reference, but you can take this stuff home and not look like a massive nerd, if that's easier.
Learn about the common medicines. There's new research about antipyretics, antibiotics and all sorts of things coming out monthly, so try and keep on top of the ones you see most frequently.

You'll have a great time wherever you are, so don't worry yourself about what it's going to be like. Enjoy!

Oh yeah, and never sign anything without being sure that you're allowed - even cleaning sign-offs from housekeeping staff. Chances are you're not meant to!

*Obviously under supervision and when appropriate. I've never seen safety or quality of training compromised by another student teaching a skill, only an extra dimension to the learning experience for students like myself.

Preamble

2010-10-22T03:00:00.000-07:00

In a bit I'm going to want to write a book review. I read a lot of nursing books, the vast majority aren't really worth reviewing, but I'm currently in the middle of one that definitely is. As I say, I'll save that for later, but reading it did get me thinking about the subject of nursing-physician relations.

The chapter I'm reading is entitled "Doctors don't do poop", an interesting idea. I've been asked, ordered and even begged by medical staff to collect faeces from patients during my first year placements, to the point where it doesn't really phase me in the slightest, but I've never had the slightest bit of assistance from a doctor. Most doctors don't even want to see the stool itself, they're happy to print off a Path (Pathology - the department who get to receive such gifts) form and have little more to do with 'it', the sample in question.

This goes for quite a few areas of care. Doctors rarely do the mundane but necessary care for patients in the way that nurses do. It's our job, so that isn't a complaint in any way, but it's interesting that they're happy to miss so much of the best and worst of health care. An anecdote:

I was towards the end of my last shift in the adult ward and the other nurses were involved in handover or finishing their paper work for the shift. One of my patients called for me, he was incontinent, in discomfort and needed his inco-pad changed. I was by myself, unable to get extra nursing help at that point in time but didn't want my patient to spend any more time wet, embarrassed and uncomfortable. By some degree of luck one of the junior doctors was coming out of the staff room, I called them over and somehow they agreed to help me. I gave him the PPE needed, explained to the patient and him what we were doing, and between us we cleaned up the patient.

The doctor was happy to help, and while not necessarily in his comfort zone we managed to get the patient clean in no time. At the end I thanked him profusely; not because it was a big deal that he was helping but that otherwise I didn't know what I was going to do to help my patient. He said it was OK and that he was only doing his job, despite it not really being in his remit. Helping out your colleagues when you can is vital to teamwork. The doctor could have refused or been "too busy", but he didn't. I don't mind that there is a strong sense of separation between our job roles, because I also know that the line will blur to help meet our patients' needs when it has to.

NMC code // I kid you not

2010-10-16T01:22:00.000-07:00

Two posts this morning:

The NMC has updated the code for nurses using social media and the internet. As I feel one should under these circumstances I have gone through this blog with a fine tooth comb to discover whether I am in breach of these rules. A good example of how the rules affect bloggers like myself is given here and here. I have copied their summary below - please have a look at the full articles so I don't steal their traffic.

Don’t post any personal information about a patient, or info that could be used to deduce a patient’s identity
Don’t mouth off about what a crap day you’ve had in a way that can be traced back to your workplace or colleagues
Don’t post pictures of yourself in a clinical environment or in uniform
Don’t give out any of your own personal information

So am I OK? Anyone can find me through the internet - this blog is tied into my own Gmail and web accounts so if you really want to know who I am then it won't be hard. If you really really want to try you can find out my Uni, and from that maybe even my placement areas. But it won't be easy - I've locked down as many ways to access me as possible, and never talk about my colleagues or patients in a way that lets them be identified to my knowledge. As always, if people want to contact me on this subject or any other there are comments and you can EMAIL me. I take my job seriously, and I respect privacy of everyone this job brings me into contact with. I hope that is enough!

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While I was away on holiday I ended up doing what I usually do - talking to strangers without any degree of embarrassment or shyness because I find it fun. I was in a toy shop in a mall when I got talking to a middle aged American woman about, what else, the NHS. I almost can't believe what I'm about to type, still; she described President Obama as "A Muslim, Terrorist, Communist." because of his proposed Health Care reforms.

I've grown up in the British system of the National Health Service. Care is provided to anyone who needs it on the basis of need. We all know there are enormous limitations to our system; there are medicines that are decided not to be cost-effective, and sometimes the waiting time for a procedure can be phenomenal. But care is always provided. I've treated people who live in poverty, families who are on the bread line, rich and even famous people, and never once have I refused care on the basis of cost or provided better care because they had more money.

I am scared of losing our NHS. Whether it is a possibility or not, it is the only way that I see myself being involved in health care because I don't need the money; I just need to know that no one slips through the cracks on my watch. I read an article by an American nurse on the subject of Health Insurance this morning and realised how lucky we are once more. No system is perfect, and I have a pretty strong feeling that in my adult life I'm going to end up with some degree of private health care, but thanks to the work of our post-war government I won't have to worry that my financial circumstances will result in me missing out on care.

I'm a nurse, I guess. I want all of my patients to get better and will do whatever I can to make that happen. Being told I can't give a treatment because of cost is offensive to me. Being told I can't help anyone because they can't afford copay, like in the US system, is offensive to me. I took this career because I like people, and I hope that I never need to compromise on that. Sure, nothing is perfect but do we really want perfection in a system that needs to be so dynamic?

I wish I'd never asked

2010-10-15T09:21:00.000-07:00

Paediatrics is nice to work in for thousands of reasons, but one of them is that our patients generally survive and live their life without having to think about hospitals and nurses all the time. One of the other reasons, the one I want to discuss now, is that we don't see many deaths. In the 12 weeks I spent in medical wards 99% of my patients survived.

Yesterday I went back to my first placement area to catch up with my mentor and get the mountains of paperwork that this job seems to involve signed off. it was great to see her and we chatted over coffee about life, nursing, and University. After a while we got on to talking about patients and shift, and the subject of my Last Shift on the unit came up. That shift was a nightmare and the fall out is still being felt today apparently, but the discussion covered one of the patients I helped with that night.

Following a diagnosis and being given two weeks to live the patient survived another three months at home with their family. I knew they were really sick, you couldn't miss it or misunderstand it, but following the news that they hadn't just bounced back I didn't know what to think. I know I did everything I was supposed to while they were on the ward. I documented it right, and there hasn't been any question that I did something wrong. I mean, I didn't make the child sick, right? Then why do I feel so... guilty? Finding out about the patients death instantly made me feel like I had let them down. Was I not compassionate enough? Could I have done something else that would have provided a 'miracle cure'?

Obviously, following this news I'm doing what any self-respected nursing student would do. I'm reflecting on my practice, on my reaction, and on my feelings.

I did right by my patient. I was supportive, patient, empathic and did everything to remain that way under a certain amount of pressure. I never really got to know them, but I did what was needed of me. I think I feel guilty because once my shift was over I stopped being their nurse and when their condition worsened I didn't know. I didn't do anything wrong, but I feel like I've let them down by not being better. Rightly or wrongly I feel like I've let myself down, and selfishly, that is bothering me as well as learning of my patient's passing.

Year Two, and so it begins

2010-10-01T10:58:00.000-07:00

Hello from the front line of Nursing Education. After a fair amount of kerfufle with the academic process of my University I have started back, ready and willing to go for a second year of studying and placement. Our first few classes have been reflective, talking about practice and what we learnt, but that's not what I want to talk to you about today.

I'm sat reading Paediatric Nursing in my free time (I'm deadly serious about that!) and I come across two student centred articles. The first is about the Nursing and Midwifery Council's changes to their competency requirements for nurses joining the register upon qualifying. The big change isn't that big a deal, and in fact is a fairly logical step for the NMC to take - all nurses need to be competent in 'essential first aid', a skill that seems entirely obvious but much ignored in nursing courses.

The second article is a little more contentious, focussing on the good behaviour of students, and especially on social networking sites, such as Blogger (Also: uh-oh!). The problem, apparently, is that student nurses, like most people, find the internet is a very easy place to talk about themselves and their experiences. This blog is a perfect example of this, I write about everything nursing here and have to work hard to keep any kind of identifying information out of my writing. I don't want to risk upsetting my patients, their families, my colleagues and places of work by writing something controversial here, so I'm not going to. The NMC is right to put out guidelines that remind student nurses of this. It is just a shame that I feel like we need to be told something that is actually common sense.

What do you think, how do nursing and the move towards social networking becoming our primary form of communication relate? Are these dangerous times or the modern revolution?

Year one - down and out

2010-08-01T09:43:00.000-07:00

I don't know if you noticed but I've been quite lax with my posting here lately. In part I want to take the blame here - I'm obviously quite a lazy and narrow minded guy when I'm working, but I think the real culprit here are my patients and students at my last two placements. It's hard to work after a long shift of caring too much. Excuse status: Plausible.

As my last post says, I worked for a month in an acute adult unit, where unlike the wards I had already worked in I couldn't expect all of my patients to survive every shift. I learnt a lot, and saw even more. I was lucky in many ways; I got to see several surgical procedures and ask all the questions I could think of; I managed to see life and death and get a better feeling of myself as a nurse in either circumstance; I learnt that being a massive nerd will only help when I qualify. That doesn't mean it was the ideal placement, but I reached the end and was very happy that I got to spend 13 shifts on the wards with the staff there.

Following the Acute unit I moved to the other end of the placement spectrum, to work in a school for children with learning disabilities for four weeks. I don't want to say too much, as hopefully I have another post on the subject in me, but it was without question the happiest I have ever been at work. More than anything the experience taught me one thing:

Liking your students/patients unconcervatively and without conditions means that even the hardest days are just days spending time with friends and colleagues.

I hope you all like the new blog layout, will check back on me over the summer as I survive my pre-reading and studying for year two, and come next term will be ready for the blitz on the blogosphere I plan to have.

Be safe, well, and happy.

Breaking the back of it

2010-06-18T02:14:00.000-07:00

Or, a diary of a temporarily adult nurse.
As part of the Childrens' Nursing course that I'm currently on students get a four week placement in an adult ward to see what we're missing and gain an insight into the other aspects of nursing that we miss by being so child-centric. My placement is on an acute medical admissions unit, which is about as far from my previous experiences as possible.

Working in paediatrics I have become a little closed minded when it comes to my understanding of nursing. I was comfortable in childrens' units but perhaps had stopped learning as much as I could. The ward that my adult placement has been on cannot be described as one that has limited my learning. In the course of the four weeks and 13 shifts that I enjoyed with the team I have learned as much as I could have possibly hoped to.

Adult nursing is different, obviously, to child nursing. Working with adults we take over much more 'non-clinical care' than child nurses generally do, as there are no helpful parents there to do it all for us. We take patients whose condition has limited their normal sense of autonomy and self-care and the ethics and morals of the work can be really interesting, but also really challenging...

One patient, Jane, was recovering very slowly from a state of extreme ill health. Jane wasn't able to talk coherently, so even though we wanted to help the lack of communication led to her and us becoming frustrated and her quality of care being limited. I know we didn't give her all the care she deserved but even now I can't see how we could have improved what we did. The biggest ethical dilemma is that of the self-inflicted illness; in paediatrics we rarely see long-term self-inflicted illnesses, but the ward I joined had everything from morbid obesity to alcoholic cardiomyopathy and the difficulty of rectifying how I feel about treating patients who tell me they want to change and return with the same problem before I've finished the placement is tough. I haven't found answers but I have found a lot of new questions to think about!

I went into the unit open-minded. I did not expect to enjoy it as much as a paeds ward, and I certainly didn't expect to have the great time that I did. The support, the learning opportunities and the change in pace to what I was used to was fantastic and I know I have developed loads by being there. Open mindedness is the key to surviving placement, but realising what I had to gain from this insight and taking advantage of that was how I made it work for me!

A corrolary

2010-05-26T09:30:00.000-07:00

For every bad day where you want to pack it in there will always be a good one where you forget that the bad one ever happened. I may not have had that good day yet but I know it's coming soon.

I gave a really interesting handover at the end of my shift today:

"The patient is a XX year old male with a 'query' fracture to his right hand following an incident on the ward."

To really make you laugh my swollen and sore hand (and pride) from the incident that I wrote about here yesterday resulted in my leaving the ward for X-Ray with a possibly broken hand and a hilarious amount of sympathy from my colleagues. As I expected there was nothing broken, just lots of swelling and a bit of pain. I feel bad that I let yesterday really get to me, but I also understand that there are a certain amount of negative experiences that make us who we are as nurses.

The moral of this experience is probably "Sometimes you won't be able to justify everything, and that's OK as long as you are doing the best for your patient". Then again it might just be "If you're trying to stop a patient hurting themselves the human shield approach is STUPID".

Off to Trust 3 on Monday and I am terrified all over again.

Ethics

2010-05-25T08:34:00.000-07:00

I am really upset right now. Not in a "break down in tears" sort of way, but a "your mother and I are really disappointed in you" way. My right hand has a pretty big graze and a bruise. My for arm is done bleeding but my elbow really hurts still. Today I was hurt by a patient who I was caring for.

In the UK we use a concept usually known as Gillick Competency to determine whether a child is capable of making a health care or medical decision for themselves. The idea is that a child who can think rationally, logically, and come to an informed and sensible conclusion - even if it's against our best advice - should be allowed to do so. This is a key ethical concept in child nursing as many of our patients can be wise beyond their years from long periods spent in hospital so no set age makes sense.

The patient I was treating is a young adolescent about to receive a routine and slightly invasive procedure. He has kicked off before when undergoing this procedure and this was no exception to the rule. He thrashed out, he hit myself and other members of staff and he told us categorically that he did not want the procedure. The question is, ethically were we right to push him into it?

It's hard to know; he's normally a mature enough young man but this entire event was caused by nonconstructive, immature and simple thinking, rather than realising that the procedure was to help keep him alive and well. I am really upset by what I saw today - a child hurt themselves and the people who have been looking after them for weeks now. So what's the answer? Is he big enough to say no or not? I don't know the final answer, I just know that the ethical aspects of nursing are harder to understand than almost any others I can think of.

Traditionally the argument is that nurses use logic to plan care, rather than being task orientated, and that is why it is a challenging but rewarding profession. Did we do the right thing? My thinking is messy and I don't know, and that is a hard pill to swallow.

I'm still terrified

2010-05-07T05:18:00.000-07:00

There's a line in Scrubs where Turk says he's glad surgeons wear masks so no one can tell how scared his face looks the whole time he's in theatre. Yesterday a doctor asked how my training was going and I told her that I'm still at the stage of constant terror - everything scares me. A slight tachycardia, or Bradypnea and I start to panic. The stuff I know, the basics, I'm good at. I'm learning how to plan care for patients and my days workload so I don't need to ask what I should be doing, but what I can do to help someone else when my jobs are up to date.

On BBC's iPlayer right now there's a show called Children's Emergency, based around the CATS (Children's Acute Transfer Service) and their work with critically ill children. The calmness and skill shown by the nurses on this show is exciting. One day I know I'll be a really great nurse. I am capable of it and I'm going to work towards it as hard as possible, but it feels so far away. When emergency situations happen I revert and lose everything I've learnt about work management; I start doing single tasks as ordered rather than thinking for myself.

This is normal, expected, and correct for my level of learning, but it's still hard to deal with. A cardiac arrest on the ward reduces me to fetching, carrying, and standing out of the way of the real nurses. My mentor from my last placement told me yesterday that I don't need to stress over this, and she's right. In an emergency she is calm and knows what to do and how to do it. In ten years I'm going to be there, and right now I need to be able to survive and not freak out under an alarm.

I've gone from running away from a crash call to running towards it and trying not to get in the way - a really big step. The next step in the learning process is knowing what else needs doing while there's an emergency, something that yesterday I made a small step towards. The next step is being able to actually help without worrying that I'm making things worse and from there I just need to get better and better.

One day I would love to nurse in an acute setting, and thinking about the 'skills-ladder' I'm climbing I know that I'm capable of it. The best advice I've ever received is to relax, slow down, and not worry about doing it perfectly while I'm at such an early stage. A successful answer to a question is more important than being able to complete the task that answer would imply and as long as I keep feeling aspirational towards my future then I should be proud to be learning.

Bon Soir!

2010-05-06T13:08:00.000-07:00

I'm on my second placement now. I was apprehensive heading into it, and now that I'm on the unit I'm forcing myself to settle in. To be honest, I was needlessly apprehensive. The ward is lovely, the staff are all nice and supportive and my mentor is pretty cool - once again I've been paired with someone on my wavelength.

My shift today was pretty revelatory - the staff on the unit have told me that in recent months it has got busier and reached the point of being near full all the time. That means that it's busy almost all of the time and the staff are happy for me to muck in. I have no problem mucking in and getting my hands dirty, so I've been welcomed by most of the nurses, HCAs and doctors.

I don't like moving from my comfort zone, but who does? I don't like struggling to find my feet but it's the experience I need to make me learn and improve my skills. I've received some nice compliments, I've shown my abilities at the basics and impressed the right people I think. Basically I'm happy with my abilities as a nurse at my stage in training. I'm grateful for the opportunities given to me by my last placement as I've walked into a new ward knowing that I'm a good first year nursing student, and knowing I needn't be anything more or less than that.

The point I'm making here is that I'm over the low I felt 6 weeks ago and I'm now onto a nice up. Let's see where it takes me!

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As an aside - this week I used my best Franglais to talk to a monolinguistic mother about her child. It was really fun using comunication skills I barely even have and it's nice doing something a little bit different - Ou est votre... mal?

A lesson is learned (but the damage is irreparable)

2010-04-29T03:12:00.000-07:00

I like my patients, almost without exception. The knowledge that the placement is time limited and a child's stay in hospital is hopefully even shorter means that I am capable of walking into a bay or cubicle with a smile and being supportive and friendly.
I miss my days patients for about 15 minutes after each shift, but when I cross the threshold to the hospital I'm getting good at leaving it behind. It isn't very often work comes home with me, and the stuff that does come home is invariably positive.
I'm enthusiastic to the point of fault about my career.
I'm always tired and coffee only works for 11 hours on a 12 hour shift. The other hour is a good time for paper work and not smiling.
Students walk miles more than staff nurses visiting pharmacy, clinical imaging, and every other ward when it's quicker than using a porter.

Survival of the fittest

2010-04-29T03:01:00.000-07:00

I wrote back in the middle of my first placement about how hard I was finding it, and how hard it was to be given piles of negative feedback. I'm now finished at HospitalOne and preparing to start at HospitalTwo for my second placement, and can reflect with a bit more distance on the learning experience that I had on my first ward.

I don't want to argue that the midpoint interview was a little harsh, I still feel hurt by what was said, but I'm a big boy now and don't need to throw my toys out of the pram when I'm upset. I sat down and reflected on who I am, as a nurse and as a student, and realised that while it isn't nice to hear these things sometimes they shouldn't stop me from getting on, and importantly, from improving the issues raised. I fixed the problems highlighted to me. I made the apologies I felt necessary, made sure that bridges I risked burning were in good shape and threw myself into being the best first year student I could be.

My end point interview took place on a mad last shift, but I got the chance to put all of my strengths to work and develop further through that shift. Sitting with my mentor at the end of the shift drinking coffee and debriefing we discussed where I had improved, specific examples of work that I had done well, and how I had taken the verbal kicking and worked it to being a strength rather than sulking and wrecking my placement.

I'm not perfect, I know that very well. I have a list of areas that I need to work on as long as my arm. But I know what they are and how I need to improve to meet my goals. I'm nervous as sin about placement two, but I have the kind of nerves that I feel on starting a long essay, or on lining up for a bike race. I'm worried, but I'm within my own ability and knowledge. I hope to learn even more this time.

Midpoint Interview

2010-04-03T03:40:00.001-07:00

Traditionally the way to disseminate information about someone's performance to them involves a "complement sandwich" - giving any negatives between a couple of positives to make it feel less destructive. That memo got lost in translation for my midpoint placement interview. Full disclosure here is that I have quite a few failings a student nurse, so the negatives I received during my midpoint were entirely justified and I can't complain about that. However the 25 minutes of negatives destroyed me, and ruined my confidence.

The last week of my placement has been a rollercoaster ride. I've expended a lot of energy in trying to fix the damage my negatives might have caused and in improving my weaknesses. The holidays could not have come soon enough and now I'm taking a little time off from Nursing completely to reset myself into the world of normal people; after Easter it's time for coursework and a new set of study on the pathology and phamacokinetics of Cardiac disorders.

Holiday equals sleep.

Sometimes there are bad days

2010-03-11T11:38:00.000-08:00

I'm on a low. It started yesterday - I didn't really achieve anything and made a few minor mistakes that I overplayed in my head. But that's not the sort of thing that should bother me, so this morning I put on a smile and hit the ward with energy and enthusiasm. I now feel my enthusiasm was slightly wasted.

My nursing has taken a step backwards this week. I seem to be making simple mistakes and missing things, making assumptions on my own abilities and being told that I'm wrong. There have been contradictions to things I was sure of, missed information, and forgotten signatures that all get the same response: "oh, it's ok, you don't know better".

Normally I work with a mentor who, if I'm honest, has got a pretty fantastic grasp on what makes me tick. We get on well, and she knows all the signs I give off as my confidence crashes. As lovely as the staff I have worked with this week have been I've never really connected with them on this level, and I've had a week of being the outsider. It's been difficult, not always being involved in conversations and looked over, but this week its felt personal.

I'm tired right now, so I know this is overly melodramatic, but the loss of my confidence this week is really getting me down. Today I managed to freeze, rabbit in headlights style, when the crash-alarm went. That's the sort of thing that makes me realise how poor my abilities and knowledge actually are. Next week I will be better, and stronger, but right now I wish that the support system I had in place would kick in. I've never met my link lecturer and I have no way of contacting my mentors outside of work, and that feels like a gap in the pastoral support I was promised.

A day in the life.

2010-03-02T13:10:00.000-08:00

Right now I'm meant to be working on my placement documents, but in light of the fact that I have a one track mind and box-ticking exercises (literal box-ticking exercises) aren't my thing, I thought I'd let you know what it's been like hitting the wards.

Part one - "A morning person"

5:30am - The alarm goes off and I tell myself that I never wanted to be a nurse. I remember my alarm has no snooze and drag myself into the shower.

6:12am - The bus leaves and I try and not think about work. Some days I read, some days I eat breakfast and some days I chat with other Student Nurses. Mostly I fight sleep and hope it's not too wet when I change buses.

7:15am - I walk into the hospital, get changed, and find my way up to the nurses office for a sit down and a cup of tea.

7:45am - My ward has a taped handover, so we all sit together and listen to the days patients, before the nurse in charge splits up the load and each nurse gets their patients and student for the shift. As student I go off and find the case notes and folders, we work out our patients care plans and what they are due next.

8:30am - We're off! Now is a chance to meet the patients, take a first set of obs and meet the families.

9:30am - I'm exhausted already! By now the doctors are done handing over and start appearing on the ward. By now the mountain of questions I've built up is too big too handle, so I get a chance to direct the medical ones at the Senior House Officers. The ward gets quite a lot of medical students, so they're used to teaching and only very rarely won't take the time to answer.

10:30am onwards - The days routine is settled in now, but chances are we have at least one discharge to be doing, which means we have beds to change and rooms to clean. Throughout the day jobs like urinalysis, observations, path samples and medications need doing, and that means we never get to sit still longer than a coffee takes. Where possible I try and stand in on the ward round for my patients. If I'm lucky I get to play med student and answer some questions, if not I get to talk to the family afterwards and debrief them.

1pm or there abouts - lunch time! To be continued :-)

--------------------------------------------------------------------

When we talk about student nurses we always use the word supernumerary. Student nurses don't make up the official staffing of the ward, we're not required for the daily running of a ward. But then again, there is one job that we do that noone else can be sure of having the time for. We're the only member of the multi disciplinary team who can always ask for the time to stop and chat with a patient.

It's funny, lots of people talk to patients and their family, but we're the only ones who can take the time out of our day to stop and just stop and talk for half an hour. I went into the placement itself worrying about my ability to communicate, and this gives me the chance to do just that.

I love being a student nurse. I can't wait to be a real nurse, but I'm going to miss the freedom to stop and ask someone how they're doing, what they've been up to at school, or what they understand about what the doctors have told them. I hope I never need to give that up.

Diary of a real nurse. At last.

2010-02-21T03:44:00.000-08:00

I have to apologise for the brief (OK, massive) hiatus this blog has been on, but hopefully this will give you a bit of an update.

On Monday I put on my uniform and walked into my first ever ward for my first ever real nursing job. Since then I have moved from standing awkwardly at the back of the room feeling out of place to running round taking obs and making (sometimes good) decisions. It's definitely the job I hoped it would be, and to my relief I'm not bored to death.

My mentor is awesome, and puts me under pressure to know the answers at the same time as reminding me that I'm just a 1st year nursing student, and don't need to know the same number of answers as a medical student. The ward itself is fantastic as a learning environment. Most of what I've seen has been respiratory and 'tropical' diseases, and I spend hours reading text books and learning everything there is to know about, well, everything!

To date there have been no tears, no arguments and no real problems although every patient is an adventure and I'm still a little scared when I walk into each cubicle. Here are a few updates on life as a nurse and what I've learned:

The mental and emotional commitment that you give to each patient is always returned in like. The more you work with a family and support them the more you learn from them, even though limits for that sort of thing are finite.
Paracetamol is AMAZING for pyrexic infants.
The hardest thing in nursing is knowing what to say to a scared mother.
You can't know it all, but there's no reason not to keep trying to.

I love being a nurse. I just need a bit more practice.

It's the final countdown

2010-01-29T12:01:00.000-08:00

In just a few short weeks (like regular ones, but more time sensitive, I have decided) I will put on my uniform, attach my name badge and my fob watch, and step across the threshold to my first ever experience of hospital work, my first experience of nursing, and my first experience of my future career. It seems strange, looking at it now, that after 5 months on the course I will only just be about to experience this, but that's what happens when you dream of bigger things than you are used to. I wanted to be a nurse, I applied, and here I am.

I've talked a little about how scary this is, and a little about how exciting it is, but I suppose the last few weeks have given me and extra insight into where I've come from and how I got here. At the request of another student I've started work at the interview days that our university holds to recruit potential students. My interview was way back in April, and as suggested by the fact I'm on the course, it went pretty well. It is still very fresh in my mind.

The interview process is pretty straightforward and simple, and looking at it now I'm almost envious of the applicants for getting the chance to answer all of these questions that have been on my mind since I first looked at an application over 12 months ago. I didn't enjoy my interview day that much at the time. The testing and interview themselves were fine, but it was a day of completely nervous energy. I was worried that I'd made a mistake, that I'd speak out of turn, or that I would do something so stupid that I wouldn't make it in. This is the best part of being able to facilitate the interview days now, having been there the worry is fresh in my mind, and when I see the applicants showing all the signs of nerves, second guessing themselves and worrying I'm in the position that I can give them the advice I wish I'd been given.

The interview isn't there to trick you. Applicants who make it to the interview stage are the ones we WANT to come and study with us, and we aren't trying to catch them out. Talking to groups of applicants who are waiting for testing and interviews is good for my morale too. They want to be where I am, and I'm an example of the best case scenario, which can only ever give one a little boost. I like working with prospective nursing students, as it reminds me of the process that I went through, and how important it was, is, and always will be to me.

On the day of my interview I had a note written to myself on my phone, for those moments that I was too nervous to function. Said phone was stolen, so I'm going to preserve something very similar here, so I don't ever forget:

Relax. You have as much right to be here as anyone else. Smile and enjoy today.

What is a nurse?

2010-01-15T03:19:00.000-08:00

Yesterday I tried on my Uniform for the first time. I was stood in the changing room of the University preparing for my OSCE, a practical examination of my nursing skills (a terrifying thought, I didn't realise I had any!) and as I put on the trousers and tunic I realised that there was no way out. Despite my fears and trepidation I will be a student nurse working on the wards in less than one months time.

I don't mean no way out in a negative way, mind you. I'm looking forward to it very much, but it's quite worrying that after virtually no time I'm going to be working with real patients (ARGH!!!!) in a real hospital (ARGH!) for almost a whole summer of being a responsible adult (argh!).

So I'm left to wonder, what have I learned this year? What do I know now that I didn't only a few months back? I know a lot of theory about nursing now. I've rehearsed several procedures, I know hand hygiene and standard precautions inside out, and I'm as ready as I can be. The next month will be spent getting fit and exercising to shake my winter blues and beer gut, and reading every book on my shelf so that I know nursing inside out. This is an amazing opportunity for me, after 12 months of working towards being a child nurse I am finally getting my chance to show that I can do it, and it won't be wasted.

One exam left, an induction day, and a swine flu jab, and I start, keep checking back for more on my innate sense of terror and how my first ever ward placement goes.

----------------------------------------------------------------------

Quote of the Day:
"House MD, Season 6, episode 7"

House: Sorry. I can't remember if I mocked you for being a male nurse.
Nurse Jeffrey: I think this counts.
House: Fair enough.

Be healthy everyone!

It's been a long time coming, kid.

2010-01-06T13:52:00.000-08:00

So this has been a month of blogging hiatus it appears. First, thank you for reading and congratulations on reaching one more year. Personally I will be calling it "twenny-ten". The coming week brings a new host of difficulties. After the close of the academic phase of the course I have one essay deadline, one OSCE and one exam left before the terrifying posibility that I will have to go out and do some nursing.

The essay deadline isn't so bad, I have thousands of words down, but I can't choose my favourites so am struggling to edit it down and fill the gaps to make it into a real assignment. Learning the theory behind professionalism as a nurse is tough after years of writing scientific papers, but I will prevail. So far my grades have been reassuring but nowhere near good enough.

The OSCE is my big hope, I have my fingers crossed that I will get there and everything will fall into place, I will feel like I deserve my clean new uniform. I know it won't be as simple as taking a pulse and realising that I'm more than cut out for the job, but it's worth a hope.

So roll on February, and roll on my 90 minute commute around London to get to work.

More soon, honest.

I'm a Child Nurse (whether you like it or not!)

2009-11-18T10:03:00.001-08:00

I no sooner had posted about changes in nursing than I had seen Zarkonnen's posting over at Not Powerless, a blog for letting people know that their voice matters, so you get two updates today. Unlike a normal post this one made me jealous I hadn't got in there and written this first. He discuses gender identity and the role of men in our cultures gender paradigm. Men are socially aloof - we choose how to talk to children and how to talk to women. However hard I want to be able to dispel this idea as old fashioned or inappropriate I find that I too follow these rules most of the time.

The worst thing is that like many social conventions I don't follow these rules for my own benefit, I follow them for the benefit of people I would normally choose to help. A while back I blogged about meeting a woman who was going through a really rough time on a bus. I did what I could to help, but she initiated everything - however visibly distressed she was I couldn't try and speak to her without it being entirely clear that I was allowed to.

This social norm makes my career change interesting. I regularly joke that I don't like children because of my slightly standoffish attitude to encounters with miniature people. The fact is, I don't dislike children, I love kids. I chose paediatrics because I like kids and want to help, amongst other reasons. But to say that I love kids, or to interact with someone else's children in public, feels like to big a risk for me. I'm desperate that things will be easier when I'm working, and I've been told by many people that they will, but it worries me - why should my gender limit my career choices?

What does being a nurse mean?

2009-11-18T09:01:00.000-08:00

The job role of the nurse has, historically, been a very changeable thing. Different eras, cultures and nations have assigned different jobs to nurses. In some places nurses are virtually doctors, prescribing drugs and diagnosing. In others they are pretty much there to fill the gap between porter and doctor, carrying bedpans and making beds.

The differences might appear stark in some cases - Australia still has state enrolled nurses, rather than the full registered nurses that the UK demands as a minimum entry qualification. This difference is looking like it will change dramatically soon too, with the UK government making entry into nursing only available to graduates.

The profession is considered to have evolved into the modern paradigm during the era of Florence Nightingale, when standardised technique and training started to come into force. These days nursing is a fully trained profession, and not the on the job "trade" that existed previously. The change in Nursing qualifications to remove the Diploma and introduce a Bachelor degree-only route into practice isn't the big deal many people seem to think it will be. The way I look at it is that Nursing is currently a profession requiring 3 years of higher Education to enter. The Diploma take the exact same amount of time as the Degree, the only difference being the demand on academic work in the final year of each course. There is an issue of funding, as the Diploma route is currently free and the Degree costs the same as a standard Bachelors from any UK university, but this is minor and will be resolved.

In my opinion the big change is, or at least appears to be, the move from a caring profession to a scientific one. A lot of reports seem to feel that removing students from wards to classrooms will be detrimental to the quality of care issued. Under current training student nurses spend over 50% of their time on placement as supernumerary staff. One article I've seen claims that this supernumerary status is a major reason for a fall in standards. The only way that having the pressure of having to know everything from the word go can negatively affect patient care and nursing skills is when the teaching isn't up to scratch by qualified nurses. University should be for expanding our minds, but the authors argument that skills can only be taught at Nursing Colleges suggests a blank lack of knowledge of what a nursing degree entails.

The mixture of practical and clinical skills with theory and ideological skills that I'm learning is spot on, as far as I'm concerned. I don't want to learn what a blood pressure means or how anti-pyrexics alter the state of a fever at a patient's bedside, and certainly not after I've been taking observations for 6 months. To say that academic skills will not benefit a nurse is ludicrous, and in my opinion quite offensive. The university nursing model isn't perfect, but it serves a job very well, and I don't want to lose it in favour of being a vocational doormat to medical staff.

Part of what I think will make me and my classmates good nurses is that we are taught so much outside of how to make sympathetic noises and tea, but training on the wards under expert staff will give us all of the practical skills traditionally seen in nursing.

First port in stormy seas

2009-11-15T02:56:00.001-08:00

So I've made it!

Reading week, a chance to finally get on top of my notes and the mess that my life has slowly become is here. As a rule I'm very organised, but over the last two months there have been papers that went unread, documents that went unfiled, and journal articles that never got indexed, so this week gives me a chance to catch up with paperwork and notes, as well as some non-nursing friends.

In the last few weeks things have been crazy! Somehow I'm busy almost 24 hours a day with either nursing, nurses, or just the day to day act of living. I keep updating here as often as I can - I know all 5 of my readers enjoy what I put here, but no promises - and in the mean time can I direct you to the Disclaimer on the right of this page (and email address found there if you have any problems) and if you fancy, why not read one of my other blogs? There are links about if you fancy a look!

Once I've got everything back on track (so hopefully by Friday, giving me the weekend off!) I'll be back online much more frequently to regale you with tales of how I'm too scared to fit a nasal catheter in a dummy (not really) and how I wake up in the night convinced that I've missed a deadline (OK, so this one's true!)

Keep well, everyone, speak soon!

What a 'mare!

2009-11-08T01:44:00.000-08:00

Until February we don't go near patients. We won't necessarily be particularly involved even then, and it will always be at the discretion of and under the supervision of, a qualified nurse. For now, there is nothing to worry about. But that hasn't stopped an early bout of worry taking over my sleeping hours.

I'm worried that despite being able to meet the academic criteria of the course I won't be able to meet the nursing criteria.
I'm worried that by the time placement starts i won't be competent, and I won't learn fast enough on the job.
I'm worried that as soon as I'm on my own I'll be making mistakes, despite knowing that I won't find myself in this position until I'm able to handle it.
I'm worried that I won't be a good nurse.

Luckily, I'm starting to learn my own behaviours pretty well by now (It makes sense, I'm nearly 23 for goodness' sake!). I know that for me worrying is part of the process of learning. When I start to subconsciously worry I know that it's a good sign, because I learn best by obsessing over material. The more worried I get the more time I spend reading nursing theory, nursing technique, and focusing on being ready in time for placement.

Here's hoping that by my reading week, when I plan to sit down and check I actually know what I'm doing, and to give the year so far a thorough going over I'll find myself to be on the path to being ready.

Wish me luck!

On the Radio

2009-11-04T13:19:00.000-08:00

At the moment the nursing course takes up two days a week. On Mondays we have 4 hours, and then 5 on a Friday. This is decidedly not much time studying in NewUni with members of staff or lecturers. Thanks to a combination of terror and excitement at the prospect of being a nurse two days feels inadequate - after working full time and being entirely unemployed for a spell my idea of a busy week is definitely set at the 35 hour plus mark, and that means that my time outside of the University needs to make this up.

There are a variety of bits to keep us busy, and we certainly can't complain that nothing is put out for us to do. Before the end of this semester we have three deadlines to complete, each week has several hours of lectures to watch online, and there's always our SimHospital to practice in. The problem is, I'm a voracious learner at the moment. I've finished my coursework up until January, I usually get my weeks lectures finished with two days classes in hand, and I have been through "a week in the life of SimHospital" enough times to tell you which my favourite days meal from the canteen is.

Note - There isn't really a sim menu in the sim canteen for sim staff, I just think it would be a nice addition to the program.

So what's a boy to do? The simple answer should be go out and have fun, or see friends, or exercise, but in actual fact the answer is that I spend my days immersed in nursing culture. I watch the two British medical "soaps", House MD from America, and follow every article, link or story on a wide selection of general and nursing newspapers. My question is as follows, however:

Will being a nerd, will booksmarts and studying and reading loads, make me a better nurse, or one who is less able to relate the piles of nursing theory that weigh me down with the practical work that I should be focussing on when in practice? I hope that I strike a balance, and that all this work pays off, because otherwise I will be a little frustrated!

Keep well!

fishandsteak

6 Weeks in - a little more perspective

2009-11-02T10:24:00.000-08:00

Sure, it's no Schopenhauer's Telescope, but 6 weeks is surely long enough to look back and assess a little. I think the main thing that has come of the last six weeks is that when I graduated from OldUni I wasn't finished studying by a long way. I always thought that leaving education would be a great chance for me to move on in my life, whereas I'm finally starting to realise that Education is definitely the way that I want to progress in my life. At 6 weeks in I'm already investigating the opportunities for further study once I start a practice career.

I've learned that while my confidence in academia is high, and my ability to study, to work hard, and to succeed at a purely mechanical level are there I have a long long way to go before I'll be a good nurse. I have no concerns about the practical stuff, but my worries about my emotional and interpersonal skills are pretty deep flowing. It's something I can learn, and my interest and enjoyment mean that I will push through, but it's still going to be tough.

Thirdly I think it's fair to say that I've learned that this was a really good decision. I am still so interested in everything to do with nursing, from the Anatomy and Physiology to the social and political aspects I find this course to fit everything I want. Only 3 months until placement starts and I can find out what I'm really made of!

To be the best

2009-10-24T01:24:00.000-07:00

I'm not competitive in most areas of my life. I was always ultra-competitive on the bike, but away from that I tend not to care less. Since starting the child nursing course, however, something in me seems to have kicked in and I am beyond competitive. I suppose it's because I realised that until now I've always just scraped by academically, and nursing matters to me so I want to do well.

On Friday I met with one of the lecture staff to discuss my academic progress, and discuss a piece of work I'm aiming to submit next week. She was happy with my progress, with my approach to seminars and my constant need to answer questions in class even when I don't know the answer, but also warned me a little of the side of me that most threatens my progress on the course. I refuse to let anything go - I need to be the best, the smartest, or the 'most right' and I know that it runs a risk of driving me mad.

Academically I'm OK, I certainly have more practice than anyone else, but my lecturer warned me that maybe that might be a little bit of a negative throughout my years training as a nurse. So here is my promise to myself for the duration of this course:

I will never handicap myself and never avoid work for the sake of that evasion.
I will work hard and start early on every project.
But I will also accept that sometimes the learning is more important than the grade, and I won't mistake the two.

My first assessed piece of work is tomorrow, a presentation to my class on smoking, and I think I might almost be ready!

Cleanliness is next to godliness

2009-10-17T07:54:00.000-07:00

Since I first put on my "wannabesociety" wrist band back in January (wow, that's a long time) I've had the same personal goal. I've been working to be a better person, to work harder, do more things that matter and generally be BETTER. Part of this was me signing up to be a nurse. I made a conscious and major decision that I wanted to stop avoiding adulthood and wasting my time in a job I hated and I wanted to do something with myself.

I thought about my strengths, my skills, my interests, and my ethics and came to nursing; specifically Child Nursing. I worked pretty hard to get onto the course - sure my natural ability and pile of previous qualifications were handy but I wanted to be accepted because the interviewers thought "wow, this guy is good!" And now I'm here, and I'm back to working hard again - I want to be the top of the class in every subject. I don't shut up in group discussions because I don't think it's my job to let things go unsaid when they could be discussed, and I spend a lot of time reading journals and articles to keep on top of everything.

In a practical session this Friday we were taught how to wash our hands properly - an important point in the modern NHS where cross-infection and MRSA are in the news much more often than anything positive. To wash with a full "aseptic" level of cleanliness one is expected to wash right up to the mid-forearms. And, in what feels like a massive decision, I decided it was time that I cut of my WNBS "better" bands and removed a potential source of infection on a ward.

Sure, they're just cotton bands, but they mean a lot to me. They are part of my year, of my friendship with Kittylovedpain and Missroo, and of my decision that I was going to do something with the life that I've got. I am Better. And now I'm cleaner too.

I see a counselor

2009-10-08T05:04:00.000-07:00

I found an article in the NY Times, written by an oncology nurse in the 'States about a very bad day:

This column could be the story of that death, but it isn’t. Instead it’s the story of how I could barely acknowledge the woman’s passing or help her grieving family members, because another patient needed me so much more.

I am lucky, in many ways. I'm older than a lot of the new nursing intake and have a wealth of experiences that while I didn't enjoy, they definitely have taught me how to cope under stress. The course comes with built in support mechanisms, which is great. We have a personal tutor and loads of lecture staff on hand at the University. When we're on placement we have a mentor assigned to us, as well as the other qualified nurses in the ward and other student nurses we work alongside.

It's pretty apparent, however, that bad days are going to happen. I'm terrified that I won't know how to react, or how to get over something sad happening. One of my best qualities has always been that I put a lot of myself into my work, but this makes me even more vulnerable when things are bad. I was thinking about this when I was deciding whether to sign up to nursing and I realised that however bad things have got I've always been blessed with a group of friends who share my interests, hobbies, and method of unwinding.Let me just point out here that I don't condone the use of alcohol or any other drug as a way to deal with stress or problems, but this post is more about having good friends who can sit down and talk bollocks until everything is worked out.

So, as part of my coping mechanism for the sad and hurtful things that WILL happen throughout my student placements, I bought a bottle of good whisky and have photoshopped a new label for it. When things are really bad I know I can come home, and my friends on my course, or my friends from OldUni, or any one of dozens of people who seem to look out for me, will be able to pour out some glasses of "Counseling" and talk the day through until we're ready to start over again the next day.

I can't imagine surviving this course without other people, so it is really a testament to them that I believe so strongly that I'm right for nursing.

Sometimes a bad day is enough to make you regret a decision. Bering a Student Nurse is Important, so have a little drink and relax. Tomorrow will be better, there is nothing you can't cope with. Keep up the Good Work.

We Should save them.

2009-10-05T11:28:00.000-07:00

The inevitable was bound to happen, umm, inevitably. As I found at OldUni lecturers missing classes through illness, research commitments or anything else is a common occurrence in Higher education. Our class lecturer is ill today so at the last minute they dragged in three other lecturers to deliver our sessions on ethics, communicating and referencing. I won’t claim that the referencing was a blast – it was just going over what undergrad and graduate level writing taught me, but the communication class was really intersting and the ethics class was something special.

Communications involved a discussion on how to communicate with the wide variety of ages and cultures we'll encounter and was really interesting, as well as giving us a chance to think about the areas that our class on Wednesday will cover - dealing with violence and agression. Afterwards I talked with the tutor about my experiences and why I've gone into child nursing, and now feel exceptionally positive towards myself as a nurse. I'll no doubt add a full post on my mursing reasons, but that can wait.

So, first session of the day: Ethics, the definition of health, and professionalism in nursing. I love a good argument. LOVE IT. If it's a real argument - not a fight between people - it gives me a chance to challenge my own ideas and really test my theories against people. Everyone went into todays argument open minded and we talked about the differing definitions of health, of wellbeing, and of society's views of such things. It was really interesting to talk about things in an open and discussive way - the lecturer made that class into something pretty special rather than the otherwise quite bland session it could have been. Only two more years before I'm in one of his regular classes!

I'm taking it back.

2009-10-04T10:57:00.000-07:00

In the film on Clerks 2 Randall, one of the lead characters of the first Clerks film, gets in trouble for using a racial slur under the pretence of "taking it back". While I learnt from him not to say offensive terms to people who will be offended, I did get the idea of taking back a phrase and taking ownership. If I said that this morning a female bus driver was driving the bus to town. Lets actually call her a fus driver. How about if I told you about the editor of my local newspaper? She's actually a feditor. Geddit? Female editor - feditor?

The term I want to take back isn't a racially insensitive one, not one that is banned from records and movies, but one which I expect to hear regularly enough for the rest of my career. By calling someone a feditor it suggests that their gender is something worth mentioning. I mean it doesn't tell us how good at the job they are, how experienced they are, just that they're female.

I'm a murse. Male nurses are still rare enough to be an oddity, but I'm seeing that as a positive thing. I stand out. A lot. None of the lecturers forget who I am, because I'm the only guy some of them have ever taught. When I go on placement I will more than likely be one of only a few male nurses in any paediatric ward I work in. People will notice when I'm working with them. In Caualty the longest running and supposedly most important character is the male nurse Charlie Fairhead. I'm going to be a good nurse, and people won't forget me. I want to get to a position where I can really help people, and it really does excite me. I'm going to be a Murse!

Induction to a new life

2009-10-04T07:00:00.000-07:00

The first week of term always feels a bit like a write off. Whether you've been at an institution for years or hours there's always a certain amount of housekeeping, administration, and general sitting on arses twiddling thumbs to be done. This week and last week have both been made up of that so far.

As much as it can be frustrating waiting to get started properly, especially after all the time that I waited for the course to begin, it's nice to know that I'm signed up and the workload is slowly starting to build. I've already got a presentation on "smoking, as guided by the DofH 'Choosing Health, 2005' document" to start preparing, working in a group of four of us. My group consists of the people I spend most of my time on the course with, which is fine as I already hang out with them a lot by choice. I suppose the only real problem is that already the group is forming into little cliques of people who get on best and I still feel pretty outside of that, so was hoping for an opportunity to work with new people and avoid being in a one man clique.

After attending a boys school until I was 18 and doing a degree that was essentially a boys club most of the time I'm really unsure of what to take from the interactions of girls in the class, so there's going to be a pretty steep social learning curve even if the workload is simple enough. Tomorrow brings my second day of study at Uni, we have more lectures and even our first session in the skills lab, so at least I have something legitimate to be worrying about for now! almost 1 week down, only 155 to go I guess!

medics and privacy, a double edged sword.

2009-10-04T06:59:00.000-07:00

OldUni and NewUni are very different universities, the reasons that I'm at university are different and the courses are very different. But so far I have to admit, I am really enjoying NewUni a lot more. Maybe the wisdom that comes with age, maybe that I'm university for all the right reasons this time, but I feel settled very rapidly.

Week one has been good - this weekend I'm doing a poop ton of filing and getting everything in order for Monday when the madness of Mursing begins. The group are pretty cool, and new friends are always good, but for now I'm just tired and need sleep! Off to the library to start working out their e-journals system!

Day one, two and maybe even three!

2009-10-04T06:56:00.000-07:00

I am exhausted. This week has been the release of so much nervous energy, I've been desperately waiting for the course to start for a while now, and I am so glad to be going it's ridiculous. I guess the problem is as it's arrived my health has given in. I've got ulcers, throat and nose problems, and a possible ear infection all kicking me right now, so at only two days into the course I'm suffering.

The group I'm with, made up of 18 child nurses, is great. Everyone seems really friendly, and the group is a little smaller than any other so we're already starting to get quite close. I haven't had a chance to meet everyone properly, but I'm looking forward to over the coming weeks - these are my friends for the next three years so I hope I don't make too much of an arse of myself.

The Uni itself is wonderful, and even though all we have done so far is the usual paperwork it's going great - I'm ready to get going, and with my power geeky ways I feel like I'm going to get a good year out of myself.

Hopefully when I next write I'll have just as many positives, and for more on this ongoing saga you should be able to click on this handy LINK RIGHT HERE!

Mursing and Nursing. One and the same?

2009-10-04T06:55:00.000-07:00

Today I went to the first open day of my new University at their Brand New campus, here in the big grey city. It was really great - just a short day which in many ways was actually quite frustrating, but really good fun and has left me very excited!

So here is what I learned today:

Everytime I told someone - another new student, a student in older years, a member of faculty staff or even a member of admin staff - that I was going into Child Nursing I got a shocked look, as if this was unheard of. Is it because of my whole "man" thing?
It is possible to turn a nasty office building into a shiny new campus in a few months. The place was stunning, and with new skills labs and library (with all the perks of being nurses only, so they could work in lots of little perks like the extra inter-library loans etc). I cannot wait to start working there.
There is something very difficult about coming back into study after such a short period of time amidst a group coming into study after a longer period. The adult and mental health branches made up much of todays guests, and the majority are mature students. There is nothing wrong there, it's wonderful the opportunities that this course provides, but things I take for granted result in long periods of discussion for other students. It could be a long first semester.
The building is roughly "L" shaped, with 3 floors accessible to students. Each one has two bathrooms. The loos are split into two groups - ladies and a single joint mens, ladies and disabled cubicle. So 6 loos for men, 6 for disabled users, and 24 for ladies out of a total of 24. No wonder they always address us as ladies!

This will be a good few years I think, watch this space.