Making the most of your nursing degree

Hello to the lovely new student nurses, cohort of 2018! Welcome to the university of Manchester!!! I hope you are ready for a tough, rewarding, enjoyable and busy 3 years.

As a recent graduate of UoM, I thought it would be nice to make a lil list of how to make the most of your degree. It’ll be a mix of things I wish I had done, and things I’m glad I did!

1.) Join a society- just because you are a nursing student, and therefore not a “normal” student doesn’t mean you shouldn’t join a society! It’s a great way to feel part of university life, make friends and allow time to focus on something not nursing related.

2.) Explore every opportunity- Throughout your degree, you will come across SO many opportunities to enhance knowledge/experience. They can come from the strangest places. I’d highly recommend keeping your eyes peeled and taking any opportunity handed to you! E.g) Nearly 3 years ago, I started as a blogger for this blog. It helped me secure a job, be involved with nursing recruitment and get my name known.

3.)  Reflect regularly- Time will fly by, and soon you will be balancing placement and academic work. It can be hard, and there will be days when you don’t think you can do it. Reflect on them! Whether its a structured reflection, a blog post (join our team!), a poem or whatever- reflecting on your experiences and learning from them will make you a better nurse.

4.) Spoke everywhere!- Once you start placement, you can start doing spokes where you experience a different area related to your placement for up to a week. E.g) if you are on a diabetic ward, you can spoke with the diabetic specialist nurse, the high-risk foot team or research nurses. Spokes help you understand the vastness that is the healthcare sector, and allow you to experience areas you might not otherwise be placed in.

5.) Don’t neglect university- During my degree, I watched many student nurses disengage with university somewhat because they viewed placement as more important. Uni and placement go hand in hand, you need one to succeed at the other!! All that academic work will be useful in placement. Go to seminars, discuss, do the extra reading. It will pay off, and it will make you a better nurse.

6.) Don’t suffer in silence – This degree is not easy. Students are prone to developing mental health problems. So are healthcare professionals. You are both! There is always someone to talk to: your AA, other university staff, your mentor, your PASS leaders, your friends, your GP, your family. Uni has a great counselling service, and Self Help is also excellent.

7.) You won’t like every placement, and that’s okay- Each nursing discipline tries to give students a wide range of placements. But there are issues- the number of available mentors is dwindling, so that can make placing students really hard. No matter where you are placed, you will learn something. Keep an open mind!

8.) Your appearance matters!- Your nursing uniform is therefor you for the next 3 years. Take care of it, keep it white otherwise people will start asking why it’s grey (I speak from experience). Don’t wash your trousers with it on the first wash. Get some comfy shoes, it doesn’t matter if they are ugly. If you need more uniform, go to Jean McFarlane student support and ask for spares. Ordering more is helpful, and not too expensive.

9.) Your life is more than just being a student nurse- It’s very easy to be consumed by this degree, because there is so much to occupy yourself with. But take time for yourself! The more time you have to relax and recharge, the better you will feel.

10.) Feedback!- No degree is perfect, ask anyone. It’s SO important to feedback any issues, concerns or things that you think worked well. Your student reps can do this on your behalf, but don’t feel like you can’t shoot someone an email too. We are all adults here!!

 

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“The Student”

Being addressed as “the student” is not my favourite thing in the world. I’ve never spoken up about it, but I feel it makes you into a commodity as opposed to a human being who is there to learn. My usual response is to introduce myself, and keep introducing myself until people understand that I have a name. It sounds daft I know, but it tends to work.

But sometimes introductions are not enough.. I was working a Saturday shift, in order to see my mentor, and it was my 3rd day of placement that week. During handover, I noticed that my mentor wasn’t there and none of the nurses were regular members of staff; but agency staff who I had seen once or twice. I was really disheartened that my mentor didn’t turn up. And then, after handover, they allocated the Trainee Nursing Associate with a nurse, and left me standing there like a proper lemon.

I was hurt. I’d spent the past 2 days working really hard on placement, during the snow and short-staffing. I thought I was finally somewhat integrated in the team.  The tiredness, shock and hurt built up, and I had to retreat to the staff room to try and calm myself down. I just kept thinking, I’m third year! I shouldn’t be doing this! Why am I upset!

I knew why. I’m a confident person, happy to talk to anyone and everyone. But when you’re in a room of people and nobody acknowledges your existence, confidence can be hard to come by.  After some kind and supportive words from my boyfriend (an endlessly calming presence even via text), I knew it was my responsibility to make something of this situation. So I spoke to the nurse in charge and (after being passed between 3 different nurses), one finally agreed to take me.

I ended up having an okay day, and the nurse I was working with let me be mostly autonomous, and still made time to teach me about NG tubes and giving medication down them. At the end of the shift, she apologised for not wanting to take me on initially. She felt that, with the time pressures and being an agency nurse, it wouldn’t be fair to me. I explained that as a third year, and having been on the ward for a few weeks now, I was quite happy being somewhat autonomous and would ask if I needed anything/wanted to learn about something.

This experience threw me, and I need to raise it with someone so it doesn’t happen again. But it did teach me how important it is to communicate your needs to whoever you’re working with, and make yourself known. It’s not easy, and it can be daunting, but it needs to be done!

If you’ve had a similar experience, feel free to comment and share your story.

If you’re interested in writing a blog for us, about anything student nursing related, please find us on Facebook, Twitter or email us.

Nursing behind bars: Q&A with student nurse, Laura, who shares her prison placement experience

One of the incredible things about nursing is that it is one of the few professions that reaches people in every part of society. This includes prisons which could arguably be considered one of the most challenging environments in which to nurse. Earlier this year student nurse Laura Golightly (pictured) was among a handful of student nurses to be placed at a prison in Manchester. We are delighted to share this Q&A with Laura who describes her experience working alongside the prison nursing team, including the daily challenges but also the huge variety of nursing skills and confidence she gained from this rewarding placement.Laura pic

What originally drew you to applying for a placement in a prison?

I have always had a fascination with prisons since growing up and watching compelling documentaries made by influential documentary makers like Louis Theroux. For many people, and certainly for me, this sub-section of society living their life behind bars in massive secure institutions was really intriguing and something that I felt I could have no real concept of. The reality of life within prison is often something that’s kept very private from the general public, including the mental and physical health problems faced by inmates and the concept of institutionalisation, this threw up some really interesting and thought provoking societal questions about the effectiveness of the prison system as a whole which I really wanted to explore, not only as a health professional, but on a human level also. It had really been a desire of mine to work within a prison, safe guarding very vulnerable members of society, before the opportunity even arose so when I saw the email detailing the placement, I knew I would do everything in my power to secure it.

How did you feel when you arrived for your first day?

I was completely overwhelmed when I first stepped foot into the prison for my first day. Starting a new student placement can be intimidating at the best of times, I’m often left feeling anxious about meeting the staff, performing up to standard, not knowing enough and many of those little worries that seem to occupy your head before starting a new placement. There is certainly plenty to consider turning up on your first day so then to be turning up to a huge Victorian building which seems to dwarf even such vast city centre buildings surrounding it, complete with barbed wire running around the parameter and prison staff greeting you with a sharp eye and a pat-down, well it certainly puts things into perspective. The first day my mentor took me into the grounds and gave me the grand tour, we discussed what general day to day life is working within the prison and he soon made me feel at ease. I have to say though, it did come as a bit of a surprise when we discussed this over a coffee and he pointed out to me that the staff serving us in the café were actually inmates.

What was your daily routine like on placement? Describe an average day.

There was no real average day within the prison, this was one factors I particularly enjoyed about the placement! There are three main areas to work and these are on reception, on the health care unit and on inpatients. The role is vastly different on all three which was fantastic for bringing variety to the role as nurses were rotated throughout the week. On reception we would take care of the medications for all inmates leaving for court or being transferred out and we would medically ‘fit’ them for departure, we would then also take care of all inmates being transferred in, this was the really interesting part. We would conduct an assessment with the patient discussing their past medical history, recording observations, their general contact details, the reason they have come to prison, their mental health, health promotion advice and some screening tools, this was their first point of contact with the medical team so there is usually a fair amount to cover and they would have a follow up within the first 72 hours to once again check in on them and discuss anything they may need to add since their first assessment. A day on the health care unit would consist of giving the meds for a specified wing (which could often take hours with the cocktail of meds some inmates are on) and then reporting back to the health care unit to complete the clinics for the day. There was an afternoon clinic and a morning clinic within this prison and these would often be clinically very similar to a GP surgery clinic. There would be many different health professionals running specialist clinics also such as psychiatric, counselling, smoking cessation, sexual health, BBV, dentistry, optometry and more, just as you’d expect to see in the community. The inpatient unit was quite different all together as these were the extremely vulnerable patients, it mainly consisted of mental health nurses and prison officers who were specialised to deal with the kind of inmate that presented in the unit. It was nothing like what I could have imagined, with huge solid metal doors, no windows, rooms without anything at all inside, no real equipment and it seemed to be constantly deafening with lots of screams and shouts from inmates. On top of all this there was the emergency response radio one nurse would have responsibility for, this would be used to request emergency medical first response. While I was on placement I attended these calls for a range of incidents such as fights, overdoses, inmates high on illicit drugs, cardiac and respiratory disturbances and mental health crises.

What kind of clinical skills were you able to practice with the prison nursing team?

The clinics were fantastic for practicing clinical skills, with lots of hands on experience being available. ECGs, dressings, injections, wound closure, suture removal and observations were all common practice. Every morning and afternoon there was the opportunity to complete the medications round also and due to the vast opportunity for spokes within the prison I also managed to complete a mental health assessment, smoking cessation assessment and observe the work of the specialist drug and alcohol team.

What do you think are the most challenging aspects of prison nursing?

The most challenging aspect of nursing within the prison for me was the prison regime itself. Many individuals within the prison have very low wellbeing for obvious reasons. To prison staff they are inmates, however to medical staff they are patients, this creates a very tricky dynamic when it comes to dealing with their needs. Being unable to encourage patients with activities to promote wellbeing was very difficult, I struggled to encourage patients to be active when they are only entitled to one hour in the yard a day and they are kept locked up in their cell for such prolonged periods of time. I struggled to encourage patients to connect with loved ones when they are only allowed a certain amount of visitation and many of the relationships the prisoners keep are strained due to their absence from home. I struggled to encourage learning when often classes are full up with long waiting lists and staffing levels inappropriate for the level security needed. The problem with prisons is that they aren’t therapeutic environments and this creates a vicious cycle that many vulnerable people fall victim to.

What did you enjoy most about your placement in a prison?

I can honestly say I enjoyed everything about the placement. The staff were all fantastic, great fun, welcoming and always happy to teach, my student colleague on placement with me was lovely, the prisoners were generally very polite and interesting to talk to. Being exposed to all the different healthcare sectors and how they are applicable to the prison community, highlighting the different demands of this small sub-section of the outside population was fascinating and I learnt how to deal with a patient who’s needs were often vastly different than what I was exposed to in my general training so it was fantastic to gain this different and unique experience.

What I really want to get across to nurses that would potentially consider a career within the prison service is that it really is a fantastic and unique experience. Often patients have very complex needs and this can lead to a really exciting and challenging working environment which really allows you to make a difference for your patients. Many of my friends and family thought I was stupid for wanting a placement they perceived as so ‘dangerous’, I really want to communicate how safe I felt in there. The prison officers are very well trained and experienced and look after the safety of the medical staff absolutely superbly. Do not be discouraged by fears of safety as officers are always on hand to assist you and will never leave you alone with a prisoner. Security measures in there are top priority for prison management and you’d never be left to work in an unsafe environment. If you have a keen interest in working with challenging individuals and nursing in a holistic and non-judgmental manner with a particular interest in mental health then the prison environment could be just right for you.

Thank you, Laura! It is fascinating and valuable to hear from other student nurses and midwives working in all kinds of different placement areas. If you have an placement experience or reflection that you would like to share on our blog, please do get in touch! Find us on Facebook @UoMPlacementProject or email studentnurseplacementproject@gmail.com.

From Ward to Community

I was really nervous at the start of my community placement with the district nurses as I had heard some horror stories from peers. The night before I could not sleep, I lay in bed with a hot water bottle for hours thinking about the challenges the placement would bring. What kept me awake was that I would have to go visit people I their houses, which I did not feel comfortable doing.

06:30am alarm went off, time to get up, get ready and head out. Once I got to the clinic, I was early so the doors were locked. I ended up standing outside in the freezing cold for 15-20 minutes. Once inside, I went to the reception, they walked me to meet the team I will be working with for the next 12 weeks. Once I entered the district nurses office, the two sisters welcomed me, knew my name which made me think that they were expecting me (brownie point for them). I was given a tour of the office, shown where all the files were kept as I would be expected to get them when they are asked for. I was welcomed to the team, what I really liked about the team was when they said I was welcomed to the tea and coffee, once you are welcomed to their collection of tea you are initiated and part of the family. This made me genuinely smile, I was going to like it here, and the team were all lovely and had a great sense of humour. I waited for the nurse to arrive as she had started at 08:00am and was doing her early visits. Once the nurse arrived, after paper work we headed out to a care home to visit 6 patients at 09:30.

On our way to the residential home, the nurse informed me of the patients we were going to see and what our role was in their care. We got to the home, went upstairs to see our patients. The tasks we were doing were pressure ulcer checks, injections, dressing changes and assessing the overall health of the patients. These tasks took the whole morning. Once we got back in the car, we head back to the office for lunch.

Next at 13:30- the team of 7 district nurses come sit together and discuss the morning visits, they talked about any issues, what afternoon visits are left, new patients, the aim is to update the whole team- all while have a cup of tea and biscuits. After more paperwork, I worked with a different nurse and we went to visit patient homes. What I found strange about these visits was that we had a code to get the key to their house let ourselves in to carry out tasks such as insulin injections. I was astonished; my idea of what I was going to do in community was totally different. After the afternoon visits, back in the office for more paper work. Then home for 17:00.

On my way home, I was thinking WOW! What a great day. You see, I have been on three ward placements all have been busy and hectic. Working with the district nurses allowed me to get to know the patients history, I was able to get a holistic idea of the person’s situation. We were in their home, their private space. Even though we were there for only 15/20minutes, that was probably the only social contact that person got that day. I found myself changing my views about working in the community; I always thought that I’d like to work in ward; fast and busy, lots to do. But now I am not too sure.

So, remember don’t judge a placement before you have met the team and give it a chance.