What can nursing give to me?

Becoming a student nurse can consume you. With placement and academic work mixed together, it can often feel like all you do is nursing! On top of that, we often focus on what you can do for nursing. But what about what nursing can offer for you?

Recently, I’ve opened my eyes and seen the reciprocity within nursing. It started with my Nursing Therapeutic module, where we’ve been learning about Muetzels model who says that a therapeutic relationship between a patient and their nurse requires three components. These include: partnership, intimacy and reciprocity. Since we explored how a therapeutic relationship could benefit both the patient and the nurse, I thought maybe nurses get more out of their career choice than I thought?

Confidence! Going into placement takes guts. You are literally throwing yourself into new situations with new people everyday, and that takes a certain amount of confidence. Speaking to the wider MDT use to fill me with dread, but now I basically chasing them around for questions. This has reflected into my personal confidence A LOT. I am more sure of myself, and what I want to get out of situations.

unknown-2Time management. I thought I was organised before I came to uni. I was wrong. I feel I’ve reached a higher-level, as uni has forced me to gain the ability to spread out my work so I’m not over-exerting myself. It’s a VERY good skill, as it’s very easy to become burnt out. Spreading out work helps you fit in the other important stuff that isn’t necessarily related to nursing/uni but is absolutely vital! Get yourself a fab diary and a calendar life will become easier.

Problem-solving. I recently attended an inter-professional workshop with our lovely midwives all about the health needs of refugees. Once we were put into teams, it was like somnurses and midwiveseone lit a spark! Suddenly, adult nurses + midwives + child nurses + mental health nurses were able to outline all these potential solutions to the fictional family we were ‘caring for’. We were more than able to use our combined knowledge to solve the situation with ease!

Honesty. Before uni, I would often be told to do something at work/school and just nod endlessly until they told me to go and do it. What would happen? I would have literally no idea what I was meant to be doing. You can’t really do that in nursing, so you end up asking more questions and understanding where you need support. This not only shows honesty, but it shows a lot of maturity as well.

This is not an exhaustive list by any means, but its great to reflect back on how you’ve grown. I would urge any of you to do the same! Not only is it a useful skill for interviews, but it really helps with realising why this degree is so worth it.

What has nursing given to you? Comment, tell us on facebook/twitter or send us an email!

How to beat second year blues

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With second year around the corner, I’d be lying if I said I wasn’t a little apprehensive.

I’ve heard of the elusive ‘second year blues’ and worry that they might already be setting in. Despite having a year under our belt, the end goal somehow seems further away than at the beginning. We’re a year wiser, with a better idea of the challenges ahead…and let’s face it, we’re probably all a year poorer too. All things considered, its no wonder we might feel a bit down.

In the blissful ignorance of first year, I ignored second and third years warning us that we’d feel like this – turns out they were right! In a quest to ease my own anxieties, I’ve asked the for their tips for beating second year blues. Here’s what they said…

Get ahead

I know most of us have spend the last few weeks catching up on sleep, earning some pennies or reminding our friends that we still exist, but it’s worth having a look at what’s coming up. By second year, we’re expected to be independent learners, so its up to us to be proactive and find out what is in store for us over the next year. I’ve been putting it off, but it’s time to get organised, dig out the diary and log in to Blackboard…what’s my password again?

Set goals

Somehow I’ve managed to erase all memory of PAD submission day, which seems like ages ago now, but I remember that we were asked to set some goals for the year ahead. I’ve just had a look back at mine and they actually make some sense. Personal development plans can sometimes seem like a bit of a box-ticking exercise, but having a goal in mind for second year will give you something to focus on and makes the time fly by.

Avoid stress

When I started this course, I made a pact with myself not to leave everything to the last minute. In my last degree, I tactically worked out my words/per hour ratio (about 400), convincing myself that it was totally fine to leave a 3,000 word essay to 24 hours before the deadline. Yeah, I always got them in, but I was an absolute wreck. Believe me, its not worth the stress. This degree is full on enough as it is, so help yourself out by starting early.

Oh and this applies to overcommitting too – a lesson I’ve learnt the hard way. Figure out what is really important and realise that it’s ok to say ‘no’ sometimes. I still haven’t mastered it, but it’s a work in progress.

Talk it out

Chances are that most of us will feel down at some point over the year, but if ‘the blues’ hit, don’t bottle it up.  With hundreds of student nurses about, you’re bound to find a kind, listening ear and you might find that others are feeling the same way.

Also, don’t forget the PEFs are there to address any issues you might be having on placement – take a look at this blog to find out more about their role and how they can help.

Remember it’s not all about nursing

Maybe it’s just me, but does nursing have a way of taking over your life? While on placement, it feels like you think, breathe, dream nursing – sometimes you just need to switch off. Step away from the stethoscope and plan some totally non-nurse activities for the weekend. A break will do wonders.

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Keep calm and carry on nursing

Conquering second year and banishing those blues is about finding the right balance. This course can take over if we let it, but by staying organised and making time for the other things we love, we can actually be better nurses in the long run.

See you next week!

DILP Week 5 – Teaching and Learning in Maternity ft Muetzel

Well the outrageous fact that next week is my FINAL WEEK is madness. Right now I’m sitting pretty at 208 hours (40 to go) but it almost feels like a dream: I’m so full of questions about the culture and the way of working out here so I feel like I’m always engaged in some sort of discussion, which makes each day really rush by.

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Shout out to my amazing Nursing Therapeutics Seminar Lead – you know who you are!!!

After one such discussion with the ward Matron, she said she felt the staff could improve their communication and social skills with patients, creating more of a rapport (this took a while to figure out as she speaks rather broken English). So I briefly explained Muetzel’s model of the therapeutic relationship, which is based around Partnership, Intimacy and Reciprocity. She was so interested I ended up making a couple of posters and giving talks to staff members in little groups over the course of the week. It was a really rewarding experience for me to see these Nurses taking on this academic knowledge and applying it, almost immediately, to practice.

It was also wonderful for me to realize how much I’ve learnt during these last 2 years at UoM. Lots of what I was teaching hasn’t come up in exams and I haven’t been fastidiously revising it, but it was still there in my brain, informing how I interact with patients and being able to pass this on was such a great feeling.

All my questions though did make for a slightly awkward discussion with a consultant this week when I asked why it was the normal procedure in Sri Lanka to give Episiotomies, no matter the size of the baby: “Because Sri Lankan women are far more petite than Western women” Fair enough, I thought (the average height of a Sri Lankan woman is 4ft11) but that wasn’t what he was getting at… Gesturing with his surgical scissors he added; “For example this woman’s vagina is far smaller than yours would be”. THANKS DOCTOR. I almost died of embarrassment.

My questions haven’t all had such uncomfortable endings though. For instance I’ve become fascinated by the many superstitions and traditions deeply woven into everyday Sri Lankan life. One very common belief is that the exact time of a person’s birth is holds great importance over the course of their life.

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Its a bit of a cross between buddhism with a big emphasis on horoscopes, couples are often matched based on Birthdays

It is always noted to the minute and this information is taken to a spiritualist (Tamil or Buddhist astronomer) who produces a big document/graph thing that contains key dates to be wary of and dates of good fortune. These can be days or years. During the times of misfortune the family can offset this bad energy by giving alms, doing charitable work or attending the temple more regularly. Equally there is some level or risk management that is involved. For example if someone is predicted a bad 2016 because they were born at 4.33 instead of 4.34 then even if it made sense with every other facet of their life, big dates such as having a baby or getting married would be delayed until they were back in good favors.

I personally would not respond well to such strict time frames but I was far too curious to know what my prophecies would be. So, luckily, I was able to take a short 20-minute stroll from my apartment to the hospital where I was born, 20 years, 6 months and 5 days ago. After a quick 5 minute trip to the records room a nurse produced a huge leather-bound book, identical to the one I have been writing baby’s birth records in for the last two weeks. Except in this one, “Baby Girl Wragg” made an appearance! Thanks to this hand-written entry I am now armed with my birth time and am setting a meeting to speak to a tamil astrologer to find out how things are going for me! Hopefully 2017 with my dissertation looming, will be a very very lucky year for me or else I’ll just have to find a Buddhist temple somewhere near Stretford.

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Baby Girl Wragg OG Sri Lankan

DILP Week 3 – A&E lessons learnt

This last week has absolutely flown by!! I’ve kept myself very busy both in and out of placement which has been tiring but so rewarding!

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Scans following the admission of a lady with drowsiness and weakness following loss of consciousness

I can now run triage efficiently and effectively on my own and have been working with some really great nurses for the last two weeks who have taught me a bit of singhalese in between tasks. Key phrases you need to know as a tourist e.g. What’s your date of birth? What is your pain scoring between 0-10? Etc.

I’ve managed to get all the nurses to ask the patient for pain scores now which is a really vital thing. I only realised they weren’t asking properly when a woman who couldn’t speak with the pain in her abdomen or open her eyes fully had a 5/10 for pain written on her triage documents.. I’m in no way saying this is the only time I’ve come across falsified pain scores, unfortunately. It wasn’t at all rare to see Ward rounding forms where all patients conveniently had a pain score of 0 on my first placement in the UK. It wasn’t the case of course but writing this down meant less paperwork and less hassling the already over worked doctors. So it was sort of left unsaid and when I did rounding a and was accurate with pain scores it was met with a general groan from the staff because they had to chase up altering patients analgesia.

Pain is such a vital symptom to understand – this should be evident by the fact that all of our hospitals have a devoted “Pain Team” of specialist nurses that are like ache whisperers.

Changes in pain, not just the score but the type or the frequency can be the biggest clue you get about what’s going on with your patient and if their records aren’t accurately reflecting this evolution of their pain then we have failed that patient. For example, a headache.

It can be cause my 101 different things but if the patient is complaining of a sharp throbbing headache associated with noise or lights and also has a rash on their abdomen.. This could be meningitis. This patient might require urgent interventions. Equally, they might be having an allergic reaction or be dehydrated. However, without going into the details, we are pretty much running blind.

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This is not where anyone wants to be is it?? 

Literally 3 hours ago as I write this a woman who originally came in suffering from loose stools for 4 days arrested! She started coughing up frothy pink sputum then her heart failed, I was lucky enough to assist in giving chest compressions and ambu-bagging her to keep oxygen pumping around her system.

I had no idea what to expect from the other staff members in such a high-pressure situation but the respect and trust they showed me was pretty moving.

Having the doctors from CCU direct their questions at me about the patient, as a humble Nursing Student, was really empowering. I’m also very pleased to say that the patient’s vitals were stable when she left our care to recover in CCU.

Experiences like that today just remind me how privileged I am to be able to not only be a Nurse but to have this opportunity to travel half way across the world and still be respected, trusted and appreciated for all the hard work I have put into the degree so far. Nursing has always been a great passion of mine and it’s a truly wonderful thing when you can see that that passion exists in Nurses across the world who will work tirelessly next to you for the good of each patient that needs our care.

Week 2 – DILP Questions Answered!

At the end of my second week working in a Sri Lankan hospital I am pretty exhausted. It’s been a really full on week; my first ever in A&E and it’s been absolutely invaluable. I’ve observed lots of amazing Nursing and care but can’t seem to keep myself from thinking “Oh, that’s not how we do it in England” every time something surprises me.

IMG_7797.JPGAfter last week’s post a few of you had some questions about the DILP and how myself and others went about it. Since I have organized my placement independently I referred to my friends currently working in Andhupura who have gone through Work the World for their DILP about their experiences too. They explaned that they chose Andhupura because it seemed to have a richer culture compared to Kandy and was near the beaches of Trincomalee which is one of Sri Lanka’s best preserved pieces of coast-line with clear blue waters and lots of snorkeling opportunities.

Firstly and often most crucially going abroad for this placement is an expensive undertaking. Going through an agency condenses all the costs however into one lump sum you pay directly to them to organize accommodation, flights etc. this can be paid in installments or in one go but the deadline is a couple of months before you fly. It has been known for people to fundraise to pay for their DILP but none of the lovely Ladies in Andhupura did but we were told by the DILP unit lead to expect to pay around £3000 through an Agency so fund raising may be a very good option.

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Our ECG machine – complete with metal suction cups

Since I organized mine independently it cost a lot less, around £1500 for flights, accommodation, visa’s, insurance and the cost of living whilst I’m here. Although recommending someone to go it alone abroad is much like recommending someone to do a home birth without alerting a midwife. It can be super rewarding and great but if something goes wrong – it can be really disastrous.

Work the World have been really wonderful with all the students who worked with them, really helpful and easy to contact which made the whole process very straightforward and stress-free. Also the students (who come from all over and include OTs and Medics) with Work the World all stay near to eachother which is nice to have a little support hub of people all going through the same thing.

People were curious about time off and whether or not we have the ability to actually experience the country and the culture whilst working 37.5 hours a week. We were unanimous in our answer of YES!! 7.5 hours a day with early starts does mean it’s not advisable to be staying up late every night having cocktails at a beach bar but there is always the weekends for that!

I’ve been working 8 hour shifts (excl. breaks) 7-3.30 each day which leaves me a big chunk of the afternoon to do as I please. With a coupe of 12 hour night shifts thrown in I’m finishing placement in 6 weeks (30 days) as opposed to the 7 weeks (33 working days excl. bank holidays) allocated by the university. This means I’ll have a week at the end of my placement exclusively for free time.

I’m lucky enough to be able to stay on for a while after placement is done to travel around the island a bit and holiday with my family and boyfriend which is a really nice goal to aim for when I’m missing home.

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“Difficulty walking, slurring speech, brain stem stroke”

The language barrier can be frustrating at times but all medical terms are spoken and written in English so you can spot quite easily what each case is about. Most of the Nurses I’ve encountered have a good grasp of English so if you ask questions, they will try their hardest to explain. The best thing about working abroad is the independence. You are relying on your Nursing instincts and knowledge, I’ve learnt a lot from my mentors and patients but I have taught them a lot as well. I’ve introduced a new standardized handover tool, which has been saving hours of staff time. I’ve been screenshot-ing and explaining tools such as the Bristol Stool Chart and the SBAR in an effort in increase the use of evidence based assessment tools. The staff are really keen to learn as am I which makes for a really engaging and exciting atmosphere in the ward.

Again any more questions you have about working abroad, working independently or the DILP in general please do comment on our Facebook page or email us at enhancingplacement@gmail.com

Mid-Season Blues??

Tired?      Stressed?      Had enough?

Feel like a failure or like you’ve made a big mistake?      Too much work and no play?

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This could be a case of the mid-season blues!

Okay so there isn’t anything technically proven about mid-season blues but I bet nearly everyone has felt it at some point in their journey.

I used to be a holiday rep and every season there would be an almost mass exodus of reps half way through the summer as they were mainly homesick, fed up of long hours and most were feeling pressure as the main summer had kicked in and it was busy!!!

I noticed the same thing in the nursing degree course. It would hit everyone at different points in the course however, but the feelings seemed to be the same.

People felt down and fed up (mainly in second year if I’m honest as the end just seems so far away).

If you find yourself feeling this way, don’t worry! It’s not just you – you are not alone.

It seems this feeling is perfectly normal and any lack of motivation right now could affect your judgement on if this course is really right for you.

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Please don’t make any rash decisions. Talk to your family and friends. Talk to your peers and tutors and discuss your feelings with them before you decide anything.

You will more than likely come out the other side and carry on with your degree with great success. Yes there will be some who do realise that now is not the right time for them, and that is ok too. No one will judge you and you shouldn’t judge yourself either. Tough decisions aren’t called tough decisions for no reason!

I sit here now in my final year that last placement and sign off is getting closer and closer! Yet I remember my friends and I, all experiencing the mid-season blues. We helped and encouraged each other through it. Providing moral support in words and tissues for the tears when they came! But, we made it and I for one have never felt prouder of myself for staying the distance!!

A good moan can do you wonders, a few beers with friends, a weekend off the study. Whatever it is you need, just have that break and look forwards and reflect with fresh eyes.  You’ll soon find yourself job hunting and thinking where did the time go –I did!

Go for it – You can do this!  – brush those mid-season blues to one side and get your head back on track to becoming the awesome nurse you will be!

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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.