The Schedule of a Student Nurse

30 Aug 2011 9 Comments

by littlenursey in Being a student nurse, Experiences, Nurse knowledge, Placements Tags: , , , , , , , , , , , , , , , ,

So a nice future student nurse left me a comment on my blog a while ago asking if I could write a post about my university schedule when I’m not on placement, which I thought was a great idea as I imagine other student nurses to be out there would probably appreciate the same thing. I will take it a little further and also talk about what happens during placement weeks.

Bear in mind that student nursing courses are different depending on which university runs it, and there are differences between diploma and degree courses. I am doing the diploma, so this post relates to my life as a student nurse studying the diploma in adult nursing at the University of Manchester. Also, bear in mind that my uni is very academic and the amount of academic work expected of you may differ from uni to uni.

ALSO,  the layout of your first year (foundation year) is quite different to when you begin your branch years (branch years are your 2 final years where you study only your chosen branch of nursing. My branch is adult).

So here goes.

Introductory and Theory weeks:
When I started the course in September 2009 I had around 1 month of just having lectures at a building at my university. These are called theory weeks (the first 2 weeks are called Introductory theory weeks). Although the very first week was fresher’s week, this is a nursing course so we did not get any days off to go out and party at all the clubs and bars or go on society events. We were in uni every week day, most days starting at 9 or 10am and finishing around 3 or 4pm. Our theory weeks were based on lectures all about the course structure, what to expect, what units we will be studying and all the basic things we needed to know before starting placement. We immediately began studying anatomy and physiology, knowledge and skills (such as infection control techniques, moving and handling, nutrition and hygiene) health and social studies and even study skills.

We had around 3 lectures each day, some lasting 1 hour and some 2 hours (apart from Wednesdays afternoons as this when the uni have sports training and events allover the campus). Lectures are always given using a PowerPoint presentation screened by a projector. We were always given a 1 hour lunch break.
Each theory day was normally based on the same subject all day, for example on a Monday we would have knowledge and skills all day. We would start at 10am and have a 2hr lecture on infection control in the morning, then after lunch, a 1hr lecture on moving and handling and then a 1hr lecture on circadian rythym (the science of sleep).  We would all bring in notebooks and pens OR print out the PowerPoint presentation from our university learning system website (ours is called Blackboard and it’s where we get all our unit material, forms, our timetable and submit assignments etc).

During those theory weeks we would also have some all-day sessions in the clinical skills labs (simulated learning in rooms designed to look like hospital wards with training equipment such as dummies, hospital beds, life-saving equipment etc). We practiced hand-washing (and got to use one of those UV light machines to see how much bacteria was left on our hands), moving patients while they are in bed,  CPR using dummies and how to give injections. This had to be done in full uniform with hair tied up. Our uniforms were free and we ordered them as soon as we started the course.

Placement weeks:
During our theory weeks we were told where our first nursing placements were going to be – as we were in foundation year we were mixed adult nursing students and mental health students. We all started placement with an adult nursing placement; for example I started working on an acute stroke ward at my local hospital. We were there for 5 weeks until we had our Christmas holiday.

During placement weeks (and this goes from the beginning to the very end of my course) we always have 1 theory day. Example: I would go to placement on Monday, Tuesday, Wednesday and Thursday. On Friday I would have to attend lectures at university, again from around 10am to 3pm. The lectures would be based on what units we are studying at the time. Sometimes (rarely) we would have no lectures on those Fridays, but would not go to placement as it would be classed as a self-directed study day instead.
On my course, I am meant to do a minimum of 28hrs on placement per week. This means 4 days on placement with each shift lasting at least 7hrs (minus breaks). You do have to work some weekends. During first year I was not allowed to work night shifts (I don’t know why).

After Christmas we went back to uni and had 2 weeks of theory, again having lectures at uni every day. We then went back to placement and spent 10 weeks having split-placement weeks (split placement is where you spend 5 weeks at 1 placement and then 5 weeks at another, but share the same progress paperwork for both placements as both placements were part of the same study unit, such as Acute Care). Between each half of my split placement I always had 1 week of no placement and no theory – these were either reading weeks or reflective weeks. Reflective weeks are useful for catching up on writing reflections on what you are learning (for your portfolio), doing your assignments or other things that need to be done for your studies.
As my first year was a foundation year I had to do a mental health placement and a community one. I worked with a crisis resolution team (caring for unwell mental health patients in the community) and with a team of health visitors (caring for new mum’s and for families in trouble in the community).
For all placements I have to complete a set of documents called Practice Placement Documents (PPD’s). These contain a big list of outcomes I have to achieve where I have to write how I have achieved them.  For example, page 5 might say “Communicate effectively with patient’s and their families…” or something similar. I have to think of a scenario where this has happened during placement and write about it. We also have to have 3 interviews with our mentors on placement, where our PPD’s are checked and the mentor signs another document to say whether they think we have achieved them or not. The interviews are always at the beginning, middle and end of 10 week placements.

So that is a basic pattern of my student nurse schedule and it is not as complicated as it may sound. I am about to enter my 3rd year where things will be slightly different again because I will be doing final year units.

You will be VERY busy. You can sometimes be covering two units at a time and both units can include an essay or an exam each, or a mixture or both. Balancing placement, placement paperwork, revision and university work will take a while to get used to at first, and you will find yourself very tired and even fed up a lot of the time. But once you know what you’re doing and learn how to prioritise effectively, you will find that the academic year flies by.

Just an extra note: Some universities offer students their own ‘academic advisor’ or something similar. If you need help with anything at university, they are your first port of call. Contact them as soon as possible and if they can’t help you they will know someone who will. Put them to good use – that is what they are paid for!

Please don’t hesitate to ask me anything about what I have written in this blog post or anything else about student nursing – I will always reply. Good luck in your studies!

From design student to student nurse: How far I have come

11 Jul 2011 Leave a Comment

by littlenursey in Being a student nurse Tags: , , , , , , , , , ,

This post is for all the people who have spent most of their lives so far doing something completely different to healthcare and are thinking of going into nursing. 

So after a long wait I finally received some good news from university last week. They’re not removing me from the course and I can continue with my studies. This was all down to an essay and a technical error , but I will write about that another time as it’s a long story and involves a lot of personal stuff.

This post tells my story about how I came to be a student nurse after doing completely different things with my life. Anyone out there who wants to be a nurse too but is too worried/scared/doubtful to become one will probably appreciate this.

Primary School & High School: 
A career in art was always something everyone (including myself) thought I was destined to do. From a very early age I was constantly drawing, painting, designing and crafting. People liked my art and I was always encouraged to develop my talents – my parents always bought me art and craft materials and my friends were always asking me to draw for them or make them things. I won art and design competitions and had my work displayed in newspapers, shops and some exhibitions.

I managed to achieve an A in GCSE art, despite how much I began to rebel against being told what to do (I always preferred doing my own thing and my teacher who tried very hard with me told me I could have achieved an A* if I was more compliant).
During high school my mum was diagnosed with breast cancer. You never think it’s going to happen to your or someone you love. She had a mastectomy and was treated with radiotherapy, which made her feel very ill and fatigued. This was my first real taste of seeing what nursing and health care was all about.

I began working at the age of 15, serving food at the kiosks at Manchester City football stadium whenever I could, then started working weekends at Gregg’s bakery when I finished high school. I only lasted a year because I hated it.

College:
I went straight to Bury college after high school with the hopes of doing A levels in graphic design, English and photography. They encouraged me to do the BTEC National Diploma in Art & Design instead for 2 years, which I absolutely loved. It was a lot of paint, sand, sketchbooks and camera film. I discovered my love of photography and based my entire final major project on it.
I had another very short job working as a waitress in coffee shop in a garden centre during college. I hated it.

University (First time):
My college portfolio featured a lot of my photography work and got me into Salford University straight after college. I began a HND (Higher National Diploma) in Graphic Design which was to last for 2 years. I decided to do Graphic Design because I’m good with computers and technology and because I knew I wouldn’t earn what I wanted with illustration. I started the course with several of my close friends from college. I also started a part-time job at Mothercare in Manchester city centre, which I loved.

I hated the course and soon realised that I hated the idea of being sat at a computer for hours everyday, designing things that I didn’t like or care about for clients. I learned how insanely competitive the industry is, that my work was not good enough and that I did not have enough drive or motivation for a career in graphics. I was no way near as passionate as my friends on the course were. I found using design programmes like Illustrator and Flash frustrating.

Stepping in to nursing:
I decided to quit the graphics course after 18 months and do lots of overtime at Mothercare. I began driving lessons and started thinking about what to do with my life. Nursing had been on my mind for the past year but I never felt mature enough to do it until then. I talked about it with my parents and my mum was very keen on the idea – she works as a health care assistant at our local hospital and healthcare is a big deal in the Filipino side of my family. The mother of my boyfriend at the time was a high band registered nurse and gave me lots of encouragement and advice.
I was working on the clothing department at Mothercare and found myself being quite good in the maternity section. I learned a lot of health information on babies, children and pregnancy, and found myself able to give advice to parents. I learned how to fit bras for pregnant and breastfeeding customers, which required me to gain their trust and go into fitting rooms with them. We were in quite intimate situations as the customer needed to be topless, and they often told me all about their problems and worries.
It doesn’t sound like much, but it was enough to persuade me to start doing something about nursing. I decided that I wanted to start with adult nursing as I felt that I was more able to communicate with adults than children. Working with children or in maternity would be something I could do later on in my career.

I didn’t think I would be able to get into university to do nursing with my background in art, so I began a one year ‘Acess to Nursing & other Allied Health Professions’ course at a college near my area. I studied English, psychology, sociology and human biology (which I LOVED). I applied to 3 different universities and had interviews at the University of Manchester and at Salford University. I didn’t turn up at the MMU interview (I wasn’t keen on it at all after visiting their awful facilities on an open day).
I managed to get into both universities… unconditionally. Meaning I was accepted just from my past qualifications and that I did not have to pass the Access course at all (which cost money). Eventually I began having several problems with money and ended up leaving the Access course to do more overtime at Mothercare. I believe that I wouldn’t have been able to get into university without being on the Access course for that short time.

Starting the course:
I left my job at Mothercare in September 2009 and a few weeks later I started the 3 year course at the University of Manchester (I decided not to go to Salford Uni as I had already been there and fancied a change). I had already been driving for over  a year, owned my own car and had already decided to stay at home with my parents. I applied to do the diploma because it offered a non-means tested bursary (with a degree it is means-tested, and my parents earn enough to mean I would receive almost no bursary). I stopped working because I knew that I would most definitely struggle to have a job that would accept me working extremely flexible shifts whilst I am on placement, and because the thought of working, being on placement, having all the paperwork, exams and essays at the same time would be too much for me.

So here I am today, about to finish my 2nd year and all I have left to do is re-submit the essay I mentioned earlier and I have an exam next week.
Getting into the University of Manchester was actually a dream for me and I honestly didn’t think I would get in, purely because I knew it was a very academic uni and because I didn’t think I was smart enough. For some crazy reason, they let me in.
If you’re genuinely thinking about going into nursing because you have a genuine passion to learn and to make a difference in healthcare, then my best advice is to just go for it regardless of what qualifications you have. I won’t lie; you will need some smarts about you to do this, but that is something you should be willing to work on.

I will be writing a post on what the course is like later for those of who want to know more :) I hope this has helped so far!

Nurses should be nice. Obviously.

13 Apr 2011 Leave a Comment

by littlenursey in Nursey news, Placements Tags: , , , , , , , , , , , , ,

So on Monday night many of you may have watched the television programme ‘Dispatches’ on Channel 4, which showed footage filmed by an undercover volunteer and porter working in areas of NMGH (North Manchester General Hospital).
When I was told about it last week, I automatically assumed that it would be full of footage of scenarios where the staff were made to look bad by twisting what they were saying and doing. I lost faith in the media a long time ago.

But it turned out to be quite shocking, with much of the footage showing things exactly how they were.
I’m not going to comment on the issue of the claim that the trust are more interested in moving patient’s around as quickly as possible to meet targets, causing the deaths of patients. It’s not my place to say and being a student, I wouldn’t like to risk my career in any way. I will end that part right there by saying that I have no opinion on the matter.
But it was the footage of the small minority of nurses and healthcare assistants (HCA’s) being cruel, unsympathetic and unprofessional to patients that upset me. Much of this happened in front of a student nurse, who I felt very sorry for.
To watch the programme click here.


Nurse Ratched hmmm?

Indeed, the programme showed a very tainted representation of the hospital. I have done most of my training at NMGH, been a patient there several times, have family who work there and I was born there. The vast majority of my experiences there have been very good ones. I have been lucky to encounter the caring, friendly, skilled and professional staff there and I can say that I have enjoyed almost all of my training there.
But no matter how much pressure a nurse is under, how irritated a nurse can get by the bed managers, or how ‘annoying’ a nurse may find a patient – calling them a ‘twat’, speaking to them like children, sitting around with their feet up to talk about their weekend and actually doing all this in front of a student is more than sickening and unprofessional.

Trying to force a patient to eat and saying “Do you want to get in bed? Eat your dinner then!” is possibly one of the cruellest things I can think of doing to a patient aside from physical abuse.
The programme was designed to highlight the pressure the NHS is under due to government cuts, and for some reason they decided to show this with a lot of negative footage of bad practice, but surely – budget cuts and work load pressure are not excuses for this terrible behaviour by nurses!

My point here is – regardless of how terrible or amazing the programme was, if you’re a student nurse, already a nurse or thinking of becoming one - please, for everyone’s sake, be a nice one!
My mother just agreed that even if there were no cuts to the NHS, those nurses would still behave that way. She also added that this is going on in many wards in every hospital in the UK, which of course has to be true.

Today, I was taking the blood pressure of a young patient who was in a bed opposite an older lady with dementia. While I was doing this, the patient said to me,

“Can I just say, it was so nice to see you go over and just be nice to that old lady over there this morning. I know she’s confused all the time, but no one has really had the time for her and I’m glad you were nice to her.”

Although this doesn’t sound like much, patients have said similar things to me  many times now, and it worries me. All I had done was sat with this old lady, spokne to her and patted her on the shoulder as she cried because she missed her nephew. Nurses and HCA’s might not always have time to do this, but when a patient is crying, we should make time, not roll our eyes and walk away.
Comforting a patient is just another example of what I consider as being a nice nurse.
Yes – we need more staff.

I was looking around my cohort at uni yesterday during a lecture, wondering how many of us would turn out like those nasty nurses we saw on the TV. Like I said before, it is only a minority of nurses and HCA’s who behave in this way, and I hope that the public don’t turn against nurses and regard them all as cranks, much like many of the public do with the Police. It is unfair and highly annoying – nurses and Police do not get good press for the huge majority of good work they do.

So I believe the old advice is right; “Treat your patient how you would like your mother to be treated”.

That means not calling them a twat by the way.

Time to stop giving patient’s overdoses…

14 Mar 2011 Leave a Comment

by littlenursey in Nursey news, Useful Links! Tags: , , , , , , ,

“Interrupting a Nurse Makes Medication Errors More Likely” http://bit.ly/fLhJFm

This is kind of common sense, but it still keeps happening. A lot.
Interrupting nurses while they are preparing medication can of course lead to errors. I’ve seen this happen a few times before.
I have also seen nurses at a south Manchester hospital wearing a bright red apron saying “DO NOT DISTURB” while they’re preparing drugs, which actually worked, and was funny to look at.

Intensive Care Unit; a learning experience not to be forgotten

12 Mar 2011 Leave a Comment

by littlenursey in Placements Tags: , , , , , , , , , ,

So I’ve just finished a 5 week placement on the Intensive Care Unit (ICU) at a hospital in Manchester, and am currently enjoying a week off. I have done a lot of sleeping. It feels like I’d been on ICU a lot longer than 5 weeks, because the amount I learned was unbelievable.

I am currently studying the Acute Care in Adult Nursing unit at university, so ICU was a perfect fit for that unit. Acute care can be considered as an urgent event in healthcare, whether that means a person being in sudden pain from an injury, or a person choking on a bit of potato.
On ICU it can be things such as a patient’s O2 saturation levels suddenly dropping from 99% to 80%, or a patient going into urinary retention and not being able to eliminate toxins and waste.
The action taken in these situations is the ‘acute care’ given, such as sticking an oxygen mask on someone and giving them 15lites of O2 a minute, or inserting a urinary catheter.

ICU consisted of an awful lot of Intravenous medicine, bed bound patients, urinary catheters, blood samples, chest physio, machinery, ventilators, tracheostomies, suction catheters and death.

It looks a little like this, only the machinery is far bigger:

Above: I could not find the artist of the above image so I don’t wish to take any credit for it – I just really like it.

A typical day on ICU – a whole day of new learning experiences:
At this particular ICU, an early shift would start at 7.30am and finish at 2.45pm. A 7hr shift with a 15min break (I much preferred early shifts as more care was given than on a late shift). You look after 1 patient per shift.
If you want to learn how to prepare IV medicine then ICU is the place for you. Just as I’d finished preparing IV drugs for 9am (aseptic technique, syringes, needles, calculations, potions and all) it would be time for hygiene care to be given. Teeth brushed, Chlorhexidine mouthwash begrudgingly given (it tastes AWFUL), full bed bath and moisturiser massaged into wherever needed moisturising. Sometimes a patient would be hoisted into a chair (if they were conscious) to help them regain muscle strength. Fluid levels, blood gases and paperwork would then be completed.
By the time this was all done, it would be time for afternoon medication. Back to the clinical room! Once the afternoon drugs were completed, any other tasks to be done that day would be completed – this could be surgery, replacement of lines, inserting a tracheostomy etc.
Most patients on ICU have a Central Venous Line inserted for the majority of their drug administration. This is a catheter that is inserted into a large vein in the neck, such as the internal jugular vein:

Above: A patient with a triple-lumen CVL inserted for antibiotic drug use. Image taken from http://bit.ly/gvmQOj

Makes it much easier with CVPL’s as large veins can take the pressure of a lot of drugs being administered several times a day.

There is no doubt that ICU was one of my most difficult placements because of how much I had to learn about the ventilation system – I will not even start going into it. The majority of patients are also admitted under sedation and can be sedated for days – this makes the work heavier and more time-consuming as you are moving a patient’s full weight when they are unable to move. Plus there are a huge amount of wires and tubes going in and out of the patient – a patient can have 3 syringe drivers on at the same time, plus 3 or 4 suspended drips, an NG and NJ tube (you can google the difference), a urinary catheter and sometimes a drain from a wound or an infected bodily organ.

The clinical technology used can be intimidating. Blood pressure cuffs are not used on ICU – arterial lines are used instead to get a constant record of the patient’s blood pressure (check this out http://bit.ly/fy5XWJ). It can also be used to get blood samples so the patient’s blood gases (blood ph levels, CO2 levels, sodium, potassium, glucose etc) can be checked at regularly intervals.

Death was definitely something to get used to on ICU – my first patient died on my 2nd shift. 1 or 2 patients died a week during my time there, some of them not that old and some of them leaving behind people who then had no one to care for them.

Luckily for me, the staff at this ICU were more than amazing. Everyone was very keen to teach me and I was made to feel very involved in patient care. I was given many opportunities to do anything that I was able to as a student nurse, which gave me the confidence to use more of my intuition. Shame that ICU also meant that I was completely knackered most of the time.

If you get a chance to train on ICU, make sure you get stuck in and do everything you are able to do (obviously, administering IV medication is a no-no, as is deciding to mess around with sedation and morphine levels without being told to). You will leave realising that you knew less than you thought beforehand. Unless you’re a registered nurse of course.

ICU could end up being my elective placement in 3rd year :)

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