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Tips for Student Nurses: Take patient confidentiality seriously

23 Aug 2011 2 Comments

by littlenursey in Being a student nurse, Experiences, Nurse knowledge, Placements Tags: advice, confidentiality, handover sheet, hospital, hospital ward, nurse, nurses social networking, nursing, nursing student, patient, patient confidentiality, patient information, patient name, student nurse, university

You will already have this hammered into your head over and over again when you start your nursing course, and again during placement. It’s not surprising – this can be a serious issue and yet it is something often breached by nurses.

Patient confidentiality basically means that unless you are passing on information or discussing care of a patient to a member of the healthcare team, you must never ever disclose any details of the patient to anyone else.
That means not going home to your family and saying “Louise is being treated on my ward at the moment” or ” Louise’s Mum was in today being treated for pneumonia”. That information should not leave the hospital.

If you decide to talk about something interesting/disturbing/confusing you have seen or done during placement with other student nurses or even friends, then make sure that you do not give any information away such as names, where they live, what they look like etc. Be very careful with this one – make sure you know that whoever you are talking to does not know the patient in any way at all as they might even be able to guess who are you talking about if you say something like “he had a big mole on his cheek” or “he had the name ‘Helen’ tattooed on his shoulder”.

So this goes without saying. NEVER discuss patients on social networking sites. You CAN write things like “My patient thanked me for helping him walk today” or “I got to change my first dressing today”. You CANNOT write things like “Looked after a nasty smelly patient today” or “Looked after someone I went to school with today”. You must also make sure that none of your friends comment on anything you say that suggests that you have been telling them negative things about a patient. I once wrote something like this as a Facebook status “Had a good day at work today, loving this ward “. A close friend of mine commented with something like “Did that old man not poo on you today then?”. I had to delete her comment immediately and send her a message to ask her not to write anything like that on my wall at all as I could get in serious trouble!
Talking about patients in a negative way or giving any information that might help others identify the patient is a big no-no. You will see this happen on social networking sites, in blogs or in comments on websites, but it does not mean that it is ok to do it and it is highly unprofessional.

Finally, while you are on placement you may find yourself going home with handover sheets in your pockets (sheets given to you at the start of shifts with list of patients including names, ages and all clinical information). You may have a personal notebook and find yourself writing down patient names when someone passes a message onto you about them. You MUST destroy all this information as this breaches confidentiality. I personally burn anything I find like that as I do not trust ripping them up or shredding them! It may sound over-the-top, but there is no way I want to risk losing my career. Make sure that you think in the same way.

So that’s it for now! The best advice I can give on this is to use your common sense and resist the temptation to gossip about patients. You can be removed from the course, or lose your license when you have registered, if you breach patient confidentiality.

Tip for Student Nurses: Don’t be afraid of dead bodies

19 Aug 2011 2 Comments

by littlenursey in Being a student nurse, Experiences, Nurse knowledge, Placements Tags: advice, cardiac arrest, dead body, dead patient, death, death of a patient, dignity, dying, hospital, hospital ward, last offices, nurse, nurses, nursing, nursing student, patient, patient death, patient has died, student nurse

I’m going to be very blunt and just say it: you will come across the body of a dead patient at some point during your training. I have noticed that people find my blog everyday by searching for information on the death of a patient, and what to do as a student nurse.
It can happen in all sorts of ways – you can start your shift and just hear that a patient has died, you can be there while they die over a time period, they can die all of a sudden from a cardiac arrest, you can discover a dead patient in their home or you can discover that they are dead when you approach them on the ward.
More than likely you will be asked to take part in a procedure called last offices. This mainly involves stripping the body of all tubes and lines, jewellery, plasters etc, washing the body and wrapping them up ready for the morgue. It can be a rewarding experience and a very nice thing to do if you wish to gently pay your last respects to a patient, whether you cared for them or not.

My tip here is to try to get involved as early as possible. Experience is the only way you will get accustomed to dealing with dead bodies however frightened you may be. There are students who are at the same stage as me (about to begin 3rd year) who have not yet had a patient die during duty or have been too afraid to perform last offices. There is nothing wrong with being afraid - a fear of the unknown is understandable. The best way to deal with this is by throwing yourself into it and just saying ‘yes’ when you are asked to do this. However you should also make sure that you work with someone you know and trust, who will respect the body of the patient, and who will accept that you may not feel like you can continue with last offices. A good nurse/HCA who asks you to help them perform last offices will explain the procedure to you and let you know that you can stop if you need to.

If you have any questions about this please don’t hesitate to ask me! For now, good luck with your first experience

Born to be a nurse.

20 Jul 2011 Leave a Comment

by littlenursey in Being a student nurse, Experiences Tags: advice, EAU, hospital, hospital ward, nurse, nurses, nursing, patient, student nurse, university

Just a quick post.

In a turn of unfortunate events I almost got kicked off of the course last month. I received the dreaded email inviting me to attend a Progress Meeting at university one evening and cried. Luckily Kov (my boyfriend) was with me to comfort me, otherwise I probably wouldn’t have been able to go on placement the morning after.
The day after the email I arrived at placement, which was at an EAU (emergency assessment unit) at the time. I completely forgot about the email until I was in the middle of treating a patient I had found in a coma. I found myself watching the nurse pushing a nasopharyngeal tube into my patients nose, and it hit me. I knew right there and then that I didn’t want to do anything else other than be a nurse.
The thought of being kicked off the course and having to find a new career terrified me, and I spent most of that day secretly panicking and worrying about what I was going to do with my life. I just want to be a nurse, and the thought of qualifying excites me so much. Luckily I was not removed from the course, which was a huge relief to say the least!

Good luck to all other student nurses out there who have to go through the same thing. If anyone wants to know what happens at Progress Meetings please let me know

Ask me a question…

06 Jul 2011 4 Comments

by littlenursey in Experiences, Nurse knowledge, Placements, Science Tags: advice, death, dying, hospital, hospital ward, nurse, nurses, nursing, patient, student nurse

Can’t find what you’re looking for on my blog? Ask me a question – just click on the ‘Ask me a question!’ link above and type in the box – if I know the answer I will do my best to reply ASAP!

One of the worst parts of working in healthcare is knowing you can’t save everyone

26 Jun 2011 Leave a Comment

by littlenursey in Experiences, Placements Tags: acute, death, dying, hospital, hospital ward, ICU, intensive care, nurse, nurses, nursing, patient, student nurse

I was discussing nursing with my boyfriend Kov a few days ago (something we often do – he questions me a lot about healthcare and seems to find it very interesting) and he said something that really made me think: “You can’t save everyone.”

It reminded me of the time I trained on an Intensive Care Unit (ICU) and witnessed death in a very different way. I had seen and heard about patients dying on other wards after being very ill for some time. But on ICU it wasn’t like that – people were being brought in from A&E with severe illness and were at high risk of dying.

During my first week there I witnessed a consultant tell a woman in her seventies that her son was going to die that day.
I had been caring for her son who was in his fifties and very unwell, under sedation, ventilated and not improving at all. His only other family was his younger brother. I was collecting a blood sample from him earlier that day as his family arrived, and I stayed with them for a little while just to chat to them and see what they were thinking and feeling. They told me that they were expecting the worst, and that a consultant had already explained that he may not pull through. They seemed to accept this, and eventually left to go and get some lunch.
While they were gone, the patients consultant found me writing at the patients bed side and told me that the decision was made – they were going to have to let the patient die. He needed to tell the patients family.

I couldn’t believe my eyes when I saw the consultants behavior for the next thirty minutes – he was extremely nervous. I found him leaning against a wall away from the bed areas, thinking about how to break the news and looking very sad. I approached him and asked if he was okay – he told me that even after years of working in healthcare he had never hardened up to breaking bad news like this to patients families. He was upset and the fact that it was the patients mother he was breaking the news to made the situation even worse.
I told the consultant that I had already met the family and that they were expecting the news, which brought him some relief.

When the patients family came back, they were escorted into a private room with the consultant, myself and the nurse I was working with that day. There I witnessed the consultant break the news. It was heartbreaking – the mother cried and found it difficult to speak, and her other son was comforting her. It was clear he was trying to be the stronger one through this. They accepted the news and returned to the bedside. The patient was taken off the ventilator and all invasive treatment was stopped immediately. He died later that day.

I found this particularly upsetting as the man was around the same age as my Dad, and the mother around the same age as my Grandma. They even looked similar to my Dad and Grandma. I heard the nurses saying that no parent should outlive their son, and I couldn’t help thinking about how the mother was there when her son was born and there when he died.

Undercover Care: Abuse Exposed

01 Jun 2011 Leave a Comment

by littlenursey in Nursey news Tags: abuse, care, care home, dignity, Panorama, patient, student nurse

Some of you may have watched Panorama ‘Undercover Care: Abuse Exposed’ last night. I don’t really know what to say about it, other than how appalled and disappointed I am.

I just wanted to post a link to it on BBC iPlayer so those of who didn’t get a chance to watch it can see it. It is difficult to watch and may bring on tears, but I feel that everyone should know about the kind of abuse some vulnerable people unfortunately receive in a place that should be trusted. I also hope that every carer, nurse and anyone else in the healthcare profession take a look at this and think about how they care for people – it definitely made me think more about restraint and whistle blowing.

Click here to watch the programme.

Dying Matters

18 May 2011 Leave a Comment

by littlenursey in Experiences, Placements Tags: advice, death, dying, Dying Matters, nurse, nurses, nursing, patient, student nurse

It has come to my attention that a majority of people who stumble upon my blog are searching for information on what it’s like to experience the death of a patient, or how to deal with a dying patient.
So after much publicity on Twitter (and perhaps other forms of media) I wanted to post a link to the campaign website Dying Matters.

The website aims to raise awareness on the issue of dying by featuring valuable information on the subject.
Although the website is aimed at the public and people who are affected by the subject of dying, I feel that it is useful for student and registered nurses to learn about dying from the public perspective.

It can be a difficult experience to talk to a patient about dying. You have to find the right moment and time, and be able to determine if a patient does not actually want to talk about it, no matter how much you think they would benefit from it. This isn’t always easy to accept, and sometimes it can be a waiting game.
I recently looked after a patient with cancer who I had bonded well with, and during my first night shift she decided she would like to talk. It was 3am, pitch black on the ward and the other patients were asleep, but for the patient it was the perfect time to talk as she could not sleep. She sat in her bed under the sheets while I sat on her bedside chair under a blanket, and we talked (whispered) in the dark until she felt she could fall asleep. I did not know she was dying until the next day (none of the staff had told me!), and her feelings suddenly made more sense. Luckily, I did not saying anything or comfort her in a way that suggested that she was not dying, and she felt content after we had talked. The patient thought I knew she was dying. I feel very privileged that she had chosen to talk to me, and proud that I was able to offer her comfort even when I did not know she was fearing her demise.

Please click here to take a look at the website and good luck in your training!

Sarah xXx

Know your patient – give them a bed bath

05 May 2011 Leave a Comment

by littlenursey in Experiences, Placements Tags: 1950's nurse, bed bath, dignity, Jennifer Craig, No Sister, nurse, nurses, patient, student nurse, Yes Sister

“…I like bed bathing patients. There is an intimacy about the procedure that leads to confidences that we otherwise would not hear. Instead of the patient in bed six, he becomes Albert Jones who takes his grandsons fishing in the canal and breeds racing pigeons.”

A perfectly true extract I love from a book I am currently reading, ‘Yes Sister, No Sister’ by Jennifer Craig.
The book is about the author’s experiences both in and out of the hospital as a trainee nurse in 1950′s Yorkshire. It’s definitely worth reading if you’re interested in nursing. Not that much has changed.