Jobs, Jobs, Jobs

Remember I had my first post qualified nursing job interview at the James Paget? Well I also had the interview for the Norfolk & Norwich Hospital (which was very similar to the James Paget interview but with a maths and English exam) and I got offered both jobs, both on the wards I requested. Which is great but also not so great.

I already work at the Norfolk and Norwich and I happen to know the staff on the ward that I got offered a job on are absolutely lovely and I know I would really enjoy it there. On the other hand the staffing at the Norfolk and Norwich just in general across all areas isn't very good at the moment where as the James Paget is excellent in comparison, the James Paget has a nurse to patient ratio of 1 to 6 (which is very good in England), the Norfolk and Norwich is 1 to 12. I brought this up in the interview at the Norfolk & Norwich and they made it pretty clear that this wasn't going to be changing any time soon and not only that but it would be likely I would be rotated to other wards... no thanks!

But then I have to consider my girlfriend Kimberly as well who is hoping to move over to England this year and also work in England, she is used to a nurse to patient ratio of 1 to 4 so 12 might be a horrible shock to her. Also more importantly we need to find her somewhere where the employer will sponsor her visa. So I decided to ring both hospitals and float the idea of this and that this would be the deciding factor and the James Paget seemed a lot more willing! Things are never simple are they!

In other news I passed my dissertation with a good mark whilst still maintaining my record of never having withdrawn a book from the library (score!). One more module to go... 

Specialist Nurses

So I'm on placement at the moment on a ward, but I just wanted to write a quick note to any other student nurses and really recommend booking yourself on days with specialist nurses because it really is so much fun. So far I've seen respiratory specialist nurses, diabetes, tracheotomy and I've got days with site practitioners, smoking cessation and hopefully tissue viability. You learn a ton but not in a boring pushy way like in classroom but by actually doing, I've been having such a great time and I think because specialist nurses obviously enjoy their speciality (or else why would they specialise in it!) they don't mind being quizzed. Just ring them up with your diary in hand and they're usually more than happy to fit you in and you will find yourself having a crash course on their subject. 

The Old a Operating Theatre & Herb Garret

A group of friends and I went to visit London the other day to check out the Old Operating Theatre which is the oldest operating theatre in Europe. 

You had to climb up a rickety spiral stair case and first went through the area where St Thomas' Hospital used to dry all their herbs and prepare their medicines, there were lots of interesting things to look round and a lot of them you could touch so it was really interactive. 

Here's some lovely bits of bodies.

Just floating around. 

And some old branded medicines - life tonic doesn't sound as catchy these days does it?

And my learning point of the day - Senna is a herb! Senna is a popular medicine on the wards as a laxative (painkillers can really back you up), and I had no idea it was a regular herb of the same name. 

Some heroin which of course you used to be able to buy over the counter as a cough suppressant amongst other things. 

And a bottle of cocaine, love the danger sign on it, you'd never get away with such a small warning and no child proof top nowadays would you. 

This is the old fashioned way of making pills on the above board, they'd all be cut into equal shape and size by using this board. 

We all were pretty horrified by the cervical dilator... don't fancy that thanks very much!

And you might have seen my previous post about traditional nurses belts? 

There were a lot of sweet nursing trinkets. 

And then it was through to the operating theatre, they call them operating rooms in America because I suppose they weren't set out like a theatre to have spectators.

You can still see the cut marks in the wooden bench where... one assumes there were amputations?

And they had all the right tools for it too! Infection rates would have been high because they wouldn't have necessarily washed these (or their blood soaked aprons) in between patients. Long live the NHS eh?

Nursing Traditions

Nursing is an old profession, and naturally there are a lot of nursing traditions but healthcare is moving strongly towards evidence based practice and so these traditions sometimes phase out. 

Some traditions you enjoy doing, like always making a bed with the opening of the pillow case facing away from the door because that's how Florence Nightingale did it in the Crimean War when they had to nurse soldiers in tents; facing the pillows away from the door meant that they didn't get filled with sand blowing through the tent. 

Some traditions you feel very glad they no longer allow, such as taste testing urine (ick) - we have urine dip sticks now thank goodness. 

I am looking forward to one tradition though in particular, when a nurse graduates, it is tradition for her family to buy her a silver belt buckle. Usually these are antique Victorian buckles (some from the 1800s) but of course you can buy new buckles styled as an antique for less.

End Of Year One

Well chums it's the end of my first year at uni, it's gone so fast. All my paperwork is handed in, my placement is now over and I was really pleased with my mark. I got my first card from a patient which was really nice.

Especially now I can tuck it into my over large portfolio! Just one more lesson and then it's the summer holidays, Rome and Ibiza, yay! 

OSCEs

Well my chums, what have I been up to so far this week... I have been revising and taking my two OSCE exams at uni for the end of year. I had to write on the flip chart during the skills lab for Dr ABCDE so my notes were... Ok I just stole the flip chart page. I did write it though! So I revised from the giant poster and I still forgot bits of it in the exam. Oh well, feeling a bit frazzled now.

I got a new raised bed that the boyfriend put together for me, good of him. Now I need to buy some compost to go in it, find a good place for it and get planting stuff. 

And I made a discovery - when you run out of soy sauce, use two teaspoons of marmite, now you know

Placement Update

So I've reached halfway house at my current placement and I've done so many hours there that for the rest of my placement I only need to go in for two long day shifts a week, so it will be quite nice to get a day off that I didn't have before. On placement your hours are meant to average out to 30 a week and I've been doing 3 long days which at my placement is 39 hours so I'm in credit.

I have a drug calculation exam coming up for next week for which we use a program called safe medicate and then after that I have my OSCEs which this year are about administering medication (tablet form) and DR ABCDE possibly including manual blood pressure but I feel fairly confident about these because we've been practising them a lot before classes broke up for placement... fingers crossed!

You Know You're A Nursing Student When...

Ads in the RCN magazine get all scientific, this one made me laugh, I especially enjoyed the graphs. All adverts should have graphs I think from now on. 

You also know you're a nursing student when you grope yourself constantly for your upside down watch before realising it's your day off and you're not wearing your upside down watch about ten times a day, making you look like a lunatic more of a lunatic.

In other news I made peach and raspberry jelly, yummerz. 

The BNF, the CQC and the RCN

Nursing is full of acronyms and today I thought, as I have a moment I would tell you about 1 that's like a bible and 2 that are in the news a lot. The RCN is the Royal College of Nursing and I would say is the main trade union for nurses - why do we need a trade union? Mainly for legal support and insurance actually. We live in a culture where people try to sue for a profit and sadly healthcare is not exempt. By joining the RCN we insure ourselves, get a few nice free things, keep up to date with any nursing news with their publication, get access to a great online library and also free legal advice and representation should we ever need it (although I hope I never do!!). The RCN is very well respected and often in the news telling politicians how it is. And they gave me a free tote bag and nursing dictionary - thanks for that!

Next is the CQC, I thought I would mention this one as I am on placement at the moment and the CQC visited. This is the Care Quality Comission, they visit all healthcare settings to make sure that everything is running ship shape and I am very happy to say that my placement passed with flying colours as working exactly as it should do, so that was good news. The Care Qaulity Comission have the power to shut down healthcare settings that are not performing satisfactorily, they also run enquiries where there have been problems which is why you might see them in the news. Everyone fears the CQC, but really it's about making things better.

The third is the BNF, the British National Formulary - a bible of all things pharmacological. I mention this because I've been studying some parts of it lately and downloaded a little free app for my iPhone (a must for all nursing students with a smart phone!). If you need to give out a drug you don't recognise? Check the BNF. Concerned about side effects? Check the BNF. Contraindications? Check the BNF. Is that the right dose? BNF.  The BNF is law as far as I'm concerned and so handy to have.

Here's a look at the free app - 

This is the main menu

But it's split quite helpfully into sections by health topics

And here's an example of the search

Well worth a look but you will need to sign up for an NHS Athens account beforehand. Happy Friday Readers!

Back To Uni After Easter

The first day back to uni has been and gone now after the Easter holidays and.. well it sucked actually. We were hanging about for 2 hours to begin with because there had been a mix up with the lecturers we were meant to have. The IT lab printers wouldn't work, then I spilt tea down myself (clever). Then we all got one of our assignment marks back and I did dreadfully only I don't understand the feedback I've been given at all and nor do my friends (ugh) and the person I need to speak to is on holiday (double ugh) and I can't even look through the actual piece of work because (wouldn't you know it?) my work has been chosen to go to the external moderators (triple ugh). So that's really really frustrating. 

I'm glad to be back home now, thank goodness.

Is That A Hair Piece?

"What?" I'd said, amused. 

"Your bun, is it a stick on hair piece?" asked the other healthcare assistant 

"Err... no...no, just my hair" I said 

"Ohh. You've got one of those doughnut thingies, haven't you" she said eyeing my head suspiciously

Well readers, not quite. You see at hospital you must have you hair off your collar, which means cut short or up, no trailing your hair through patient's bodily fluids and what not! If I put my hair up in a bun it either falls out or just generally looks a bit messy and those bun doughnuts look like a lot of effort with hair pins and so I buy these from ebay - click here

They're so easy, you just twist your hair up in them and they look far better than I could ever do with just a hairband for under a few quid. Sorted. 

And rest assured I will never, ever be pinning fake hair into my own, eurgh!

Module 2

Well chums, I've finished my module one of my degree and it's straight onto module two. Although the nice thing is that all my assignments have been handed in so that's a weight off my mind. The only thing I still have outstanding is waiting for all the expenses (about £600!) to be paid back to me from my placement for accommodation and travel costs - not just because it's a lot of money but because my placement was far away and I had to pay out all that money I had to get a loan from the Dean of Students (what a chore) and really would like to get that paid off as owing money stresses me out. 

I've already been assigned my next placement which I'm really pleased with and its far closer to me so no loan or crazy expense claims which I detest. Hurrah!

Busy Bee

Well, I have been busy these past few weeks. I'm still on placement which is going well (mostly!) that's 30 hours a week. I'm also doing class or independent learning each week, that's 7.5 hours a week. I'm working at my HCA job, that's 12 hours a week. Travel to placement and back on the bus twice a week is 6 hours a week. So that's 55 hours a week busy. Then on top of that I've got 3 big assignments:

 - a 3,000 word communication essay

- a portfolio of my first module's work

- assessment of practice booklet, review and 3,000 word written evidence

Phew - I need a holiday!

New Skills

I did my first aseptic wound dressing today which was handy cuz earlier in the week I had a skills lab on aseptic non touch technique - this means everything has to be sterile, no touching the wound with my grubby mitts, sterile trolley, wound pack, gauze waterproof dressings, saline solution to clean and it turned out lovely. 

I also did my my first ECG where you monitor the persons heart and attached little sticky pads across the patient and attach them up to leads on the ECG machine - two problems with this. If it's a lady her boobs are sort of in the way, if it's a guy when you take the pads off his chest gets a free part wax... oops!

Luckily my patients were lovely and I didn't make any mistakes!

Anatomy Lab

I had a session in the anatomy lab at university today where they keep the cadavers for medical science and my class had an introduction to the lab.

 I wasn't too worried about seeing the dead bodies, you had to place all your belongings away in a locker and wear a white lab coat and we walked into a cooled clinical looking room which they had one complete body on a metal table and on a different table they had a severed arm and a leg that had been skinned so you could see all the muscles and bones. 

This might sound gory but it really wasn't, it was all carried out very respectfully to the bodies, the genitals and face are covered and any tattoos are removed to protect the donors identity as much as possible. We only saw parts of the whole body not all of it at once and it looked like... well any other body really just still and stiff. The limbs looked like meat that you'd buy to cook, I suppose you don't think of meat that we eat being muscle but it is and it reminded me personally of roast beef. 

Apparently pretty much all of the donors are elderly, 80+, more women than men and they purposefully seek out to donate their body for anatomical study once they die which is really kind of them because it was really useful to see. The cadavers are specially embalmed using chemicals that preserve the tissue (this is why the bodies go stiff) and left for three months for the cadavers to gain the full benefit of the embalming chemicals the bodies are then used over the course of an academic year (or in special circumstances over three years) and then at the end of the year students and donor's families are invited to go to a special cremation of the donor's bodies and the students give thanks for them. We are the first nursing cohort to visit the anatomy lab (usually it's just med students) so this was very special. 

I hope you'll understand that I have no photos to share on this post but if you're interested (and I haven't put you off), I'd really recommend taking a look at some of Gunther von Hagens' work, he is the man that has the famous Body Exhibition - I saw it in New York whilst I was there and although you think you know what everyone looks like inside from books, it really is an eye opener. 

Clinical Skills

I spent today doing lots of skills practice at school. We learnt how to take blood glucose readings (although I already do this at work but it was fun to test my own for a change). At least one part of me is normal!

Then we got to practice intramuscular (into the muscle) and subcutaneous (into the fat) injections using water to inject and a lovely slab of fake rubber skin as you can see below. So that was all good fun. I have done injections on placement before but it's something I think is quite fun to practice. It's much nicer to stab fake rubber skin with a needle than actual people. 

What I Won't Miss

So lately I've been on my first nursing placement but I'm coming to the end of it now and my last day working (for no pay I might add!) is my birthday... so that's going to be joyous. 

I shan't be missing seeing the moon on the way to work, the moon is an indisputable sign that I should be in bed. 

Nor shall I miss walking past the creepy misted over forest in between the accommodation and the hospital which I am convinced is full of murderers! That or wild animals... in the forest... probably more likely?

But the thing I shall miss least of all is the boring, expensive, long bus journey of rubbishness. Until January that is when I return to all of these joys. Happy November readers!

First Year, First Placement, First Day

So.... it went pretty good actually. I had a shift that's called a long day and that's 7am - 8pm (a lonnnggg dayyyy). I'm on a ward placement in a hospital for two weeks which means it's busy busy, everyone coming and going. I woke up about 5.30am, it took me about 5 minutes of fumbling in the dark to realise the annoying sound I kept hearing was my alarm (playing a piano riff apparently). I didn't have a great nights sleep - under the pillow case my pillow has some sort of plastic covering (which may mysteriously disappear when it meets my nail scissors tonight!) and it was really noisy?!? Someone said oh yes it's like the pillows patients have... err no it's not, they have nice fluffy pillows. My noisy pillow and I will most definitely come to blows before I snooze tonight. 3am is not the time for crinkling loudly!

So anyway, the general layout of a ward for those of you who haven't worked on one or been patients/visitors is that there are bays (usually 4 or 5) of beds each with 6 patients and also side rooms with just one patient in or sometimes two if it's a long side room. The ward is usually then divided into teams so you know who you're responsible for. My team had two bays and 4 side rooms which is a nice number to keep busy with but not swamped. 

We had hand over where we discuss all the patients and any changes/needs for the day and then I was in the thick of it. I was really glad I'd done HCA work before so I knew all the basic things like obs and personal care, what was used for what. I got to use a drug chart and give out medication (heavily supervised - don't worry!) and I gave an injection which was exciting. I shadowed some of the physios too which was interesting as I hadn't seen that side of patient care before. 

I met my mentor briefly but she was working the night shift and I think the ward had tried to be kind and not give me a night shift my first two weeks so I'm only with her one day and my associate mentor two days next week. So instead, I spent the day with the charge nurse and a staff nurse in our team, both of whom were really nice and easy to like and let me try new things out.

Now I'm back in the accommodation and have dined on my lovely evening meal of a tuna sandwich and a sprite (the cafe was closed!). Bring on tomorrow eh? 

Placement Woes

So as I may or may not have complained to you I have a placement bloody ages away from my home (despite my home being next to two different hospitals!) and consequentially I have to stay in hospital accommodation... not happy. Although luckily the actual placement itself should hopefully be interesting and fun.

So as I'm staying away tonight I had to pack my bags last night and let me tell you - they feel heavy. Particularly the laptop. Pussy cat did a little sniffing inspection before I left but both bags passed.

Some kindly soul gave me a little miniatures pack of toiletries last Christmas which were handy to take away with me - also I felt good about using them up. I think I must be difficult to buy for because every Christmas I get tons and tons of toiletries that sit unused in a box I have for the toiletries (that's how many I get) until they are used or (more likely) I throw them away because I haven't used them. This is especially true of make up. I was rummaging through the toiletries box last night and found eye shadow and nail varnish that someone had bought me when I was 12... I am now 23, they really must be thrown away. Incidentally if anyone wants seriously old make up/nail varnish do feel free to root through my bins!

So I looked like a bag lady, luckily as we headed towards the end of the day I got offered a lift to the accommodation I'm staying at so I got to forgo the crappy long bus ride! Hurrah! So now I'm settling into my little room, it's a flat of four rooms and there are other girls that are already nurses who live here permanently, all very nice. 

It's a bit basic. It reminds me of when I lived at a hostel. But its next to my placement, free wifi and I know two other people staying here on their placements which is good.

Hopefully tomorrow all goes fine :)

Uniformly Hideous

Check out the pattern of my student nurse uniform.... attractive stuff....