One Down!

So that’s it, placement is finished!

I’ve really loved it. Over the last few weeks honestly it feels like I’ve properly thrown myself into it, and really enjoyed everything that I've been doing. It’s gone so quickly, and I won't pretend it’s been easy- trying to juggle a family life and placement as well as writing an essay and making sure that was in on time- but it’s definitely been worth it. It’s 100% made me realise I've chosen the right career path. 

I’ve done so many different things and met some really interesting and lovely people. My mentor has been absolutely fantastic, and the other nurses that I was working with were lovely as well. I feel so lucky that they were such a lovely bunch of people, and they made me feel completely comfortable and able to be myself around them. I was quite pleased as well that my mentor said my communication skills with patients was really good as well, but I honestly think that comes from years of working in a bar and talking to every kind of person! We’ve had some really interesting and varied patients, which has been really good as I’ve been able to experience a lot within quite a short placement. I think I've grown in confidence as well, I feel like I’m able to talk comfortably to patients now and I don’t feel so awkward and nervous about it. I like community nursing a lot more than I thought I would. 

I’ve found out I’m not as squeamish as I thought I would be as well. 

There’s been so many interesting patients. We had one wound which had to be packed daily. Originally it was thought it was an abscess which the patient had had lanced, but it turned out to be a fungating tumour. We had asked plastics to reassess them and they had taken biopsies, and the medical diagnosis was non-Hodgkin’s lymphoma. The patient had deteriorated over the 3 weeks we were seeing them, and we had to phone an ambulance on our last call to have them taken to hospital. So it was good to see why accurate nursing notes are important to keep as it means that when different nurses visit patients, then they can see if there’s anything unusual going on. 

I’ve been able to give some injections as well which was good as I was quite nervous about that for some reason! They were mainly tinzaparin ones as I had built a relationship with that patient, so she was comfortable with me giving them. I’ve learnt a lot about wound-care as well and the different types of dressings/packing, and why it’s used, which I know is going to come in useful over the next few years. I also got to see male, female, and suprapubic catheters being changed, and did a number of palliative support visits as well as helping set up syringe drivers. We also did one bereavement visit after a palliative patient had passed away. I was a bit nervous about that call because I didn’t really know what to expect, but I think the family were prepared for it, and they were happy that he was comfortable in his last few days more than anything. 

Over the last few weeks I’ve really familiarised myself with all of the paperwork required for community nursing, which has involved a lot of different care plans, initial patient assessments, patient notes, skin bundles, nutrition pathway documents, syringe driver documents, and risk assessments. It’s been good because I’ve been quite confident in filling these out as well, and even got together a few new patient notes folders myself. My mentor was really helpful in showing me how to fill them all out correctly and got me to do it for a number of patients as well, which I definitely think boosted my confidence. She also showed me how they order patients equipment as well, like the EHOB cushions and other pressure relieving equipment. It’s a little bit like online shopping ha!

I think what has surprised me most is that my mentor trusted me with a lot. I’m really grateful for this and it gave me confidence in my own ability. She would ask my opinion on things (I’m sure she already knew but I feel like it was to build me up) and trusted me to prepare dressing packs for patients we were visiting the next day, as well as doing a lot of complicated dressings myself. She also got me to phone GP surgeries and patients about prescriptions and things. It might not seem like a big deal, but it feels like it to me. We had quite a complicated patient about half way through the placement as well, they had Huntington’s disease and really struggled to communicate, and his condition had recently deteriorated quite a lot. A family member of his had LPA, and he was being referred for a capacity assessment and CHC, as he was not engaging with care and it was becoming detrimental to his health. It was really interesting to see the entire process of this, and it was good to develop a relationship with the patient, as his communication needs we’re a lot different to other patients I had met, so I feel like I definitely learnt something. I got to sit in on the CHC meeting with my mentor as well, as they were trying to move the patient into a suitable placement instead of having him live alone. This was along with family members, a social worker, and a Huntington’s specialist nurse. It was a really good experience and seeing how different teams come together for the good of one patient was really eye opening. 

I’ve managed to get quite a lot of my competencies signed off, which has been great as we don’t find out what our next placement is until mid-August, but it takes a lot of the pressure off as well. I managed to get my dignity essay finished as well, which is great, I just did a bit every evening and managed to finish it the week before the deadline. 

So, all in all it’s been really good. 

I got my mentor and the other nurses a card and some chocolate when I left because they genuinely were really lovely to me.