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. 

Community Placement and New Experiences

Well, the first two weeks of placement have been absolutely packed full of new experiences. 

I took a notebook with me, so I could write down the main things that I’ve done, and I tried my best to keep a diary but honestly keeping on top of it was impossible! Working with the community nurses has certainly been eye opening, I don’t think you realise how many different things they do until you’re out there doing it. My mentor was off for the first week on annual leave, so I was with a few different nurses until she returned, but it was actually really good to see how a lot of different people worked. Everyone has their own way of doing things, but the outcome is the same which is good. Every patient is so different as well, so I got the opportunity to see and do loads of different things. 

Over the past two weeks I have done a lot of wound care, mainly venous leg ulcers, lymphoedema patients, wound packing, I got to take clips out of a few hip and knee replacements, and stitches out of wounds- which I really enjoyed. I’ve also seen quite a lot of palliative care patients, which has involved syringe drivers, PICC flushes, and PEG water changes. It was really interesting to learn about the different medications used in end of life care. 

I tried to get stuck in straight away.

Mainly because I was really quite nervous about it, so I thought that would be the best way to overcome any fears. If I’m honest I’m not really that confident about my abilities, and I really struggled the first few days. It was difficult feeling comfortable walking in to patient’s houses and introducing myself, and I felt really out of my depth. I got into my own head about it quite a bit and thought that the nurses would think I was stupid because I didn’t know anything, it did make me quite upset for the first few days. I’m not sure why, I think it’s just because it’s all so different from anything I’m used to, and I was really aware that people might be judging me on my knowledge (or lack of it). 

After a few days that passed though, and I got really involved with the wound care, and we saw some really interesting patients. By the end of the week I was able to give the nurse the dressings she needed for particular patients who were in compression, and I was able to remember what we used for them on previous calls without having to ask. So that boosted my confidence a bit. I've seen a few palliative care patients as well which has been really interesting. I was quite pleased that I actually managed to do the medication calculations correctly- the nurse let me figure it out (before she checked it) as we were drawing it up- which was good as it gave me a bit of a confidence boost with that. It was really interesting as well to see all the different paperwork that comes with having controlled drugs in a patient’s home. It was strange though, meeting patients who knew that their disease was terminal. I guess I found it a little awkward because I've not really dealt with death before, so seeing these patients who have seemingly accepted the illness was different. 

I am finding it easier to talk to people now though. That start was really hard but honestly over the last few weeks it has gotten a lot easier. I think it’s helped as well that I’ve seen a few of the same patients so have managed to build up a relationship with them, mainly through having conversations about seemingly random things like their dogs, or kids, or the weather ha! 

But so far it’s been enjoyable, even if it did take some getting used to at first. Just got another 3 weeks to go now, it’s going really quickly. It has been difficult though, trying to juggle family life and being at placement 5 days a week. I mean, I appreciate it's a normal working week, but with Cal looking after the baby all the time and working nights as well it's just seemed like we have no other time in the days! But we both know it's only temporary, and we're working quite well around it as well. 

The Start of Something New

I’m Milly, I’m 28, and I have decided to go ‘back to school’.

This sounds like a bad intro to an AA meeting.

 I first went to university in 2009, when I was 18, and had no idea what I was doing or why- I mainly did it because all through GCSEs and A-Levels it’s kind of drummed into you that university is the next step. In hindsight, I probably wouldn’t have gone, I hated it and ended up working in a bar until 2 years ago. Hindsight is a wonderful thing. Now, I did enjoy being a barmaid, and was going through all different types of management training in preparation to make a career out of it, but I reached a point where I decided it wasn’t for me. I was going through some things and took what I can only call a leap of faith- I quit my job, applied for an Access to Nursing course in the local college, and planned to start that in September. I was lucky that Calum (my boyfriend- am I too old for that phrase?!) actively encouraged me to do it, and was really supportive of the whole idea.

Then, somewhat unexpectedly, we found out we were going to have a baby. I emailed the college, who were great, and they said come and do the course anyway and they’d figure out deadlines and extensions etc once I gave birth. Cue lots of tears and tantrums (from me) during this course, but I passed, and got into University. I actually cried at the interview, because my baby was 6 weeks old at the time and it was the first time I’d left her for more than an hour, and my boobs were leaking haha! So, now you know, even if you cry you can still get accepted. She’s a year old now though, and is in nursery once a week when Calum is in uni (he’s doing an MA in some kind of computer wizardry) and then he looks after her mon-thurs when I’m in uni in the days. I’m really lucky to have him support me through this- not many men would- but he knows that it’s going to be a better future for our whole family.   

So, 3 weeks ago I started the Adult Nursing degree. I know, starting in March is weird, but there are two intakes of nurses a year, and I wasn’t able to start in September because the baby was still only 7 months old and I wasn’t ready to leave her just yet. I’ve actually found it better, as the March cohort is smaller, so lectures aren’t packed and you can actually get to know people. The first few days was mainly an induction, and paperwork, and surprise vaccinations for things like Hep B- and meeting people- which is definitely not as easy as it is when you’re 18 and all bond over drinking games! It been really nice though, all the girls in my group are lovely, it's odd though getting used to being around adults again all day every day. But we’ve finally settled into lectures now, at the start it’s mainly introductions to the topics and modules, lots and lots of law and ethics. 

They have to go through everything in the beginning- literally everything- the nursing code from the NMC, the law, what’s expected of you as a student nurse, safeguarding vulnerable adults and children, what to put and what not to put on social media. Honestly not all of it was completely interesting- and some bits did have me questioning what on earth I was doing there, I’m not going to lie. But then this week we’ve gotten more into things like microbiology, and infection control, and anatomy- and it genuinely is fascinating and I'll expand on it in other posts- so I know I’m on the right track. 

As the weeks go on we’ll find out anyway- first exams are after Easter!