Transition from student to nurse

Last week I completed my university module concerning preparation for role transition – from student to becoming a nurse.  It culminated with my delivery of a 20 minute power point presentation, which reflected on my learning journey – where I was at the beginning, where I am now and where I need to get to.  There were certain criteria which had to be met, and hereby follows an outline of the main material that I covered.

Choosing and using a reflective framework was the key requirement, and the one that I used was Gibbs (1988).  I like the way that the headings prompt and guide the reflective process, and I particularly like the Action Plan stage, because past learning is used to inform future learning too.

reflective cycle

I used Gibbs Reflective Cycle to frame all of my presentation, and directly used the headings and order as illustrated above, e.g. description, feelings, evaluation, and so forth.

Another key requirement was to carry out self-assessments in order to determine my learning needs.  I used the Honey and Mumford Learning Styles Questionnaire (1992) (- reflector, theorist, activist and pragmatist), the VARK 80 item questionnaire (visual, auditory, reading and writing, kinaesthetic), a Key Skills (2003) assessment and the NMC (2010) Standards for Pre-registration Nursing.

SWOT

The results of all these self-assessments were collated into a SWOT analysis – strengths, weaknesses, opportunities and threats.  The weaknesses were then used to create SMART goals – specific, measurable, achievable, relevant and time-bound, and propositions of how these goals would be achieved.

SMART

Besides these basic requirements, a discussion of role transition was also included.  The work of Duchser (2012) was used to illustrate the three stages of role transition within the first year of becoming a nurse; with transition shock taking place in the first 3-4 months of becoming a nurse, followed by a middle stage of lots of new learning and knowledge acquisition, then a final few months of finding stability and settling down.

The presentation was a personal challenge, because I am not a natural public speaker.  I enjoyed putting the slides together however, and I practised presenting them a few times each day for a couple of weeks before the actual day.  I am glad that I had the courage to approach the challenge, but am now looking forward to commencing my next piece of assessed work – a 6,000 word report on evidence based practice, which is something that I am more familiar and comfortable with.

References

Chartered Institute of Personnel and Development. (2015). SWOT analysis factsheet. Retrieved 17 May, 2015, from http://www.cipd.co.uk/hr-resources/factsheets/swot-analysis.aspx

Department for Education and Skills. (2003). Skills Strategy White Paper- 21st Century Skills: realising our potential. Cm 5810 The Stationery Office.

Duchser, J. B. (2012). From Surviving To Thriving: Navigating the First Year of Professional Nursing Practice (2nd ed.). Canada: Nursing the Future.

Gibbs, G. (1998). Learning by Doing: A Guide to Teaching and Learning. London: FEU.

Honey, P., & Mumford, A. (1992). The manual of learning styles (3rd ed.). Maidenhead: Peter Honey.

Nursing and Midwifery Council. (2010). Standards for Pre-registration Nursing Education. Retrieved from http://www.nmc.org.uk/standards/additional-standards/standards-for-pre-registration-nursing-education/

VARK Questionnaire Version 7.1 Retrieved 17 May, 2015, from http://vark-learn.com/the-vark-questionnaire/

Hospital Visit

a & e

I was recently unfortunate enough to suffer a minor trauma to my right (and dominant) hand. The incident resulted in a visit to a nearby Accident and Emergency, who after cleaning and bandaging my wound and administering some painkillers, sent me on to a specialist hospital in a neighbouring county.

Upon visiting the specialist hospital, I was expecting to receive some speedy wound stitching within the clinic, and then an immediate discharge back to my home. I was somewhat surprised therefore when the doctor advised that I would require a small operation under local anaesthetic. The procedure was carried out in the theatre within the hour, and then I was back on the ward to be admitted overnight.

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The reason for my overnight stay was due to my need for IV antibiotics over the next 24 hours. The cannula was skilfully inserted into my uninjured left hand, and then a drip with antibiotics was attached onto the cannula every 8 hours. My injured hand was securely bandaged and had to be kept dry, so it was therefore fairly difficult to carry out simple things like eating and drinking, dressing and using the bathroom.

I was admitted to a very comfortable side bedroom with an en-suite bathroom. Post-surgery, I was promptly brought a cup of tea and some digestive biscuits, and was also asked to choose a meal for lunch and for the evening. There was a television to watch if I wanted, but, being a bookworm, I enquired whether there were any paperback books upon the ward. Not realising that I was having to stay overnight, I had arrived without a book. For me not to have a book is highly unusual, as I cannot possibly stand a day without some form of reading. A lovely health care assistant promptly found me three different titles, and I happily passed the time indulged in a gripping crime novel.

The same wonderful health care assistant found me a clean nightdress, toothbrush, toothpaste, comb, soap and bath-towel. Being an unexpected admission, I had left home totally unprepared.

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The nurses were also really lovely, chatty and helpful. I even met a fellow student nurse, who, unlike myself, was training to be a general nurse. The student nurse was really pleasant and carried out my admission assessment, cleaned my wound and gave me a tetanus injection. It was great to chat about placement experiences and our hopes for the future. The student was training at a different university to mine, but our courses sounded fairly similar in the common foundation element, and we therefore had lots to talk about. Furthermore, the student was a mature student like myself, and it turned out that we were the same age.

Hospital food often receives many negative comments, but the meals that I had as a patient were very acceptable, satisfying and tasty. There was plenty of choice on an illustrated printed menu, and I was also relieved to find that there was a genuine vegetarian section. When I say genuine, I refer to the fact that many people erroneously think that vegetarians eat fish! This is completely wrong, and in fact refers to a pescetarian diet. I personally am a ‘real’ vegetarian, and definitely do not eat fish or any animal by-products. It was therefore reassuring to find that the hospital were aware of this difference, and catered very well for me with at least 10 different meals.

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My stay was a comfortable one, with a constant stream of hot drinks, plenty to eat, and a good book to read. I struggled to shower with my one hand, but since coming home, have perfected a one-handed bath.

It was frustrating to temporarily lose my ability to drive a car, and I have had to rely on trains in order to get to university. Waiting around for trains is a negative, but, on the positive side, it was good to utilise the travel time for some valuable reading time. It was also interesting to view the journey from a different perspective, through both town and country.

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I am unfortunately temporarily unable to work in my part-time job as a carer, but should hopefully get a clean bill of health soon. Washing people in showers and moving people in hoists is naturally quite impossible with one hand out of action!

It has been an interesting experience to view a hospital from the perspective of a patient, and I really felt that I should share what a positive experience it was. The hospital was clean and comfortable, the staff were friendly, hardworking and efficient, and I was very well looked after for the whole of my stay.

I am due to visit for a check up on Friday, and hopefully will be able to get rid of my dressing. Well done National Health Service for a great level of provision! It makes me very proud to be a student nurse.

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Fifth placement over and exam complete!

Last Friday I officially completed my fifth placement out of an eventual nine – so there are just four more to go before I qualify as a nurse. Yesterday I also sat the Year Two Semester Two exam on physiology, pathophysiology and assessment, which was three hours in length. All the hard work is hopefully starting to pay off, and the distant end of March 2016 is gradually getting nearer, and is less than half-way now.

My fifth placement with the Crisis Team (now called the Home Based Treatment Team) was exceptionally good, and I feel that I learned plenty. My prime objective was to complete a full patient assessment and all the associated paperwork – face-to-face client contact, initial assessment documentation, risk assessment and care plan. Fortunately this placement provided plenty of opportunities to practise these skills, and I had the benefit of working alongside a very experienced team, who demonstrated some very skilled interactions and interventions with clients.

It was good to support patients within their home environment, and to help prevent them from deteriorating and having to go into hospital. Naturally, this was not always possible, but on the opposite side of this process, we would often support patients upon arriving back home after being discharged from hospital. When improvement and stability was gradually achieved, it was then also possible to transfer the care of our patients back to the Community Mental Health Team.

fingerprints

Alongside the placement I was able to complete four ‘spoke’ days, in order to gain extra experiences. Two days were spent with the RAID (Rapid Assessment Interface and Discharge) teams at two separate A & E departments, one day was spent at an inpatient psychiatric hospital, and another was spent with a Community Mental Health Nurse. During the latter, I was fortunate enough to experience a visit to a closed high security prison, and upon entering, was subjected to a body search and scan, the taking of my index finger prints and the removal of my shoes. It was amazing to go inside the old Victorian prison and onto the wing. If anyone can recall the old prison comedy drama called Porridge; well that is exactly what it was like inside.

prison

Other notable placement experiences included: talking to a suicidal patient over the phone, and being able to calm them down enough for me to call for an ambulance; making an adult safeguard referral; and taking part in a home visit involving an interpreter. It was a rich and rewarding placement experience with a wonderful team to assist me in my learning; I was very fortunate.

I had been building up to yesterday’s exam for the whole of my placement, and initially I was concerned that I would forget much of my university lecture content whilst working in the community, but fortunately this was not the case. The main medical conditions that we focused on were diabetes, heavy alcohol consumption, osteoarthritis, and stress, anxiety and depression. During placement I was able to meet real-life patients with all of these conditions, and I found that I was able to talk with them and advise them directly, with confidence, about many aspects of their condition. Much of my recent learning became relevant with clear practical application and knowledge based in reality. Accompanied with some evening and weekend revision, I felt well prepared for yesterday’s event.

exam room

Like all exams that I take, I wrote non-stop for the whole duration of three hours. Historically, I never finish exams early, and usually have to rush with the final question; and yesterday was no exception. Fortunately I was able to sleep well the night before, and did not let nerves affect me too much. I was panicking a little about remembering quotations and evidence sources to back up my knowledge, but most of them proved to be lodged in my brain and were utilised on the day. I do not yet know when the results are due to be released, but I am guessing that it might be in a couple of months’ time. Fingers and toes crossed – how will I bear the suspense? I will be very scared on the day that the marks are released.

mental capacity act       mental health code      mental health act manual

Hungry for yet more learning, I am now looking forward to starting the final semester of Year 2. The module is called Nursing Practice and Decision Making, and I am already acquiring some of the texts ready for some preparatory reading. There is still a small part of Semester Two remaining, and I am particularly looking forward to some specific learning regarding dementia; as this is a topic that is personally very close to my heart. Additional to my university learning, I have also secured myself a day on an Advanced Dementia student seminar next month, which I am greatly looking forward to. I have also just become a Dementia Friend too.

dementia friends