The truth of being a student nurse!

Night shift = 4am coffee and
biscuits

Nurse P - pretending to be
patient for simulation!

The truth of being a student nurse is a complex thing, this isn't meant to scare any prospective nurses out there, however I think that it's important to know what the reality is before you get stuck in.
For those of you not in the know, I'll do a quick heads up of what's what!

• In the UK, to train as a nurse you must be 18 years old (or 17 1/2 in Scotland)
• You must do a 3 year degree course through a University, either a BSc or a BN
• All Nursing and Midwifery courses (as well as a host of others) are funded by the NHS
• You must have completed either 6 months full time or 12 months part time working as an HCA or a support worker before you start the course
• The course will be 50% theory and 50% practice
• Although you are not qualified you must still adhere to the NMC Code
• CRB checks will be carried out on all applicants
• Although you cannot be held accountable for your actions in practice, you can still be taken off the course if you are found to be of "poor character" 

So there we are! I'm going to address these - and more stuff besides - in as much of an order as I can!

Because you are doing what is essentially an academic course at a university (a list of universities offering Nursing can be found here.) you do need to be prepared for the work you will be required to do, this means academic essays, exams, practical exams ect. This is not a reason to be deterred, but it is something to be aware of, the world or nursing and the work we are expected to do is very different from a) what we traditionally did, and b) what the media often portray that we do.

A number of health care courses are NHS funded, including; chiropodist, dietitian, occupational therapist, orthoptist, physio, prosthetist (these guys are awesome - they make legs!), orthotist, radiographer, audiologist, speech and language therapist, dental hygienist, dental therapist, nurses and midwives. At the moment social work is also funded but there are rumors that that may change. However, the lure of what is essentially a free degree shouldn't be too tempting, because you are tax payer funded they make you work for your money, while I can't speak for every university - mine makes us sign in for every lecture and if you don't attend - you will be asked to leave. 

Jeremy Hunt - Health secretary

Last year Jeremy Hunt, Tory health secretary (former culture secretary - which led to an unfortunate spoonerism on BBC radio 4's Today Program) decided that nurses were "too posh to wash", which is utter bollocks first off - but secondly and more importantly means that all nursing students much now have completed the requisite number of hours as an HCA or a support worker before they can do their nursing. I happen to think that this is entirely stupid for a few reasons; I have never met a nurse who can't be bothered to wash a patient - but I have met many who can't because due to red-tape and staff shortages haven't got time to help the HCAs and support workers to do washes, also being a student nurse is a massive financial burden for 3 years, you are living on £6000 or less a year (dependent on household income) and the only way many people can afford to do it (including myself) was to work every shift going for a few years before starting, being a support worker for a year or 6 months is not enough to pay the bills and save up for training.

Lectures - YAY! Now I love uni, but we get a lot of lectures on very complicated stuff. There's a look of despair and terror that you see in everyone's faces after we've left a 3 hour lecture on neuropathic pain, like shell shocked war veterans we sit about eating our butties and drinking our coffee and wonder what in the name of christ we're all doing here. As well as all that jazz, there's also simulation sessions - some are a riot, like learning to put a patient on a bed pan (my friends turned me ... and then rolled me off the edge of the bed and laughed!), some are interesting, like learning how to do CPR, and some are just bizarre - like the simulation day I spent dressed as a patient while being treated by other students. As well as all this you'll be going on placement, for each placement there is a whole host of documentation to be signed off and photocopied and woe-betide the student who forgets the last crucial signature! So far I've had:
 - Surgical

 - Neuro-rehab
 - A&E
 - District nursing (coming soon) 

so hypothetically you should get a good variety! As part of being on practice you must experience the 

"24 hour cycle of care" - which is just a fancy way of saying NIGHT SHIFTS basically! Night shifts are fine, if you're on a ward where there is stuff going on at night - if you find yourself on a ward where everyone is essentially quite well, eg. orthopedic surgery then it will be dull as ditch water - which is where 4am coffee comes in. My favorite thing about going on night is that you get to watch everyone else in traffic - off to work, and go home to your bed. When you're on nights - you will always avoid the traffic!

The NMC Code - you will know it back to front, inside and out soon enough, it will guide and terrify you in equal measure ... OK, perhaps I'm exaggerating a little! The Code is essentially the bible written by the Nursing and Midwifery council, it out lines what is expected of you as a nurse, the standards that you must maintain and to break the Code is genuinely a serious matter. By going on the NMC register (which is much like the GMC register for doctors) you are promising to abide by the code - and to follow it's rules:

• Make the care of people your first concern, treating them as individuals and respecting their dignity
• Work with others to protect and promote the health and well being of others in your care, their families and the community.
• provide a high standard of practice and care at all times.
• Be open and honest, act with integrity and uphold the reputation of your profession.

CRB checks are very unexciting to be honest, but necessary. When you apply for the course you will be asked to declare any criminal records that you have, which is then checked with a CRB when you begin. They always say that they assess everyone on a case by case basis, so don't feel like you have to lie to get in. Far better than to have a chance to explain yourself than be thrown off the course before you've even begun for lying on your CRB declaration. As I said, they're assessed a case by case basis, so if robbed a car radio 15 years ago then your probably OK, but if you glassed a bloke in the face last Wednesday then there may be some issues!

So I guess that's your lot - I hope it's been informative for anyone thinking about starting their nursing, it's a big leap, and a lot of work - but as far as I'm concerned, 100% worth it!

A&E - or - how I was saved by organised chaos

For those of you from over seas - A&E is Accident and Emergency in the UK, and what is probably better known as an Emergency Room in America ect. Before Christmas (yes - this is overdue) I had a month on A&E as my placement, which was brilliant - I absolutely loved it!

I am one of those people who believe that it isn't a crisis until it can't be fixed by WD40 and gaffa tape! So I feel that A&E is perfect for me, it's all about "sorting stuff out", a patient comes in and we "sort them out" before they are either sent home or moved on to somewhere else in the hospital, we have 4 hours to patch them up, get them in a safe position and then we ship them on.

I learnt so much, there are moments when I feel helpless and hopeless and A&E just made me feel so hopeful and helpful! I was making a difference to people's lives at the moment when they need the most help in the world, either though grief, or through pain or suffering, through sickness and injury we are there, we will sort things out. Or that's the idea anyway!

In my time as a student nurse, I've seen patients die and although sad, in my case it was patients who were, not to put it crudely, dying already, the end was inevitable and expected. However on A&E I had my first experience of unexpected death, and unexpected sickness.

"We've all had days like that, haven't we? You make one small mistake, and because of that you make a bigger one. You leave your wallet by the bed. Then you go up to get it. You trip over the rug, you break your leg. Next thing you know, you're in hospital with a fatal infection. Just because you forgot your wallet."
Waking the Dead: Subterraneans  

I encountered many things in A&E, from the bizarre toilet brush in an uncomfortable place, to the common place accidents that taught me that no-one should be allowed to open a packing case before midday, from the un-eventful vomiting bugs, to the terrifying and family destroying diseases coming to a head. I learnt quickly that things happen every day that we can't predict, we make millions of decisions every day that effect us in a variety of ways, short term and long term.

"Life is fragile.
We're not guaranteed a tomorrow so give it everything you've got."

We can predict no-thing and we can't just let life pass up by, assuming that there's always tomorrow, because as I stood there doing chest compressions on a woman who had had a heart attack, I know that her husband hadn't woken up that morning imaging that he had only hours left with her, I know that when he had slept next to her the night before he hadn't know that it was the last time he would do so. In the same vein the woman who fell of a trapeze didn't imagine when she woke up that morning that she would spend that evening in surgery, and the woman who saw her son off to work after breakfast, didn't  imagine that by 9pm that evening she would be agreeing that his ventilator could be switched off.

Life has a way of throwing up the most unexpected hurdles, and just like any other hurdle we can either jump over them and continue onto the next hurdle, or they floor us and there is no recovery.

The perfect relationship? The perfect home? The perfect job?

And all this, all of it - it saved me, while on placement you're constantly looking for the thing, the department that inspires you and that you know you want to work in. 99% of us are always looking for that perfect something, the perfect relationship, the perfect home or the perfect job - and for student nurses it is exactly the same. Every placement we are assessing whether this is something we'd want to do when we're qualified, sometimes we have an enjoyable placement, but we couldn't do it for the next 40 odd years, sometimes we have a god awful placement, and sometimes we have a brilliant placement and we know - 100% that this is what we want to do. And that's how I felt on A&E, I felt completely reassured and confident in my choice to be a nurse, I was doing enjoyable jobs; dressings, IV's, neuro obs, ECG's ect - there was no routine and I loved that! No knowing what was coming through the doors, and I loved the unknown, the surprise, and the fact that I was making a minute by minute difference.

Now I don't want you to think that I only enjoyed A&E for some kind of adrenaline kick, I don't at all, the un-known is scary. But whereas on a ward I found it all too easy to feel lost and useless and bored in the endless shifts of drugs rounds, ward rounds and 6 hourly obs, in A&E there is no routine, you can be doing 15 min obs on a patient in cubical 1, while running through an IV on someone in 2, while awaiting bloods on someone in 3, everything is happening and you can see a patient improve or deteriorate under your care and nursing very quickly, and you have to be able to react to that in an instant.

Just to clarify, I am not knocking nurses who work on wards, they are brilliant - they are putting in the time to slowly build a patient back up to health! We are all superstars, it's just that some of us are superstars who like the slow and steady, and some of us are superstars who like the fast and furious.