The end of the line?

"I seldom end up where I wanted to go, but I almost always end up where I need to be."

Douglas Adams

Each university is different; some allow re-sits of exams - some do not. Mine does. One resit on each exam, a second attempt before you're off the course - which is lovely! However for me, this was not enough. I recently didn't do well on a resit, and when I say I didn't do well - I mean I did catastrophically badly!
So - now my place on the course rests in the hands of 1 man, and 30 minutes in his company. The exam was a practical, and in those 30 minutes I had to prove to one man that I was (a) competent, (b) safe and (c) had two brain cells to rub together.  I failed on all three counts alas.

What this means for my future in nursing I don't know, this all happened on my most recent placement so while talking to a 3rd year: Nurse D, he pointed out that I'm 2/3 of the way through and I'd be an idiot to give up now - and that to give up now would be to waste the last two years of training. While Sister S on the ward agreed she also said that if you're struggling with your 1st and 2nd year then 3rd year will be no easier - and that to go through all this again would be heart breaking and soul destroying if it led no-where.

So I'm at something of a crossroads - do I stay on the course that makes me happy but that might cost me a lot of money for me to fair? Or do I take alternative option - ditch the course and give up the thing that makes me very happy and chose a path that might cause me a lot less heart ache and I might be very good at ... who knows! Who knows what I'll decide to do - or what the future holds.

I have honestly no idea what to do - but hopefully a trip home for three weeks will clear out my head and help me make the decision!

The sixth sense (or how all nurses are a little bit psychic)

In the world of nursing there is a long accepted "nurses intuition" or sixth sense, which means that even when all the evidence points to the contrary we can often look at a patient and say:

"Now ... I don't like the look of him."

Not in the sense that we think are patients are ugly you understand, but in that once you've seen a fair few sick people everyday for a few years, you start to get a feel for when someone's taking, or about to take, a turn for the worse. They could have perfectly health observations but something about that patient tells you to do an ECG or bleep a doctor or at the least keep a closer eye on them for a while.

Which is great, psychic nurses - excellent!

This becomes a difficulty however, when you realize that a patient looking "a bit iffy" isn't exactly quantifiable, we live with a medical system, and I work within one, which relies on things being quantifiable and score-able. In the NHS we have the EWS or Early Warning Score system, which gives you a score for the patients observations, which ideally is 0 - anything above a three and a doctor must be informed.

If you are curious - an EWS chart!

Which is great, it's a fairly fail safe way of monitoring a patients overall health and spotting a problem quickly. However, it really doesn't account for the sixth sense, in which many nurses, doctors and other health care professionals can look at an outwardly healthy patient and know that there is something up. If you can't justify investigations then the general consensus is that you shouldn't be doing them, which is fair enough - you don't replace your car's battery just for fun, or re-tile your roof just for the sheer hell of it. So why would you do an ultra-sound on a patient with no signs of cardiac problems?

But I worry, surely we're ignoring a vital skill that health care professionals pick up subconsciously, a vital skill bred from long experience and acres of knowledge. We're in danger of forgetting that that patient is a human being, with a very complex body that can do all sorts of crazy stuff to confuse us, and see them as a car - which doesn't need to go to the garage until that red light starts flashing. Tools and charts and scoring systems are good, when used in conjunction with common sense and humanity. But rely on them solely and you will a) loose the heart of the NHS and b) miss out on excellent medics who know something is wrong - but can't do anything about it.

Bad placements and failing (again)

I have mentioned before on a few occasions the "bad placement", that thing that most (if not all) student nurses encounter at one point or another. I was a little cocky and smug about the fact that although I have had placements that I have enjoyed less than others I have never had a really bad placement. However, this semester this all changed:

***

First off, and this part was no-one's fault, I was pitched from pillar to post and back again due to a missing mentor, a secret reshuffle of placements and a bit of miss communication. After all this, a week into my placement I was moved from my nice, if a little dull, placement in a doctors surgery to a team of "district nurses" about 7 and a half miles away.

My somewhat temperamental baby 

So - off I set on my trusty steed to the office where I was told I would meet my mentor a "district nurse" - I arrived 15 minutes late due to a left turning that I made for no apparent reason, to meet my mentor D. I was quickly corrected and told that despite being informed that this was a team of district nurses - I was actually going to be working with a team of health visitors (HVs).

Now, for those of you who don't know (this included me prior to this placement) the HVs are the nurses who take over from the community midwives when your baby is 14 days old, and will continue to monitor the child's health and development up until the age of 4, when school nurses take over. 

I am an only child ... we wont go into my in-depth
knowledge of Balamory.

As an adult nursing student I felt a bit lost, the other student on the placement was a children's nurse and so was at an advantage to me, in that she'd spent 18 months working with children and learning how to interact with parents and children while my involvement with babies and their families was few and far between. I have friends with babies and small children and while I can do playing with Lego, and singing along to Balamory (really showing my age here). My medical knowledge of children and their development ect. is patchy at best. And I felt out of my depth pretty much straight away and I will be the first to admit that I didn't address that as well as I should have done. In fact I dealt with that pretty bloody badly by going a bit quiet and rabbit-in-the-headlights-y. 

The placement was not only completely outside of my comfort zone it was also a total baptism of fire, I like to think of myself a reasonably un-shockable young woman, I am used to people destroying themselves or being destroyed by others but some how in all of this I had completely neglected to consider people who harm children. They are always so pure and un-complicated to me, children, they have the whole of their lives before them and they are filled with possibility - and who could want to hurt that? Now I'm not naive, I'm not unaware that people do hurt children, however I suppose I always thought in my safe, if complicated, family that occasionally bad people hurt children, but it's rare and they are bad people. Black and white, crystal clear and simple.

I was wrong.

Sometimes hurt and destruction is born of love, the mother who can't see she is hurting her child, the abusive father who really does believe that it was all a mistake and will never happen again. And everything in between, from the people who haven't got the capacity to care for their child, no matter how much they love them and would never actively hurt them, to the people who are poor decision makers and believe the lies of the people they love. This struck a chord regarding my own family, and while that isn't something that I'm going to go into right now, this made it very hard to deal with some of the cases I had. 

It taught me that I have a long way to go before I can really be detached and view every patient I see and case that passes through my hands with total detachment and impartiality. And on the flip side is that a good thing? Should we, as health care professionals want to be detached? Or is our humanity part of what makes us good nurses? I have no idea in truth, but I think being truly impartial and un-shockable is probably a good thing.

I hated that placement, I am sorry - but I really did, I felt physically sick most days and lost every single moment. I had a bit of a run in with my mentor D, which again I wont go into for the sake of professionalism but - give me half a bottle of wine and you might just get it out of me. So all in all ... not an overall success.

***

Talking of not succeeding, you may recall (or maybe you have better things to remember) I spoke a long time ago about a three hour exam this semester. 

Which has now been and gone

YAY!

And I've had the results back

So much less yay

I failed, I essentially drowned the patient in saline and then didn't create a good therapeutic relationship with her father which is a massive failure on the whole. But it's OK, it's all cool - I have a re-submission, one last chance to save myself before I'm chucked back into the sea of would be nurses.

So that's just ... bloody brilliant!

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.  

A call to arms to protect the NHS.

There would be no Breaking Bad in the UK .... that may be or may not be good NHS propaganda!

This comes as my first post of 2014 - and I feel like it's important that this is a message that gets out there.

Nye Bevan (1897 - 1960) Labour Health minister 1945 - 1951, MP for Ebbw Vale 1929 - 1960
Clement Attlee (1883 - 1967) Labour Prime Minister 1945 - 1951, MP for Limehouse 1922 - 1950

In 1948 Aneurin Bevan (Health Minister) in Clement Attlee's Labour Government founded the NHS, a fantastic institution. I wont bore you all with my opinions, you can read them here! But suffice to say I am a massive supporter of the NHS, the principle that health care is free at the point of access is brilliant and I can't comprehend anyone who doesn't support that.

Nor do I understand the Tory party's decision to systematically dismantle the NHS, and what I understand even less is our decision as a nation to just sit back and let them!

Now, for those of you who either aren't into politics, or who aren't from the UK and into our politics, here is Nurse P's fun fact file before we kick off!

• All hospital & GP's surgery's  are free to attend and free to get treatments from.
  
  Everything from cancer treatment to antibiotics, from heart attacks to freezing off warts!
•  Eye check ups and glasses are free or subsidised (dependent on the price of the frames usually) for all children, those on benefits, those in full time education and retired individuals.
• Dental care is subsidised by the NHS, you will be charged a one-off fee of either £18, £49 or £214 dependent on the treatment required and regardless of how many appointments it will take to complete the job.
• The Tory party (the right wing Conservative party) are currently in power, on a technicality, in a coalition government with the Lib-Dems (the central Liberal-Democrats) in the 2010 General Election.
  At the time they promised that in all the cut back that they would make they would not touch the NHS and that NHS budgets would be ring-fenced. That has not happened.  

  

  Cameron's election campaign in 2010

• The Tory party are BIG fans of privitising public services!
  
  1979 - British Petrolium (BP)
  1983 - Associated British Ports
  1984 - British Telecom (BT)
  1986 - British Gas
  1989 - Water
  1994 - British Rail
  2013 - Royal Mail
  
  (A brief list - and completely non comprehensive!)
• The NHS is being systematically broken up and sold off to the highest bidder.

Post being (almost) elected - Cameron's election posters were ... improved!

So - that is my simple fact file, and they are all facts. Even the Tories fully admit what they're doing ... well behind closed doors that is! And not only are they trying to break apart our NHS they are doing it with the

help of an orchestrated media campaign. The media oligarchs who run the right wing press in the UK are intent on informing us how shit the NHS is, how we have no-choice but to opt for privatisation if we want a functioning health service.

Case in point here is a selection of headlines collected from the British tabloids. And as you can see, they are pretty determined to make our National Health Service seem as poor as possible so that the inevitable introduction of a pay as go system.

I've said before and I'll say again, the NHS is not perfect, it is full of problems and needs work to keep it alive and working well. However at it's core is a really important principle and it's one that we as a nation need to defend and look after and protect because it's a brilliant thing that we should be proud of.

So this is my call to arms, to protect the NHS - lets not let it go like we've let the others go. Please, lets fight - because we should be furious and angry and we should be on the streets screaming them down and fighting for our right to health care free at the point of access.

A clip from BBC Radio 4's News Quiz

Back in the saddle!

So here we are - a brand new house, with a different set of house mates and a brand new year. Year 2 - which I promise you is totally terrifying! I am now 1/3 of the way through my course - 2 years away from being a qualified which is proper proper scary.

My scared level right now!

Obviously with each continuing year and semester, what the hospital and the uni expect from you becomes more and more, and so I find myself - a year in, and not entirely sure that I'm ready to be a second year. But hey - how do you know how something's going to go until you dive in!

So aside from being petrified about what the future holds what else is happening in Nurse P's life? Well I've discovered that a dangerous thing to say in my house is "Anyone fancy a brew?", a tolerance/love of Coronation street is vital in the house, and I'd forgotten that Cheerios are lush when your drunk!

Just jump in!

This was a piece of advice that I gave to a nurse starting her first placement, on my latest placement I was faced with so many opportunities to try out new skills that I had observed, like making up IV's, catheterising, dressings and passing NG (naso-gastric) tubes. But a lot of these things i.e. the NG tube, will happen occasionally and not on a lot of wards, so if you get the chance to do one - then do it!

A properly placed NG tube on an X-ray

Over my 10 week placement, but the time I reached my 9th week I had seen two NG's being passed, and while on a night shift one needed doing. So - putting on my best confident in this face I asked to do it. It was terrifying, it's easy to put an NG down the trachea instead of the oesophagus for example. (For the record - that is a bad idea!) And obviously, shoving a tube down someone's nose isn't much fun for them, and a lot of people have really strong gag reflexes, some people will try and hit you, scratch you and kick you, but after a point it becomes more important to get the tube down to their stomach to feed them than to avoid being maimed. With the 12 hour shifts and the missed breaks and the poor pay, half the fun of nursing is getting to be a martyr and striding into the house at 8am after a night shift to proclaim: "I got kicked in the stomach tonight but at least Mr Smith isn't going to go into a diabetic coma on my watch!"

Edith Cavell .
A WW1 British nurse, executed for helping Allied soldiers escape occupied Belgium. 

So my tip to the lovely student nurse I met on my (now former) ward, was to just jump in, if you see someone about to do something that you're interested in, then go on and ask if you can watch. I've watched:

• Chest drains, ( I actually became part of Dr Williams' Chest Drain Dream Team!)
• Lumbar punctures,
• PICO dressings,
• A Bronchoalveolar lavage,
• Seen some really funky wounds,
• Passed an NG tube,
• Removed cannulas 
• Watched a load of X-Rays

and many many more things besides. Speaking to the fellow student nurse, she was nervous and was a bit unsure about how to get to do stuff. I tried to reassure her and now I'm trying to reassure you guys too - the way to gain experience is to nag, wheedle and blag your way into watch procedures, because once you've watched once or twice, you can offer to lend a hand for the next few, and after that you can ask to do them yourselves.

Experience breeds Competence

I've now finished that particular 10 week placement, and it's now onwards and upwards, that pesky assignment that I was worried I had failed I passed so I'm clear to move onto the second year! I've moved out of halls (or the prison-cum-psychiatric hospital that my Mam christened it) and into my new shared house which is very exciting, it's going to be fun if a little difficult, we're all very different people with big personalities, different interests, different senses of humour and everything so I'm sure sparks will fly but we're all really close friends and we all love alcohol and bacon so I'm sure that things wont be too bad!

The idea that I'm now a second year student nurse is terrifying, 1/3 of the way through my course, my Mam pointed out that I left high school and started 6th form 3 years ago - and in 3 years time, I'll be a qualified in my blues, hopefully doing everything right (ish)

I'll speak to you all soon, and if any of you are particularly interested then my next post is going to be a "Student nurse haul" blog post, about what you will need for those of you starting your training in September.

Moving on and my addiction

"There is no standing still because time is moving forward."

Greg Lake

It's not something I've ever really considered, when you think of nursing you think how great it is to be helping someone, or how hard it is when there's someone you can't "fix" or the paperwork pisses you off, or the hours get you down. But I never really considered how we as nurses are expected to just move on.

Treat a patient for weeks, months or years - grow close to them and their family and then to lose them and within hours to be treating a totally new patient as if the previous were never there.

I lost a patient over the weekend, I worked Saturday - and Monday. At Monday handover we were told that we had lost her the night before, by the time drugs rounds had started the room was being fogged and by tea time we were admitting a replacement. And that's meant to be fine: we've lost A and in her place is B. You don't think that when you become a nurse - you don't imagine that you're going to be in a position where you just have to switch off and over so quickly, and it's hard - it's so hard, because it's not the kind of thing that we're programmed to do, we're meant to care, we're meant to care and yet we're meant to just move on without being emotional, and that's inhuman and hard.

So on I move, I smile and I welcome chat away - and then when I get home I think: think about how this works, I drink my tea I eat my pasta I watch my tele and I think.

"This is my life, I  can either think; there's one person who I did everything for to make their end more comfortable, I learnt from treating them, and here's a brand new person - who needs my help and who I can transfer all this new knowledge to. Or I can jump - go and leave and take myself  off and become a temp again."

And I've chosen - I'm staying. If you don't move on and fight it out and keep going then you're never going to get anywhere. Nothing worth having comes easily.

I am an addict.

I don't take drugs, I don't drink to excess, I'm not a sex addict - I'm a courgette addict. I mean I've always liked courgettes, but recently someone told me that courgette, prawns and tomatos make a lovely pasta sauce so: off I go and make some very nice pasta sauce with courgette in.
 And BOOM! I'm now on my 3rd week of eating courgette with everything - every single one of my tea's these 3 weeks have consisted of courgette with something - anything - as long as it's courgetty!
Agghh - it's so delicious! I'm going to assume that this is an OK addiction, I mean if you look at alcoholism, heroin addiction, smoking and hardcore courgette addiction and I'm pretty sure that mine'll come out the safest!

Call the midwife: delusional or inspirational?

First off - I love Call the Midwife, I feel I should make that abundantly clear before I start this post! Come Sunday nights I look like this:

And I think you'll agree that that's a pretty sexy look - Well done Beeb, Well done Heidi Thomas-McGann, Well done Call the Midwife - you make me look like that! But some of my lecturers have discussed weather Call the Midwife is a force for good, or for evil ... (Well not quite evil, but you get the gist!) This year, there has been a massive boom of midwifery applicants - because girls have been watching the program and falling in love with the idea of being a midwife. Which is great, I don't think anyone is disagreeing that more people need to get into the field with real conviction and love for the profession.












But, just as anyone who wants to be a nurse after watching Carry On Nurse, is setting themselves up for a crushing disappointment, anyone who thinks that the world of midwifery and nursing is like Call the midwife is asking to be smashed in the face with a bowl of sputum.

Now, I don't think for a moment that anyone at the beeb, Jennifer Worth or Heidi Thomas-McGann were trying to create an advertisement for midwifery, and if people truly believe that the story of four nurses, four nuns, a wheeler dealer handyman, a overworked unloved GP and a police constable working in the tenement building of Poplar 55 years ago is an accurate depiction of life as a modern nurse working in the NHS - then they deserve to be disappointed and are fools! I mean if I stepped towards one of my patients with a spirit lamp they'd run a mile, and if you think that I get to spend my days delivering pig shit by hand to my patients (... you'll have to watch the series) then you'll be sadly disappointed.

However, I think all the people (including the university interviewers, some of whom have a blanket "mention CTM in your personal statement or interview and you're not getting in" policy) would agree that while CTM doesn't reflect the work of being a nurse or midwife, it does reflect the heart behind the work. I love my work, it's heart breaking, it's life affirming, it's terrifying and it's wonderful , but it also involves an awful lot of paperwork, mind-bending calculations and some highly confusing bio-chemistry from time to time. There's a lot of work that isn't nursing but treating the patient.

CTM is a fantatsic show, it's full of love, it's about powerful strong women who help other equally strong women give birth, with grace and heart and a passion for their vocation. And I think that they a fantastic role models, for young girls, young women (like me), older women and everyone in between. It's beautifully written, with sensitivity and real respect for the profession and the lives of the women it features. It weaves together the sometimes hard to deal with lives of the poorest people in London, featuring abortions on the kitchen table, abusive parents, teenage prostitutes and the nightmarish memories of workhouses, with the sweet and sometimes odd lives of the residents of Nonatus house. It also features the sexiest doctor on TV since the lovely Luc Hemingway left Holby City. And not just any Doctor, a doctor who's sexiness caused a nun to leave her calling - we're talking THAT level of sexiness!

The lovely Dr. Luc Hemmingway off Holby City Vs The lovely Dr. Patrick Turner off Call the midwife

There is also some utterly fantastic acting, which I think isn't mentioned nearly enough in reviews, There's the outwardly streetwise blond bombshell Trixie, who is totally devoted to her work and her patients, and not nearly as experienced as she pretends to be. We have the quiet and kind Cynthia, utterly caught up in her work but able to be strong and work with total conviction, the emotionally damaged and polo-neck lover Jane. The protagonist, naive Jenny, off men since a love affair with a married man that she could never have, who starts the 1st series out of her middle class depth.

Aside from that, there's the always brilliant Jenny Agutta playing the stoic Sister Julienne, Judy Parfitt as the fast declining demented Sister Monica Joan, and the young Sister Bernadette played by the frankly stunning Laura Main, who managed to do losing her faith while falling in love wonderfully! (Falling in love with Dr Turner incidentally - and hey, who can blame her!)

I think CTM is one of the best Dramas on tele at the moment, it's well written, well acted and with compelling story lines. It reminds me why I wanted to be a nurse in the first place on the days when I forget, and I think it can show us all how fantastic that, not only doctors, nurses and midwives but the NHS as a whole is. The mothers in the show are getting fantastic care because of the NHS, still then in its infancy, care that 15 years earlier they wouldn't have had, and if people see CTM and realize that - then that can only be a good thing. But - CTM can only be great when it's audience watch it for what it is, the dramatization of one woman's experience working for the NHS 55 years ago, it's wonderful - but it doesn't represent the NHS today, which is a pity, because I would love one of those hats!

It's been too long!

I am very sorry - it really has been to long since I last posted a post!
In recent weeks I have spent a very long time working on an assignment, failed said assignment and am now in the process of sorting out a re-sub, which is dull for me, but would be even more dull for you to read about!

But what else has been happening in Nurse P's little world? I hear you cry, well:

1. We've been allocated our next placements for 3 weeks time,
2. We've been given the dates for our next exam,
3. I've baked some truly fantastic cakes,
   And ...
4.  I have spent a lot of nights watching tele I never got into on my laptop to cope with my failings as a Student nurse!

I'll deal with them one by one!

1. I'm being sent to a Neuro-rehab ward, which I'm really looking forward to, I'll be dealing with everything from strokes to spinal injury which I think'll be really interesting. My last ward, although I loved it, was mainly booking people in and taking obs - so I'm itching to get back out there and learn some personal care skills, as well as really hot up on my clinical skills like injections and drugs rounds - they're really important skills to hone and I think to be second year student nurse you really do need a good grasp of such skills.
2. Three weeks to go - and then I'll be sitting my final exam for my first year! It's a seen exam, which on the one hand is great because it means that I can formulate a strong answer and really prepare, on the other hand, for dyslexics like myself this can present there own challenges.
3. And when I say truly fantastic - I mean astonishingly fabulous and brilliant! I made them for my friend T for her birthday, and when I went round for a glass of wine 2 days later they were gone!! I've attached the recipe, mine were so delicious but a little wonky on top so I chucked on a bit of chocolate fudge butter-cream on top. My own recipe of melted dark chocolate, butter and icing sugar blended and whacked in the fridge to cool for a bit.
   http://www.wilton.com/recipe/Brownie-Cupcakes
4. I've done a whole load of old Dr Who's, from the Tennant and Ecclestone era - I'd forgotten how good they were! And on my flatmate's advice I've taken My Mad Fat Diary out for a spin - and love it! If you haven't had a look yet - find it on 4OD and try it out, it's really good, funny, sweet and very moving at times. However: for those whovians among you - here's my run down on my top 5 favorite Doctor Who episodes!
   
   5. The God Complex (S6E11)
   4. The Unicorn and the Wasp (S4E07)
   3. Utopia (S3E11)
   2. The Idiots Lantern (S2E07)
   1. New Earth (S2E01) OR Boom Town (S1E11)

Hope you guys have have a fantastic time in all the lovely weather we're having finally  And I'll speak to you all soon!

There's a lot of love in a hospital

First off - I'm very sorry for being so bad at posting up until now!

But here I am all the same - I'm still on placement at the moment, and despite the tiredness and finding it hard to be apart from all my family I'm loving it. Which I think can generally be taken as a good sign! Someone, a non nurse, asked me what's the best thing about working in a hospital - which is a hard question, because working in a hospital is such an odd thing.

Being a nurse is hard to describe, but working in a hospital? Much much harder! So what is it like - well - it's lovely, I imagine that it's akin to working in a hotel or airport - you see people, for a moment in their lives. Depending on where you work - it could be their first breath, their last breath, a one off visit, or one of many - but either way you'll see their life in all it's gory details, families under stress, utter joy, heart break - the whole shebang!

But most of all I see a lot of love, when people come to my current ward for surgery - they're stressed and scared - quite understandably - as are their family. And it's in this snap shot that you see raw emotion and true love. When I admit a patient for surgery and see their friend, their parent, child or spouse say goodbye, see them crying or just having a silent hug I know that what they have really is love, it's the tie that bonds and that can't be broken. I'm not naive - I'm not for a moment suggesting that no-couple has ever broken up after going through something like surgery. But that true love that I see then, it may fade it may not, it may even go - or it may stay, but the love in that moment - that love that covers all relationships - and is all consuming - that cannot be broken. It's a little like the opening scene of Love Actually, attached below if you haven't seen that scene!

I often ask people how they met their husband or wife, I think it puts them at ease and makes them forget about being scared of the surgery: so here I have my top 3 favorite answers!

1. "I was playing tennis with an friend in 1936 while I was on holiday in Wales, and this beautiful girl walked past the court, I turned to my friend and said what a pretty girl I had just seen, and he told me that the girl was his sister."
2. "She was a roadie with my rock band in the 70's ... that band was terrible!" 
3. "We were both in the Gilbert and Sullivan society at university, but he didn't notice me, so I joined the ballroom dancing society and spent a long time trying to become his dance partner."

The NHS is never not a little ambiguous

NHS letters - are always confusing, for a start, your surgery may be a day surgery - but may not be performed on a day surgery ward - which is very confusing for the patients. But quite aside from that basic bit of confusion which is easily sorted, there's the slightly worse area of Surgery letter confusion: when can you eat and drink!?

Today, one poor man was sent home because before he left the house he had a swig of orange juice: 3 hours before his surgery. Some might call him silly - but I wouldn't because on his letter (the same letter sent out to all surgical patients) states that you can drink "clear fruit juice" up to 2 hours before surgery. Now, myself, the nurses and even the surgical registrar all thought that orange juice without bits in would be fine, but the consultant anaesthetist said no. According to him "clear fruit juice" refers to squash - which is fine up to 2 hours before surgery along with water, pop, and black tea or black coffee - not actual physical juice.

This isn't the first time this has happened, although usually it's not so much of an issue, if a patient's scheduled for 9am surgery - and at 6:00 they drank some tea then we just put them at the end of the surgical list at 13:00 or later. But this poor gentleman was unfortunently last on the list - and because he came in an hour late for surgery there was zero lee-way for the surgical team. I was sad about that one - he was really nervous and having just got him changed for surgery he was just beginning to relax when he was sent home again.

So here is Nurse P's quick guide to when and what to eat for surgery!

(obviously - don't JUST listen to me, pay attention to your own surgical letter too!)

1. Don't eat on the day of your surgery
2. White tea and White coffee, fresh fruit juice, milk based drinks ect. can be drunk UP TO 6 HOURS BEFORE surgery.
3. Black tea and Black coffee, squash or cordial or water ect, can be drunk UP TO 2 HOURS BEFORE surgery.
4. If you need to take medication, or your surgery is delayed and you ask very nicely then the nurses can try and get you a sip of water if the anaesthetist gives the OK.
5. If all else fails and you feel like your mouth is drier than the Sahara in August then ask just to swill some water around your mouth - we usually don't mind that!

BCG disaster!

Disaster has struck Nurse P – due to an audit on the university I’m not allowed to go on placement without my BCG, I should have been getting at the end of February (not my choice – you’re allocated the appointments by occupational health) and just staying the hell away from any patients with TB in the mean time! But no – it’s all change, I’ve been sent for a blood test to find out if I need a BCG, and then then sometime next week I’ll be jabbed, with a developing scar on my upper arm and be free to go back out into the world and heal the sick. Which is cracking – in the mean time I get to spend 10 days not quite sure where I stand and doing random bits and bobs of work. I have so so so almost finished my assignment, I am going to do the last 500 words before I allow myself to leave the library and go and have a lovely shower and a stir fry for my tea! Bliss!

What’s odd about being back in the North of England is that it really does feel like home now, as much as I miss Wales and being back at home home (I even listen to Welsh radio when I’m working) my little room, my little flat my little city is where I belong right now. I had to cycle 3 miles to get my bike fixed this morning – and then walked back in the cold winter sun to do my essay, it was only after I got back that I realised, that while 3 miles off on my bike to find a repair shop would be nothing back home, suddenly it was nothing here. This city is now so a part of my life that I’m kind of confident in getting around and about!

Anyway – that’s enough of me being philosophical – and hopefully when I next post – I’ll be back in the hospital!

New Year!

Well – a very merry Christmas, and a happy new year to you all!

The apocalypse didn’t come and I was spared being killed by fire and brimstone while on the train through Cwmbran! Not that Cwmbran isn’t lovely – it’s the home of the Wagon Wheel – but I’d rather not die while travelling though it a few days before Christmas! (Can I recommend the song Fresh Prince of Cwmbran – by GLC while I’m here!?)

But – here we are, 2013, and I’m back up North, back in England, back in my little room and back to work – because we did our exam before Christmas I had a stress free fortnight of reading, drinking and watching criminal minds, but back to work with a bump I’ve taken up residence in the nursing school library to use their computers, my laptop has unfortunately gone kaput – and so I’m at the mercy of the slow and clattery computers here instead. But they’ll do! To celebrate our return to the fore, and the fact out student loan has come I hosted a Gin party - for the record, I thoroughly recommend it - although we all had horrible hangovers the next day, we had cocktails with very cheap gin, very cheap vermouth and assorted mixers - the Tom Collins, Gimlet, Old fashioned and Martini were a success! My friend Nurse O's improvised punch ... less so! 

The lethal concoction - only palatable when shotted followed by a lemonade chaser!

I’m slowly working through an assignment on health conditions and their effect on not only the individual but their family and friends too. I’ve chosen HIV as my condition – a bit of a cop-out perhaps, but I find it interesting – the social stigma some feel (note: some not all) as well as the problems encountered with the actual condition is half the battle – physical heath is hard to achieve without mental health to accompany it. It’s not due until April, but with 8 weeks of placement ahead of me and my practice assignment returned to me with “Shockingly shit” written across it (implied – not literally!) – It’s time to get my head down and weep into the keyboard I think!

I’ve often eyed up midwifery from afar – and thought about whether I could do it, and I think I could – I find it really very interesting, not only labour and giving birth, but about how your own health effects that of the unborn child – and how the body is truly amazing in creating life, but that’s true of nursing too I suppose!

If there’s one thing this course has taught me so far – it’s that the body is an amazing thing, that can destroy itself, regenerate itself, heal itself, and create life!

(God I’m being profound – back to the day job of drinking tea and cooking pasta Nurse P!)

finger + blender = ....

Tonight I had an evening of knitting and Mad Men planned, but I made the mistake of popping out to Tescos  for a pint of milk at 8pm, and ended up going to A&E. I walk out of my flat and found my friend T sat with my friend C getting first aid, after T - like an idiot - decided to put his finger in a hand blender and switch it on ... to "see what would happen", he then promptly fainted and hit his head on a cupboard, getting an inch long cut on his scalp, concussion and one hell of a bruise on his cheek.

Since C said he wanted to go to the pub, it was decided that I should accompany T to A&E, because I was a) sober, and b) "it'll be useful for you to see how they do the stitches!". So off I pop, with no book, no phone, no Knitting and no cash to A&E, I got to enjoy T flirting with the two female paramedics, and then a hour and half's wait - a hell of a game of eye spy. But - eventually (and after sitting through 3 rotations of waiting room's full) we were let in to cubicals, I should say at this point that that wasn't a complaint of NHS waiting times in A&E, T was a pillock and in pain, but he was fine in himself, he had minor concussion, but nothing that a good nights sleep and a few days wont cure.

The triage nurse and the doctor were lovely, the both thought that he was a total pillock, and told him so, but equally they both looked after him very well. His head was pretty easy to fix, a wash through with some saline and then he was glued back together. But his finger proved a little bit more problematic, it bled - an awful lot - it took three goes to get the steri-strips to stick down, but in the end, it worked, and we were sent home with a couple of pamphlets and a lot of laughing.

But what struck me was the comeradery and the real care of the staff - yet another moment when I've felt, completely and utterly reassured in my choice of occupation - which is nice among all the moments of being unsure and worried, to have a moment of being so sure!

Surgery

Today, while on the ward I was "spoked" out into theater, I got to watch surgery. It was scary and not something I would want to work in, HOWEVER it was bloody fantastic to see, one operation was the filling away of inflamed cartilage in a patients knees, it was a laparoscopy so in terms of blood guts and gore there wasn't much on offer, and it was very interesting, to see all the bone and cartilage, and fluid and how it all sits together, but - watching a man file away at some cartilage was horrible, however good it is for the patient, it still looked like they were raping her knee. I was demoralised and feeling sad I hadn't enjoyed it, especially since I was looking forward to going in to watch some surgery, but a saviour came in the form of Bob the anaesthetist, who sent me off to Theater C, after the first knee had been completed, theater C had a hemicolectomy, the removal of a portion of the colon. This was far more up my street.

The colon is part of the bowel, and so before surgery the patient must have an enema to "empty the field" it was only after I had left the theatre that I realised that this particular patient had been admitted by me this morning, and I had watched him have his enema - not glamorous or exciting but I did like the circle of life quality of my day! Seeing the guts of this man out on the table was incredible, however many diagrams and photographs of the internal organs one sees, you never realise how much there actually is inside of you, in terms of sheer volume, there is shed loads let me tell you! I'm amazed that it all fits in, it makes you think "OH - that's why I haven't got a flat tummy!" because there is so much inside of you that makes you work, I mean you could fill buckets with the amount of stuff there is going on in there - honestly! I'm quite small a person, and I'm amazed that there's room.

Before the first surgery I helped to put the patient under, I held, the mask in place, and pushed the tube to help her breath once she was anaesthetised into her windpipe. If you want to know what one looks like: it looks like a rubber vagina on the end of a tube ... obviously!

I'm just about to come to the end of my first placement, and it had honestly been a completely fantastic fortnight, I've learnt skills, I've made friends, and I've met so many great patients who I hope are all now well on the way to recovery! I've met the worlds sexyest anaesthetist this side of anywhere, (who doesn't wear a wedding ring, and I've put my colleagues on the task of finding out if he's married haha!) and I've learnt the pain of putting TED stockings on patients, TEDs are the work of the devil and are evil to put on people, (think insanely tight flight socks) but are useful in preventing DVT's.

Oh - and I've become the queen of doing blood sugar testing!

Today is why I became a nurse!

Not a particularly original topic for my blog I grant you, but none the less. Today, the 4 mile round trip on my bike in the pouring rain at 6:00 was all worth while, it's so easy as a student nurse to get bogged down with exams and assignments that fill our lives, it's easy to feel useless and shitty when you have no idea what you're doing - but today a patient almost died, and I helped save his life, not much, I mean I wasn't performing open heart surgery or anything, but I was on hand, and taking obs and when the family were crying and thanked us all as they left, I though - yeah, I did that, that's why I want to be a nurse, to look after people.
I'm no fool - I know that it wont always be so easy, and the outcome wont always be so good. And in all honesty, that patient was seriously ill - us saving them now, isn't going to give them another 20 years. But we did a little something - and sometimes that's all you can ask for!

Being a real nurse for a fortnight!

I've been a little down recently - I don't really feel much like a student nurse at the moment, a prime issue with an academic course for a practical occupation of course is that you spend an awful lot of time studying things and not an awful lot actually doing things.
But on Monday - Monday will see me on my first placement at our local hospital! I'm very excited - I have a uniform (which is very exciting since the mayhem of getting it in the first damn place ) - I have a fob watch - I have a slightly grumpy mentor  and now - surely - maybe - possibly - I'll start to feel more like nurse!

The heart of the matter

Firstly - I apologise for being so rubbish at posting - things have been getting a bit on top of me up here!

I have issues with the nervous system - it, and the endocrine system are very interesting don't get me wrong - and when they go wrong they really do go wrong. And they do they go seriously wrong - so clearly to learn about them is important ... however - they are an enigma, a mystery and one hell off a confusing thing.

The heart I love, the heart is a mechanical thing, it's a pump, it's fantastically simple and a truly beautiful thing - hell I can even draw a picture of it!! (You'd never guess that I got a B at GCSE art would you!?)

But the nervous system is a whole other kettle of fish! It's a complex system of electrical impulses running through your body - it's fallible and brilliant but so so so very confusing, tied in with the endocrine system - a crazy ass mixture of hormones that are all reliant on one another and interconnected in a way that to me is just double Dutch!  But hopefully - in time, it'll all come clear in the end ... I hope!