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!

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!

You know you're a student nurse when ... (Top 5)

Today, in a pub half an hour away, while eating a large quantity of cake, I engaged the help of four fellow nurses to help me construct a post for my blog.

A few spectacular cakes (for a few spectacular nurses)

YOU KNOW YOU'RE A STUDENT NURSE WHEN ...

by: Nurse P, Nurse C, Nurse L, Nurse B, Nurse T and Nurse O.

• You can discuss all manner of gore and bodily functions while eating your tea ... and you will
  
  
• Friday nights are no longer alcohol fueled and full of wild and sweaty dancing - it is now all about brews and Eastenders
• But when you do drink - Jesus Christ do you make up for it! 

I'm not sure any of us know what we were celebrating ...
 but presumably we were celebrating something! 

• You are the worst hypochondriac thanks to your best friend Google - but you're really lassie fair about your health
• Sod Dr Chris on GMTV - you are now your families sole source of medical knowledge and will be called upon for all their aches and pains

This kind of thing only happens in films ...

You know that perfect scene in the film? 

The one where the boy finally declares his love for the girl ...

I actually love Andrew Lincon a little

Or the friend in the cafe gives the protagonist the perfect pep talk ...

The film that makes me grateful
for every decision I've ever been
allowed to make!

And the hero makes the right decision and someone is saved ...

"Oh you're Celtic? ... There's lovely"

All of these are cracking plot devices, don't get me wrong I love a good love declaration/pep talk/happy ending, but they're hardly realistic. Life happens bit by bit and very few of us will ever have our faith realigned in a perfect pep talk, or unburden ourselves in the snow on christmas eve to our dream partner, or ever have the chance to save an entire family and change history.

However, I did indeed have one of these strange only-happens-in-a-film moments recently:

I was sat on a train, on a spur of the moment trip home after a few hellish days, straight off a night shift still in uniform sat quietly with a book and bottle of squash. I had been giving myself a bit of a hard time and thinking about dropping out of the course a bit, mainly because I kind of lost faith in myself and started doubting my own knowledge to the point where I was making mistakes because I was second guessing myself. Anyway, feeling a bit shitty and wandering what the point was I was considering dropping out and was content with sloping off home to work my way through an assignment and then I met this woman, who was sat opposite me and who spotted my uniform, that was unsuccessfully hidden under my cardigan. And she changed everything.

She was a midwife, who had qualified two years ago at my own university, and the hour or so we sat and talked convinced me that I am absolutely on the right path, with a mixture of anecdotes which remind me of the good times, and her own stories of training which reminded me that the second year is a long hard slog that no-one enjoys and only the ones who can persevere through it are meant to get through it.

A strange moment of pure co-incidence, where a total stranger who I just happened to sit opposite helped me out and at just the right time when I was at my lowest eb where I needed to be and which was the right path (or track - geddit!) for me.

I shall finish by saying - trains are awesome, I love trains. I've met cool, lovely, funny and just plain odd people travelling around the place, always talk to people on trains because how many other times in life are you going to spend a few hours sat with a group of total strangers, unable to leave and all in exactly the same position?

Student nursing 101: how to change your body clock!

Now, you may well be one of those people who can just flip a switch, set their alarm for 5:30am and just get up and be ready no - problem. Well, for the rest of us it takes a little more work, so here are Nurse P's top tried and tested methods for switching your body clock!

The "slow and steady" method

Set your alarm clock a little bit earlier every day over the weekend to get yourself sorted.
eg:

Saturday - 7:30am
Sunday   - 6:30am
Monday  - 5:30am

Great for: those who love to slowly acclimatize and love early mornings
Bad for    : those who like a lie-in or have any intentions of getting drunk on Friday or Saturday night.

The "make your self tired" method

Exhaust yourself the day before placement; run everywhere, cycle a full load of shopping back from Asda, take the kids out for a three hour trek around the park, make a souffle, have loads of sex, swim 10 miles and then do a load of ironing. And then chill out in bed with a cup of herbal tea and a good book.

Great for: those who have a million and one thing to do and have the energy to do them all in one day.
Bad for   : those who are always organised in advance or who like Sunday afternoon tele with a glass of wine.

The "Don't stop 'till you drop" method

Have a massive lie in on the Saturday, and then work straight through the night until the next evening, not going to sleep until around 7 or 8pm on the Sunday - so you wake up refreshed and sorted on the Monday!

Great for: Night owls who like to work until dawn on assignments, and then keep going all the next day.
Bad for   : Anyone with important stuff to do on Sunday, you will not be up to operating heavy machinery! Or anyone who may well take a nap.

2nd year blues

All through the first year of my course you will find hoards of people (by which I mean every-one) who are either newly qualified or third years who say a variation on the following:

"The second year's the hardest, you will cry and breakdown and want to drop out. the second year will be the ...

WORST YEAR OF YOUR LIFE!"

So - is it true?

Uhhhh ...

Ummm ... 

Well ... 

OK ... yes!

Where I am in my head!

 I give up - I can try and pretend that they're all liars, but they're not. These two months back at uni have been really bad, I've felt lost, scared, snowed under, like dropping out, like jacking it all in to work in a bar in Australia! People say that whatever your course the 'Second year blues' is fairly common, you've lost the energy of year 1, and the scary exciting almost finished feeling of year 3 is yet to come. So am I alone? 

I have friends who've thought about dropping out recently, because the work load suddenly goes from 0-60 in precisely no time, and for some reason everyone seems to be doing far better than you. The work load is insane, not because it's massively hard (although ...) but because nursing courses are full of little tiny bitty things that need filling out and completed, which is confusing and infuriating and crazy.

Oh and there's a three hour exam too .... yeah!

Three hours ... WTF!?

The makings of a good nurse: practical or theoretical!

Textbook good nurse:
Florence Nightingale 

What does make a good nurse? 

Answers on a postcard please. Because, really, truly, I don't know! You see the problem is, what is on paper as a good nurse  doesn't always translate into a good nurse in practice.

The nursing courses today are all degree courses, which is fantastic in empowering nurses and giving us a broad skill set that means we can work as skilled, well trained healthcare professionals. However, it also makes the occupation much more, exclusive. Suddenly people who would make awesome nurses, who could more than cope with the drugs calculations, the dressings, the comforting patients and the long hours, but can't write an essay to save their life, or reference an article for that matter. Does that make them a bad nurse? Or unsuitable for the occupation?

Not in my opinion, but then again I'm biased. I am terrible at essays, I love my lectures, love my placements and without sounding like a smug idiot - I think I'm a damn good nurse. Obviously I'm a second year nurse - I've got a long way to go, but I feel that I do do a good job when I'm on duty. I make sacrifices for the work and I love it (not making sacrifices, I mean the job!) but arguably I may never make it to being staff nurse because I really struggle with my written work.

Is it fair? Is it right? And is it the best way of selecting the best nurses in the country - especially when I for one know student nurses who are piss-poor at placement and awesome at exams and therefor are going along like super-stars ... when actually they might not make the best nurses.

Just to show that I'm not an embittered old harpy - I also have some lush friends who are brilliant on placement and brilliant at their assessments and will make brilliant nurses!