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!

Nurse P's top 10 tips of being a nursing student!

So, it's occurred to me that the majority of you reading that will either be prospective student nurses or current nurses. So I thought I ought to do some kind of top 10 run down of tips since I'm almost at the end of my first year.

10 
There are no stupid questions.

This one's not just for nursing, pretty much anyone can benefit from this one. But in nursing, for that is what I know,  it is particularly important. Firstly in lectures, you're going to learn a lot of stuff ... or rather you're going to be told a lot of stuff that you're going to be expected to remember, and asking questions - helping you to understand the wider picture of the patient, the condition and the body. And when you're on placement ask questions, I don't mean be pestering and pulling on your mentors sleeves, but ask what condition a patient has then you can research it, ask the physio what it is they're doing, ask where things are because there will come the day when a doctor grabs you at the nurses station and says "Can you bring three blue cannulas to side room 8 please?" and you're going to have to fetch some and know where they are. Same goes for asking how something works, when your mentor asks you to set a litre of water to run through it helps if you're not staring at the machine like this!

9
It might feel like it's all hopeless - but it's better than you think.

Oh my God, it's not going in and, I'm going to be shit at this and OH MY GOD I DON'T UNDERSTAND! I'm prepared to put good money on every-one of you reading this will either have thought that at one point in the course or will do at one point or another. Yeah - we all have, I have, I will again, it's going to happen - live with it! Try not to feel as if it's all entirely hopeless, things, in my experience, tend to come together in time. Sometimes that thing that seemed like double Dutch to you in that lecture, suddenly makes sense once you attend the relevant seminar, or once you have another lecture a fortnight later that pieces the pieces together or even once you're on placement and you see that thing that makes no sense to you, in the flesh and suddenly you get it!
And there is no better feeling than something going wrong on the ward and going onto automatic pilot and knowing exactly what to do and sorting it. And I found that I knew exactly what to do once, just because the stuff that had been taught in lectures has seeped in and stuck without me even knowing and I was very proud of myself.

8. 
Buy a stethoscope. 

They are like gold dust, if you get asked to do the obs on your bay, and you can't find a stethoscope - you're screwed, so buy one and make it bright! Because when someone tries to steal it and spends the rest of your shift wandering around with it around their neck, it helps if you can spot it. I recommend Littmann stethoscopes - they are ace, genuinely the best ones you can buy, not cheap but like wine and shoes good things rarely are!

7.
Be positive.

Yeah a confused patient just tried to hit you as you were wiping their bum, yeah you're 10 hours into a 12 hour shift, yeah you're tired and hot and your feet hurt. But try to be positive, some days are going to be shit and some are going to be amazing, some will make you want to cry and some will make you want to sing with joy. But no-one, especially not the patients are going to benefit from you hating everything. Off load onto other student nurses when you get home, with a glass of wine and last nights Corrie, but the time when you're at work is the time to extenuate the positives. You might forget about that patients you looked after for 3 days 2 years ago, but chances are they wont forget you, and the aim of the game is for them to remember you as that cracking nurse who was really helpful and supportive, as opposed to that miserable bitch who walked around with a face like a slapped arse. Take your break alone, outside and let your armour fall with a cup of tea, a packet of crisps or a cigarette (whichever floats your boat - or all three!) and recover if needs be, but your patients need you to be strong, so try to be.

6.
You're not a normal student - so don't try to be.

You're at a uni - with many students attending it, and chances are you will bump into them, live with them, end up being filmed by them for course work, have sex with them or maybe even marry them! But the time will come when you realise that you're not like them,  they're different! Because all those stereotypes about binge drinking during the week, lie-ins and missing lectures are possible for them.

• Nurses have long years, a normal student will usually finish in or before June, and return late September or October. A nursing student will finish in the middle of August and start back at the beginning of September. And forget a 4-6 week Christmas and Easter, it's two weeks for us.

• Whereas a normal student will often have a 2 or 3 day week, a nursing student will have a 4-5 day working week in lectures, not to mention those pesky periods on placement with 5:30 starts.

• Due to some very specific training from the NMC guidelines, you can't really miss lectures, you'll have to sign a register and if you don't turn up then it's bye bye! 

I'm not saying that being a nurse is dull, or boring or anything even vaguely like that, I mean what other course means you spend your lunchtime laughing about catheters!? But if your flatmates are going out on the lash on a Tuesday night while you have 9am lectures the next morning, suck it up, swig some Horlicks and settle down to watch tele. You can still go out an have fun, trust me - I've drunk enough to feel a bull on occasion, but just remember that while you're both here to get degrees yours is a professional qualification and as a result you get to have a lot less mid-week fun. On the plus side you will quickly become the human equivalent of Eastenders Wiki page!

5.
Stop trying to look sexy - it's not going to work!

This isn't a vendetta against fake eyelashes or anything don't worry, I love my falsies for a night out! But in your uniform, when on placement,

don't think you're going to look like her, because you wont, I mean for a start the tunics make you look like a Moomin, the trousers make you like like your applying for a Simon Cowell look-a-like competition and those shoes ... well, if I say lesbian police-woman then you get the idea! But you know what, that ugly tunic and those trousers that come up weirdly high are actually really comfy, don't flash your arse when you bend over a patient and are loose enough so that you can bend and stretch. (The also have massive pockets that are great for stashing stuff in!) Those shoes are ugly as hell and as comfy and supportive as though you were standing on cherubs covered in silk wrapped feathers. It's the girls who come in with freshly curled hair, eyelashes that could knock out Joe Calzaghe they've got so much mascara on who start to slide down the warm sweaty slope first, you might not look sexy - but if you look no wors 12 hours after you started the shift than you did than when you started - then go and give yourself a pat on the back!

4.
Don't fall at the first hurdle.

What's this? You've failed an exam? Well - I'd give up now if I were you.

Yeah - not really - don't fall at the first hurdle, we all fail exams and think "OK, so this isn't for me, I'm off home." have a good cry, drink a lot of wine or eat a lot of cake, shout, rage, dance on your own with your ipod in but don't give up. Or at least not because you've failed an exam, if you come to realise that the course  and the occupation isn't for you then maybe you should re-think your options. But we all fail at least once and it's hard and soul crushing and we all wonder about dropping out. But remember why you started all this,   if you fail more than once and have to take a year out then that might be the time to consider your options, but until then - don't start to apply for the temp work just yet eh.
(For the record this also applies to placements, you might get a shit one where the nurses hate you, the patients hate you and you just want to curl up into a ball and weep, but for each shit one you're pretty much guaranteed 2 good placements. And while you're loving your next one - that annoying friend who loved their last one will be crying into the pillow because they hate this one!)

3.
Be appropriate.

I add this one with caution, because appropriate is a kind of a how long is a piece of string thing. What everyone thinks is appropriate is different, I mean I have no issue when doctors and nurses pop out for a fag break, but some other people do. However some things are probably universally thought of as inappropriate:
(these are all things that student nurses I know have done)

• Telling patients how shit faced you got last night/will get tonight.
• Telling lecturers how you used to be into drugs but you're "not in that scene any more"
• Telling people loudly in the staff room how much you hate Matron or Sister, hate them if you like but keep it schtum!

2.
It's poo - get over it! 

This one seems obvious for nurses, but you'd be surprised about how many people struggle with this, everyone has something that makes them retch and want to vomit, be it blood, poo, urine, fluid from a stoma bag, sputum, pressure sores ect. (For the record mine's sputum - cleaning out a trachy tube makes me want to do exorcist style vomiting.) But in the nicest possible way you need to deal with this and get on with it, it'll still disgust you and you'll still shudder but it needs doing, your patient needs you help them as best as you can - so you need to the job in hand. My top tips for getting through are:

• Grin, this helps stop the gag reflex - you'll look a bit manic and insane grinning wildly but hey, go for it it's worth it for not retching over a patient's face!
• NEVER NEVER NEVER inhale through your nose, I made this mistake once ... never never never again.

1.
Remember to laugh.

This is actually me - I'm really hairy when I don't shave.

You are on your way to having some of the best times of your life, some of the funniest incidents will happen to you when you're on the wards, you'll see the most bizarre things, have the oddest things said to you. And the best way of coping with all the bad stuff, the heartbreaking, the painful and the soul destroying is to look at the great, funny and bizarre stuff and to laugh, laugh on your own, laugh with the doctors, laugh with the nurses, laugh with fellow students and laugh with all your mates who are already concerned about your sanity, and will be even more so now!

So I hope that my 10 tops tips and advice for prospective and newly starting student nurses have been of some assistance, please do tell me in the comments section if there's anything you feel I've missed out!

My God I'm stressed!

So ... I'm stressed! And it's not often that I say that, I'm the kinda gal who goes, "Nah I'm fine!" or "Ach, it'll all be OK.", "Worse things happen at sea!" is another perennial favourite. It's not that I don't worry, I do, and I panic and get a really sexy red chin when I'm not chilled out. But over the years I've become the one who sorts issues out, I'm the girl who's there with the hugs and tea bags. 

Are you worried/nervous/upset/angry? Then come to my house, I'll make you tea, I'll crack open the cake tin (because I am the only person since 1963 who own's a cake tin) and you can talk things through. Nurse P will make everything better. 

And because I may be a nice and kind person, I'm also irritatingly honest and fairly stingy with compliments so when I tell you that you're a wonderful person and that all the pain is worth it because you're going to be brilliant at what ever it is you're trying to do, (be it soufflé making, nurse training or learning to drive) it tends to have the desired effect, in that people buy me cake and make me tea and pick me up when I'm sobbing with heartbreak or alcohol.

Because who wouldn't love that face and coat!

So when I'm stressed, I downplay it, I'm emotionally constipated about things that really worry me, whereas bad boyfriends, bad patients and bad shit in general my upset me, and I can talk about  'till the cows get home. If it worries me or is stressing me out then expect me to hole up in my house until through a combination of tea, cooking arse-kicking food and watching re-runs of Jonathan Creek gets me back on track. 

I'm stressed because I have a great deal on my plate at the moment , first off that assignment that I failed a while back - my re-write has not started looking better than the shite original and not passing it second time around means good bye nursing course, hello going back to being a receptionist where my line manager hates me and always told me I'd make a bad nurse. Secondly my new placement, 12 hour shifts are OK, the work is great (obvs loads more piss, shit, and vomit than last time - but I love it!) and the patients are lush sooooo - what could possibly be bothering me. WELL! 

"The human body is the only machine for which there are no spare parts."  Hermann M. Biggs

1954 Morris Minor saloon 

We have a patient on the ward, they are dying and I'm sorry to be so blunt, but this patient in their early 20's is dying - and by all rights they probably should have already died. It's only through medical intervention and their families un-ending support and belief in their relatives ability to recover. Which they wont - doctor's have been pumping their body full of anti-biotics and blood transfusions and everyone, all the doctors and all the nurses know that this person is simply not going to recover, not through lack of trying or because we're cruel but because the human body is an incredible thing but like any machine, which is of course essentially what it is, there is only so much it can take. Think of a Morris Minor car, an absolute beast of an engine, a beautiful car and a rarity. In 1954 they were 10 a penny,  a very common car, but now rarer than hens teeth. There's only so much a car can take, only so many times the gear box can be changed and the fan belt replaced and the rust covered and the pain touched up. We are but machines, very clever and complex machines but engines none the less and there is so much we can take. When I see this patient and I care for them and I watch the doctors doing yet more blood and nurses set up another IV of antibiotics, part of me aches to say: "Just let go, let go and let your child rest in piece, it may seem in human and cruel but it's not - it's the kinder thing to do than to just keep this going. There is no quality of life, there is nothing of your child to save." Perhaps I'm cruel, perhaps I'm heartless, perhaps I would understand if I were a mother. 

But I'm not a mother, I'm a nurse and I see how much this family wants their child to be healthy again and I respect and understand that, but as a medical professional I can also say with the same mind that understands all of that, that there are wishes and their are facts. And in my line of work sometimes we have to work with wishes over facts, however unhelpful such wishes may be.

I don't want to dispirit you all - so in some rather better news, I've just passed my final exam of my first year! Woop Woop - which is making my stress a little better, as is my recent discovery of YooMoo frozen yoghurt in my local Tesco, I personally recommend the Tropicoolmoo flavour it's very VERY nice, and the perfect thing for when I get back from the crazy humid heat of the ward to my nice cool house! I love summer as much as the next man, but in the hospital the heat is something else. And here's a photo of a celebratory ferret - to celebrate passing exams and discovering frozen yoghurt!

Until next time: au revoir! 

I'm back - and exhausted!

2 days in,
25 hours on the ward already completed,
5:30am my alarm goes off,
8:00pm I get home

And I am LOVING it! I mean I'm tired, and I'd forgotten how annoying all the reams and reams of paperwork are in the hospitals but I'm loving it.

All the parts of nursing that I didn't get to do on my last placement I've got to do now, including personal care, drugs rounds, dressing and perianal swabs. (on others ... not that I've done them on myself you understand) Last time there I had patients who were completely compos mentis this time, very few are, which means learning a whole new way of interacting with patients which has been hard, but quite enjoyable generally although hard.

Nursing's a strange thing, put on a uniform and an ID badge, and suddenly you're allowed into the most intimate corner of people's life, clean them up when they're incontinant, wipe away their tears when they cry and they don't know why and hold their hand when their scared of everything.

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!