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

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!?