Nee Naw Nee Naw Nee Naw! sirens, flashing blue lights, high speed driving on the wrong side of the road! what a rush!! So I went out with the paramedics on friday, as you have probably guessed it was very exciting and exactly like it is in the movies!! I was under the impression from reading the induction pack that we would be given an observer jacket and told to watch but not interfere, however the paramedics I was with were brilliant and included me in every job we had, asking me to get things and letting me look after patients on board. From 7am to 7pm it was non-stop, going from one scene to another, not good if you have small bladder syndrome! One good thing was that every call was different, ranging from shortness of breath, road traffic accidents, collapse, seizure, death, CPR, and back injury so we didnt really encounter the same situation twice! Variety is definately the spice of life! I was also really impressed with all the equipment on board, including and ECG machine and mobile observation unit. The paramedic I was with cannulated most of the patients so that the hospital could gain access and give any medications or fluids on arrival. One of the calls was to a nursing home where a lady was found unresponsive, when we arrived she had passed away but had not signed a DNR (do not resusitate) order, so we had to administer CPR. It was a very emotional situation as the lady was very old and would not have wanted to be resusitated. I honestly thought I would be so scared in that kind of situation and wouldnt remember what to do but a strange kind of calm came over me and while I was doing chest compressions, it was like I emotionally cut myself off from what was going around me. I can really explain it but i was weird! Mostly I was just worried about hurting her as she was really frail. In the end though her time had come and you could tell she didnt want to come back. Well I hope that you all get the chance to go out with the paramedics at some point of your training as it was really enjoyable.
This week I spent a day going around with the acute pain team. To be honest I thought it would be a bit boring but I was totally wrong as it turned out to be really interesting. I feel that I know much more about epidurals, patient controlled analegesia (PCA) and the different types of medicines used to control pain. The nurse I was shadowing asked me lots of questions and drew some pictures to show me how they put the epidural in and how it works. So I feel alot more informed about pain now and how to assess patients pain levels.
With this year coming to an end (well the nursing academic year) I have lots of last minute things to do… The boat home is booked for the 11th Aug, so until then I only have 7 shifts left on placement, 1 spoke day with the paramedics, 1 OSCE, 1 assignment to finish and submit, 10 reflections, 1 medicines management book, 1 infection control book, oh god I wish I hadnt started that list! I really cant wait until the holidays and lots and lots of that precious entity called sleep!
The opening ceremony of the olympics starts today and the whole country is geared up for the event. It probably wasnt the best day to pick to head off down to london for the weekend but many a student was seduced by a £5 bus ticket. I have however booked a train ticket back, well I can only suffer one six hour bus journey! So when my grandchildren ask me where I was on during London 2012 I can say on a sweaty megabus stuck in olympic traffic!
Im so excited, and I just cant hide it, im about to lose control and I think I like it…………Ah it felt good to get that out! SORRY! Its just that there are only three weeks of year two left and im beside myself with joy! Finally the light at the end of the tunnel is becoming brighter every day. I can safely say that everyone in our cohort will be delighted to see the back of year two. Even though it did go extremely fast, there was something about being a second year that caused immense dislike amongst our intake. Maybe it is something to do with being in the middle year, the novelty from first year a distant emotion yet still slightly quite green in comparison to the third years. Whatever it was, the ecstasy of finishing this year has started to course through my veins and I can feel myself becoming impatient for the last three weeks to hurry up!! Come on already! Im starting to annoy myself now because I keep looking at the calender over and over to calculate the number of shifts, that are left in the year. Just in case anybody is interested, thats 13 shifts because in the last week we have two study days! Also our ward have been really good and have organised different spoke placements for us, so far we have gone out with the outreach team for a day and we are due to go out with the pain team and with the ambulance service for a long shift wich means that technically I only have 11 shifts left on the ward! Happy days! I will put off panicking about going into third year for a couple of weeks, that freak out is for another day! Actually speaking of third year, all the graduations in Edge Hill took place last week, everybody looked lovely in their caps and gowns! I watched some of the videos on the website and it was really emotional, it would bring a tear to the dryest eye! worth a watch if you are feeling a lack of inspiration or motivation on the course. I will look forward to that day, when I get that well earned peice of paper, for now though its full steam ahead to the end of year two.
Virgin media really annoyed me this week as they cut off the internet and after two engineers and talking to approximately 24 people on the phone, continuously repeating my story my frustration levels had reached an all time high! I really hate automated telephone services, can you imagine if we had an automated nursing service! good job we treat each person as an individual, well in theory thats the way it should be! Anyhow sorry for the rant! I had a very interersting night last night, I arrived back from a friends house around 1.30 am and found my next door neighbour but one sitting on her step, slightly worse for wear, locked out so I invited her in for a beer and a chat. So inbetween her slurring and falling asleep on my couch, I heard the words ‘death’ and ‘house’ inbetween her incoherent mumblings… A little taken by surprise, I said ‘sorry did you say somebody died in this house? and she looked at me like ‘you didnt know? so then she told me that an old lady who used to live her threw herself off the landing and one of our neighbours found her as she looked through the letterbox and saw her feet dangling!!! Lets just say that I felt every bit of blood drain from my face! I went to bed at 4am shaking and misinterpreting every rustle and creeking floorboard! I woke up still in shock and kind of angry that the landlord didnt mention anything when I signed the lease! So now I cant erase the image of an old lady hanging from my landing, plus yesterday when I was cleaning the house, I fixed a broken banister!! ohhh god! I am now looking up the local priest so that I can get the house blessed! I am now in the process of having a chat with myself and trying to convince myself that people die in houses all the time, but its not something your aware of most of the time! Easier said than done! Especially with a hangover! I think the hair of the dog is in order, not just to remedy the hangover but to calm my nerves enough to sleep tonight!!
In the words of simply red ‘I don’t want to see no Doc I need attendance from my nurse around the clock’ A wise man that Mr Huknall! So I have just finished a row of nights on the unit and am off for a few days now, which in fairness I need to recover, especially as I only had 3 hours sleep after the first shift so the second night was torturous! There is something nice leaving for home when everybody else is coming in for work, however the drive home is terrifying and i always thing I am going to fall asleep at the wheel and end up back in the hospital! I noticed that on nights patients tend to deteriorate quicker and it is quite hectic if a few patients are going downhill at the same time! Also there were a few incidences where some very confused patients became aggitated and aggressive, I narrowly escaped bieng kicked in the stomach which is a good job as I may need my womb and ovaries at a later date! The staff though handled these occurrences very well, I felt a bit hesitant at first because I wasnt sure if I should help or if I was in the way! I was so glad to get home after my last night, I went to bed but woke myself up at 1pm and forced myself to stay awake until late so I could get back into a normal routine. So back on days from now on and only 4 weeks until end of year 2!
I flew back to Ireland last friday evening for a friends wedding on the saturday. Apart from the monsoon like conditions, it was a great day with great food, quite a few drinks and really good company. Even though I was a tad hungover on the sunday, I thought what the hell Im off on the monday so I might as well go for round two so off I went to the pub …. em again. Needless to say when monday came I resembled only a version of my former self and felt like I had been dragged through a hedge backwards. The flight home was short thank god, especially as the guy next to me decided to use me as his sounding board and tell me all about his travels and basically how great he was the whole way back to Liverpool. The down side to all this fun (there is always a catch) is that because I had 3 days off I now have to work 10 days in a row with no break, Im only on day 3 now and trust me I have felt better! I have found that once you have hit the wall of tiredness the next day you get better and can carry on….. but I am still waiting for that to happen! I have felt though that I am much more settled in placement now and it doesnt feel so daunting, however I still feel like there is so much more to learn before I qualify next year. I am hoping next year goes quite fast as we have an option to go abroad in January which if I can raise the money for I will definately do and our first module of third year is our own choice,I have chosen pharmacology as I think it would be useful for any nursing career. So Only 7 more shifts until next weekend and only 34 more shifts until the end of second year!! Yey! Uh Oh here comes the wall……………………
The weeks are flying by, by tommorow I will have completed week four of placement and it feels like I have only been there about a week! Today I was shadowing a nurse who is on the outreach team and also the MET team (medical emergency team). We had only been in around an hour when we got an emergency bleep and as the holder of the red bleeper I can honestly say my heart actually stopped beating for at least a couple of seconds! We rushed to the ward and met the rest of the team who were all buzzing around the patient asking questions, taking blood, taking observations, it was quite excting really, obviously not for the patient though who was quite unwell. I was then sent down to the ward with a syringe of blood to do a blood gas, on my way back I didnt have time to wait for the lift so I ran up around 5 blocks of stairs and was so out of breath when I got back that I thought I might need some oxygen! The great thing about this placement is that as a student you get to spend all your shift with another nurse whereas on another ward you only get limited supervision and spend alot of time left to your own devices. I think that this will be the best placement I have over the 3 years and hopefully it will be a great benefit to my experience.
Lying in bed knowing that you have to be up at 6.30 is no fun at all, however I have a bit of a routine going now so my body has adjusted and Im just waiting for my brain to follow although its well known that I never have been much of a morning person. This week on placement has been really interesting and I have felt as though I am starting to contribute to patient care if only on a very small scale. The nurses on the unit know so much and are highly skilled in so many areas, at first I didnt understand most of what was going on but after 3 weeks I feel like things are starting to come together now and make more sense. I was talking to one of the nurses the other day and she was explaining to me once you get to know the job, it becomes second nature and the nursing proceedures are always the same, I took comfort in this and realised that it is when you get your first job that you will really start to learn. I took out a femoral line the other day, one line goes into the vien and the other into the artery, I had to press down really hard afterwards to make sure the wound didnt bleed to much, my patient was brilliant and didnt flinch at all, I bet I would be crying like a baby if I had to get that done. The same patient said to me ‘Enjoy life and make sure you have a good job so you dont have to worry about money’ some of the best advice comes from people in the darkest of places.
I am sitting on the couch, half comatose with my eyelids almost closed, the sun is shining outside and I know I should be delighted that I have a day off, but I cant muster up enough energy to move from a sitting to a standing position. Must be the effects of a very busy first week on placement! The 6.30 am starts are going to take some getting used to… again! In fairness though it is more mental tiredness as I have been trying to absorb copious amounts of information on my first few days as a critical care student nurse. It has been amazing so far, truthfully I have learned more in five days on this placement than the whole nine weeks of my last placement, not that I am complaining as I am grateful for the basic skills that my last placement provided. So far this week, I have taken out cannulaes, arterial lines, suctioned patients on life support, leaned about all sorts of different medications including sedation, pain relief and antibiotics, watched MRI scans, ultrasounds, tracheostomy care ect… I am convinced that my fertility levels are gradually being destroyed after being exposed to numerous portable xray machines! I made the mistake of asking my mentor what was going on behind a curtain when I spotted a doctor all gowned up wheeling a trolley with some very dodgy looking instruments into a patients cubicle, she swiftly opened the curtain, pushed me inside and said to the doctor, my students is going to watch if thats ok and then left me there! The doctor was in the middle of inserting a chest drain and Im sure my face went green, but I managed to stay consious while he eplained the proceedure, why they were doing it and he even got his consultant to draw a picture of a lung and what had happened to the patient! With all this excitement in one week, I am sure the next 10 will be just as hectic, but it is definately one of the best placements of my training so far.
Our class has just started a new eleven week placement this week. This will be our fourth placement since we started in 2010, so after this we only have two left! It sounds really strange saying that! Anyways I arrived on monday and found that there were two other students from my class and two third years from another university also on the same placement. After the morning induction we were given a tour of the ward and were assigned to a nurse to work with for a few hours. All of the students apart from the third years who didnt look phased in the least looked like they were going to pass out from fear! Personally I have never seen so many machines and tubes in action and it all seemed very overwhelming! Being an intensive care ward, the patients are all very sick and require the the most specialist care available. Compared to my last placement it is much more intense and there is so much to learn, different medications for pain and sedation, ventilation and more in depth knowledge of observations such as blood pressure and heart rates. The following day I met my mentor and worked with her looking after one patient and I have to say I learnt so much just in those hours, I got to meet the patients family and felt that just by chatting to the family and helping my mentor that I made a small contribution to the patients wellbeing. I really enjoyed working with one patient and giving them all my attention rather than try to divide my time for a lot of patients. There is a definate need for extra study for this placement and I will be hitting the library in a major way to try and learn as much as I can about this type of nursing. Being honest, I was not really looking forward to starting placement due to the huge amount of assigments we have been doing and felt like the old motivation levels were on the down low, but this placement has definately given them a kick start and I am looking forward to the next ten weeks.