Student Nurse Blog Week 20

January 13th 2005

Well, I had a good time over the Christmas period, I did quite a few shifts back in Endoscopy and was pleased to see my friend’s there again. I did a couple of shifts on the wards as well. I returned to Worcester at the start of my Independent Study week (last week) for my maternity experience.

On the Tuesday I did resus and manual handling training for my NHS Professionals contract. Then on the Wednesday I started my maternity experience. What a great experience that was. I did some reading up on pregnancy, childbirth and labour, along with possible complications and problems. That enabled me to link practice in with theory.

I got a bit of a shock on the Saturday. A few weeks before Christmas I was given a one-day-a-week contract to work on my current placement ward as an A-grade HCA. I was under the impression that my contract would start the following weekend. However, I received a phone call on Saturday evening from one of the HCA’s asking me if I could swap my early on the Sunday for a late, as she wanted to do something on the Sunday afternoon. I didn’t even know I was working on the Sunday! However, I was grateful for the extra money, so didn’t complain. Hence to say that I worked a late on the Sunday as a HCA - the shift went well with no problems, but was quite busy.
Just to reinforce to me how staffing can be a big problem on the wards; the nurse in charge on the late shift was trying to organise cover for the Monday morning. There was one trained nurse on for the Sunday nightshift, there should be two, but she had to go at 7am (due to flexible working hours). There are usually three trained nurses on during the day, sometimes just two, however, the day shift didn’t start until 730am. And even then, only one of the trained could start at 730am. On of the other trained nurses didn’t start until 9am due to flexible working hours and child care and the ward Sister, who was making up the third trained, couldn’t start until 830am (again, due to flexible working hours and childcare arrangements). After an hour of phoning around the only way the nurse could cover it was for the 730am nurse to come in half an hour earlier, and the Matron in charge of the medical wards, along with a charge nurse (clinical bleep holder) to cover the ward from 8am. What a nightmare! The problem is, the staffing shortage on the ward is a continuing problem. This then puts extra stress onto the remainder of the nursing staff.

On Monday I returned to my medical placement. I started the week off with an early shift. It was nice to be back on the ward. The shift was an extremely busy shift. Although I didn’t get to learn any new skills that shift, I was able to practice some of my already learnt skills, as well as being able to experience some valuable patient contact.

On the Tuesday I had a fire lecture in the morning (again, for my NHS Professionals contract). That was quite good and lasted about an hour. I had a couple of hours off, so was able to do some more work on my case study assignment. In the afternoon I did a late shift. That was a busy shift, but a little quieter than the Monday. I was able to give a couple more injections (subcutaneous) and did a drug round supervised. I am feeling a little more confident now and part of the team on the ward. However, I still get the occasional shift where I wonder if I am doing the right thing and whether I really am cut out for it all. I only get these feelings once in a while and so infrequently that I normally don’t worry about them. Most of the time I feel great and, even when it is really busy and you have three jobs to do at the same time, I would never turn back or drop out of my training. I think that if I had more bad shifts than good shifts then that would be the time to start worrying – or even reconsidering my career options.

Today I did another early shift. A patient had died at around 6am this morning and the night staff hadn’t had time to do the last offices. It wasn’t on my section of the ward, but I asked if I could help one of the HCA’s to do the last offices. I have done them before at the other hospital where I worked, but because each NHS Trust is slightly different, I thought it would be a useful experience to do one here. Also, I hadn’t done any last offices as a student nurse, so again thought it would be useful. It is a little less complicated at this hospital. Here they wash the patient the same and make them presentable. But here they do not bind the big toes and ankles together with twine (string) like they do where I used to work. Also here they put the patient into a white body bag. We didn’t do that where I used to work. We put them in the usual white rob/cover and then placed a sheet over them until the porters picked them up. The other difference that I noticed here is that they don’t have a property book. Instead they write on a property form, which is then signed and counter signed by a witness and collected by the bereavement officer (along with the patient’s belongings and their notes). I am not sure about not having a property book, as I feel it offers protection and an easy reference point for staff, due to carbon copy remaining in the book and on the ward). I was also able to remove the patient’s catheter, which is only something I have seen done before, but not had the opportunity to do myself.

However, each NHS Trust is different and they all have their good and bad points, and good and bad systems. Hopefully we should be able to learn from each other to bring out the best possible practice. With the current Trust I work at I have managed to bring some good suggestions of improving a couple of small things. These changes have come with me from the previous Trust I worked at.

Today’s shift was fairly quiet. I was able to sort out a problem with a patient’s transport arrangements for treatment at another hospital. I accompanied the doctors on their ward round and did two drug rounds supervised. When the junior sister came in for the late shift they still hadn’t filled the A-grade HCA post for the night shift tonight. Because they are always short staffed and everyone is so stressed at the moment (a couple of people have gone off sick due to stress), I offered to cover the shift as an extra – on my one-day-a-week HCA contract. So I left early. I will be back in tonight, but as a HCA. I will not do my early (student) shift tomorrow, but will come in late in the afternoon for my final practice placement interview with the ward sister. I will shuffle my student shifts around to ensure that I do the full 37.5hrs this week. I also have a HCA shift on Saturday night.

Til the next time, catch you all later Matt

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