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Are you ever ready for your first Cardiac Arrest?

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by Andrew H.
Are you ever ready for your first Cardiac Arrest?

Are you ever ready to perform CPR for the first time? This is Andrew's story...

I was lucky enough to have a placement in A&E, it was my dream come true and the place I want to start my career. However, as with anything new I had some anxiety, one of the biggest was performing CPR. We have all kissed a dummy and made its chest click, but what was it going to be like in comparison to the real thing? As a CPR virgin I had many different thoughts, would I remember how to do it? Would I be able to do it? Would I just be in the way as a student?

My second day on my new placement, the red phone rang and I was called over by the nurse in charge, ”We have a cardiac arrest on its way, go and join the team”. The over sensing fear rushed over my body, with a strange element of excitement, soon blown out by the enormity of the situation. The team were forming and next to me was a fellow student who was on her first day, both looking as petrified as each other.

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As on TV, the consultant gave each person a job, even us!!!! Can you do compressions if needed? He asked. Of course, I said yes, but with the blue gloves on my hands started filling with sweat, my heart thumped in my chest, my stomach churning and my head trying to remember my training. The other student was asked to scribe, supported by a nurse. Wow, we are really part of this team, fully involved and supported by the others around us. The doors then flew open, it seemed like something out of the movies at first, but then reality kicked in and I was taking everything in. The patient was transferred to the bed and he had a Lucas machine strapped to his chest. For those of you who have not see a Lucas machine, it basically does the compressions for you. Unfortunately, this patient had been down a long time out of hospital and the decision to stop was made a short while after he arrived.

Even though I hadn’t really done much, it really felt like I had. The emotions of the situation draining my energy. After we had helped dress down the patient, we had the opportunity to have a debrief with the nurse in charge. She explained the whole process to us and how advanced life support was different to basic life support and gave us the opportunity to reflect on the situation. We were further debriefed by some more of the team, which made us feel as an important part of the team. I was gutted to see my first death and probably slightly relieved that I hadn’t had to do CPR, but I still had my CPR virginity.

Anyway, the following week another cardiac arrest came in, all the same emotions and feelings came flashing back to me. This time I was asked to scribe and keep a time check, a really important job in the situation. Then seconds later they arrived, a fireman performing compressions supported by an ambulance crew. Swiftly he was slid onto the bed and compressions began. If anyone hasn’t seen a resus room when a cardiac arrest comes in this is how I would describe it; 'organised mayhem' in the most subdued controlled environment, that probably makes no sense but it’s the only way I can describe it.

Time ticked by and compressions continued, I was shouting out every two minutes so they could perform a pulse check and the drugs were being administered. Suddenly I was asked to help with compressions, with out even a thought, I was there hands the patients chest performing compressions. It felt so different to that dummy we had practised on, but I had remembered, I was fully involved trying to save this mans life. I carried on rotating with other nurses and doctors with the compressions as well as helping scribe when I could. After what felt like hours, the man had a pulse and we were able to transfer him to the cath lab to have a stent inserted, unfortunately later on that day that patient died.

It was an amazing experience as well as a very sad experience. I had been part of a team trying to save a mans life, I wasn’t just a student, I was an active member of that team. Feedback was given to me by a couple of the doctors throughout the situation, giving me a confidence boost that I was doing the right thing. Reflecting on this experience has taught me a lot about being a student nurse and if I can pass these on to other students they would be. Firstly we are part of the team, we support nurses and doctors through potentially life-saving interventions. Secondly, we need to grab the chance to get involved in any situation we can, however daunting it may be at the time. Finally, belief in our own abilities, we are training to become nurses for a reason.

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Nursing apprenticeships could put 'both patients and apprentices at risk'

Previous research found hospital-based apprentice training was unsafe and inefficient, and did not equip nurses with the necessary skills for the future.

Published on

by James M.
Nursing apprenticeships could put 'both patients and apprentices at risk'

The Royal College of Nursing has warned MPs that the apprenticeship system risks putting both patients and apprentices at risk.

Speaking at the Education Select Committee, Janet Davies, Chief Executive and General Secretary of the RCN, said there was clear evidence that trainee nurses should complete degree-based training - which is safer and more consistent than the old-style apprenticeships.

Evidence from the Judge Report and Project 2000, both carried out in the mid-1980s, found hospital-based apprentice training was unsafe and inefficient, and did not equip nurses with the necessary skills for the future. Under the old system, apprentices had to learn from an inadequate number of fully qualified registered nurses, which reduced both patients’ quality of care, and the quality of the training.

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With more than 40,000 nurse vacancies in England alone, there are fears history could repeat itself with the new apprenticeship scheme.

The RCN claims that apprenticeships risk putting undue pressure on overstretched NHS services, as they place the responsibility for training staff on cash-strapped employers, instead of universities.

Apprentice levy does not cover the full cost of training.

Danny Mortimer, Chief Executive of NHS Employers, previously told the House of Commons Health & Care Select Committee that the cost was “probably something in the region of £125,000 to £155,000 over the four years of a nursing apprenticeship, and the levy will not capture all that cost.”

Nursing degree students fund their own studies and spend 50 per cent of their time in practice placements - where they can learn directly from experienced staff.

For apprenticeships to work as they must...

The Royal College of Nursing believe that the following steps should be taken to ensure apprenticeships works.

  • Ensure access to a variety of clinical placements across community, general practice, social care and acute settings to ensure nursing students have the necessary exposure and experience of working in different environments.
  • Ensure access to safe, effective and appropriate learning environments where nursing apprentices have protected time for learning and access to mentors and assessors. Currently, providers will struggle to meet this requirement due to the unprecedented pressure they are facing.
  • Protect the supernumerary status of nursing students. Any compromise to supernumerary status of nursing students would compromise patient safety as well undermine nursing students’ learning ability.
  • Ensure a robust quality assurance process is in place to make sure that patient and learner safety is guaranteed and that there is consistency is the skill, knowledge and abilities of all nursing graduates, whatever route they take into becoming a registered nurse.

We need to keep both students and patient safe.

Janet Davies, Chief Executive and General Secretary of the RCN, said: “The big challenge we have is ensuring we’ve got a proper environment where students can be students and where patients can be kept safe.

“Many of the Directors of Nursing that we talk to feel the cost of training has just been transferred from the Government to employers, who are already overstretched.

“We are currently working in an environment where we have 40,000 registered nursing vacancies. These are the people who have to be the mentors and supervisors and their focus has to be providing safe care to their patients.

“It is not chance that we have the level of vacancies that we have. This was because of poor policy, and saving money in the past. Apprenticeships themselves will not fix this. We need a whole picture of where we need investment in nursing education.

“Before the introduction of the graduate fee, 41% of people on nursing degree programs were over the age of 25. We know the representation of people from local communities and ethnic minority backgrounds was better than the rest of the student population.

“We need to have incentives for people to be able to have a university education as well as people having the opportunity via an apprenticeship. Both models need investment not just one over another.”

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Education

NMC launches new educational standards to 'shape the future of nursing'

Part of the changes includes the removal of the cap on the number of hours students can spend on simulation activities.

Published on

by Ian Snug.
NMC launches new educational standards to 'shape the future of nursing'

Student nurses will start to train against the new standards from January 2019.

Last week the Nursing and Midwifery Council (NMC) launched 'ambitious' new standards of proficiency that set out the skills and knowledge the next generation of nurses need.

Alongside the new proficiencies, the NMC has introduced a more modern and innovative approach to the way universities and their practise partners train nurses and midwives - the NMC claim these changes will allow greater independence of assessment, and greater innovation by placement providers.

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The NMC has also removed its standards for medicines management and instead encourages employers to instigate rigorous medicines management procedures.

Unlimited simulation.

Finally, part of the changes includes the removal of the cap on the number of hours students can spend on simulation activities - despite concerns this could reduce the total amount of time student nurses could spend on placements.

The new standards represent two years’ work and have been developed alongside nurses - as well as students, educators, healthcare professionals, charities and patient groups from across the UK.

Jackie Smith, NMC Chief Executive and Registrar, said: “Our new standards represent a huge leap forward. They raise the bar for the next generation of nurses and not only match the demands of the role but the ambition of the profession. This is vital as in the coming years many thousands of new professionals will join our register, delivering care to millions of people.

“We’ve also overhauled the way universities train nurses and midwives. They’ll be given more flexibility to harness new ways of working and embrace technology so they can equip the nurses and midwives of tomorrow with the skills they need to deliver world class care for years to come.”

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News

Government 'puts final nail in the coffin' for NHS Bursaries

The vote to remove NHS bursaries passed by 273 to 199 and comes at a time when there is a shortage of 40,000 in England alone.

Published on

by Sarah J.
Government 'puts final nail in the coffin' for NHS Bursaries

The government has voted to remove the NHS student bursary for post-graduate students.

A debate took place yesterday after the Government announced plans to remove post-graduate nursing bursaries for students who hold already alternative degrees.

In 2015, the Government removed bursaries for undergraduate students.

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The 'fast-track' two-year course is currently undertaken by around 1000 'mature' students every year and the change will, instead, see students rack up thousands of pounds of student loan debt - experts warn this will only further reduce nursing numbers.

The vote to remove NHS bursaries passed by 273 to 199 and comes at a time when there is a shortage of 40,000 in England alone and official UCAS figures show an exponential decrease in applicants.

Nursing leaders have warned that the ongoing, worsening shortage could lead to a repeat of the incident at Mid Staffs.

Failing the next generation of nurses.

Angela Rayner, Labour’s Shadow Education Secretary, said: “The Government has badly failed the next generation of nurses today by forcing through further cuts to their support and burdening health students with yet more debt.

“Labour will continue to fight these regressive cuts at every step to make sure health students can get the support they need.”

Jonathan Ashworth, Labour’s Shadow Health Secretary, said: “The Government’s decision to abolish NHS bursaries has led to a huge fall in numbers applying for these courses and will make the NHS staffing crisis even worse.

“Now Ministers are pushing ahead with further bursary cuts in the face of all evidence.

“By cutting bursaries for postgraduate students, the Tories’ vote tonight makes it even harder for people to train to work in the NHS.”

We need more Nurses. Not less.

Prior to the vote, Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: “The decision to remove undergraduate support resulted in a collapse in trainee applications. Ministers should think very carefully before risking a further drop at a time when our health and social care system is desperately short of nurses.

“This is the quickest way to train top-quality registered nurses and should be expanded, not cut off. The current shortage of nurses is jeopardising safe and effective patient care and the Government urgently needs to encourage more people to enter the profession.”

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