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My 'average' day as a Student Nurse

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by Deirdre Mulvenna-Pegrum.
My 'average' day as a Student Nurse

Ohhh… What is that beeping noise? Stop it! Go and see why that patient keeps pressing the buzzer, will you? Oh, no, wait. It’s my alarm.

Out of bed, still dark, lucky the heating has just come on.  My dogs are weaving in and out of my legs, more excited than I to be up at this ungodly hour - again.

Time to wander downstairs, get that kettle on. First cup of the day – but possibly my last drink until my break time.  Make the most of it.  Dogs into the garden, thank goodness, no barking this early.  Come on you two, time for biscuits.  At least I know my husband will give them a walk when he gets up – when it is light and the birds have stopped their dawn chorus.  What am I saying?  It’s too dark for even that yet!

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Right, tea done.  Cannot face breakfast at this hour – just have to hope I get a fifteen-minute break later and be able to get some toast…. Into the shower.  The dogs follow me upstairs and settle back into their cosy beds.  Thanks.  I feel even better about going out into that drizzly, dark morning.

RELATED: 10 FACTS ABOUT BEING A STUDENT NURSE.

Uniform on.  Coat needed, it is chilly today.  Rucksack with portfolio, check.  Parking scratch card, check.  Car keys, check.  5.50am, out of the house.  Headlights on full.  I hate the drive to work in the dark and come home in the dark days – it is a really hard slog.  Sometimes I try to go for a walk during my break just to get outside and see the sun and inhale some good, clean air, rather than antiseptic and sickness.

It's a long drive to the hospital.  It is more enjoyable as the roads are quiet at this time of day – I think doing this in rush hour would finish me off.  Arrive safely.  Parking good too this time of day, so no mile walk from the car park – especially as the rain has just started now.  I head into placement, ten minutes early.  Time to put my bag in a cupboard – no lockers for us students.  I always worry about leaving anything valuable there.  No offence intended to anyone.  I have learned to carry my cash – a small amount – in my uniform pocket – which is not ideal, but needs must.

Wash my hands, remember the wrists and finger tips – you never know who is observing you.  Into the ward.  Good, my mentor is not here yet.  I grab a seat.  The thing about nursing is, grab a seat while you may, it does not happen often!

Time for handover.  Not many in-patients today.  Good, but the ones we have will keep us busy - I'm sure.

Check the list – we have eighteen patients, more male than female, due into the ward today.  I will wait until my mentor tells me which side to work on.  I guess I shall end up helping whoever needs me though – as is usual.  I do not mind this.  It allows me to see how different nurses, both male and female, work and how they treat and care for their patients.

When I first arrived at this placement, one nurse treated me like a porter; go the pharmacy, walk this patient to the entrance to meet their lift.  I put up with precisely one day of this.  I asked my mentor, ever so subtly, if the other staff were aware I was actually a third year, not a first year, and that I would really appreciate observing them if they did not want me to actually do things instead.  That did not happen again.

Eight o’clock.  Breakfast time.  Then observations and reporting any concerns.  Encouraging those who could to walk to the bathroom, making sure they are steady.  Check to see when they should be discharged, and encourage them to get dressed and sit in the patient lounge.  Once they are there, and all their belongings packed up, time to get the paperwork on the go.  Check to see if they need appointments, check to see if they need to go home with instructions or drugs, and make sure they understand all about them.  Once their escort arrives, it is time to get the bed stripped and cleaned down, as theatre have been on wanting us to take another.

Theatre gets backed up as they cannot get the recovery bay clear.  It is so frustrating.  This continues all day.  We have three visits from the bed manager.  It is no good – we cannot make beds magically appear. We cannot discharge patients until they are ready.  We all feel under pressure, me included.

Time for a break.  Fifteen minutes.  I grab a coffee and a healthy snack bar.  I can eat them outside.  Back to the ward.

More patients.  These want to have a snack and leave.  Luckily, they are all able to.  We do not have anyone who needs extra care until after lunch – which was a lovely salad and a walk around the hospital – it’s raining too hard to venture outside, much as though I would love to.

The changeover has been constant.  We only have twelve beds, and have to rotate a minimum of eighteen patients, sometimes more, in a day through them.  It just takes a couple who do not recover well to hold this up.  Sometimes it is so busy I do not exchange more than a few words with my mentor.  We have to be constantly aware and observant of all the patients.

This is exhausting. I did not get another break this afternoon.  I do enjoy chatting with the patients though.  It is good to make them have a laugh when it is appropriate.  At least most of them went home smiling and happy.  Great – give them the friends and family card… Cynical old me.

Handover sheet updated.  I grab a sneaky seat – remember when I said earlier, take a seat when you can?  This, apart from my break, has been the second opportunity today.  Thank god for flight socks – my legs would need lifting into the car individually if I did not have these sexy beauties.

Handover is given to the night staff.  Hopefully, they will not have a difficulty shift.  There are only three patients staying in.  Problem is though, even though they are fully staffed, it is likely someone will come and steal one of the HCA’s, or even a nurse to work elsewhere in the hospital.

Time to go home.  Get my rucksack.  Did not have time for my mentor to do anything in my portfolio today.  Will just have to wait for the next shift.  It’s dark again.  Head lights on full.  Thank the lord for the light traffic.  I would hate to think about how I would feel stuck behind a learner or a tractor as I wend my weary way home.  God, the dogs will be sulking.

Home, bag down, my lovely dogs pleased to see me.  It is 8.30pm.  It has been a long day.  Time for a cuppa, ring my mum and make sure she is okay.  Then a quick shower and then I should be able to hear my pillow whistling for me.

Yup, there it goes.   Good night all.  Until 5am tomorrow...

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News

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.

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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.

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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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