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Preparing for Your Placement in Clinical Haematology

Clinical haematology can encompass a range of sub-specialities.

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Clinical haematology wards are busy places, full of very sick patients – understanding the basics will put you ahead of the game.

Clinical haematology can encompass a range of sub-specialities such as; bone marrow transplant units, general haematology wards, haematology clinics, genetic mapping centres, obstetric haematology and day case units.

Throughout your placement you will be exposed to a multitude of haematological conditions and it will be a unique opportunity to develop skills, knowledge and gain confidence in dealing with these.

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Patients in these areas, generally, have very poor immune systems – so you’ll be advised to stay away or wear a mask if you arrive at placement unwell.

What to Expect from your Placement

The ward or unit routine will differ from trust to trust, but this is something you will pick up quickly – so get as involved as you can.

You will see the day-to-day management of conditions such as; leukemias, lymphoma, myeloma, sickle-cell and various clotting disorders. Over-time these patients become very knowledgeable about their conditions – so use them as a resource to learn.

Most units actively participates in clinical trials governed by the National Cancer Research Network (NCRN). This will involve patients trialling potential new treatments for heamatological conditions.

You should get plenty of experience managing a septic patient. You should familiarise yourself with ‘Sepsis 6‘ and clinical escalation within your trust; Doctors, CCOT, Emergency Medical Teams, Hospital at Night etc.

Preparing for your Placement

There are a few things you can do to prepare for your placement within clinical haematology;

Try and visit your placement before you start. Wards and units can vary greatly. Visit the area you have been assigned to before you start and ask if there is anything you should be aware of prior to starting.

Identify your learning needs and outcomes. Identify these early and be aware of the skills you want to develop or learn – this will help you get the most from your placement.

Brush up on your anatomy and physiology. Familiarise yourself with the mechanisms of bone barrow and the haematopoietic stem cell cycle.

Read up on the basics. You should read up on the basics of haematology – familiarising yourself with the different types of leukemias, lymphomas and myelomas. The MacMillian, NHS Choices, Cancer Research and Bloodwise websites are fantastic recourses to help get to grip with the basics.

Understand the social impact on patients. A cancer diagnosis can be devastating to both an individual and a family, with individuals remaining inpatients for months at a time. Consider the impact this would have on a family; emotionally, financially, spiritual, sexual, professional etc.

Learn about neutropenic sepsis. Neutropenic sepsis is a life threatening complication of anticancer treatment and a genuine medical emergency. haematology patients have a tendency to deteriorate quickly so be sure to escalate to your mentor if you discover an unwell patient.

Research area-specific medications. You should read about commonly used anti-virals, anti-fungals and antibiotics. You could also invest in the Drugs in Use (Nursing and Health Survival Guides).

Understand the risks and complications of blood transfusions. You will see patients being frequently transfused with red blood cells or platelets. Understanding the complications and reasoning behind these transfusions will put you ahead of the game.

Look at ABCDE assessments and their importance. This systematic approach is used for the assessment and treatment of patients ABCDE model.

Chemotherapy will be administered in these areas. Although it will be interesting to watch you will be limited in your involvement due to the enhanced training required to administer. 

Getting the most from your placement

Haematology wards and units are usually very busy places, although you are supernumerary their will be jobs you’ll be asked to undertake independently once deemed able. There will be the chance to easily obtain learning outcomes and measures of practice.

You should use this placement to gain experience managing a patient load, managing a septic patient, clinical decision-making and, if possible, arranging insight visits with specialist areas.

The final and most important piece of advice I can give you is to ask questions and get involved. 

Resources

Former student nurses share their top money-saving tips

“A nursing degree is very different to most undergraduate courses.”

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Student money saving tips

Direct from former student nurses, the Student Money Guide is packed with useful tips.

New nursing students should claim fuel reimbursements, car share, compare markets and supermarkets and seek second-hand textbooks to make their student funding, and part-time wages go as far as possible, updated advice from the Royal College of Nursing (RCN) says.

The College’s latest Student Money Guide for nursing is packed with useful information on childcare, travel expenses, charitable funding and tips for those moving into private rented accommodation.

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The top money-saving tips.

Direct from former student nurses, the guide offers some top money-saving tips, which include;

  1. Develop a good relationship with your bank – meet and go through all the options and accounts which will save you most money and give you the best interest rates
  2. Use online materials, the RCN Library for example, instead of buying textbooks – If you do buy them, try advertising on university notice boards for second-hand copies, or, have a look at www.abebooks.co.uk. Use cashback websites, such as Quidco, when making purchases.
  3. Get a Young Persons Rail Card if you spend over £72 a year on rail travel – all full-time students are eligible, regardless of age.
  4. Claim fuel reimbursement if you drive further to placement than to university – it is offered, so you might as well.
  5. Be penny-wise, seek out free pickings – go to sites like Freecycle for free furniture, kitchenware and bicycles.
  6. Check out your local discount warehouses for basics, cleaning products, toilet rolls, washing powder and buy these as a household to split the cost of a bulk buy – it is well worth it.
  7. Share lifts to placement and do food shops with fellow students.
  8. Make sure your supermarket shop is cheapest – check online comparison sites like mysupermarket.com ahead of your shop.
  9. Use your local butchers and market.
  10. Take a packed lunch and flask to university – you will save a small fortune and probably eat better.

Nursing is different to other degree courses.

Claire Cannings, Senior Welfare Adviser commented: “A nursing degree is very different to most undergraduate courses. The placement element means there is less time for part-time work, and the long shifts mean childcare and travel is often more expensive.

“Fluency with finances, brilliance with budgeting and keeping clued-up on things complimentary can pay dividends. This can, in turn, impact positively on study and well-being through a student’s learning years and beyond. It’s amazing how many grants and funds students are entirely unaware of which is why we’ve collated all the information they need in one place.

“While the RCN will still be making the case to Government to invest in nursing education, we hope the guide will continue to be a valuable resource to our current and potential members.”

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Clinical Updates

Induction framework for General Practice Nurses launched

It also provides guidance for practices employing General Practice Nurses.

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The document provides a framework for both new and experienced general practice nurses.

NHS England, in collaboration with The QNI, has launched a new Induction Template for General Practice Nursing.

The Induction Template is has been designed to enable employers to ensure that nurses in a first career destination role in General Practice are well supported when taking their first career step in primary care.

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Not just useful for newly qualified nurses, the 51-page document provides an induction framework for all new general practice nurses, enabling them to develop key skills required for the role.

It also provides guidance for practices employing General Practice Nurses.

Nursing associates, health care assistants and student nurses preparing for a primary care placement may also find the template useful.

A great start to a long and exciting career’.

The author of the document, Queen’s Nurse and experienced nursing mentor and educator, Sharon Aldridge-Bent said; “Developing this template highlighted the urgent need for a comprehensive induction and orientation programme for all nurses new to general practice.

“This most certainly will assist with recruitment and retention of nurses in the primary care setting.”

Paul Vaughan, Head of Nursing Now England, responsible for the delivery of the GPN Ten Point Plan, said: “this new resource will enable employers to ensure they provide nurses new to general practice with a really good experience of working in the sector and ensure they have a great start to their long and exciting career working general practice.”

The resource underpinned by General Practice – developing confidence, capability and capacity – A ten-point action plan for General Practice Nursing (2017) contributes towards the overall strategic goals outlined in the General Practice Five Year Forward View.

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