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Preparing for Your Placement in Accident & Emergency

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Accident & Emergency is one of the busiest places in the hospital. Your placement will be a unique opportunity to experience emergency and unscheduled care in a controlled environment.

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

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A&E placements can also include insight visits to a variety of areas including; fracture clinics, plaster rooms, critical care areas and your local ambulance service.

Some A&E Departments are a combined adult and paediatric service – you may be expected to care for these patients too.

What to Expect from your Placement

Accident & Emergency will include a variety of patients from a variety of specialities who will be suffering from a variety of conditions – A&E, if nothing else, is varied and like the proverbial ‘box-of-chocolates’.

Accident and Emergency Departments are generally split into multiple areas, this is a brief overview of what you can expect in each area. 

Resus – Patients who have been brought in with a life threatening illness or are likely to require input from intensive care. This can include; cardiac arrests, trauma patients, overdoses, respiratory arrests etc.

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Triage – Patients are assessed, usually by a Nurse, on their arrival to the department – this will include a set of baseline observations and a brief history. The patient will then be signposted or ‘streamed’ to the correct area – this will determine the patients priority and time they will be seen in.

Majors – Usually for patients who have attended with a complex or urgent medical condition such as COPD or heart failure. Elderly patients with limited mobility tend to be seen in this area.

Minors – Patients who have attended A&E with minor illness and ailments such as coughs, colds and vomiting and are ambulatory.

Injuries  – Patients who have attended with suspected broken arm or leg will be seen in the injuries area. This area is usually closely linked with x-ray and plaster room.

First and foremost, do not worry – you will be surrounded by very experienced Nurses, Doctors and allied healthcare professionals. A&E, generally speaking, is a very safe and controlled environment with very experienced and senior staff at the helm.

Your mentor won’t expect you to have an in-depth knowledge of A&E interventions if this is your first placement but they will expect you to ask questions and participate in care.

Expect to deal with a lot of sensitive issues while on placement, some of these might ‘hit close to home’, communicate with your mentor and ensure patient confidentiality at all times.

Preparing For Your Placement

There are a few things you can do to prepare for your Accident & Emergency Department placement;

Try and visit your placement before you start. Emergency Departments can be intimidating places. 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 physiology and function of core systems, it will bode you well.

Look at ABCDE assessments and their importance. This systematic approach is used for everything within Critical Care – everything from handover to invasive treatment is based around an ABCDE model.

Research triage systems. Every hospital uses a different triage system although most are based around the Manchester Triage System.

Getting The Most From Your Placement

You’ll either love your A&E placement or you won’t. So it is important that during your placement you focus on transferable skills you can learn and/or improve on in this area, relish the opportunity to deliver global (holistic) care in this environment and understand the complexities of why patients attend A&E.

Spend time with all members of the team; Doctors, Nurses, Nurse Practitioners, Physios, Social Care, Specialist Nurses and the countless others!

Download the BNF app and consider buying a Clinical Skills Nursing Survival Guide.

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

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Education

Student nurses to receive ‘political lobbying lessons’

The session is designed to equip students with practical skills and knowledge they can use to develop a good relationship with their local MP.

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Nursing students will learn how they can work with MPs to promote the nursing profession in a new training session organised by the RCN.

Members of the RCN’s student committee and student information officers – the RCN’s representatives in universities – will learn their way around the UK parliament and the government from the UK Parliament Outreach and Engagement Service.

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The session is designed to equip students with practical skills and knowledge they can use to develop a good relationship with their local MP.

The RCN’s public affairs team will talk through the college’s approach to engaging with parliamentarians, especially the crucial role members can play. The team will explain different tactics and approaches students can take as well as what they can ask MPs to do to show their support for nursing staff in their constituencies.

Janet Davies, chief executive and general secretary of the RCN, said: “To work effectively, any union must be able to engage MPs and ministers.

“We know our members make the most powerful advocates for the profession. When frontline nursing staff sit in front of parliamentarians, you can see they listen.

“It’s through the hard work of members that vital issues such as safe staffing, harassment and health policy reach the top of the agenda.

“When nursing faces challenges on every front, the RCN wants to make sure our advocates are fully-equipped.”

Charlotte Hall, chair of the students’ committee, said: “Student nurses represent the future of the profession. Learning to engage with MPs is vital if we are to effectively shape that future and ensure the best possible care for patients.

“With these skills, committee members and student reps will be able to help other nurses make their voices heard on behalf of the profession and patients.”

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Nurse apprenticeships to introduced at nine more universities

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Nursing apprenticeships are to be introduced at nine more universities in England by September 2018.

Nine universities are to be given part of a £4.9 million grant by the Higher Education Funding Council for England to devise their training programmes for nursing apprenticeships over the next year.

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This is the second wave of investment from HEFCE’s Degree Apprenticeship Development Fund, designed to produce 4,500 apprentices from the following higher education establishments.

  • Coventry University.
  • Keele University.
  • Leeds Trinity University.
  • University of Cumbria.
  • University of Suffolk.
  • Southampton Solent University.
  • Birmingham City University.
  • Sheffield Hallam University.
  • Middlesex University.

Madeleine Atkins, HEFCE Chief Executive, congratulated the universities provided with funding;

“They will now work with employers to develop new degree apprenticeship provision across a variety of sectors. This will help more people to access higher education, and to follow their chosen career, while closing the skills gaps in the economy”.

Last year, in its first wave of apprenticeship funding, HEFCE gave money to four universities so they could offer nurse apprenticeships from September 2017.

Alongside this plan, Health Education England revealed last month it intends to train up to 45,000 new nursing associates by 2027.

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RCN introduces new infection prevention course

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The RCN has announced an innovative new course which will provide nurses working in infection prevention and control (IPC) with the skills to lead the fight against antimicrobial resistance.

The RCN Professional Development Course for Infection Prevention and Control is an introductory module designed for nurses working in the NHS, independent and social care sectors.

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The course will prepare nurses working in or have an interest in IPC for the current and future challenges to their work resulting from antimicrobial resistance. It will be piloted in Spring 2018.

Resistance to antibiotics in health and care settings is increasing globally as well as in the UK. Public Health England’s campaign, “Keep Antibiotics Working”, recently highlighted the key role nurses can play in the fight against antimicrobial resistance. Infection prevention and control and the work of IPC nurses is pivotal in reducing the need for antibiotics and combatting this threat in all care settings.

On the programme, participants will develop clinical and leadership skills in the prevention of infection, learn how to lead a service improvement project in their workplace and the most effective ways to manage and sustain change.

Rose Gallagher, RCN Professional Lead for Infection Prevention and Control, said:

“The UK is leading the fight against antimicrobial resistance and the prevention of infection. Antibiotic resistance is a very real risk whereby simple infections are prolonged or become untreatable.

“Nurses have paved the way as clinical leaders in the prevention and management of infection and this course is responding to their current and future training needs. It will focus on practical work-based learning and develop specialist nurses that can adapt to changes in clinical practice and service provision in line with changes to health systems.

“It’s important we focus on the prevention of infection everywhere, not just in hospitals. The role of IPC nurses is constantly evolving and this course will help direct improvements to combat the rising threat of antimicrobial resistance in all settings.”

Further details about the course will be published in the New Year and expressions of interest can be registered on the RCN website.

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