Wednesday, 16 July 2008

Diary Summaries Year One

As part of my 'get-my-fucking-act-together-and-organise' routine, whilst waiting for a pointless biology lecture I can not get away with skipping over I've completed my diary summaries for the first year. Read and enjoy: or not, as they're quite dull. I'm really only pasting them here as an online back-up.

Diary Summary: Semester One

My first placement saw me based on a neurorehabilitation ward. Being rehabilitation based, the ward saw the same patients for long periods of time. The placement gave me extensive experience of the workings of an MDT, most of whom were attached permanently to the ward. This gave me valuable insights into the roles of the Occupational Therapist, Physiotherapist, Psychologist and Social Worker. I attended two MDT meetings and became aware of the evidence based practice and clinical governance that would be used within them.

From a nursing point of view, the placement gave me solid experience of essential cares, especially to bedbound patients. The nature of the ward meant I developed my skills in building up relationships with patients on a day-to-day basis. These two basic skill sets would be vital for my further placements. I was also taught more advanced skills, like Neurological Observations and how to effectively tally a Glasgow Coma Scale, skills that would also prove useful in later placements.

Due to the nature of the injuries and conditions of the ward's patients, I was able to complete several sections of my Exposures booklets on this placement. I passed my communication OCSE. I gained an insight into the often complicated area of acquired brain injury, too.

Diary Summary: Semester Two

My second placement saw me based within a surgical ward specialising in gastroenterology. This seemed an ideal second placement as, unlike the former ward, patient turnover was generally quick. Unlike the previous ward, the was less input from a MDT and more input from the nursing team.

From a nursing point of view, the placement encouraged the development of skills relating and communicating with patients who I would only meet for short periods of time. This was a valuable experience that taught me the value of different ways and methods of communication, and posed quite the challenge. From a clinical point of view, there were more things to witness and start to learn: the removal of surgical slips, chest drains and catheters, for example. It was on this ward that I experienced my first patient death. And I worked my first three nights of my training.

Like the previous ward, this placement allowed me to complete more of my first year paperwork, including my Administration of Medicines booklet. I attended special sessions on new techniques and equipment used in NG feeding and special sessions on gastric banding and bypassing for bariatric patients. Otherwise, my time on the ward developed my knowledge of the GI tract and it''s role and function in daily life.

Diary Summary: Semester Three

My final first year placement saw me on a acute medical ward. The balance of MDT and nursing input was more equal in this environment, and there was a mix of long term and short stay patients.

From a nursing point of view, there were further opportunities to learn more about essential care. Given the ward received predominantly cardiac patients, they often needed help mobilising or washing. There was less to do and learn from a clinical point of view compared to previous placements, although I did receive more practice in preparing and administering IV solutions. These would often be diuretic solutions, therefore I also learnt quite a lot about the action and results of these.

I finished up my paperwork for the first year. The context of the ward helped me develop my understanding of the heart, it's A&P and the impact heart conditions have and will have on the growing, ageing British population.

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