Monday, 6 October 2008

The Second Year then...

It's a long time coming, but it's time to procrastinate about the second year of this wonderful Diploma I'm on. As previously mentioned, this module is split into two. The first module is all about Health Promotion, which means I struggle to stay awake during lectures and seminars and get into all sorts of trouble.

I have a few problems with this concept of Health Promotion. Don't get me wrong, it's important. Nurses should be nursing people before they get sick (even if this idea is not something I personally want to follow up in my career) for the first time or any concurrent occasions. No mean feat, but it is a noble goal. My main problem, however, is the idea that nurses have to work closely in line with local policies and government white papers they have little control over. Maybe it's just the socialist in me, but I'm against being used as a tool of the government. And we could debate how regular, hospital-based staff nurses are the foils of HMG, but those involved in Health Promotion are - in my opinion - more so.

Apart from that, the lion's share of health promotion theory is all too Humanist for my tastes. I'm a Freudian with lashings of Cognitive, Behavioural and ginger beer, thus generally lack faith in anything Carl Rogers would adore. Not that it is not without certain value to certain groups of people, it's just of little interest to me.

Speaking of which, the second module this term revolves around nursing people with acute and critical illness. This is where my passion lies, blatantly. This is where a nurse needs to be skilled both technically and personally (i.e. around and about people). To say it's cutting edge stuff is perhaps a bit insensitive, but it's true. It's where I would like to be.

My responses to each module have been quite predictable. I'm excited and interested in acute and critical care, seminars in which we speak and debate the technical skills and - more importantly - how they relate to patient care. There is this underlying, excellent reminder to keep your centre in mind. Don't go requesting a CT scan until you've had a chat with the patient (if possible) about how they're feeling. If a patient feels unwell, don't jump straight for the DinaMap until you've looked the patient over with your eyes and experience.

Health promotion seminars drone on about government initiative after government initiative which, if you look into it, haven't made much of a difference anyway (although we never get to debate this in seminar). "Saving Lives: Our Healthier Nation" for example has been recognised as not reaching it's aims. This is government-speak to say it failed. But instead of doing something radical, another document was producing, full of management speak and, as a respected colleague of mine has pointed out fancy collections of letters that are "just words". Words, of course, backed up with bureaucracy. This time, however, the ideas are constantly backed up with the idea of "choice". "Choice" being a byword for privatisation through the back door, another issue we don't get to debate. My anti-capitalist leanings aside, we spend very little time talking of nursing in the read world and instead speak in abstract, disconnected terms. I assume the essay I have to write on an issue related to health promotion will have to be full of such terms, too.

My next placement is within a cardiac rehabilitation environment, which should certainly be an experience. I shall, of course, end up doing my health promotion essay about issues pertaining to coronary heart disease. This is an easy option, but why make it hard for myself? The essay itself is pretty yawnsworthy. Discuss health promotion related to a certain issue, including primary, secondary and tertiary care/prevention. Given our other assessed piece of work is about CHD, I think it's wise to do it about that. If a little boring.

Anyway, the second year: a mix of beastliness (in the good sense) and boredom, so far. The jury is still out. I might like Health Promotion once I get into placement and see it in action, but for now I am more excited about my upcoming critical placement.

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