Wednesday 18 December 2013

Don't Take It Personally


Last week I found myself engaged in a conversation with someone in which it emerged for the first time that I was a student nurse. I noticed immediately a look of surprise upon the person's face, and before I had chance to ponder the reasoning behind such a reaction, was met with a detailed account of numerous experiences of poor nursing care that she and various members of her family had encountered. I apologised (on behalf of the nursing profession!) for their collective experiences, and offered my sympathies in relation to the numerous emotive events that were effortlessly reeled off. I was genuinely remorseful for what had happened.

Most of you, I suspect, would have reacted in much the same way and left it at that. I however (rightly or wrongly) felt the need to go one step further and try and offer explanations to some of the events that I felt could perhaps be attributed to wider, less personal drivers. 'Staffing is a major issue' I found myself saying, 'I know from placements that quite often there just aren't enough staff'. I have no idea what if any comfort I was hoping to provide by offering this information, but thankfully she seemed not to be offended, and at least acknowledged my point regardless of its agenda.

A few days prior to this, I found myself in the midst of yet another debate regarding the perceived inadequacies of current nursing education on Twitter - a topic that you may be aware I am particularly passionate and vocal about! It had stemmed from a positive exchange between myself and another tweeter in which we highlighted the seemingly high calibre of our future nursing workforce, before being hijacked by a third party whose primary motivation appeared to be the blanket belittling of university-educated student nurses (see, vocal!).

I’ve encountered this argument so many times now that I’m literally bored by it - in fact it incurs an instantaneous eye roll pretty much without fail these days. Don’t get me wrong, I quite obviously like a good debate - it’s good to challenge and be challenged, but on this occasion I decided the safest option would be not to engage, and that’s what I did... for a whole twelve hours or so.

Preceding all of these incidents however, was yet another recent dispute that (for one reason or another) in this instance I did manage to avoid, again involving student nurses. This time though the focus was on those amongst us deemed to be ‘academic achievers’, and claims regarding their supposed attributable practical and compassionate downfalls. Reportedly and not surprisingly, it proved rather a contentious issue.

As with the ‘old-style-of-training-is-better-than-the-new’ argument, I’ve personally encountered this mindset out in practice - albeit only the once. Now on the whole I’m pretty happy with my general performance at university, but I consider myself to be neither superior, nor a showboater. As with most, if not all students at this particular juncture, I still have a lot to learn both in and out of practice. In addition, the issue of my compassion has never been brought into question, and has always been something that has been highlighted in an entirely positive manner.

Overall, it was a pretty disheartening experience, but ultimately I was able to disprove any preconceived ideas regarding my motivations and practice, although I felt the whole situation put me an automatic disadvantage right from the start. Thankfully the process of convincing them that I wasn't simply a textbook-quoting robot was a quick one, but I know that neither myself nor some members of the staff involved were ever completely comfortable with my perceived academic prowess.

These accounts illustrate just some of the persistent attitudes and obstacles that we as student nurses are up against before we even qualify. Add to this the hopeful expectations some hold for our ‘new generation’ in light of the prolific and often epic failings of our much-beloved healthcare system and profession (admittedly this is undoubtedly the exception as opposed to the rule), and it seems we have rather a lot to prove. Perhaps it’s good that we encounter such adversities now, before we register, and officially inherit all of this collective baggage. Perhaps it’s good training. Perhaps it will even stand us us in good stead. Who knows. I for one though plan on taking it one step at a time, perhaps I should start with learning not to take it all so personally first.

Tuesday 19 November 2013

The Shortfall


Truth be told, I've struggled with third year since day one: it's not quite what I thought it would be, yet at the same time it is. It's not the workload, lack of social life, or even the new tangible weight of pressure and expectation that's the problem - OK, maybe it's some of that - but rather the issues I've already touched upon in an earlier post that are bothering me, which to make things worse, are coupled with seemingly unshakeable feelings of self doubt.

I recently completed my first placement of third year, and it was absolutely one of the toughest things I've experienced to date. For the first time ever since beginning my nursing education, I very nearly arrived at the decision to walk away from it all, and I'd be lying if I said the thought isn't still lingering somewhere in the back of my mind.

For the past four weeks I've been in a state of flux: wrestling with feelings of complete inadequacy and incompetence one minute, only to swing to feelings of accomplishment and gratification the next - though the latter has been considerably less frequent in occurrence.

I finished second year on a high, replete with a newly-found and much-needed confidence that I perhaps had what it took to be a nurse, and a good nurse at that. Yet, here I am at the beginning of my third year, questioning whether or not I am in fact cut out for all of this.

At first I thought it was simply me that was the problem: specifically my lack of confidence and self-belief. I reasoned that I was placing too much pressure on myself, and prematurely at that. Yes, I'm in my third year, but I'm at the start of it, not the end: I'm not a qualified nurse yet. However, with only ten short months until I do actually qualify, this form of logic is of little comfort to me at this particular juncture.

To further exacerbate things, the placement area itself was that of a 'heavy' acute ward, the kind of ward I had not experienced since the beginning of my first year, and it was absolutely a shock to the system. For those who work in different fields, the nurse-to-patient ratio can be anything from eight to ten patients per staff nurse, if not more. I should mention at this point that I've often been described as an unashamed idealist by some of my friends, and I suppose in many ways I am. I aspire to and enjoy the kind of nursing that addresses all patient needs: otherwise known in the trade as holistic, patient-centred care, and in my experience, acute adult wards are often not where this occurs. 

I want to make very clear that in my experience this is rarely due to the quality of nursing staff on these wards, but rather the number of staff and resources that are deemed 'sufficient' to provide 'safe' patient care in such settings. These wards are often filled with older people, requiring extensive medical and nursing input and interventions. 

An average morning on such wards usually consists of the following: a nursing handover, the serving of breakfast, the administration of medications, the facilitation of patient hygiene needs, and the participation of ward rounds; all of which is completed just in time (hopefully) for lunch to be served. 

Following lunch you have: regular 'turns' and 'checks' (which would have also been performed throughout the morning) to maintain, the first set of documentation to complete for each patient (which ideally would have been done earlier but there probably wasn’t time), IV antibiotics to prepare and administer, three medications rounds, dressings changes, the carrying out of physiological observations, any additional nursing interventions that are required, consultations with patients' loved ones, an MDT meeting to attend depending on what day of the week it is, a final set of documentation to complete, and nursing handover to give; all of which is to be completed before you finish your shift and go home, though most likely not on time.

What I’ve described is only a very basic and general rundown of an average shift: I’ve not even touched on the hypothetical three discharges that you somehow managed to squeeze in, nor the three new admissions that all arrived during your final medications round, precisely one hour before the night staff are due to arrive for handover.

This is the daily reality for most adult nurses on acute wards, and it is this that creates what the brilliant nurse-blogger @grumblingA insightfully articulates as ‘compassion hunger’ for many of these nurses - the post for which you can find here. It’s not a coincidence that as a student nurse with less but ever-increasing responsibilities, I seem able to build better rapport and relationships with patients than most staff nurses - at least in my opinion - which is another insight the aforementioned author highlights in the same post, but that I only recently began to really focus on and scrutinise - a fate that sadly I suspect awaits me.

So what now? Where does all of this leave me? Right now, I’m not sure. All I know is that I’m left with lots of questions and doubts, and feeling woefully short of answers.

Monday 4 November 2013

The Student Nurse Blogger Collective




For those of you who are reading this outside of our own independent blogs we feel a little introduction is in order; we are a new double act of student nurses who go by the names of Laura, and Florence Nursingtales (Flo for short). We both run our own independent blogs, which aim to chronicle our lives and experiences as student nurses and beyond. Laura runs a blog called She’s Off Again; a blog about life as a third-year, mental-health field student nurse, and Flo runs Florence Nursingtales; an anonymous blog about the life of a third-year, adult-field student nurse. We've both been running our blogs for over two years, and first connected with each other through this wonderful world of social media.

We're both passionate about blogging, and wholeheartedly believe in the benefits and value it can offer to student nurses alike. So together with Britain’s Nurses, we’ve come up with a plan in order to convince more student nurses to get involved in this amazing experience.

We recognise that many student nurses are interested in starting a blog, whether that be through running their own independent blog, or by becoming involved in community blogging. However, we’re also aware that there are those out there who for a number of reasons feel unable to get involved, and that’s where we come in! Whether you struggle with technology, writing, or time, we’re on hand to help. We want to support student nurses, regardless of field, location, or progression point, to get involved in social media and offer their experiences of life as a student nurse through blogging. We’ll help with promoting blogs from both experienced and newbie bloggers, answering questions, and sharing tips and strategies to make the most out of your blogging journeys. Ultimately, we’re offering a one-stop shop that will hopefully suit everyone’s needs, and as you may have guessed, we’ve called it: The Student Nurse Blogger Collective. 

So how do we plan on achieving this? Good question! Here are some of the things we’ve come up with:

Blog Ring - There are plenty of brilliant student-nurse bloggers out there, though in our experience, finding them can often be a challenge! So we've come up with the idea of setting up a blog ring; a free service which allows you to connect with others who blog about the same subject matter. The plan is to incorporate these blogs into a public blog-ring list, so anyone looking for student-nurse blogs can find them all in one place. This initiative also supports those new to blogging who are looking for a little inspiration and guidance. We’re in the process of setting this up, so we’ll update you all once it’s all done.

Platform - We both know how busy and time consuming running a blog can be. So for those of you who feel unable to commit to running your own full-time blog, we have the perfect compromise in the form of a collective-blogging platform courtesy of the lovely peeps over at Britain’s Nurses. You can blog as little or as much as you like - no pressure! We hope that such a platform will encourage more students nurses to at least give blogging a bash, and who knows, if it goes well, you might even be inspired to start a full-time blog of your own! Huzzah!

Anonymity - For those of you who desire to blog anonymously, you can either email from your personal account stating that you want the post to be anonymised, or you can create a non-identifiable email account and email either ourselves or the lovely Stina over at Britain's Nurses with your post - pseudonyms are of course welcome too. Equally, we welcome those who would like to attribute their identity to their work. Either way, we’re keen to provide an open and inclusive space for reflection on all nursing matters. We are of course happy to to accept anything as long as it adheres to the NMC’s the code…, and guidance on social-networking sites, regardless of things such as writing style, word limits, etc.

Buddy System - Whether you like the idea of setting up on your own, or building your confidence over on the Britain’s Nurses platform first, we’re hoping to offer a mentoring system for those who’d like some support. By pairing newbie bloggers up with experienced bloggers, we’re hoping to provide help and support every step of the way. There are lots of student-nurse blogs out there that feature a brief flurry of activity in the early days and then nothing more; we hope to stop ‘blog abandonment!’ by supporting baby bloggers through the early days. All offers of mentors and mentees are welcome, just get in touch.
So, if that little lot hasn’t enticed you into our blogging world, here are our top reasons why it’s pretty fabulous to be able to call yourself a student-nurse blogger:

Professional development - blogging is a tool that can help build on your skills as a competent practitioner: it can help improve your reflective skills; a key skill in nursing, as well writing abilities, and IT skills, amongst others.

Portfolio Evidence - You’d be surprised how valuable blogposts can be in terms of providing evidence for portfolios; watch those hollow lever-arch files fill up in no time at all!

Support - Being a student nurse can be an isolating job at times. We often have different holidays to the rest of the student population, spend more time in university which means less time off, and often hold innumerable responsibilities. All of these things combined make it hard to fit in with the more typical student events and opportunities, which is where blogging comes in! Blogging is a brilliant way of building up support networks; providing you with contacts from all over the UK and beyond. Not only that, but sharing stories with others helps boost morale and provide a much-needed reminder that you’re not on your own when things get tough.

A Diary for the Future - Upon qualifying, Laura has come up with the brilliant idea of getting her blog professionally bound and made into a book (I am totally stealing that idea! - Flo). It will then serve as a permanent reminder and memento of her time at university, providing her with something tangible to look back on and treasure for years to come. 

And that's it! If you’re a student nurse reading this thinking ‘I could do that!’, please, please get involved and join us in our mission to get more student nurses blogging. You can either contact us through stnbc@outlook.com, or via our Twitter account @STNBC
 
Laura and Flo xx


Monday 7 October 2013

Bravery


During a recent eye-opening conversation with a much-loved, long-standing friend, it was revealed to me that she believed me to be brave. ‘Brave for what?’, I asked. ‘Brave for being a nurse’, she replied. I’ve experienced similar remarks like this before, and each time I’ve struggled to make the connection. Upon further discussion, it usually becomes apparent that the reasons behind such thoughts include something similar to the following: the long hours - 'your shifts are how long?!', dealing with the expulsion of imagined gallons of bodily fluids on a daily basis, looking after 'all those drunk patients who end up in A&E of a weekend' - I've never worked in A&E, and perhaps most frightening for them, caring for those who are in pain, or critically ill, or dying.

Whilst most (if not all!) of the aforementioned issues may have daunted or scared me at the beginning, the truth is that I tend not to worry about such things now. Instead, as I fast approach my transition from student to qualified nurse, my fears have shifted to more political and logistical-related issues. Those of you who follow me on Twitter may have picked up on this of late, with my fairly incessant tweeting in regards to the likes of: safe-staffing levels, skill-mix ratios, the underhand and not-so-subtle privatisation of the NHS, the seemingly-endless cuts facing our already-underfunded and under-resourced healthcare system, the avalanche of tick-box exercises that are now an everyday part of the nurse’s role, and, what I have at times perceived to be, a saddening lack of solidarity and support within the nursing profession. All of these things (and of course there are others) seem to me, to be competing and conflicting issues that ultimately oppose what we, as nurses, instinctively and intrinsically value.

I've written previously about my last placement, and what an absolutely wonderful experience it was. My development within those ten short weeks was tremendous - thanks to my fabulous mentor whom I’ve already tweeted and written about rather extensively at this point. However, with that much-needed development and increasing autonomy came the stark realisation of what it is to be a nurse in today’s (internal and external) political climate, and truth be told, I’ve struggled with it ever since.

Hopefully, most of you will have recognised by now that I want to be a nurse for the most simplest and sincerest of reasons - I want to care for people. I'm not in it for the glamour or the money (I'd have to be a fool if I were), or the international opportunities; I'm in it for the patients, nothing more, nothing less. But how much will my pre-qualifying desires match up with the reality of post-qualifying responsibilities in light of all these conflicting influences? Experience and reality tell me that they won't, at least for the most part anyway. At some point in the not-too-distant future, I suspect that I am going to have to try and reconcile these disparities and attempt to arrive at some level of acceptance; if not in the hopes of avoiding a severe sense of disillusionment and protecting my own sanity, then most definitely for the sake of my patients, and that, is going to take a great deal of bravery indeed.