Tag: Nursing Placement

Part 2. Being on Placement During the COVID-19 Pandemic: Diaries

In the second part of my series Being on Placement During the COVID-19 Pandemic, I take on a three week placement in paediatrics in a rural hospital and a week in ophthalmology. I also face a lack of PPE and a COVID-19 scare.

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I’m baaaaaack! Yes, I have been MIA but I’m hoping to get back into the blog! I wrote this post a long time ago and was deciding whether to post it or not but I think it’s important for me to reflect on my practice and for others to gain a little insight into what it’s been like to be on placement during the COVID-19 pandemic as a nursing student.

This blog post contains general entries from my time on placement and any information regarding a particular hospital or patient has been omitted or changed for privacy reasons.

02 July 2020

I was expecting to go to the Coronary Care Unit for my last block of placement but I’m very excited to be in paeds! I had it as one of my placement preferences but had never gotten it. I can’t lie, I’m a little bit disheartened that I hadn’t gotten a critical care area for my last placement but I’m trying to stay positive about it. Paeds is very different to adult nursing. I feel like a little bit of a fraud because everything is done so differently; the med checks are the same in principle but completely different to what I’m used to in practice.

I’m way out of my depth. I had to take out an IVC [intravenous catheter] from a four year old. I’m sure she won’t even remember it but I felt awful. She cried the whole time – not because taking out a cannula hurts but because it hurt her to have the bandaid taken off which secured it. I feel like all I do is make these tiny tots cry when I’m trying to help them.

1o July 2020

I have been in paediatrics for two weeks now. I feel like I have been here long enough now to say with confidence that this is the situation: we are severely lacking PPE [personal protective equipment] and just about every second patient is ?COVID [nurse short-hand for suspected of COVID-19]. When those patients do come in, I want to be able to protect myself and everyone else by wearing the appropriate PPE. But the reality is that we don’t have the PPE we need because other people are panic buying and the hospitals themselves are stockpiling [this is not isolated and is widely reported].

I am really conflicted about this because if the worst does happen, I want the stockpiled PPE to be there but I’m also interacting with patients who could have COVID-19 without the right masks and gowns. It’s a complicated situation and definitely not a safe one. Despite my concerns, thankfully none of our ?COVID patients have returned positive results.

EDIT: Since writing this post there has now been a new confirmed case of COVID-19 in this rural town.

17 July 2020

I’m coming to the end of my placement in paeds. I have really enjoyed working with this team of fabulous nurses and learnt a lot. I feel like this placement has taught me so much about medications that I wouldn’t even have thought about nursing on an adult ward.

I have also learnt a lot about resilience and standing up for myself – I will not be bullied by six year olds (or anyone). This week I looked after one patient who had broken their leg. They had a full leg plaster cast. I felt bad for them of course, I wouldn’t want anyone in that situation, but they were the rudest, cognitively intact patient I have ever cared for. They were rude to me and their mother and demanded constant attention from the nursing staff. They even kicked me one day when I was helping them into their wheelchair (I’m really hoping it was an accident). I love kids but I’m not sure that paeds is for me.

What I have loved about working in a rural hospital is the relationship between the staff, from the doctors and nurses to the ward cleaner (who is a legend by the way and helped me out in so many ways). It was nice to be respected as a nurse by everyone in the team even though I was a student. If they had a concern about a patient I was looking after, they came and spoke to me directly (with my supervising nurse there for support of course!) and I felt confident enough to approach them myself with patient concerns. On nights when it was quiet, we all had dinner together – even the doctors (socially distanced with all rules followed – it was a small ward with few staff).

22 July 2020

I was supposed to begin my last week of placement EVER this week. That didn’t happen. I developed a sore throat over the weekend and couldn’t attend placement. The likelihood of it being COVID-19 was minimal but that’s just not a risk you take. Two days ago I got my second COVID test and let me tell you… it’s nasty.

They performed a nasopharangeal swab. They told me that they don’t put it all the way into your nasal cavity anymore but it sure felt like something was going up my brain! I understand though – better to make sure you get all you can for the test.

For now I’m waiting for my test results to come back.

30 July 2020

My test came back negative so I am back to placement. Although I was slightly delayed, tomorrow marks 800 hours of placement. It took a lot of blood, sweat, tears and pooh (literally) to get here. My CLN [clinical liason nurse – preceptor] gave me a lot of encouragement and feedback to get through this last month. And while I’m super proud of myself for finishing my degree, I still think I know nothing. Not quite sure I’m ready to be a nurse but I’m sure the confidence will come with experience.

As for ophthalmology, the hours were great. I finished work everyday at 5pm and was consistently home for dinner. I learnt a lot about eyes, which I hadn’t thought about since we studied anatomy and physiology in the first year of our degree. It was good to refresh my knowledge and add to it! I feel like I didn’t use my clinical nursing skills too much but it was a nice change of pace and everyone was super accommodating even though I was only there for a week. I also learnt that I definitely need to get my eyes tested.

Now the ‘second wave’ is picking up. Everyone is becoming more cautious once again. Only time will tell how this will play out.

In the words of Doctor Mike, once again, ‘Stay alert, not anxious’.

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Part 1. Being on Placement During the COVID-19 Pandemic: Diaries

Placement is the time where you put your clinical skills to the test as a nursing student. I put together some entries about my experience on my last placement during the COVID-19 pandemic.

This blog post deals with the death of patients. If this brings up any worries or concerns, please reach out to someone or visit: https://www.lifeline.org.au/.

30 April 2020

It was not long ago that all placements had been cancelled. Thankfully the number of COVID-19 cases have been declining in Australia and some placement areas are now taking students again. I got the email yesterday that I would start placement in five day’s time (but only if certain criteria were met). At first I felt relieved that I had gotten a placement, which brought me one step closer to completing my degree.

Now, it’s sinking in a bit more. I got another email today about protocols for entering and exiting the hospital, and infection control measures that need to be taken. Although I won’t be in an area of the hospital where COVID-19 patients may be, it’s a little worrying to think what I could expose myself, my family and my patients to.

06 May 2020

I’ve been on placement for a few days now. So far, I’m loving working on this ward! I’m feeling a lot less nervous about the COVID-19 pandemic as I’m working on a designated ‘clean ward’ (a ward that doesn’t take any COVID-19 or suspected patients) and there is hand sanitiser everywhere. I’m also feeling a little safer because the number of COVID-19 cases has decreased so much. I’m lucky enough that the area I live in has very (VERY) few cases now.

When we were doing our ward orientation, the CDN warned us students to go straight home. If we needed to go to the shops at all, we should go home and get changed first, not because of the infection risk (because we’re a clean ward and everyone has been being very careful) but because some staff members had been abused by members of public. This was so disheartening.

I’d always felt proud to be a nursing student and to wear my uniform – as if it was saying ‘I’m here to help’. I just couldn’t believe that anyone would be yelling at someone or refusing to help any one of the amazing nurses I have worked with. I can understand that people may be fearful of catching COVID-19 as it can have devastating consequences but I think that we, as healthcare professionals, know that as well as anyone. And that someone would be rude to a nurse that could help them if they were to become ill … I just don’t know how to feel about it.

19th May 2020

I haven’t been writing as regularly as I should – being on placement and trying to study is super tiring. I’m feeling kind of grateful that we haven’t been allowed to work (at other healthcare facilities because of COVID-19) while on placement, otherwise I don’t know if I’d be able to do it. I know it’s not something that I should be complaining about because it’s about to become my new normal. I guess it’s just a matter of adjusting.

I guess placement has been a little bit up and down lately. On Friday there was a MET (medical emergency team or code blue) call and I scribed. The nurses were doing other things for the patient and the doctors were trying to figure out what was going on so I ended up being the scribe. Thankfully there was another student I’d been on placement with who was helping me collect all the information like vital signs and tests being done. I was super nervous but I think I did an okay job, even if it was only for five minutes. I came out of the MET feeling really proud of myself – that I’d contributed in that situation.

Later that same day, my first patient passed away. Over the weekend a second patient I had looked after passed away and on Monday night a third patient I had looked after passed away. They say it happens in threes. The death of my patients wasn’t something that really shocked me or scared me, they were palliative patients and I knew it was going to happen but I was quite sad when they passed away. For my first patient, I was privileged enough to help with her after care and I felt honored (the only way to describe it) to help her in that moment.

22nd May 2020

Today was my last day of placement. Last time I wrote I think I was definitely feeling some stress and sadness – mostly tired, I think [insert crying laughing face]. It’s safe to say I’m feeling much better (thanks to sleep) and more confident in my practice as a baby nurse. I’ve definitely learnt a lot during this placement in terms of clinical skills, my interactions with patients and colleagues. There’s still a lot I need to learn on my final placement but I can’t wait to finally become an RN!

I looked back at my previous entries and how worried I was about going into the hospital environment during this pandemic. I’m still worried with some of the restrictions lifting but I’m so relieved that our numbers have been so low. I can’t imagine how it must be in other countries. If things had been worse, I’m glad that I’m in a position where I could help in some way.

Placement can be hard sometimes. It’s just important to keep the positive experiences in mind during those times. And there are so many positives about nursing.

Some Things We Probably Should Have Known in First Year: Advice From Students and Teachers

In honor of International Nurses Day last Tuesday, I asked some nursing students (and teachers!) to share some advice to other students to help prepare them for studying and working as a nurse.

This week, we’ve seen the stories of so many amazing nurses in celebration of International Nurses Day. This day was particularly special as this year is the Year of the Nurse and Midwife. Although this was not the year most of us were expecting, there has been a fantastic celebration of all the hard work that nurses do and deserve to be recognised for!

Nursing can be a challenging (but very rewarding!) job. Learning things in class doesn’t always entirely prepare you for what you might face on placement or on the job. I asked some nursing students and teachers ‘what was something you wish you’d known in first year, when you first started?’ Most nurses could talk all day, so it’s a little bit of a longer one! Thank you Elise for the idea of doing this post!

From the Students:

‘Semester one can be a struggle to find a balance between uni and everything else but you do manage to find your feet and find that balance despite uni being sometimes overwhelming. Three years seems like a super long time but it’s not – it goes by so quickly. Teachers really are more like your friends and really want you to do well because they are your future colleagues and you might be caring for them one day. Don’t be afraid to ask your teachers for help.’ – Amy

‘We’re all learning forever – don’t be afraid to ask lots of questions and jump at every learning opportunity that is presented to you.’ – Tash

‘Uni provides so many opportunities to be involved in! You have the chance to be part of clubs, societies, study abroad, faculty led programs, and volunteer and employment positions are often advertised to us. Apply for them even if you’re not sure you’ll get it or you’re thinking ‘yeah that might be alright but I’m not sure’. There is no harm in applying. The worst-case scenario is that you won’t get it and that’s okay. Other times you will get in and it might surprise you. Merely getting your degree restricts your knowledge to the curriculum. Being involved in other things broadens your experiences and helps you grow as a person and a professional.’ – Blair

‘Make good, strong relationships with your peers and teachers. There can be some hard days and weeks so having an awesome and encouraging group of people to support you can make such a difference.’ – Emma

‘Uni gets easier! During the first year it’s quite difficult trying to find resources and understanding them, learning how to learn, stuff like that. But it gets easier!’ – Cam

‘Do all the gross stuff like showering, bed pans and gross dressing changes because eventually you’ll get used to it and it’ll just be normal work. Read the Occupational Therapy (OT) notes – there’s so much super useful information. OTs coordinate how patients interact and are nurtured by their environment. They have information on eating habits, pressure injuries, mobilisation, socialisation and so much more. It makes nursing so much easier with this information and your patient can get the best care.’ [Side note from Daisy: they also generally have some great handwriting!] – Dash

‘Take every opportunity that gets handed to you. Always ask for feedback. Nursing friends are the best therapy [they know what you’re going through!]. When you have an opportunity, take a break. Learn to take care of yourself even in the busiest time periods. You are going to see and deal with things that the average person won’t. Make sure you reflect and think talk about it! Mental health is just as important as physical health. And always remember why you are doing what you’re doing – find your motivation. Sometimes placement gets tiring – you want to procrastinate with assignments or you don’t feel like studying for that exam. Make sure you know how to drive your drive and passion in these moments!’ – Elise

From the Teachers:

‘I wish I’d known how to perform in the moment, having a whole list of catch phrases to get through difficult situations and how to write your own narratives for different situations. “Sentence stems” can be very helpful. If they say… you can say… For example: “Aren’t you a cute little lady?” “You can call me nurse, or you can call me … but you need to stop calling me that or I will have to get another nurse.” or “Why do you need a three year degree to help me wipe my butt?” “If you make it out of hospital without any complications, you’ll be glad you had a nurse as educated as me!” – Dr. Kasia

‘Figure out your own way/structure of documentation. This takes time. Nurses can work anywhere! I don’t think people know where nurses work. You can work on cruises, the community, outside the hospital – most nurses work outside the hospital. It’s so diverse and it looks different in every setting. You probably won’t end up working where you might have thought you would.’ – Fellon

Some Advice From Me:

Everyone has been spot-on in their advice. The first year is especially hard while you’re trying to figure it out but you’ll get the hang of it in no time! If you’re paired with a nurse on placement that you really get along with, try and work with them more. The more you work with that person, the more trust they’ll have in your ability so you can start to do more and more. If there is something you really want to learn, ask. The worst they can say is no and you don’t want to regret not asking. In most cases they’ll try their best to make it happen for you! Try and make the most of every opportunity and have fun!

I hope this will be helpful to some of you and that you’ve celebrated the nurses in your lives this week! Thank you all the amazing nurses who contributed to this post! If there’s anything else anyone would like to share please leave a comment – I’d love to hear any advice you might have to share!

The Terrifying Experience of Giving My First Injection

For many students, giving an injection can be a terrifying experience. It can also be one of those things that makes you feel like a real nurse! This is the story of giving my first injection.

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The information in this post has been de-identified and some of the details changed to protect the identity of the patient. All the information in this blog is consistent with the NMBA Social Media Guidelines and can be found here: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines/Social-media-guidance.aspx . This is NOT a ‘How to’ and should not be taken as instruction on how to do injections. This is just me, sharing my experience of giving my first injection.

I was lucky enough to be doing a community placement during my second year. The nurses I had been working with asked me if there was anything I wanted to do while on placement with them. Of course I had a list as long as my arm but what I really wanted to do, more than anything, was give an injection!

I’d been practicing preparing different medications and giving injections on dummies in class and I couldn’t wait to give my first injection. Luckily, the nurses had one patient who was receiving medications by intramuscular (IM) injections. By chance, his last dose was due later that day. A wave of terror washed over me. There was no time to go home and reexamine my textbooks – this was happening today. I had never even had the opportunity to give any oral medications before.

The nurses informed me that the patient was particularly afraid of needles and that he might be a little apprehensive in letting me give the injection or he may jump from the needle as he had done previously. This was all very helpful information that would later help me give the injection.

We arrived at the patient’s house and he invited us inside. I was so nervous, I was sweating. The nurse asked if it would be okay if I gave the injection today and he consented. I began preparing the medication and the patient. I was so nervous about getting it right that it took me almost ten whole minutes to prepare the medication.

The patient asked me ‘Are you any good at giving these?’ I felt like a deer caught in headlights. I said ‘You can let me know after this.’ It was all over in a second. It went smoothly. No apprehension. No jumping. After all my nervousness, I had given my first injection! (My first ever medication for that matter!) I felt like a proper nurse!

Now that I’m in third year, I’ve given more injections than I can remember. I still get excited and nervous giving them! And I still have a long way to go. Almost every time I need to give an injection I need to look up the medication in the Injectable Drugs Handbook and it still takes me almost 10 minutes every time but practice makes perfect.

There’s more to nursing than giving injections but it was super exciting to give my first injection! And to any mums, happy mother’s day!

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