Monday, 25 June 2012

My last placement as a student nurse

I have just finished my last placement as a student nurse. It was very bizarre to contemplate that it was my last shift under the protective shield of the student nurse uniform – after three years!!! For if there are many hardships that we as student nurses can complain of, there is also always the protection of not quite being accountable for what you do. You practice under a nurse’s PIN number and as such all you do falls ultimately on the nurse you work with. I am talking only of ultimate accountability, not responsibility. If you err, you will have consequences but ultimately it is the nurse who is called to account for your actions.
Why, you may ask? Well, the ‘Code of Conduct’ as written by the Nursing and Midwifery Council (NMC) state that nurses are responsible for the work that they delegate to others and that they should be aware of the task and the capabilities of whom they are delegating the task to. If a nurse asks you to do something (and this is especially true if you are unsupervised) then they should have considered that you know what you are doing. And I have never been involved in a case where I was asked to do something I didn’t know what I was doing.
But back to my last shift of my last placement of my last year as a student nurse. I looked at the nursing team I had been working with for the last 16 weeks and realised that I would miss them all terribly. I had grown quite fond of them. And I considered how much I had learnt in my time with them. I opted to get away from medical nursing and do surgical nursing for my last placement. Mostly because I had done so much medical and not enough surgical nursing and wanted more exposure before I qualified. They had taught me much about analgesia, wounds, dressings, drains, enhanced recovery and how to do much with very little resources. In particular, I was deeply impressed with the healthcare assistants in that ward, who were very capable and hardworking. The nurses were most generous with their time and knowledge and were very firm about shaping me for my new role as a staff nurse. I am very grateful.
There is a slight adjustment, if you will, that all student nurses must make. It is a very slight shift of going from a passive worker to an active one; one who predicts what must be done. As a student nurse, you are working under a nurse who will decide what needs to be done and then delegate tasks accordingly. You work under this protection for just over two years and a half; and there is a safety in not having to make decisions but working towards a common goal with someone else. Then one fine day, you need to start making decisions for yourself and your patients. Mrs Smith’s blood pressure is low after her morning dose of 5 mg amlodipine (antihypertensive). It was high but after amlodipine it is quite low and she is complaining of feeling faint and she isn’t drinking much. You do another set of observations and realise it is even lower than before. Well, you can advise her to drink more fluids and you know that it might be wise to bleep the doctors and let them know.
This is the adjustment – whereas before you might just have gone to the nurse, informed her and then trotted off eagerly for your coffee break, happy and content that you had done all you could have. Now you must bleep the doctor, now you must have the charts at hand and ensure her fluid intake is adequate, now you must ensure her safety is maintained and that she doesn’t get up and have a nasty fall due to dizziness.
It’s a slight shift but one that needs to happen. And when one does, one has even more admiration for nurses. It is very odd how much my attitude towards nursing training has changed in the three years of my training. I used to think I did nothing except go fetch the commodes and get the water jugs filled for patients and wonder how I would ever learn enough to be a nurse. But it all ‘clicks’ in your third year and you find that actually, you are going to be ok.
So there I was, about to walk off the last ward I would ever trod as a student nurse and I have to say I was both jubilant and frightened. But I was so very happy that I did undertake the training and all of a sudden all the possibilities for my future have increased. It has not been easy – the hours, the placements, the financial strain, the stress, the academic work. It hasn’t been easy but it was really worth it and I am a better person because of it. My future is much brighter now. 

1 comment:

  1. sooo proud of you!

    Go,go ahead and I´m sure you have found your persona-a nurse!