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Community Nursing: allowing continuity to better patient outcomes – a student nurse’s QI experience

JodieKennedy_QNISCertW

Nurse Jodie Kennedy

Community Nursing is a highly demanding and complex sector due to an ageing population and the rising number of patients living within the community with long term conditions.

I undertook my first Community placement during the final year of my Nursing degree. I was extremely apprehensive going into this placement as Community Nursing was not an area that I thought that I would enjoy. However, the team that I joined to undertake my Community placement were undoubtedly the most welcoming and supporting team I could have wished for. I was given the opportunity to take my own caseload of patients. As a third-year student it was crucial that I showed enthusiasm, drive and motivation to promote health care within the Community sector. I achieved this through my Quality Improvement Practicum that I devised and implemented within my 10 weeks of being with the team.

Quality Improvement is a major aspect of Nursing.  As healthcare professionals, it is vital that we always strive to deliver evidence based care to promote effective safe practice through education and further learning. My QI Practicum was to “Improve the daily completion of the Daily Pressure Ulcer Safety Cross”. This was done through continuous auditing and devising a new daily planner for the Nursing team to ensure that daily completion was being achieved, as failure to do so leads to discrepancies, and can have an everlasting impact on patient safety.  I’m delighted to say that as a result of completing my QI project on the daily completion of the Safety Cross it went from 22% to 100% accuracy.

On completion of this placement I also left another form of documentation that I had devised: “Daily Pressure Ulcer Safety Cross – Nursing Intervention”. This new form of documentation allowed the team to obtain accurate evidence of the provisions of care that they were delivering to patients on their caseload with pressure area. I thoroughly enjoyed my Community Nursing placement, and on reflection, I was continually learning, and the opportunities within the sector to promote learning were always made available to healthcare professionals.

On receiving the news that I had won the QNIS Undergraduate Award for promoting excellence in Community Nursing, I felt extremely honoured and proud to receive such as prestigious award.  I was overcome with emotion to be informed that my hard work within the Community sector had been recognised, which was something that I set out to achieve whilst undertaking my Quality Improvement project, which strived to promote excellence in care delivery within the Community sector. Winning this award has made me even more determined to continue my Community Nursing Career in the future.

At present, I have just started my first post in an Acute Admissions Unit working with first line assessment and dealing with acute deterioration and patient management. Looking to the future I would like to continue to work with Quality Improvement which requires commitment and drive to change aspects of care delivery that would continue to benefit patient outcomes. I would also like to move away from an acute setting in the future to develop my Nursing career within the Community Sector. I enjoy the thought of one day becoming a Tissue Viability Nurse Specialist or a Colorectal Nurse Specialist.

I feel that Community Nursing allows for continuity which is a huge part in bettering patient outcomes. I hope that throughout my Nursing career that I am able to satisfy patients’ needs, as this is very rewarding and fulfilling as a Nurse.

Jodie Kennedy, 2017 Graduate, University of Stirling
20 November 2017

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About to start your nursing degree? Check this advice from Student Nurse Kim

Nursing_123RF_31309931_lStarting as a student nurse can be pretty scary and nerve wracking but it’s full of excitement and surprises. You might even find that it is the best decision you make. After two years as a student nurse, having never looked back, here are a few things that might help you get through first year. If not the whole of first year, at least the first few weeks!!

  • Introduce yourself to as many people as you can. You might not know everyone in your class, and you might not see them every day, but your cohort are your colleagues. The friends you make here will get you through the good and bad and they can last for life.
  • Attend all classes, and attend on time! You’ll no doubt hear rumours that it’s OK not to go to all the classes but it isn’t. They are for your benefit, you’re learning and it really does help with placement and exams. Also, try turn up on time, it’s just rude if you don’t.
  • Talking of exams and essays, prepare in advance!! Don’t leave them till the last minute, take advantage of the study time, the student support and the lecturers’ knowledge. Remember to proof-read your work too, as it can make a difference in the marks. You can always get help from friends, they provide the best support (and the coffee)!
  • Take advantage of the skills groups and sessions, including the communication ones. These are where you might see equipment for the first time, experience a skill or work as a team. You will do all sorts in these groups, so make the most of them. Use the time and take advantage of the knowledge of the lecturers, doesn’t matter if you make an error here, they will show you how to correct it and learn from your mistakes. You can often get a good laugh at these sessions, trying out a leg bandage for the first time is always interesting!
  • Placement. This is 50% of the course. The best advice here, make the most of it. Ask millions of questions, get hands on experience, research what you do, speak to other students, share your experience (without breaching confidentiality of course!) and enjoy it. You’re only in placement for a few weeks at a time so do what you can. You will be surprised how much you will learn in a short space of time. And remember to always act professionally, both in and out of placement.
  • Everyone gets a Personal Tutor; they are there for you for the three years you are in university. So why not get to know them. You’ll see them every semester after placement anyway, but nothing is stopping you speaking to them. They are not only there for your placement sign off, but a whole host of things, could be study-related or it could be personal, you don’t have to worry alone, they will listen and give the best support available.
  • So, this is your school for three years, your home if you like, then why not get involved? There are always opportunities to be a part of what the nursing course has to offer. From helping trial new interview styles to promoting your school to others there is plenty to get involved with. Offer to attend conferences and present your work – take them – great for your CV! There is no better way to show your passion for nursing than helping others.

Well, that I think covers the most important areas to think about and consider when joining us on this amazing journey. Make the most of these three years, ask questions, get creative, be inspired and be inspiring. I hope everyone enjoys their time at University just as much as I have and I wish you all the best.

© Kimberley Blues, Student Nurse (Adult), University of Stirling
29 August 2016

A student nurse’s guide to an away placement: Isle of Barra, Outer Hebrides

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Student Nurse Holly McMurray

Many students are not keen on undertaking an away placement – they may think it’s inconvenient, expensive, and that it won’t really add much to their learning or contribute to their future practice. But it’s not at all, it’s a great experience that everyone should try, if they can.

Accommodation
I was lucky enough to be able to rent a room for the duration of my placement from my mentor who runs a guest house as well as being a district nurse. My room was lovely, I got breakfast and dinner, and had access to everything I needed including the washing machine, ironing board etc. I really couldn’t have asked for better accommodation and hosts.

Transport
Travelling from Stirling to Barra is quite a long journey, around 10 hours, if you go by train and ferry, which is the cheapest option, around £25 single. The ferry journey can be quite boring so I would advise taking a book or something to do. I’d also recommend taking a blanket and pillow so you can sleep because the seats are also quite uncomfy. When you arrive at Castlebay one of the nurses will probably collect you and take you to your accommodation, otherwise there are buses and taxis which can be pre-booked.

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Barra runway

The other option is to get the plane from Glasgow airport to Barra, it is quite expensive between £30 and £75 single depending on how far in advance you book from Flybe, but it only takes about an hour. The plane is tiny – seats around 20 including the pilot. It is a really good experience though as Barra has the only tidal airport in the world – the beach is the runway!

Placement
The Island has a 5-bed hospital called St. Brendan’s. The hospital includes 3 single rooms and 1 twin room, a treatment room, a physio room and a dentist. The community nurses are also in the same building and have their own room upstairs.

There is one doctor who is on call 24/7 and is based in the GP surgery which is around 0.5 miles from the hospital, though new plans are currently being developed to build a new hospital which will house everybody together to make working as a team easier.

Within the hospital everything is nurse led as there are no other health professionals which are constant on the island. All Physio therapists, occupational therapists, dieticians, speech and language therapists etc. are all mostly based on the isle of Lewis in Stornoway which is the main hospital for the western isles, and they visit Barra occasionally. There is also only 1 midwife on the island, who only works 7 hours per week, and only 1 health visitor who is very willing to take student nurses on visits and also to baby clinics – I even got to go on the ferry to the Isle of Uist to visit a few new born babies!

Shoreline-HousesWDuring my time in Barra there weren’t many patients, but I got to spend time with lots of different healthcare professionals – health visitor, midwife, diabetic nurse, practice nurse, community nurses. There were also lots of training days whilst I was there – management of the acutely ill patient, psychoactive substances, continence management and advanced life support. So, although it might be quiet compared to Forth Valley there are plenty of opportunities to keep you busy.

The island itself has very few shops and amenities, so if you do go to Barra I’d recommend bringing everything you need.  The islanders are very friendly and welcoming, but during the winter there isn’t much to do.  There are, however, many events during the summer such as a festival and various fetes/open days, and the beaches are lovely as well, even in the winter.

Overall, I’d definitely recommend going to the Isle of Barra for a placement, to experience how it’s done in a remote and rural area.

Holly McMurray, 2nd year Adult Student Nurse
University of Stirling
Published 13 April 2016

Student blog: Volunteering with the Red Cross inspired me to become a nurse

“Finding your passion will lead you to finding work that motivates and satisfies you”
– Dr Val Gokenbach

Photo of Student Nurse Dominic Burns

Student Nurse Dominic Burns

I’ve been a volunteer with the Red Cross since high school, after doing some skills sessions over a few weeks as part of personal development. Never did I think though, that signing up to volunteer as an Event First Aider would open up so many opportunities or even lead me into a career in Nursing.

Whenever I’m speaking to people about volunteering, most are generally positive. Of course there will be the odd person who doesn’t understand ‘why anyone would choose to do that and not get paid for it’. For me, volunteering started out as being something that would help fill up my weekends, and let me go to events that I was interested in. Not that I’m saying it doesn’t allow me to do this now, but over time I can see how the experience has helped me change and develop as a person and continues to do so. Not only this, but from the perspective of being a Student Nurse, it has also helped me develop my essential skills which are, undoubtedly, used every day on clinical placement and beyond.  Communication, team-working, decision making, leadership, the list goes on. All of them competencies required to be demonstrated in clinical practice, and all of which I have been able to develop and refine through my volunteer work with the Red Cross.

Over my years of volunteering, it’s safe to say that I was bitten by the bug, and became quite passionate about it all. I wanted to bring this passion for the Red Cross to others, but in a way that would be more inclusive and supportive of those who didn’t fit into the ‘regular student’ role i.e. student nurses, as well as the rest of the student body.

We’re all aware that Universities’ and their Student Unions have lots to offer with regards to clubs and societies. Getting involved with them helps to enhance the university experience, shape views and gives skills required for jobs – unarguably a major attraction for students. What a lot of people may not be so aware of however, is that students studying degrees in Nursing are a group with the lowest engagement rate with clubs and societies at the University of Stirling. Why? After speaking with a lot of Student Nurses, the general consensus is that they don’t have the time to fit in extra-curricular activities or voluntary work due to the demands of the course, including placements. They may not have the time to commit to training schedules due to variations in timetables each week, or conflicting off-duty whilst on the wards. Ultimately they aren’t able to access some of the amazing opportunities that are available, which can help them become better practitioners – through their training and post qualification.

Photo of students learning CPR for babies

Learning CPR for babies

With all this in mind, I set up the Red Cross group at the University, at the end of my first year/beginning of second year. I think it’s safe to say that it did, and continues to, require a lot of effort to keep things running smoothly, but it is definitely worth it. We’ve been recognised by the Student’s Union for what our group has achieved, as well as locally and nationally by the British Red Cross, which speaks as a testament to everyone who is involved.  Student Nurses have been enabled to develop their practical clinical skills, skills in communication and documentation as well as opening up the door for advanced training in Resuscitation Support Management and Trauma Management, free of charge for example. Above all a flexible approach to how people can access training and events has allowed more people to engage and learn, which is the ultimate aim. Personally I feel I’ve developed my own skills even further by leading the group. I have been able to experience, very early on, management of volunteers, working to meet aims and objectives whilst leading a team, even with pressures such as time and financial constraints. I am certain that my experiences in regards to this will be beneficial and help me in my nursing career in the years to come.

Of course there may be some of you who are reading this who have your own passion for something and are bored of reading about me telling you what you can learn with the Red Cross. What I’m trying to say is it’s about getting involved with something that will expand your horizons and develop you as a person, even if you do see it as just a hobby. Maybe you haven’t had the opportunity to pursue what it is you’re interested in. Well, as the saying goes “if opportunity doesn’t knock, build a door”. Get involved in something you are passionate about, you never know where it will lead and what you can achieve because of it.

Dominic Burns
Third Year Student Nurse (Adult Branch), University of Stirling

Student Nurse blog: Looking after yourself so you can look after others

Two years ago I started my BSc in Adult Nursing at Highland Campus, University of Stirling, and it feels like it was only yesterday. First years, everyone will keep telling you how quickly the time passes and believe me it does. Blink and you really will miss it. The first few weeks are exciting and really quite nerve-wracking and don’t even start worrying about when you have to get ready to go on that first placement just yet!

This first semester will go so fast. You will learn a lot and gain many new skills. You will also learn a lot about yourself. The one piece of advice I would give myself two years ago would be to look after #1. You cannot care for anyone else if you are not physically and mentally at your best. Nursing is stressful and you are not immune from the stresses of the ward because you are a student. You may also be balancing a part time job with your studies to make ends meet. Make sure you are aware of your own mental health and you make time do to things for yourself.  Whether your idea of relaxing is running, soaking in a bath, meditation or kickboxing, just make sure you have something that allows you to escape and unwind.

Grab every opportunity that comes your way because you will be guaranteed to learn something. Don’t despair at being sent away on placement, it might be the only time in your career you find yourself working out the logistics of getting a patient back home to an island that has a runway only functional at low tide! And use the support system you have in your cohort. You will be from so many different walks of life, of different ages, with different experiences but you are all starting on the same step and you will all be going through the same highs and lows!

“I’m not telling you it’s going to be easy, I’m telling you it’s going to be worth it!”

Rachel Leighton
Third year Student Nurse, University of Stirling

The Florence Nightingale Foundation Students Day: proud to be called a nurse

Photo of Students attending Florence Nightingale Foundation Students Day 2015

Students attending Florence Nightingale Foundation Students Day 2015

I was very proud to recently being given the opportunity to represent the University of Stirling at The Florence Nightingale Foundation Students Day, which was held in London at St Thomas’s Hospital on 6th May 2015.

Different universities throughout the UK were given the opportunity to nominate nursing and midwifery students to this annual event, which is held to commemorate the life and work of Florence Nightingale. There were approximately 80 students who were invited and we all gathered in the Governor’s Hall within St Thomas’s Hospital.

There we met with the founders of The Florence Nightingale Foundation and leading healthcare professionals where we were asked to submit questions to the panel.   We all gathered in small groups and were given different topics to consider.  Some of the questions we raised were:

  • Should skills be required be standardised through all universities and trusts?
  • Do we give enough consideration to mental health in adult environments?
  • Should students have more involvement in research?
  • Leadership, is it just for management?

being just a few asked. The panel answered all the questions with enthusiasm, wisdom and experience valuing all questions asked.

Photo of Florence Nightingale

Florence Nightingale

Throughout the question and answer session we were all encouraged and supported to raise additional questions, which was a part that ended up getting very lively and gathering great enthusiasm, with great feedback received from the panel members.  The panel ensured that all questions were answered, also giving us great advice for future placements and careers, as well as advice on difficult situations like escalating concerns and getting the right support and opportunities out of our placements.

The response from the panel left us all feeling very inspired as well as feeling very proud to become nurses and midwives of the future.  A final note given was for us to believe in ourselves, it is always better to aim high, it is never too early to make a difference and to believe in ourselves. The panel members and founders of the Foundation made us all feel very welcome and ensured that we all felt relaxed, included and our opinions to be important.

Following on from the panel discussion we had the opportunity to watch a film about the life and legacy of Florence Nightingale before visiting the Chapel in St Thomas’s Hospital.  After that we went on a tour of the Florence Nightingale Museum where we learnt more about the foundation of her nursing school and how it all began.  This gave us all a good insight into Florence Nightingale’s background and the incredible research and work she achieved and the many lives she saved, as well as the impact and influence that her work still has on nursing practice today.

At the end of the day we all attended the 50th commemoration service at Westminster Abbey, with an attendance of over 2,000 people.  We had the opportunity to look around the Abbey before the service began as well as being given the opportunity to visit the Florence Nightingale Chapel.  Westminster Abbey was a truly magnificent building and was breathtaking to see.

The Florence Nightingale commemorative service began with a choir and the atmosphere was amazing which continued with a procession being led by a Florence Nightingale scholar carrying the lamp, which was lit and escorted by student nurses and midwifes.  Upon their arrival before the altar, the lamp was then passed between Florence Nightingale scholars, which is a tradition that represents the passing on of knowledge.  This service was a memorable end to a truly inspiring day.

Throughout the day I had the opportunity to meet with students studying adult nursing, mental health nursing and midwifery making many new friends along the way and learning about different students’ experiences, advice and goals.

I truly found the day to be very inspiring, educational and thought provoking.  Certainly a day I will never forget and I would certainly recommend other students, if given the opportunity in the future, to attend as it is certainly an experience that will leave you feeling extremely proud to be called a nurse.

Julie Furzer, 2nd year mental health nursing student