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

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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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Male Nurses Today – why men should choose a career in Nursing

Today is International Nurses’ Day and this year we are marking it with this film.

Male Nurses Today title

Thanks to all students involved, both on camera and behind it.

12 May 2017

NHS Forth Valley Nurses Choir: proud to be nurses

20160702_145901bThe NHS Forth Valley Nurses Choir was born from an idea for Nurses Day which a couple of us put to our Director of Nursing, Professor Angela Wallace – she thought it was a great idea.

It didn’t happen immediately for various reasons including having someone to lead a Choir –  so as a challenge she made it one of my objectives!  It took ages to find someone to lead the Choir, however after some time and through a colleague (who is also a member of the choir), we found the lovely Phillip Todd.

He comes with a wealth of experience, as an actor, film editor, an award winning mod singer, and graduate of the Royal Conservatoire….. The Military Wives have Gareth Malone, but WE got the amazing Phil.

And so the Choir formed in September 2014.

By Christmas that year, we had sung for the Friends of the Hospital, the Health Board at the end of their meeting just before Christmas and the Patient Public Panel at their 10th Anniversary Celebration.

In addition we sang in the wards of one of our Community Hospitals.  What a lovely heart-warming experience that was!  In the dementia ward in particular, the patients sang along with the choir, every word they sang and their families were so delighted. We as nurses were all pretty emotional about that!

Funny story…..We had been asked to sing for the NHS Forth Valley Board Members at the end of their meeting, just before Christmas.  The hospital capacity had been challenging. I am usually in charge of the music.  I use my personal iPhone to play the music via blue tooth through speakers – so in general I stand at the front and at the end of the row.

As I am no technician I hold the iPod in my hand so I can start and stop the music etc.  At the end of the singing for the Board Members, a very senior Doctor came up to me and said well done Rita, How is capacity – what’s happening? as she looked to my phone in my hand?  I looked at her puzzled?  Then realised that she thought I had been texting back and fore – dishing out orders or something – as we were singing!!  I mean really??  I explained nicely that it was the music I was in charge of!  How I wish I was that smart!

We are very lucky to occasionally be able sing the Atrium of our lovely new hospital and as we do so we gather money for various charities, usually one which a choir member has nominated.

One year later in September 2015 we were nominated by members of the public for a Staff Award in the Volunteers category……. WE WON!  What a great achievement that has been for us [pictured].

Winner-Volunteer-Award-Nurses-ChoirThe Royal College of Nursing (RCN) asked us to entertain them at their Reps Conference in October 2015 in Edinburgh.  We were to sing 7 songs.  We were extremely nervous about that I guess, having a fear that it would not go down well.  Fear not!  Our singing went down a storm.  The audience (all nurses) know how to enjoy themselves.  You just have to picture a scene of a sea of people standing at the back their mobile phones in hand with the torch switched on and them swaying back a fore – it was so funny but gave the choir a good feeling.  They gave us a standing ovation!

Christmas time was very busy for us.  We were asked to be part of a Christmas concert for charity.  Some of our local doctors and nurses were heading out to Tanzania to man a ship called the Voyage of Hope and they needs funds – I guess that was our real first big audience.  It was a truly exhilarating experience for the Choir.  The feedback we got was tremendous and gave us a real boost in confidence.

The Nursing Standard got to hear about the Nurses Choir and came to meet with us and arranged a photographer to come along to take photos as we were singing in the Hospital Atrium one day.  They wrote “Forth Valley Nurses’ Choir is making a name for itself by singing at hospitals and charity events. Their audiences – including people with dementia – experience emotional release during the songs, while the nurses benefit from the camaraderie and wellbeing associated with singing in a choir”  We made the front cover of the Christmas Edition of the Nursing Standard.  Wow!

2016 has seen us grow and grow. While continuing to recruit more members we continued to sing different songs together.  The Choir is made up of many fields of nursing, all designations of nurses and in true nurse style have developed a fantastic team where everyone works together, something I personally, am proud of nurses for.  We wear uniform in public and we are proud to be nurses and represent nursing.

This year has seen us take parproud to be nurses and represent nursingt in the opening Ceremony of the Royal College of Nursing Congress – a HUGE event for nursing.  We are proud to have been asked.  During the ceremony our Nurse Director, Professor Angela Wallace, was given a tremendous award of a Fellowship of the Royal College of Nursing in recognition of her work for nursing.  Another proud moment for us, the Nurses Choir and for her to be honoured…… we were present woop wooping!  A great day for NHS Forth Valley Nurses.

We also were asked by the RCN to represent nursing as well as sing at the Scottish Government State Opening of Parliament celebrations.  Some of got to wear old-style uniforms dating back to the early 20th century.  It was a thrilling day being part of the procession down the Royal Mile as well as getting to do what we love…. SINGING.

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NHS Forth Valley Nurses Choir pictured at the Opening of the Scottish Parliament

We are having our summer break right now but are due to start back in early September with already a charity concert booked at the end of September….. I wonder what the rest of 2016/2017 will bring for us?

© Rita Ciccu-Moore and Lynne Paterson, NHS Forth Valley
2 September 2016

You can view the Choir singing here:

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

Witnessing poverty and severe illness motivated me to nurse

CaitlinUrquhart2I have always enjoyed helping people, in every aspect of life therefore nursing is something I have always considered. However it wasn’t till after my travels to South Africa – witnessing poverty and severe illness – that it was made clear to me that I wanted to strive and work to the best of my ability to become a successful, compassionate nurse.

I went out to South Africa with a charity called GAGA (Goodwill And Growth for Africa) volunteering constructing a vegetable garden in a pre-school. Here we worked as a team to plan and put it all together – this was not as easy as we had first thought. With solid, dry ground and just the basic tools we did our best. But we worked together and finished it within our 2 week visit. We involved the children who attended the school along with some of the teachers, allowing them to learn new skills.

GAGA Logo 2 - Copy [28461]We also had the opportunity to visit other projects that the charity were funding which was fantastic. We went to see another pre-school, a medical centre and a home/family that looked after and cared for people of all ages that suffered from disabilities, illness or children who were left abandoned by their parents. Such amazing work that goes on in this country and they are so grateful for the very little they have.

SAGROUPPICcropThese projects were all difficult things to see, the poverty that they live in and put up with on a daily basis is unreal. People don’t understand until they witness this first hand. What a massive eye-opener this trip was, it has showed me that I want to make a difference and help in anyway I can. I feel that by becoming a nurse this would be possible. I would love to go back and do more volunteering in this country!

Caitlin Urquhart, 1st year Student Nurse, University of Stirling
19 June 2016

What inspires us to nurse?

Nursing_123RF_31309931_lTo mark International Nurses Day 2016 we asked our nursing students and staff what inspired them to nurse; this is what they said:

“For me, a role that matters and allows me to contribute to the society I live in.”
Ric, second year student nurse

“Circumstances saw me having to support myself through education from the age of 16, I always persevered, knowing my aim was to become a nurse one day. Life and motherhood saw ten years pass. I knew then that if I want to truly encourage my daughters to become whatever they want to be, it was through doing it myself. An HNC, years of work experience and a year of night college later I am exactly where I know I should be! My daughters are proud of me, and I am proud of myself. Nursing is where my heart is.”
Sandra, third year student nurse

“What motivates me is the opportunity I have to make a difference and to improve the quality of life for others, which for me is more of a calling than a career.”
John, second year student nurse

“I wanted to make a difference, sounds corny but it’s true! I never wanted to do anything else, it may have taken me a few years longer than most, I’m now 37 but now I’m finally making that dream become a reality.”
Hazel, first year student nurse

“I was inspired to go into nursing while working in a high school, I witnessed so many young people struggling with their thoughts, feelings and emotions, not knowing how to manage these.   I want to be able to help them make a difference in their lives so they can mature and grow into confident individuals who are ready for adulthood.”
Pamela, second year student nurse

“I worked with a lovely probationary teacher last year who went into teacher training later. She inspired me, it’s never too late to achieve your dreams.”
Liz, first year student nurse

“I worked in a dementia unit for nearly 4 years, to begin with it was ‘just a job’ (I was 19 at the time and didn’t know what i wanted to do career-wise!) but as the months progressed and I received additional  training and  learning regarding the job. I realized how much I deeply cared for the well-being of all the clients and their families and loved how the feeling of providing care, support, comfort and compassion to each client was like receiving a personal reward on a daily basis. My experience of working as a Care Assistant prompted me to start my training, broaden my skills, expand my knowledge and continue onto a career of more person-centred care.”
Kirsty, first year student nurse

“Helping someone when they cannot help themselves even by just making them smile, nursing is such a rewarding career”
Lindsay, first year student nurse

“When I was 17 other people kept telling me that I should go into nursing. They said I had a strong value base, caring and compassionate nature and an ability to influence people. I always wanted to be a teacher, but didn’t apply as I could not spell! Who would have thought I would end up being a nurse teacher!”
Janet Smith, Teaching Fellow

“I’ve always been interested in the science behind the human body, but witnessing the care and compassion shown by nurses when my Granda was dying made me realise that nursing was the dream career for me –  I wanted to make an impact on someone’s life like those nurses did for me and my family.”
Holly, second year student nurse

“What motivated me to choose nursing was the never ending possibilities nursing offers, as well as being able to make a difference in someone’s life. I also wanted a career, and not just a ‘job’.”
Michelle, third year student nurse

“When I was young (3/4), I spent a lot of time with my granny around nursing homes and would often help the nurses with tea, biscuits and bingo so I was around the environment from a young age. When I was 16, unfortunately I got ill. Although this allowed me to see all the different departments of the hospital I was in. I always had an interest for some science-based jobs, but personally experiencing the kindness of the nurses on the ward made me decide that it was what I wanted to do. I really wanted to give something back, to make other people experience the high level of care and compassion, like the care I had received. And well, here I am!”
Ryan, second year student nurse

“Seeing several family members working in mental health services, and the public’s perception of mental health issues, inspired me to train as a Mental Health Nurse.”
Sophie, first year student nurse

“I wanted to be a nurse because I care about other people’s health and well-being. Whether that be children or adults. I am a mature student and sadly have lost my own parents and my children are more independent. I suppose there in a need in me to nurture and care for other people and I want to make a difference, however small.”
Liz, first year student nurse

“The film Patch Adams.”
Sandra, third year student nurse

What motivated me to become involved with research was the awareness that when someone is in the same position for too long they can stop questioning, they become too set in their ways and are resistant to change.  I didn’t want to become complacent.  I was questioning everything and I needed to be involved with finding answers.”
Gaylor Hoskins, Clinical Academic Research Fellow

“I have always enjoyed helping people, in every aspect of life, therefore nursing is something I have always considered. However it wasn’t till after my travels to South Africa – witnessing poverty and severe illness – that it was made clear to me that I wanted to strive and work to the best of my ability to become a successful, compassionate nurse.”
Caitlin, first year student nurse

“I saw nursing as a challenge, a changing challenge and I’ve never looked back. Can’t wait to qualify!”
Kim, second year student nurse

“The reason I went into nursing is because my aunts are Mental Health Nurses. Initially it never really appealed to me. I was always complaining of how bored I was getting in my job. My aunts said they knew I would make a great nurse and to give a shot. I applied to work as a Rehab Assistant to see if I liked it. I did! I then put my application in to Stirling. The thing I like about it is that you’re always busy, no two days are the same, it is very rewarding and there is job satisfaction. I wish I did it earlier. I have never looked back since!”
Blair, first year student nurse

“I have always had a great amount of empathy for others, I chose mental health nursing to utilise this and have a career in which I care for people every day.”
Ela, first year student nurse

“What motivated me to get into nursing research was the opportunity to use my skills in technology, decision making and interventions to support care delivery, and make a meaningful difference to patients and those who care for them.”
Dr Julie Cowie, Lecturer

“I chose to nurse for the opportunity to make a positive impact on people’s lives, no matter how big or small.”
Kourteney, first year student nurse

“I am constantly inspired by patients and I love the feeling I get when I help others, it is so rewarding, the difference you can make to a person’s/family’s life is incredible and to be in a privileged position to do this is so humbling.”
Nicola, first year student nurse

“The idea of nursing being a rewarding career with so many areas that one can work in and the fact that I love working with people inspired me to get into nursing.”
Davinia, first year student nurse

“My mum and older brother work as nursing assistants in our local mental health wards and always talked about how rewarding it is as a career. They have inspired me to become a nurse from their experience and my want to help others.”
Fionnuala, second year student nurse

“I chose nursing because I liked interacting with people and thought it would be an interesting job – I was so right.”
Dr Susanne Cruickshank, Reader in Cancer Nursing

“I always wanted to study at University and, eventually, at the grand age of 46 I started my nursing degree. Now 2 years into my studies I am loving every aspect of it and looking forward to joining the nursing profession. It was definitely worth the wait!!”
Jane, second year student

“As I was born with a heart defect and went through a heart transplant at the age of 8, I have spent a lot of time in the hospital. The people that supported me the most, held my hand through different procedures and was always there for me when I was scared and vulnerable, was the nurses. They inspired me every day through their hard work and always with a smile around their faces which made me look at life in a more positive way even though that wasn’t always the case. That’s why I want to be a nurse, I want to give something back and help other people as they helped me and my family through the hardest times of my life”. Emilie, second year student

And the last word from Hazel:

“Complications after my surrogate baby was born meant an emergency trip to theatre. I will never forget how I felt a nurse suddenly hold my hand, I never saw her face but that hand ‘spoke’ a thousand words.”
Hazel, first year student nurse

Nursing in Shetland – working as an Advanced Nurse Practitioner on a non-doctor island

ChrisShetland has something for everybody, with the northern lights, amazing scenery, wild weather and low crime, and stunning wildlife. Working as an Advanced Nurse Practitioner across these islands offers a new dimension to nursing. I currently work on an island called Bressay.

Bressay is classed as a non-doctor island, thus the role of the nurse is key in the delivery of primary health care. Shetland has 5 non doctor islands – Bressay, Fair Isle, Foula, Fetlar, and Skerries. Each island has a resident nurse who provides a 24 hour service, thus providing all first contact, chronic health management and emergencies. Each island has a varied population ranging from the very young to the elderly, thus nursing practice has to be up-to-date and transverse across age ranges. Each island is only accessible vie ether boat or plane. These island nurses are supported by a General Practitioner who visits, but this can easily be hampered by the weather. Each island, apart from Bressay, has a nurse’s clinic where all up-to-date resources are at the disposal of the resident nurses; this allows for health care delivery to be tailored to meet the needs of individual patients.

This role of the non-doctor island nurse is unique to Scotland. There is very little known about these unique nursing roles. In 2012 I commenced a Clinical Doctorate in nursing with the University of Stirling; this has enabled me to explore the role of non-doctor islands and its uniqueness to nursing practice. The Doctorate has enabled me to reflect on my own practice and allowed me to critically analyse my own clinical areas and the importance that it plays across primary care delivery. I have commenced my final piece of work for the programme; the aim is to explore the role of nurses on these non-doctor islands. We know at this time that remote and rural healthcare practices have significant recruitment and retention difficulties; the aim is to explore what attracts and retains nurses across non-doctor islands. This will allow for strategic planning of service delivery as part of the 2020 vision.

I moved to Shetland in 2014. I trained in Liverpool at Edge Hill University and qualified as a nurse in 2004 and since then I have taken many pathways along the way. I started as a staff nurse in Accident and Emergency, I then took up a lecturer practitioner role with Edge Hill University, and then I specialised and became a Resuscitation Training Officer.  I have always had an interest in remote and rural setting, with this goal in mind I started to look at options available. I first noticed a job in Shetland on one of its non-doctor islands, so I dedicated to join the nursing bank to see if I liked it. Over the following two summers I spend much time visiting Shetland’s more remote islands providing relief for the resident nurse. I was fortunate enough to get offered a job full time as the resident nurse for Bressay.

At the time this was a difficult decision to make, thus leaving family, friends and a career pathway that I enjoyed, but I needed something different. I have currently been in post for 4 years and I love the everyday challenges that remote and rural nursing brings. Shetland life takes a little getting used to. However I would struggle to return to an urban setting although I still have family in Liverpool and it’s a pleasure visiting friends and family.

Chris Rice, Advanced Nurse Practitioner, NHS Shetland
Clinical Doctorate Student, University of Stirling