Friday, December 29, 2006

Tagged!

Well I disapeared a bit over Christmas, quite unintentionally. I was very busy, and had a great Christmas. I hope my readers did too, and failing that have a great New Year.

Well, I have been tagged. I don't quite hae the eloquency or the creativity of MrMan's Wife but here goes...

A - Available/Single? No, in a (relatively) long distance relationship for the past 4 years.
B - Best Friend? Poppy, she doesnt' read this blog so perhaps I should show her my appreciation sometime
C - Cake or Pie? Cake, unless it's apple pie with custard
D - Drink Of Choice? Tea, where there is tea there is hope.
E – Essential Item You Use Everyday? My mobile, though my feet would say my hot water bottle or heated slippers, they would probably die without them
F - Favourite Colour?/ Black, blue or purple, oooh or silver. Or turquoise/emerald green.
G - Gummy Bears Or Worms? The bears are cuter
H - Hometown? Good ol' London town
I - Indulgence? Oooh, I have so many, especially post-Christmas. But probably biscuits to go with my tea, or chocolate in small quantities.
J - January Or February? Neither particularly, I suppose possibly maybe January.
K - Kids & Their Names? I have a golden retriever, Corri, a black and white cat, Blot, and a ginger cat, Zampa, and they're just like small children. (Only Blot is actually mine, they're family pets)
L - Life Is Incomplete Without? God. (Though chocolate, science fiction and love are pretty important too. But assuming you believe in God and that He is the creator of everything I think He covers that)
M - Marriage date? None yet, though I always think a summer or warm autumnal wedding would be nice.
N - Number Of Siblings? One younger brother.
O - Oranges Or Apples? Apples.
P - Phobias/Fears? Being alone, getting older and being dependent on others. (That's just one fear)
Q - Favourite Quote? Hmmmm... My bedroom walls are covered with poem and quotes, written onto the wall paper with black marker. The following quotes aren't my favourite, I don't thik I could choose a favourite, they are pretty good though.

  • "He's not the Messiah, he's a very naughty boy" is always good for a smile (taken from Monty Python's The Life of Brian)
  • "Be not inhospitable to strangers, lest they be angels in disguise" (this was written above a doorway in a bookshop, The Shakespeare Co. Bookshop in Paris)

R - Reason to Smile? I am loved (that sounds vaguely familiar) and I have a lot of chocalate
S - Season? Summer, though the grass is always greener on the other side and I always want it to be a different season as I'm either too hot or too cold.
T - Tag people? Hmm... I don't have anyone to tag who hasn't been tagged already. My readers (if there are any other than MMW), anyone who reads this and wants to please comment with your answers.
U - Unknown Fact About Me? Unknown to who? Unknown to me? Well would someone please tell me what it is?
V - Vegetable you don’t like? Gherkins.
W - Worst Habit? Apologising, it drives people mad, and then I apologise for apologising.
X - X-rays You’ve Had? Dental, chest and hand.
Y - Your Favourite Food? Pasta in creamy tomato and herb sauce with grated cheese, or sweet and sour chicken with fried noodles/rice
Z – Zodiac sign? Leo, hear me roar.

I'm obviously abit slow today, I thought the questions were a bit random, it's only after adding some bold tags I've noticed the question is for each letter of the alphabet!

Tuesday, December 19, 2006

Jobs

Well I've had it confirmed. My next placement is in A&E at the first hospital of my choice. Not a great surprise as I was the only one in my group to apply there, but I'm pleased nonetheless. I'm looking forward to the 13 weeks I will spend there, it should also provide some things of worth to write about!

I was job searching today. I'm having second thougths about doing an extra year straight after my course, so I'm going to apply for work as well as the course and make the decision at a later date. A hospital local to me is recruiting in several areas of paediatrics, with interviews in the beginning of March, it should time well with my qualifying in April. I'm going to call to arrange an informal visit and then get working on my application. I've only ever applied for one job before Is tarted training and I am aware of how high the competition is for good paediatric jobs at the moment, I find the prospect of applying and having to sell myself quite daunting!

Sunday, December 17, 2006

Exam feedback and nails

I went and collected my exam results and read my feedback. there was some helpful stuff, some things I disagreed with and then one comment in particular that really upset me. I happened to bump into my tutor and ended up crying in her room. I've not had this tutor long, and I'd not realised how good a tutor she was until that point. She was very encouraging and supportive and made me feel much happier about it.

The comment was that my work displayed "marginally" safe practice. To me, it seemed to imply that I was a barely safe practicitoner, and that is far from the truth. My Practice Based Assessments have always graded me very highly and I have very good reports from the staff I work with, my safety has never been in question. I was unhappy because it's not the sort of statement I want on my record. My tutor told me that I should be proud of myself for passing first time, as many poeple on the course don't do that, and that I shouldn't worry too much about the wording one person (who I have had a persoality clash with) chooses to use. She said she'd read my file and that I get good results but that sometimes I expect too much of myself and I need to relax and focus on the positive things, Im starting to wonder what exactly they've got written about me!

I don't deny that it wasn't a good exam answer, and I often feel that my written work lets me down. But I don't think that's a matter of not knowing the theory, I think I'm fairly knowledgable, but it seems more to be that I can't "talk the talk" - I can't write things they way they want me to. I've become a bit of a cynic, but my mother (who is a headteacher (and come to think of it also a cynic)) agrees with me, that these days education has become more about "playing the game" and saying right things, the way they want you to, than actually knowing your stuff and being an individual. It comes back to the thing I mentioned previously of my opinion only being valid if someone else has said it already.

Enough assignment grumbling before I become too disheartened!

Completely off the topic, I had acrylic nails put on yesterday. Never again, the woman was a sadist!

Thursday, December 14, 2006

Blogs

I've added a few new Blogs to my links. The Wife of a Schizophrenic, as the name suggests, is a blog written by the wife of a schizophrenic; "A brief explanation of Schizophrenia, it's affect on our marriage, and our experiences with mental health services". It's a heartwarming and informative read. Also by the same lady is There's Life Jim, it's a lighter read and I just love the way she thinks!

Finally, Tales From Tragedy Towers - Life at NHS Direct, this is quite a new Blog but if you ever wanted to know what not to call NHS Direct about, or have a morbid interest in the stupidity of others it's definitely for you! It's funny and eyeopening, giving a greater understanding of the service that gets such bad press.

Oh, and an update. The Portfolio has been deferred so I can slack a little bit more, and I got my exam results over the phone, passed both though I'm not too happy with one of my grades and look forward to reading the feedback. It was a typical administrative error, like the time they kept sending me letters threatening to kick me from the course for failing a piece of work I had passed on first attempt.

Tuesday, December 12, 2006

Results

Oh, one annoyance. I was due to get my exam results yesterday for my written and practical exams that I had deferred. But they now won't be available until the 22nd of January, for some strange reason relating to the moderating not posting them back in time. I don't really understand that, but it's a bit inconvenient, especially as I wanted to use them as evidence in my essay.

Portfolio and A&E

Today I'm trying to write my Portfolio essay. It's a 4,000 word essay reflecting on my last 2 years of training and discussing my strengths, my weaknesses and how I intend to develop these when I qualify.

It's due on the 5th of January, and whilst I could write it before then I'm a little worried I'm not going to have ad raft ready for my tutor before they break up for Christmas, and I'd really like not to fail this one. I think I've left it a little bit late! But I definitely needed the holiday, I was quite stressed! I'm only just realising how much more work I need to do in a short time, I hadn't really thought about my tutor not working over Christmas.

I really must get comments emailed to me or something. The lovely Mr Mans Wife has left me several interesting and encouraging comments on older posts that I didn't notice until today. I promise to notice all future comments!

I was thinking back to my A&E placement, the best I've had by far and thinking about some of the things I saw and did there. I think I'll post about that sometime. But two situations sprang to mind today.

We had a mother bring her baby into the triage room. I can't remember the age exactly, but around a year old. The child was alert and smiley.
Nurse: Hello mum, what's brought you to see us today?
Mum: Bobby didn't sleep well last night
Nurse: Okay *makes note* so what is it that made you decide to come to the accident and emergency department? What has concerned you?
Mum: Bobby didn't sleep very well.

The child was very well, alert, smiling, had no temperature, no history of cough or cold. Now I know parents know their children and it's important to listen to their concerns, but there was nothing wrong with this child! The part that got me was her only concern was that he didn't sleep well last night... well what did she think we could do it about it the next day in A&E?

Another day I was out with a LAS crew and we were called to an unwell child with abdominal pain. The child hadn't passed urine in about 12 hours (though that was overnight) and he had a mild abdominal pain and a slight temperature. Now the child looked a little peaky, but nothing awful. They decided to run the child to the local hospital, at which point they ask who will be accompanying them in the ambulance.
Dad: I will. My wife will take our other children in the car and follow us.

... So why didn't you just drive to your GP, Walk-In Centre or A&E in the first place instead of calling an ambulance?

We also had numerous cases of children coming into the A&E department with a complaint of itchy eyes and sneezing. It was the summer. Yes, you've guessed it. It was hayfever.

I do worry about some people.

Monday, December 11, 2006

Let down

Today on the radio we were listening to discussion about a local Bishop who got rather smashed at a function, did some embarassing things, sustained some minor injuries and claims he has no memory of the night in question. You can read a BBC article about it here. There's been a right hoohar about it with people phoning in left right and centre to say it's a disgrace, he should step down, he should be punished, he should be forgiven, it was a mistake and he should learn from it. A variety of views mostly from Christians phoning in. Then, someone phones in and says "Hello. I am a Mulsim. I feel very let down by this man" and for some reason this really got on my nerves!

Part of me has a "What's it got to do with you anyway, it's not even your religion" attitude towards it. However I shall not be that intolerant and we are all entitled to an opinion. Had the man rang up expressing his feelings about the responsibility religious leaders should take or something along those lines, I could understand and accept that.

It was the fact that he kept saying he felt "let down" by the man. I found this hard to understand, how could he be let down by a religious leader of a religion other than his own? Surely it's more of a let down that the man worships a different God and follows a different doctrine? I just found it a bit mad, then he felt "let down" by this man's actions. He must feel let down by poeple all the time!

I'll probably have upset a few people here, but it is my blog and I've tried not to offend! Feel free to comment if you disagree or think I'm being terribly narrowminded and judgemental!

Sunday, December 10, 2006

Warning: This could be lengthy

Well, I'm back! After a week in the sun of Gambia I am now incredibly tanned (read: as pale as ever, though perhaps less unhealthy looking). It gives me a warm, fuzzy feeling to know that people actually read my Blog, not just the friends I have badgered to do it!

On December 1st I dragged myself out of bed at 4am, after just 3 hours sleep, to drive with some friends to East Midlands airport for our 9am flight. Our tickets said to be there at least 3 hours before check in. We arrived at 5.50am to discover that check in doesn't even open until 06.15, on the brightside early is better than late. The flight to The Gambia is 6 hours long, unless of course you go via Bristol... Yes, via Bristol, this added another hour and a half to our flight time. The plane was incredibly and uncomfortably cold, there was actually ice on the inside of the cabin and despite numerous requests to turn the heating up nothing changed. We eventually got some thin blankets, but they only had 5 or 6 (better then their original claim of none) which left many passengers without.

We arrived around 17:00, Gambia is on the same time zone as the UK. We stepped out of the plane into bright sunshine and began to sweat almost immediately. The hassle began as soon as we went to claim our baggage with us having to fight off porters to carry our own bags. That was one of the difficult things to adjust to, the hassle we got pretty much wherever we went, my stark whiteness screamed out new tourist. The drive to our hotel took about half an hour and revealed some of the extremes of Gambia. Large, beautiful, gated houses and small, dusty huts. New, shiny cars and beat up old ones that would not be roadworthy in the UK.

Our hotel was in the capital Banjul, 4* by Gambian standards it was nice. The service we received was amazing, the staff at the hotel was so helpful. Our rooms were serviced daily, incredibly thoroughly. Whenever we passed a member of staff they would greet us and ask how we were, so very different from the UK.

Some things we did:

We went on a fishing trip on the creeks and River Gambia, ate dodgy sandwiches and I ended up with diarrhoea and another member of the group diarrhoea and vomiting. That wasn't so much fun. Lost one whole day of the holiday and felt quite delicate for the next couple.

We went to a couple of nature reserves and we saw monkeys! We fed the monkeys peanuts, they took them from our open palm and sat on our shoulders eating them. So much fun, I could have done that all day.

We visited a Crocodile Pool, the local people believe them to be sacred creatures and the women bathe in the pool for fertility. We stroked crocodiles, shook thier paws and met Charlie, Gambia's star croc.

We visited a place called Tanji to have a lazy afternoon on the beach. We got out at the fishing village intending to walk along the beach but were swamped by aout 25 local children clamouring to hold our hands and for sweets or money to buy a football, so we ended up having to turn around and find somewhere else.

We were offered several cute babies. I'm not sure how serious the offers were! We waved at many a gorgeous child and threw sweets out of the car window as they chased along after us.

We drove around in a taxi that definitely would not have been roadworthy in the UK. At least 12 years old, the window screen was cracked into 4 held together by glue and some big stickers in the centre of the crack, the hand brake didn't work (as we discovered when we rolled back into a post!), the brakes were a little didgy as was the clutch. We had to push start the car one day in the town!

The holiday was more expensive that we expected. Despite the poverty, eating out was actually on par with England and we hadn't anticipated that. We could have gone for the really budget local food, but the quality was dubious, in the local market the fresh fish and meat was crawling with flies (literally) and retrospectively I'm glad we didn't; one stomach upset was enough!

Some aspects of our trip I found difficult to get used to:

Bumsters: These are people on the street/beach outside the hotels and in the town who target tourists and offer their guide services for a price. Often they will approach you being friendly, perhaps help you with something and then try to get money out of you. Sometimes they were aggressive and rude, other were just very persistent. Walking the beach outside our hotel you would be stopped frequently by people wanting to take you to their juice bar, or their shop and it was very difficult to deflect at times. Our hotel had a guard for this reason who would move the poeple on, and also reccomend trustworthy people on the beach to act as a guide, like Omar the postcard seller who took us into the market one day. He didn't ask for payment but was of course tipped, he seemed more itnerested in making friends. Nat stopped in the street to look at a shop and found someone shining his shoes without him asking, the person then pressured Nat to pay him for the service. It is far easier to pay them than argue it out.

The difficulty is that tourism created these people. They exist because we do. Gambia is a very poor country and a for a lot of these people tourism is their primary income. It puts you in a difficult position knowing that you are far wealthier than they are, but you are often faced with deviousness and are hassled into giving money for things you don't want.

Haggling. You are expected to haggle for everything in Gambia. It isn't a culture we're very used ot in Britain, and particularly they way I have been brought up. Some things were overpriced, but I find it embarassing asking someone to sell something cheaper, especially knowing I have more money in my pocket than their monthly income. I don't know if anyone reading this has seen any Monty Python but in one of the films, The Life of Brian, Brian is trying to hide from the Centurions and wants to purchase a beard in the market. It's a very funny scene, (read it here) Brian is willing to pay the full amount but the seller wishes for him to haggle. Well it was a bit like that. I tried to purchase a piece of artwork in the market, the starting price was 600D which I would have paid, but instead the seller was trying to teach me to haggle ("Now it's your turn, choose a starting price").

Poverty. There are about 50 Gambian Dalasis to the £pound. We were surrounded by poverty, and that in itself wasn't too difficult, you were immersed in it, you could see it in the streets, in the housing, in the clothing. It was the individual cases I struggled with, the ones that made it real and personal. Lamin White Cap was our taxi driver most days. We would pay 600d (£12) between 7 of us to drive half an hour to Serekunda to eat out there. He would wait around for 2 hours, then charge 50d (£1) for every hour after that, then drive us back. Sitting there eating in a really nice restraunt I realised that I was spending more on this one meal than Lamin was charging for the whole trip for the 7 of us. Lamin was a private taxi driver working for a company employed by the hotel, what we paid him he probably took very little home of.

One night driving back from dinner we were chatting to Lamin about his family, he has 5 children. To go to primary school it costs about 400d (£8) a term, Lamin struggles to pay this for all his children. His oldest son would like to learn Arabic, but that isnt' taught in primary or middle school, he would have to go to high school but that costs 1,500d (£24) a term (5,000d (£100) for private) and his father cannot afford those fees. Lamin does not drive his own car, he cannot afford it, yet he is not even one of the poorest in Gambia.

I think a lot about that conversation. The cost of schooling, he can just about afford primary and middle school, some can't even afford that. Yet it is so little money to us in the UK, but it is a very difficult situation to change. Who do you help? You can't help everyone. How do you help? You can't just give them money, which charity do you choose to support? It weighs heavily on my conscience.

I cannot do the country justice and this post has barely touched on the things I did and the things I thought whilst I was there. I have an album uploaded that I can email to people if they are interested, it's a bit odd and I can't link it only mail it. Drop me a comment if you're interested. But for now, here are three of my favourite.



I apologise for any typing errors!

Wednesday, November 29, 2006

People and suitcases

On monday I travelled up to Nat's. I had a big (and very heavy) suitcase with me. At Elephant and Castle station there are some stairs and I was strugging down them with my suitcase in one hand and leaning on the hand rail for support. Three people were coming up not using the handrail for support, and instead of moving around me expected me to struggle around them. How ignorant are people? Because I'm a polite person I moved around them, but next time I think I'll just stand still and see what they do. Instead I just muttered things about inconsiderate and ignorant people.

I dislike using pubic transport when I have a big bag, aside form it being inconvenient I don't like being in people's way, but as I don't drive I haven't got a lot of choice.

Monday, November 27, 2006

Looking good.

I saw my ethics lecturer this morning, after she kept me waiting for an hour, and she read through my essay and told me it was good! There are just a few small changes I need to make. So, I'm quite happy about that, though I won't celebrate until it's been marked because from past experience I know what the marker says about the draft may be entirely different to what they say to the submitted essay.

Sunday, November 26, 2006

A productive day

I went into work today to get the last few things in my skills schedule signed off. I thought it would be horribly difficult knowing what my mentor has been like in the past when it has come to signing things, but actually it was smooth and fairly painless. It's a relief to have the Schedule out of the way and ready to submit next module.

I finished off my ethics essay tonight, I think it might actually be a load of rubbish, but I'm seeing a lecturer about it tomorrow and I guess she'll give me a clue.

I'e been quite stressed this weekend, having to get my schedule sorted and finish that essay, but also I'm going to Nat's tomorrow, we're going to a funeral on tuesday and then I'm staying there until friday when we fly out to Gambia for a week with some friends. So I've had a lot of packing and organising to do on top of my university work.

On the brightside, my parents being the Christmas lovers that they are have put up our Christmas tree, it looks beautiful as ever, and the kitten loves it.

Saturday, November 25, 2006

Assignment grumbling

I'm currently writing a (bad) ethics essay. This is an essay that I have really struggled with, not because I lack in ethics(!) but we have received little teaching in university on ethical theory and principles which adds to the difficulty in writing this essay and the way in which we are expected to write is not the way we behave in real life. The decisions we make in practice are guided by ethics and by the standards laid out by the nursing and midwifery council, but we do not have the time to stand around critically analysing and discussing each decision we make applying relevent ethical theory (such as deontology or utlitiarinism) and principles (benificence, non-malificence etc). Many of these theories and principles are second nature to some degree, nonmalficence the principle that we shall no do harm for example. I don't know that I would go as far as to say this essay is a waste of time and will have no relvence to practice, it will, but the relevence is from the research I have done into restraint and policy, not because I have applied a consequential theory to the scenario or looked at the level of autonomy the patient has.

I know, I'm just moaning. But as with many of our assignments it doesn't seem to be about furthering our development but more about showing the university we can say all the right things in the right way. What you write in an essay does not reflect your ability to be a good nurse, it's jsut learning to talk that talk.

One of the things I struggled with in the course is how little my opinion is valued in terms of assignments. We have had to write many essays on various topics throughout the course and my opinion is worthless in them if I cannot back up what I say with a reference. I understand the need for evidence based practice, and I'm not denying that there needs to be sound a knowledge base in what we write but it is disheartening to know that my opinion is only worth something if someone has said it already. Where is the room for new ideas? All the references I use, someone had to come up with them in first place.

Friday, November 24, 2006

My week - an overview

This week has been pretty good. I worked three shifts. The first was out on the ward, as opposed to HDU, on a night shift. We are so undersaffed and underresourced and with the forthcomin gclosure of the ward the staff have had enough. The highlight of my night shift was being womited on by a baby who just would not stop crying, with a pretty useless father who seemed to feel it was the nurses job to do everything for his daughter, he'd just lie in bed when she cried or come and get us and point out that she's crying. Well.. yes.. and what do you think we're going to do that you can't do better as her father?

Yesterday I worked with B and she's a star, really helped me get some of my skills schedule signed off. Once again understaffed, I think it's helpful for them when I'm working as I can (fairly competently) take my own patients easing the staff load slightly. Highlight of that shift? (I typed shit then by mistake, Freudian slip?) Hmm. I did my first subcut injection and it's about time really. Hardly news worthy I know, but I had a sense of fulfilment doing it - I quite like doing injections, maybe I'm abit of a sadist.

Today I worked with my mentor. I don't think I've mentioned him before. He has been the most challenging mentor I have had I think, for reasons I won't go into here/now. But I have learned a lot of patience on this placement, and a lot about how not to treat people and patients. I was really hoping I'd find some way to get out of it as it was my last shift, however I didn't and I survived and it wasn't entirely horrendous. The highlight of today was being told by one of the senior sisters that I've "got what it takes to go far in nursing", that she's seen me in practice and that if they could offer me a job in April they would do, with the forthcoming closure and reshuffle they won't be able to, it's good to know though.

Oh, and I did a really good blood gas today, not a big deal at all I know but I feel like I always fuck them up and have to get someone else to do them, so it felt good. It really does make a difference having a supportive and encouraging person working with you when you're not feeling confident (it also helps that it was a compliant 9 year old and not a kicking, screaming babe).

Oh, and having done my durgs assessment last module I'm allowed to be a second checker. I like it, it's fun, but I also feel like I'm helpful and contributing.

I should really go back and check my typing, but I'm tired and can't be bothered so I apologise for any mistakes, if you begin to read this blog on a regular basis though I'm sure you'll get used to them.

Tuesday, November 21, 2006

Acronyms and Danger

Recently on a comments thread of a blog I have been following, the topic of hospital acronyms came up. It made me think about the little things I've not learned during my 2.5 year's training. TTA/TTOs. I know what they are - medication the patient takes home, but I've never really been sure what they stand for - that's not something they teach in university, (thanks to those who enlightened me on that thread).

Something else, incredibly stupid that in my third year I'm still a little hazy about, is the medical heirachy. When I'm asked to bleep the doctors for a particular task I'm never quite sure which one they mean, SHO, reg, consultant? I tend to go for the nice ones who'll either give me what I want or point me in the direction of someone who can. I was discussing this recently with a fellow third year who said she also is never quite sure - clearly a gap in our training!

Blogging. It's dangerous. I started reading Random Reality's blog because it came up in the Metro and looked like interesting reading. From reading his Blog I've moved onto NeeNaw's and Diagnosis N.F.I, from their Blogs I've started reading Mr Man's Wife and from there I've started glancing through about 5 different others! It's a wonderful way to avoid writing my essays, and the bonus is I can kid myself that it's all relevent to my training!

Monday, November 20, 2006

Diploma vs. Degree

I'm due to qualify in April, I wasn't really looking forward to it for several reasons.
a) I've got so much work to do between now and then I just want to give up and sleep through the winter
b) I'm not entirely sure I'm ready to be a staff nurse. Don't misunderstand me, I actually think I'm good at what I do (a rarity for me) and have the potential to be a good staff nurse I'm just not sure I feel ready to go out there and do it yet
c) I actually have to find a job

I'm so close to finishing it seems almost impossible yet I know, despite a,b and c, it will be a relief in some ways. So why am I now considering doing an extra year?

I've trained on a 3 year Diploma course, Degree or Diploma I exit the programme as a registered nurse child branch. I left school with just AS Levels, when I decided I wanted to do nursing a Diploma was the best option, I could have done an extra year at school to get onto a degree programme but the funding is better on the Diploma and it seemed like the best idea at the time. Afterall, I don't need a degree to be a good nurse.

During my training I realised that I want to get the degree at some point, I had thought CPD modules later when I'd qualified would be a good idea. However, my university runs a "top up" course full time for a year starting the month after I qualify. I'm planning on applying for it, my (ever supportive and loving) parents will help support me for another year and it seems better than trying to to it later when I may have other commitments like a mortgage or a family.

Why do I want a degree? Well there's definitely an issue of pride. Employability, well either way I'd be a registered nurse but in these cash strapped times who would a ward rather employ; a diploma nurse who wants to be sponsered to degree or someone who already has a degree? If faced with two applicants, a good diploma nurse and a not-so-good degree nurse I don't believe having the diploma would disavantage, however being on an even pegging in terms of "goodness" greater qualification has to be a bonus. If I leave nursing having a degree, regardless of it's relevence, will be looked on positively. If I want to go on to do more study, which I think I will, having the degree now will make it easier to access other courses. Finally, it is not going to disadvantage me doing an extra year of study and having more qualifications.

Do I really want to do an extra year? I was looking forward to these essays being the last I would have to write for the foreseeable future, I don't relish the idea of further study now. But I feel it would be better to get out of the way whilst I can. With regards to a,b and c...
a) doesnt' really change, I've always fancied hibernation as a life choice.
b) I would have another year to feel ready to be a grown up, maybe I won't feel ready then either but I certainly will have more experience under the safety net of being a student (though realistically I'll have a PIN and seeing as I don't seem to be counted as supernumery now I can't see that I will be then).
c) Perhaps the job climate will have changed by then.

The other downside is that on the Diploma course my tuition fees were paid and I received a nice bursary, this I will not get for the extra year and I anticipate the fees being quite high, I'll have to take out a loan (I've not needed to thus far) and be poor for a year whilst my friends go out and work and earn the millions nursing has to offer.However, at just 21 I have my whole life ahead of me, one extra year is nothing in the grand scheme of things.

Of course, all this is subject to my application and acceptance onto the programme however as one of their current students I think it unlikely I wouldn't be. So I'm now trying to mentally prepare myself for another year of essay writing and new found poverty.

If you read this far you deserve a cookie.

Tuesday, November 14, 2006

Doom and gloom

We have a careers day on thursday, which has now become a careers half day as there aren't any jobs. I personally find this amusing, but then I have an odd sense of humour.

Only one Trust agreed to have a stand at the fair, everyone else cancelled as the job situation in the local area is so dire. I've also been told by several different people in the last week how restrictive training to be a paediatric nurse will be, so apparently it's all doom and gloom that I have to look firward to in April. Apparently I should have trained as an adult nurse, but the thing is I don't really like adults so that would have been a drawback!

Monday, November 13, 2006

Obesity

So one of my biggest issues at the moment is obesity in children. In the last few weeks I have come across several very obese children on the ward. I personally feel that if an adult wants to be obese, fine they can make that choice for themselves but they should not be making it for their children.

Obesity is such a well publicised issue along with healthy eating that parents can no longer plead ignorance. But what motivates a parent to over feed and poorly feed their child to the point of obesisty? And I'm not talking a little bit chubby, I am talking clinically obese. For example, a 15 year old, 1.5m tall weighing in at 110kg. A 5 year old, 45kg (yes he was tall for his age, but he wasn't *that* tall). This 5 year was due to have minor surgery, the anaethetist was talking of cancelling the operation because obtaining venous access was very difficult due to his excess fat. Fortunatly venous access was obtained and the operation went ahead. I wonder though if the cancellation would have "taught the parents a lesson"? It's not about punishment and unfortunatly it would result in the child's care suffering but clearly the parents are not paying attention to their child's health needs and what will it take for them to realise it is a problem? They obviously didn't feel it was a problem; the 2 McDonalds, a packet of crisps and a packet of maltesers the night before clearly indicated this, as did the claim that they didn't feel he ate very much.

The child's diet and weight bordered on being neglectful or abusive as my collegaues have suggested, but these were clearly very loving parents, they just wanted to make their child happy. I think something has gone very wrong in our society, material things and food are all too often used as demonstrations of affection. I regularly see it in my work, parents not knowing any other way to show thier child love other than by buying them things and giving into their every whim whether it's good for their health or not. I wonder if they truly realise the damage they're doing to their children.

I'm trying not to jump on the obesity band wagon, but I've recently realised what an issue it's becoming and it is a difficult one to address. In many cases I think it is the result of parenting that the child has become obese and it's difficult to tackle as not all parents are compliant. I also feel that at times there is a hesitency to raise the issue on the part of healthcare staff; being fat has very negative connotations in this society and it's hard to turn round to a parent and tell them not only is their child fat (we try to come up with nice words for it) but that it's their responsibility - no parent likes to be criticised. It's an issue that needs to be dealt with very sensitively and it is easy to criticise, as I'm sure you've realised through reading this. I'm not sure what the answer is but I think we need to provide education for these parents, hard facts about what the consequences of childhood obesity are, but also a supportive and nurturing environment to help them to change their child's lifestyle.

I added some new links, for those of you interested in what we're doing in Iraq there's a site that attempts to keep a record of the casualitise to date. I've also added links to 3 blogs which I'm following with interest, I hope I've not broken any Blogging etiquette in linking.

Monday, November 06, 2006

Beautiful, wonderful

So, yesterday I got to pass my first NG tube, beautiful.
I got all my paperwork finished and signed, wonderful.

I realised just how soon I'll be qualifying and becoming an all grown up staff nurse. Although when on placement I'm working full time I'm always aware that I have a finish date and am counting down to it. I'm going to have to get my head around the fact that this is going to be my life come April/May. Assuming I can find a job.

Saturday, November 04, 2006

Door buzzers and lumbar punctures

Most wards have a buzzer entry system, particualrly children's wards, we're not supposed to let complete strangers come say hello to the kiddies.


Me: Hello soandso ward, can I help you?
Person: Open door please
Me: Who are you here to see?
Person: Door open please
Me: Yes, but who are you here to see?
Person: Bed 5
Me: Which patient?

At this point there's usually a name mumbled, often Mohammed (we usually have at least 3 on the ward at any one time) and I let the person in now I'm more convinced they're not an axe murderer.

These conversations get me every time though. If there's a buzzer outside a locked door I think it's a safe assumption the person using it wants to gain access, yet I frequently get that response as though I'm a slighty dense person who's not quite realised what the bell is for.

On other matters, I saw my first lumbar puncture today, I'm not sure how I've managed to get half way through my third year without seeing one (or, come to it, passing a NG* tube on someone other than myself). It was quite good, I was the "catcher" for the CSF. I only managed knocked the needle out of the sterile field so the doctor had to plug it with his thumb between sample bottles, I didn't spill any though so I'm fairly happy! We learn through mistakes and and the doctor was very nice about it.

The poor kid also had a plastic container taped to his head which I realised protected his scalp cannula. Not seen one of those before, cool if a little odd looking.

* I noticed when reading the page about NG tubes that it suggests that injecting air down the tube and listening for air entry into the stomach as being reccomeneded practice for confirming the position of an NG tube. I just wanted to say that that is not the case and is not something we do in practice any longer. The article mentions aspirating and testing with pH paper, this is the reccomended practice. Just thought I'd bore you with that, I've got lots more info about testing NG tube placement if anyone happened to be interested! ;p

Tuesday, October 31, 2006

Things

Things I liked today:
1) Getting an easy OSCE question.
2) Getting a glowing written report from my mentor.

Things I didn't like today:
1) Smelly people on the bus.
2) People walking slowly, aimlessly down the middle of the pavement leaving no room for the puropseful striders to overtake.

Things I learned today:
1) A TenderFoot does exactly what it says on the packet. It gives you a tender foot... or a tender finger in my case. I'd heard they were pretty brutal so I thought to try one out, and yes I can confirm it, they hurt.
2) Microwaving a Kosher soup for 5 minutes makes it explode a little bit.


We've had a child on the ward recently with Prader-Willi Syndrome, one I've not come across before and quite interesting to care for. I was going to discuss this a little but had a pang of confidetiality conscience.