Subject Description:
Students will focus on issues that impact on nurses and nursing work. They will focus on personal and professional development with an emphasis on registration requirements, job application, transition to the role of RN Division 1 and future career directions. Students will explore contemporary factors impacting on professional nursing practice, including the role of the nurse in health care and the effect of political and/or economic decisions on the provision of care.
Assessment:
1. Professional portfolio worth 40% with letter of application, curriculum vitae and 1200 word discussion paper on maintaining competence in nursing practice.
2. Group presentation worth 20%
3. 1600 word Professional Development Plan for final year of Bachelor of Nursing, identifying learning needs and reflections on how I achieved them on clinical placement, worth 40%.
So far the lectures and workshops for this subject have been about Grad year, what is involves, the application process, the interview process, the challenges, the benefits and so on. Yesterday in workshop we did mock job interviews in our groups and gave each other feedback. This is really good practice. We were given a list of about 50 questions that often get asked in grad interviews, so we can plan and practice our answers. I'll be applying for graduate positions in June/July this year, so this subject will be really useful for getting on with that.
Friday, February 25, 2011
Nursing Older People Week 1
Subject Description
Students will encounter the health needs of older people in diverse settings, but particularly in acute care settings. They will consider the biopsychosocial aspects of ageing, older persons’ responses to multiple pathology and recent advances in the ability to regulate the biology of ageing. They will further develop skills in advanced nursing assessment. The importance of the nursing roles in promoting, maintaining, and restoring the health of older adults will be a major focus. Consideration will be given to the potential negative impact of care on the older individual’s ability to live a meaningful, productive, autonomous and responsible life.
So, basically after this subject, I will encourage all my elderly patients to start using anti-ageing cream if they haven’t already, to prevent ageing, LOL.
Assessment:
• 20 minute Group presentation in final workshop worth 20%
• 1500 word individual report on healthcare issues for elderly patients worth 30%
• 2000 word individual case management review based on real patient from clinical placement worth 50%
• 2 week clinical placement start May 23.
I won’t be doing much for this subject until the second half of the semester because I am in the last placement group and most of my workshops are also later in the semester.
Complex Care Nursing Week 1
This is my biggest subject for the semester with twice as much content as the other two. This is the subject description:
Students will work as a member of a health care team and investigate the usefulness of selected therapies for individual clients in an acute health care setting. The impact of complex health problems on the individual and carers will be emphasised. Students will develop knowledge and skills in order to engage in person-centred care with individuals experiencing a range of complex acute and chronic health care issues. In the clinical setting, there will perform focused assessment and apply clinical reasoning to further develop their skills in planning and delivering care that incorporates pathophysiology principles, medical technology and discharge plans.
My assessment for this subject:
• Three week clinical placement – must complete this satisfactorily to pass the subject. My placement starts very soon on March 14th!
• 2500 word assignment worth 40%
• 2.5 hour open answer exam worth 50%
• Workshop participation (homework tasks) worth 10%
This week this is what we covered in the subject:
Lectures
• Advance Care Planning: respecting patient choices and withdrawal of treatment - this is about trying to find out what people want for themselves before it too late to ask (lose their capacity to make a decision). It takes the burden off families to make those difficult decisions. The principles of respecting patient choices are dignity, autonomy, informed consent, and prevention of suffering. Everyone has their own feelings about what make each day meaningful for them, such as spending time with loved ones, eating delicious food, mobility and able to carry out basic activities of daily living, and environment. Situations one might consider unacceptable are not being able to recognise or communicate with loved ones, not being about to eat or do basic activities of daily living independently such as toileting and bathing. Also some people like the idea of a quick death rather than a long drawn out death with lots of pain, suffering and boredom, so they have a preference that if their heart stops they do not want to be resuscitated. It's important to think about these things and tell your next of kin - partner, son/daughter, mother/father - what your wishes are. Or you could just get a tattoo.
Labs
• Emergency scenario – focused assessment
• Performing an ECG (we learnt this last year so it was just practice)
• Interpreting an ECG
• Management of underwater seal chest drains
• Management of central venous line catheters
Workshops:
• Reviewed pathophysiology of the heart
• ECG interpretation
• Patient scenario health issues and procedures:
• Transischaemic attack
• Percutaneously inserted valve
• Transesophageal echo probe
• Angioplasty
• Angiogram
• Aortic stenosis (showing up in angiogram)
Students will work as a member of a health care team and investigate the usefulness of selected therapies for individual clients in an acute health care setting. The impact of complex health problems on the individual and carers will be emphasised. Students will develop knowledge and skills in order to engage in person-centred care with individuals experiencing a range of complex acute and chronic health care issues. In the clinical setting, there will perform focused assessment and apply clinical reasoning to further develop their skills in planning and delivering care that incorporates pathophysiology principles, medical technology and discharge plans.
My assessment for this subject:
• Three week clinical placement – must complete this satisfactorily to pass the subject. My placement starts very soon on March 14th!
• 2500 word assignment worth 40%
• 2.5 hour open answer exam worth 50%
• Workshop participation (homework tasks) worth 10%
This week this is what we covered in the subject:
Lectures
• Advance Care Planning: respecting patient choices and withdrawal of treatment - this is about trying to find out what people want for themselves before it too late to ask (lose their capacity to make a decision). It takes the burden off families to make those difficult decisions. The principles of respecting patient choices are dignity, autonomy, informed consent, and prevention of suffering. Everyone has their own feelings about what make each day meaningful for them, such as spending time with loved ones, eating delicious food, mobility and able to carry out basic activities of daily living, and environment. Situations one might consider unacceptable are not being able to recognise or communicate with loved ones, not being about to eat or do basic activities of daily living independently such as toileting and bathing. Also some people like the idea of a quick death rather than a long drawn out death with lots of pain, suffering and boredom, so they have a preference that if their heart stops they do not want to be resuscitated. It's important to think about these things and tell your next of kin - partner, son/daughter, mother/father - what your wishes are. Or you could just get a tattoo.
Labs
• Emergency scenario – focused assessment
• Performing an ECG (we learnt this last year so it was just practice)
• Interpreting an ECG
• Management of underwater seal chest drains
• Management of central venous line catheters
Workshops:
• Reviewed pathophysiology of the heart
• ECG interpretation
• Patient scenario health issues and procedures:
• Transischaemic attack
• Percutaneously inserted valve
• Transesophageal echo probe
• Angioplasty
• Angiogram
• Aortic stenosis (showing up in angiogram)
Week 1 - Hospital Orientation
A whole day of lectures was devoted to introducing us to the hospital's philosophy of care and policies.
Patient outcomes:
• Health goals are met
• Positive experience
• Not harmed
• Timely communication
Regular assessment of patients’ basic needs (hourly checks):
• Pain
• Toileting
• Mobility
• Environment
• Other – ie, “is there anything I can do for you?”
Criteria for a MET (Medical Emergency Team) call:
• Resp rate > 36 resps per minute or < 6
• Oxygen saturation of <90% on oxygen
• Threatened airway
• Systolic blood pressure < 90
• Heart rate > 140 or < 40 beats per minute
• Sudden drop in Glasgow Coma Scale by 2 points (neurological score)
• Prolonged seizures (could be a stroke)
• Uncontrolled pain
• Other serious concern (eg. uncontrolled bleeding)
Nurses’ role during a medical emergency:
• CPR – compressions and/or bagging (breaths)
• Medication
• Reassurance
• Runner
• Scribe
• Remove clutter
• Reassure other patients and visitors who are nearby
• Information
• Delegate roles
• Interventions
Policies:
• Hand hygiene
• Manual Handling
• Risk assessment and management
• Patient aggression
• Infection control - For gastroenteritis, staff must not come to work for 48 hours after their last symptom of vomiting or diarrhoea, because they will still be infectious. Gastro can KILL elderly people, infants, and those with compromised immune systems.
Adverse Events
In Australia the statistics are that 16% of patients admitted to hospital experience one of the following during their stay:
• Medication error
• Fall
• Pressure ulcer
• Wrong blood
• Hospital acquired infection
• Wrong site surgery or wrong procedure.
Patient outcomes:
• Health goals are met
• Positive experience
• Not harmed
• Timely communication
Regular assessment of patients’ basic needs (hourly checks):
• Pain
• Toileting
• Mobility
• Environment
• Other – ie, “is there anything I can do for you?”
Criteria for a MET (Medical Emergency Team) call:
• Resp rate > 36 resps per minute or < 6
• Oxygen saturation of <90% on oxygen
• Threatened airway
• Systolic blood pressure < 90
• Heart rate > 140 or < 40 beats per minute
• Sudden drop in Glasgow Coma Scale by 2 points (neurological score)
• Prolonged seizures (could be a stroke)
• Uncontrolled pain
• Other serious concern (eg. uncontrolled bleeding)
Nurses’ role during a medical emergency:
• CPR – compressions and/or bagging (breaths)
• Medication
• Reassurance
• Runner
• Scribe
• Remove clutter
• Reassure other patients and visitors who are nearby
• Information
• Delegate roles
• Interventions
Policies:
• Hand hygiene
• Manual Handling
• Risk assessment and management
• Patient aggression
• Infection control - For gastroenteritis, staff must not come to work for 48 hours after their last symptom of vomiting or diarrhoea, because they will still be infectious. Gastro can KILL elderly people, infants, and those with compromised immune systems.
Adverse Events
In Australia the statistics are that 16% of patients admitted to hospital experience one of the following during their stay:
• Medication error
• Fall
• Pressure ulcer
• Wrong blood
• Hospital acquired infection
• Wrong site surgery or wrong procedure.
Tuesday, February 22, 2011
New semester - final year!
Wow, this week is so jam packed with classes and I also have heaps of homework to do to keep up. I'm going to try to find time to update my blog during the week because there is lots to write about but homework, staying organised and getting enough sleep are my priorities. I'll definitely update on the weekend though.
Wednesday, February 16, 2011
Basic Life Support Update
At the beginning of last year I did my First Aid Certificate and every 12 months I need to do a refresher for the CPR component. With my new job, I'm lucky that I can do Continuing Professional Education Updates online and it is subsidised. I just did the Basic Life Support Update which was an online tutorial covering the updated guidelines for CPR and basic life support from the Australian Resuscitation Council. The new guidelines incorporate the latest evidence for:
1. Managing an emergency
2. Unconsciousness
3. Airway
4. Breathing
5. Compressions
6. Automated External Defibrillation
7. Cardiopulmonary Resuscitation
It cost $12 to do the update which will be deducted from my first pay. For the assessment there are 3 attempts allowed before you have to pay again. In the first attempt I got 8/10 and I checked which ones I got wrong then did the second attempt straight away. The second time I got 10/10.
There are lots of other updates I can do if I want but I'll leave them for now because they cost money. Closer to the time I apply for grad positions I might do a few more because it will be good for my resume.
Found out my timetable which starts next week. It's jam packed with classes Monday to Friday for at least the first few weeks, so I'll be pretty busy and have lots to blog about.
1. Managing an emergency
2. Unconsciousness
3. Airway
4. Breathing
5. Compressions
6. Automated External Defibrillation
7. Cardiopulmonary Resuscitation
It cost $12 to do the update which will be deducted from my first pay. For the assessment there are 3 attempts allowed before you have to pay again. In the first attempt I got 8/10 and I checked which ones I got wrong then did the second attempt straight away. The second time I got 10/10.
There are lots of other updates I can do if I want but I'll leave them for now because they cost money. Closer to the time I apply for grad positions I might do a few more because it will be good for my resume.
Found out my timetable which starts next week. It's jam packed with classes Monday to Friday for at least the first few weeks, so I'll be pretty busy and have lots to blog about.
Monday, February 14, 2011
Yay! I got my first nursing job!
So, spent last week relaxing and finishing off my assignment (mostly relaxing). Handed in the assignment on Friday so should get my result for Mental Health Nursing soon. Also sent out a my CV to a few nursing agencies last week and today I had a job interview with one of them and I got the job! They're taking me on as a Personal Care Attendant/Assistant in Nursing. I already got a uniform! Hoping I can get one shift a week, preferably on the weekends, which also pays more than weekday.
I don't know my uni timetable yet but I did find out today which clinical school I'm in this year (very happy with it, very good hospital, and convenient for me to get to by public transport). And classes will start a week earlier than I expected, which means they start next Monday the 21st.
Will enjoy doing nothing for the rest of this week, just relaxing, because I'm sure things will start getting very busy very soon.
I don't know my uni timetable yet but I did find out today which clinical school I'm in this year (very happy with it, very good hospital, and convenient for me to get to by public transport). And classes will start a week earlier than I expected, which means they start next Monday the 21st.
Will enjoy doing nothing for the rest of this week, just relaxing, because I'm sure things will start getting very busy very soon.
Thursday, February 3, 2011
Final week of placement - finished!
Today was the last day of my placement! It has been awesome. This week I spent lots of time with the psychiatrists sitting in on their daily meetings with the patients where they talk about how the patient has been feeling, how their medications are going, how they've been behaving on the ward (good or bad), whether they can have their leave increased or restricted and plans for after discharge. It's been really interesting, and because I've been having quite a bit to do with the patients' care the doctors asked me what I think about the patients' mental state too.
I also got to teach yoga and meditation again this week because one of the patients requested it. Four people came to the class which is the maximum number that can fit in the room.
Sat in on a few Mental Health tribunal hearings as well. This is part of the Civil and Administrative Tribunal and is an actual legal proceeding with a tribunal member, two independent doctors, the patient's psychiatrist, and nurse. In the first hearing I went to the patient was very articulate, eloquent, answered the questions and talked about his mental illness (bipolar) with a lot of insight. It was surprising because most of the time he is really annoying and immature and non-stop talking about anything and everything. I told him I was impressed and he said he behaves and speaks differently when he's in front of the judge. I told him he should at least try to be like that all the time and he would be out of here a lot quicker. The second hearing I went to was a patient that was completely delusional, thinks he is a world champion kick boxer, international secret agent, knight and saint, a billionaire and the list goes on. He also thinks he has a really fit amazing body. The reality is he looks like a homeless bum and has a huge gut and lots of health problems, and is unemployed and living on the disability support pension. He thinks they must be confusing him with someone else.
Today I went in with the doctor (who is African) to review the mental state of this patient. The patient mumbles and rambles quite a bit and uses a lot of jargon which makes it difficult for the doctor to understand him. So I had to help interpret. Then we went and reviewed another patient who was delusional that he and his parents were murdered when he was a baby, and that he is a clone of his former self and his 'parents' are imposters. He also believes that he has a silicone computer chip in this thumb that he can set off atomic bombs that are located in Croatia and because of that a local gang, the Cro Boys are after him and want to kill him. He only feels safe in the psych unit. In addition, he says he is Jesus Christ and that's why all the Jews and athiests want to kill him. If that wasn't enough stress already, he also has bikie gangs after him, the police want to kill him because he is privy to the knowledge that some police officers use drugs, and he needs to get surgery that will stop him from being able to get an erection because he is due to start military training (also a delusion) and in the army it's not allowed to masturbate or have erections. He asked me to organise this for him because it's his body and his right. "What are my chances for approval?" I just said "I'm not sure".
There have been a lot of delusional patients this week, very paranoid, shouting, smashing things, verbally abusing staff and each other. The atmosphere has been crazy. Also it was really hot the first two days this week and then it's been hot and humid for the last three days so that makes it even worse, and the patients have more trouble sleeping. There aren't enough beds in the high dependency unit (only 4 because one of the rooms is unoccupiable due to a leaky ceiling), and there are probably around 10 patients that need high dependency care at the moment. But they have to be in the low dependency unit instead and that upsets all the other patients because the environment's not as calm, and they get wound up.
Anyway, all in all the placement has been a fantastic experience. All the staff have been so wonderful, caring, patient and keen to pass on knowledge. They've also been very complimentary and encouraging, giving me lots of (but not too much) responsibility. I've been encouraged by quite a few of them, including my clinical educator who did my assessment, to pursue a career in mental health nursing. I could certainly see myself doing it for a few years, and there is no shortage of jobs, just a big shortage of nurses it seems. They even said we hope you come back and work here. At the very least, it is a very good referee to have on my resume for my job hunting this year and for grad positions.
Big drive back to Melbourne tomorrow.
I also got to teach yoga and meditation again this week because one of the patients requested it. Four people came to the class which is the maximum number that can fit in the room.
Sat in on a few Mental Health tribunal hearings as well. This is part of the Civil and Administrative Tribunal and is an actual legal proceeding with a tribunal member, two independent doctors, the patient's psychiatrist, and nurse. In the first hearing I went to the patient was very articulate, eloquent, answered the questions and talked about his mental illness (bipolar) with a lot of insight. It was surprising because most of the time he is really annoying and immature and non-stop talking about anything and everything. I told him I was impressed and he said he behaves and speaks differently when he's in front of the judge. I told him he should at least try to be like that all the time and he would be out of here a lot quicker. The second hearing I went to was a patient that was completely delusional, thinks he is a world champion kick boxer, international secret agent, knight and saint, a billionaire and the list goes on. He also thinks he has a really fit amazing body. The reality is he looks like a homeless bum and has a huge gut and lots of health problems, and is unemployed and living on the disability support pension. He thinks they must be confusing him with someone else.
Today I went in with the doctor (who is African) to review the mental state of this patient. The patient mumbles and rambles quite a bit and uses a lot of jargon which makes it difficult for the doctor to understand him. So I had to help interpret. Then we went and reviewed another patient who was delusional that he and his parents were murdered when he was a baby, and that he is a clone of his former self and his 'parents' are imposters. He also believes that he has a silicone computer chip in this thumb that he can set off atomic bombs that are located in Croatia and because of that a local gang, the Cro Boys are after him and want to kill him. He only feels safe in the psych unit. In addition, he says he is Jesus Christ and that's why all the Jews and athiests want to kill him. If that wasn't enough stress already, he also has bikie gangs after him, the police want to kill him because he is privy to the knowledge that some police officers use drugs, and he needs to get surgery that will stop him from being able to get an erection because he is due to start military training (also a delusion) and in the army it's not allowed to masturbate or have erections. He asked me to organise this for him because it's his body and his right. "What are my chances for approval?" I just said "I'm not sure".
There have been a lot of delusional patients this week, very paranoid, shouting, smashing things, verbally abusing staff and each other. The atmosphere has been crazy. Also it was really hot the first two days this week and then it's been hot and humid for the last three days so that makes it even worse, and the patients have more trouble sleeping. There aren't enough beds in the high dependency unit (only 4 because one of the rooms is unoccupiable due to a leaky ceiling), and there are probably around 10 patients that need high dependency care at the moment. But they have to be in the low dependency unit instead and that upsets all the other patients because the environment's not as calm, and they get wound up.
Anyway, all in all the placement has been a fantastic experience. All the staff have been so wonderful, caring, patient and keen to pass on knowledge. They've also been very complimentary and encouraging, giving me lots of (but not too much) responsibility. I've been encouraged by quite a few of them, including my clinical educator who did my assessment, to pursue a career in mental health nursing. I could certainly see myself doing it for a few years, and there is no shortage of jobs, just a big shortage of nurses it seems. They even said we hope you come back and work here. At the very least, it is a very good referee to have on my resume for my job hunting this year and for grad positions.
Big drive back to Melbourne tomorrow.
Subscribe to:
Posts (Atom)