Thursday 21 June 2012

Best books for nursing students

Hello readers!!
Today I'll be chatting about the nursing books i could not live without (Well... okay... I COULD live without them but it would be hard...). These books are my favourite by-the-way. I have so many i love but these are the main ones! ^   ^ Head down to your uni library if you are interested. I haven't linked them to Amazon or anything because almost every uni library will have these books. Do you really want to waste £130 of your student bursary on one book? That's what I thought... Just search your library catalogue. It saves pennies. So, here we go. In no paticular order...


The Royal Marsden of Clinical Nursing Procedures
Such an amazing book but SO heavy -_-... This is the most important book of your training though, whcih regards to learning clinical procedures anyway. This has pretty much EVERY nursing procedure but it's great to learn from because its set out well, with great diagrams and in an easy-to-read way. Probably not a good idea to buy this or some of the other books mentioned in this post as many, if not all of these are very expensive (some over £100...) Just head down to your university library. More often your uni library will have withdrawn books and you will be able to take them home for free. Anyway, I love this book so get one if you can!
 
British National Formulary
This book is a must for when you are on the wards! It simply lists all drugs and their indications, side effects etc. I believe they are released a couple times every year (March and Sept, I think) which is great because it means they are always up-to-date. Plus, they are always such pretty colours!! Anyway, don't panic if you don't have one, every ward has at least three or four. You don't have to pay Amazon prices either. Just run down to your pharmacy dept. and ask if they have any they are chucking out. (They always want up-to-date ones obviously). So, get your hands on one!! 

Gray's Anatomy
Every nurse needs to have some knowledge about A&P and this book is amazing! It's pretty heavy for the layman mentally and physically (It'a a BIG book...) but it's a must for any student of biology or healthcare.





  


  
Principles of Anatomy & Physiology
This book is actually available as two separate volumes and is actually one of the best A&P books I've read. It covers almost everything you need to know as a student nurse and is perfect for assignments. This book was actually recommended by the A&P lecturers and I found so many copies in the library. Only problem was that I would have to stay in the stacks and flick through the book to make sure I had the right volume with the right topics in before taking it out! Other than that, highly recommended!


                                         

The Incredibily Easy! Series
I LOVE this series because, being a first year, some aspects of the course and of your training are quite daunting. This series helps to clarify some of the harder topics. Each chapter starts with the very basics and gradually delves into the deeper and more analytical stuff. The text is broken up into smaller paragraphs, making it easy to read. And text is also accompanied by cartoon pictures which is quite cool. There are quite a lot of books in this series and so far I've only read about three/four but I hope to read them all eventually! There are books on: Wound care, critical care, clinical skills, fundamentals of care, mental health, nursing pharmacology, assessment, nutrition, paediatrics and many more! Check them out!  


Nursing Calculations
Although this is a book of little pages but is very easy to get through. It simply comprises of a lot of drug calculations and is set out like a maths textbook. But it starts with the easy stuff and gradually gets to the more difficult calculations. It's easy to carry around, weighs practically nothing and the answers are at the back which helps you to check what ones you got right or wrong... Anyway, this is a MUST! I love it!





                               
The Student Nurse Handbook
This was one of the very first books that I took out at the library and it's brilliant!! It helps students to gain an insight into nursing before going on their first placement and it really did help me a lot. It gave me insight regarding what to expect once I stepped on the wards. I actually kept this in my bag during lectures in case I had a spare minute to have a read and I'd also read it on the bus. It's easy to carry around and cover a multitude of topics. I also used this for my interprofessional module!! Like gold dust!!




Well, I suppose that covers it! I hope you have found this post useful! I've been under a lot of stress lately what with so many assignments and trying to arrange my next clinical placement (which is actually with a district nurse, buzzing! lol) I hope you are well and I hope you have time to research into these books because I love them and have found them so beneficial!
Take care!

Emily

Tuesday 12 June 2012

Patient Experiences & Expectations

Good afternoon readers!
I hope you are well (: I know i've been posting quite a lot but I want to make up for all the time that I was absent! Today I'll be talking about the expectations that patients will have of nurses and of their care and how we as health care professionals can improve the patients overall hospital/care experience! Enjoy!

Patient experiences and expectations
*Expect good standard of care from health care professionals
*Good communication between staff
*respect religious views i.e. same sex care
*Feel safe and be heard
*To be treated with respect and dignity

Health care professionals' expectations
*Correct resources to enable effective nursing
*To be treated with respect and acknowledgement
*Not be abused
*To be respected by other staff
*To be paid

Gaps between Health care professional and patients
*Shortage of staff
*Poor management or teamwork
*Lack of training, communication and experience
*Financial constraints
*Cultural differences
*Lack of equipment

Reducing gaps
*Improve staffing levels and education
*Educate patients
*Make patients more proactive in their care
*Reduce paperwork?
*Increase health promotion
*Increase awareness of risks of treatments
*Decrease use of jargon

Main focus of complaints
-Attitude of staff
-Communication failures
-Poor standards

Rights of patients
-To have complaint dealt with efficiently and properly investigated
-To be made ware of the outcomes of the investigation
-To take complaint to independent ombudsman if not completely satisfied
-To receive compensation if harmed
-Make a claim for judicial review if directly affected by unlawful act

How can health care professional engage effectively with patients to improve handling of complaints and improve quality of care delivery?
-Attend to complaint
-Listening and noting
-Checking needs regularly
-Knowledge and understanding
-Communicating
-Patient needs to be kept informed
-Try to resolve internally and not going to the media
-Know your boundaries as a student
-Understand patient expectations and get to know them when admitted
-Be open minded
-Support
-Explain complaint procedure
-Patient understands his/her right and responsibilities
-Have an awareness of advocacy services

Responding to complaints
-Apologise
-Ensure that it won’t happen again
-Decide how serious the issue is and how likely it is to reoccur
-What can be learnt?

Why feedback is important…
*Tells you what is working Helps you to identify the problems and risks and prevent them from worsening
*Highlight opportunities for staff development

Brief introduction to NICE
*An organisation set up in 1999
*Decides which new drugs and treatments should be available on the NHS (I'll probably discuss this is more detail in a later post so keep your eyes peeled!)

Above all...

Think about how your behaviour contributes to the patients overall experience

And that's it!!! I hope you have enjoyed this post! I'll try to post as much as possible. Time is very limited for me at the moment but I will do everything I can to give a weekly update AT LEAST!! (: Enjoy your day!

Emily

Monday 11 June 2012

Bowel Elimination & Urinalysis

Hello all!
Today I will be discussing bowel elimination. I know, to some, this may seem like quite a gruesome subject but i actually love talking about it! It's so facinating! My mum and dad, before i started nursing, were concerned that I wouldn't get used to the 'bad sights' i.e. blood, poo, wee and many more. But actually i don't find it too bad. Anyway, the point i'm trying to make is that it's just a fact of life and it's just part of human anatomy. So, here we go...

GI tract
*Is a tube from the mouth to the anus
*Consists of smooth muscle
*7.5m long
*Includes pharnyx, oesophagus, stomach, small and large intestine

Important organs of the GI tract

Mouth
*Tongue provides taste
*3 gland produce saliva...
1.parotid
2.sub-mandibular
3.sublingual

Pharnyx
*Allows passage of food from mouth to oesophagus
*Epiglottis closes over larnyx to prevent aspiration

Oesophagus
*Muscular tube
*25.5cm long
*moves food from pharnyx to stomach
*Fibres contract, propelling food into the stomach
*Lower end remains closed to prevent reflux of gastric contents

Stomach
*contains two sphincters (muscles)...
1. Cardiac (Protects the entrance to the stomach)
2. Pyloric (Guards exit)
*Stores food
*Mixes food wih gastric juices

Small intestine
*End products of digestion are absorbed through membrane lining of small intestine and into the blood stream
*Nearly ALL digestion and reabsorption takes place in the small intestine

Large intestine
*Absorbs excess water
*Stores food residue
*Eliminates waste

Liver
*Metabolises proteins, fast and carbohydrates
*Detoxifies the blood
*Converts ammonia to urea
*Synthesises proteins, amino acids, vitamin A, D, K and B
*Creates bile to help digest fats and absorb cholesterol

Gallbladder
*Found under the right side of the liver
*Stores bile

Pancreas
*Releases insulin and glycogen into the blood

Key Terms
Mastication - Chewing
Deglutition - Swallowing
Polyuria - increase in volume of urine
Nocturia - getting up frequently in the night to urinate
Anuria - nonpassage of urine
Oliguris - production of abnormally small amounts of urine
Dysuria - Painful urination

Characteristics of normal stool
25% solids
75% water
*Consists of bacteria, undigested fibre, fat, inorganic matter and protein
*Bilirubin produces brown colour of stool
*Bacterial decomposition of proteins creates unpleasant odour of stools
*The 'Bristol Stool Chart' is a chart that is widely used in healthcare settings to determine the type of consistancy of stools

Charateristics of abnormal stool
*White stools indicate malabsoption disorder or blockage in the liver
*Thin stools may indicate haemorrhoids or colorectal cancer

Factors affecting elimination
*Body position - Sitting aids bowel movement. Can be difficult for patients to go when on a bed pan because squatting aids bowel movement.
*Exercise - good muscle tone aids elimination. Reduced physical activity can increase chance of constipation.
*Faecal diversion - alternate route for bowel elimination is called a 'stoma'. This is sometimes performed in patients with bowel cancer, bowel obstruction or in crohn's disease.
Two types of stoma
1. Ileostomy - Part of small intestine redirected through abdominal wall
2. Colostomy - Part of large intestine or colon is redirected through the abdominal wall.
*Fluid intake - Decreased fluid intake means the stools become hard and difficult to pass. The longer the stool remains in the colon, the more dry is becomes. Stool that doesn't remain long in the colon will be watery, resulting in fluid loss.
*Ignoring the urge to defecate - for patients with chronic conditions (or haemorrhoids) it may be painful to go to the toilet or due to lack of privacy they may not be able to go. Both can lead to constipation.
*Lifestyle - Bowel movement is convenient for their lifestyle. Stress, fear, anxiety, anger or depression, including the stress of hospitalisation can alter ones bowel elimination.
*Medication - Opioids and iron tablets can cause constipation. Antibiotics can cause diahorrea. Antacids can cause either.
*Nutrition - increased fibre in diet assists in bowel function (i.e. fruits, veg, cereals.)

Urinalysis
*Urine dip tests - Dip the test stick in the urine specimen for 30 seconds and observe the change in colour against the corresponding chart on the bottle.
*The urine specimen bottles are usually red and have boric acid inside in order to preserve the specimen
*24 hours urine collection bottles (More like 'tubs' i guess...) comes in large white bottles. Make sure these are labelled correctly with the time and date on.

Understanding Urinalysis Results
*Glucose - Excess sugar in the urine usually indicates diabetes mellitus
*Ketones - Indicates diabetic ketosis or calorie deprivation
*Blood - Indicates infection
*Proteins - A small amount of filtered plasma proteins can be found in normal urine but total protein excretion does not normally exceed
150mg/24 hour. If a ppositive reaction is seen this usually indicates infection or poor kidney function
*Bilirubin - Indicates poor liver function, serosis or anaemia
*pH - Normal range approx. 7.4 to 6 in the final urine
*Specific gravity - measures urine density, or the ability of the kidney to concentrate or dilute the urine over that of plasma. A score of 1.002 and 1.035 is considered normal.

Okay, so that's it for today I'm afraid! But i really hope you enjoyed reading this post! To those who aren't nurses, this might sound overbearing but, as a nurse, you just deal with this sorta thing and you realise that it's just human nature and it's nothing to be embarassed about. I also want to say, thank you very much to all my wonderful readers out there - even if you total just one or two, you still mean a lot to me! Thank you for continually reading what I post! See you again soon!

Emily

Wednesday 6 June 2012

Introduction to Ethics & Moral Reasoning

Hi there! Today I'll be briefly talking about moral reasoning and ethics.

Why is Ethical and Moral Reasoning important in Nursing?
*Often faced with situations that involve moral and ethical issues andd concerns and dilemmas about what is the right thing to do.
*Caring for patients involves complex interactions and treatments
*Raises questions about whether we are going harm or good.

Comparison between Morals and Ethics

Morals
*Principles and rules of right conduct
*Private and personal
*Commitment to priciples and values usually defended in daily life

Ethics
*Professionally and publically stated
*Involves process of questioning and perhaps changing one's morals
*Inquiry and study of principles and values
*Formal responding process used to determine right conduct

Factors influencing Ethical decision making
*Law
*Social & cultural attitudes
*Media
*Politics
*Upbringing
*Education
*Experience

Ethical Principles
*Autonomy - Right to self-determination
*Beneficence - Duty to do good
*Non-maleficence - Duty to prevent harm
*Veracity - Truth telling
*Justice - Fairness and equality
*Paternalism - Allows someone to make a decision for another
*Fidelity - Duty to keep to ones promises and commitments
*Respect for others - Duty to treat others respectfully and without prejudice

Take a look at the video below:

Further Reading

Siviter, B. (2008) The Student Nurse Handbook, 2nd Edn. Bailliere Tindall.

Fant, C. (2011) Ethical Dilemmas in Nursing [Online]. Available at: http://www.nursetogether.com/Career/Career-Article/itemid/2520.aspx (Accessed: 6 June 2012).

NMC (2008) The code: Standards of conduct, performance and ethics for nurses and midwives. Nursing & Midwifery Council.

Well, I suppose this concludes a rather short but interesting topic! I'll be back later with more!! :D

Emily

Friday 1 June 2012

Guide To Clinical Placements

Hello everyone!!
What a fine day it is - the first of june!! I cannot believe how fast time has gone! I started this course on the 20th Feb and it feels almost like yesterday!
Today I'll still be talking about clinical placements but I'll be writing up a guide! I'll be explaining everything you should expect for your first day, what you should bring and what to do and what not to do. Enjoy!

What to bring

*Yourself - Kinda obvious but would be very hard without
*A fresh, clean and crisp uniform - The night before make sure your uniform is ironed, washed and hung-up on a hanger. You want to make a good impression, after all.
*An A5/A6 notepad - This is very important because on your first day you will learn a lot!! By writing these things down, you can research them later!
*Comfortable shoes - They always stress 'presentation' at university before you start placement. But sod that! You'll be on your feet a lot. Actually, you'll be standing about 95% of the time so pick out shoes that are FLAT and COMFORTABLE. They dont have to look particularly pricey and they dont have to stand out or anything. Just make sure they ensure comfort and are black. (It helps to check your trust policy too!)
*Your phone - bring this as your mum will no doubt want to ensure you are getting on ok but keep it in your locker, not on your person.
*Your practice assessment documents - this is very very important. Dont lose them eight because they have to last the whole three years!!
*Tea bags and your lunch - Normally you can't use the hospital tea bags because they are 'only for the patients' so bring your own. Or buy some at the hospital shop.
*An clear, open mind, ready to take in LOTS of information.
*A smile

What to expect of your placement

*Expect it to be busy - most wards/clinics are, so be prepared to come home feeling exhausted!
*The other staff nurses and HCAs might not be so friendly towards you - this is quite a common occurance but, to be fair, expect this when you start any new job. People in general are xenophobic or just hate training up new people. Dont take it personally. Also they might just be too busy to talk that much. Theres more time to chat on break, I suppose.
*Expect to meet lots of new people and remember lots of new faces - remember that you have to not only remember the faces and names of the patients but also the faces and names of the people you are working with!!
*Expect to be standing 95% of the time - when you get the chance, take a minute just to sit down. I don't mean everytime your at the nurses station, steal a chair for half an hour! I mean, just get the weight off your feet when you have a spare minute because you are bound to be tired and stressed.
*There will be doctors everywhere - well, maybe a bit of an exaggeration but you will see them pretty much everyday and they might ignore you. Try to take the initiative and ask them what they are doing and why. Most dont mind explaining things if they aren't too busy because most of them love their jobs!

What your placement will expect of you

*Be on time - Now, I didn't actually do this very often, I must say. And in my mid-point interview, the staff nurse kind of said, gently-put, that I should 'manage my time better'. Which was pretty fair enough.
*Relating to the last point, take on any advice they give you and do so in a humble manner - we all make mistakes and need advice from time-to-time. But try to accept anything they say because they know best. They are only trying to help you learn.
*Be honest - If you dont know how to do something, say. If you do something wrong, say. If you need help with something, say.
*Be willing - At handover, dont stand chewing gum with your arms crossed. It looks like you actually dont want to be there and you dont actually want to learn. Ask if you can take that cannula out, ask if the nurse you can document something, ask if you can take this patients obs, ask if you can go down to the blood bank for them, ask if you can order a patients TTAs for them. Not only does it show that you are willing to learn, they also realise that you are bothered and they may help you to seek out learning oppourtunities.
*Be tidy - Kind of said this before but I'll say it again because its so important. Remove jewellery, dont wear a ton of make-up, remove false nails and eyelashes. Dont chew gum and wash your hands before handover or touching a patient. Tie your hair up. Most things in nursing are common sense and this certainly is. So make sure you act and LOOK the part.
*Show commitment and be a responsible learner.
*Ask questions - they will not expect you to know everything neither will they expect you to have had care experience before because, believe it or not, a LOT of student nurses actually haven't had any care pexperience before their first placement. I didn't.

Adult learning

*You're not a sixth-form student anymore. You are responsible for your own learning which means that if you are happy to stand in the sluice (And, trust me, this happens!!) they won't come and fetch you and spoon feed you information. So, take the initiative.
*Make sure you keep your PAD docs up-to-date. This is vital as it is you who is responsible for getting the skills signed off. No-one else.
*On your days off, head down to the library and research some of the things you did not understand. If you are unsure what a colonoscopy is, open up the royal marsden and take a quick look. Or just research things online. It all aids towards gaining knowledge!
*On drug rounds, ask the nurse if you can take the leaflets that you inside the drug packets. These leaflets are amazing! They explain the uses of medication and how they work and are perfect for quick reference and gaining knowledge quickly and easily.
*Also, this might be an unconventional one, but you can neevr start learning too early. Even if its your first day, ask the nurse if you can give a patient their Clexane injection, ask if you can prepare medication for IV, ask if you can conduct a blood glucose test. It's good to start early. Better than starting late, anyway.
*Also, always maintain a professional character, you are representing yourself and the university, remember.
*Remember that you are responsible for your own actions.
*Research into your ward specialties.
*Remember your rights as a student and that you are classed as supernumerary and DO NOT count in the numbers.
*Moreover, bear in mind that you DO NOT 'work' there. You are a student and are gaining insight to the work of a nurse. You are there to learn as well as work. Also, you are not under an employment contract and therefore don't actually have the rights of an employee. But refer to a previous post entitled Guide To Choosing A Trade Union which explains why joining a trade union as a student nurse is important.
*Another thing: There will be times when you are sooo busy, yet again there will be times when you'll be sooo bored. When times get boring, don't just sit around. Take this advice: Open the BNF. Every ward has one. Or check that the patients have everything they need and are comfortable. Or just sit and chat to the patients. Fill in some charts. Take a look at the hoards of folders they have on infection control or ward policy. Ask the hostess if she needs any help handing out the trays of food. Check all documentation has been filled in and none are nameless or without a date etc.
*Also, remember to reflect upon mistakes. You can write it down or just vent on your mum! But remember CONFIDENTIALITY!! Dont use a patients name or any other personal detail.

Your mentor/s

*They are there to help you learn, yes, but they are there as a support network. If you are having troouble with something, they are there to sort out the issue you are facing. So, talk to them. That's their job. I actually have spoken to a few other students who have had many problems with their mentors i.e. their mentor didn't speak to them or their mentor was a 'rude cow' or whatever. Well, then, don't just complain about it, do something! Go to your clinical practice facillitator and they will also help you.
*Chase your mentor up to fill in documentation for you, as well! don't leave your PAD docs 'til the last week because you might not get it all done!

Other students

*On your ward, you will almost definately be with other students. These student may be older, younger or more experienced than you. Make sure you talk to them because they will help you as well. On my ward I had a 29-year-old, second-year (almost third-year, actually) who helped me so much. When the other nurses weren't available, she would teach me how to do things e.g. taking out a cannula or doing mannual BP. She also helped me on my assignments as well!
Don't forget to keep in contact with the other students in your cohort too! They act as a great support network for you.

Furthermore...

KNOW YOUR LIMITS!

Make sure that you don't do anything that the university has told you you must not do. i.e. don't touch an IV pump unless a nurse is there to supervise you, don't give an intramuscular if you haven't done the theory for it. Again, kinda common sense but when you are in a difficult situation it's hard to maintain your objectivity.

Ok, I think that's all! I hope you have had a good week and I hope this post has been of some interest to you! Have a good weekend,

Emily x

Sunday 27 May 2012

First Placement

Hello everyone!
Yes! I'm finally back! Please accept my apology for not posting for a while! Everything has been so up-in-the-air lately especially with clinical placement and so many assignments! I suppose I had so much more free time to post at the beginning of the year but now my timeis so limited because of how many essays we have to do!! Anyway, It's good to be back! I love posting/updating this blog because it makes me feel as if I've accomplished something for the day ^ ^ Over the past few weeks I've actually been on placement and I must say, it was such a fun time! And it was so different to what I've ever done before.

My first placement was on an infection control ward, an isolation ward, which means that instead of having bays, the patients had their own side rooms with their own shower, toilet and wash basin. And before we entered or left a room, we had to put on or take off gloves and aprons and wash our hands to reduce the spread of infection. Most of our patients were admitted with gastrointestinal complaints such as C-Diff but we also had patients with MRSA as well.

Looking back, it was so much fun and I gained so much experience just from those five weeks. The staff were so friendly towards me and I felt quite comfortable. I know that many of my other fellow students did not have such luck and were paired with quite b**chy mentors!! xD But I must say, for the most part, the others enjoyed their placements too. I was worrying so much that I wouldn't enjoy the work or that I'd make too many mistakes or end up killing a patient!! luckily, I didn't... Also, because my ward was infection control, We were required to wear 'scrubs'. Now if you dont know what these are all I'll say is this... Ever watched 'Scrubs' as in the TV show? Y'know the uniforms they wear? The sleepwear-looking blue/green outfits. Yeah, we got to wear those which was quite an experience.

I also had a lot of learning oppourtunities. For instance, I was shown around pharmacy (which is a pretty incredible place, actually!), Endoscopy, the blood bank, MDTs, EAU, pathology, microbiology, infection control (the actual team and department)... and so many other departments that I cannot actually call to mind right now.

I also was fortunate enough to have a second-year with me on the ward. She helped me so much and assisted in my efforts to get used to the structure and routine of the ward.

I learnt a lot from this experience. I did make a few mistakes but on my first placement, it was expected. Looking back, there are a few things I wish I'd have said and a few things I wish I hadn't. Working 37.5 hours a week, 8 hours a day, on a shift pattern was difficult but it made the experience all the more interesting. Meeting other HCPs was quite an experience as well. I'd never worked alongside doctors, consultants, phlebotomists, pharmacists, dieticians, physiotherapists, occupational therapists etc. so this was also an interesting experience.

overall, i really enjoyed my first placeent and I hope my next will be just as good! Anyway, I've spoken enough! I have so much more to chat about but that can all come in a later post!! 'Til next time, Emily x

Sunday 8 April 2012

Blog Hiatus

Hello readers!
...I must apologise...
I'm afraid that I won't be updating for a while. Or at least for the next few weeks I'll only be updating once-a-week-ish.
This is due to a few personal issues and for this reason, I'll have limited internet connection. SO... that means less time to post -_- I'm SO sorry.
I just want you all to know, even if i do only have one or two regular readers, i LOVE you! (: I love being able to post on here and thank you so much for regularly reading what I write.
It actually is an honor to be writing and anyone can read it. Anyone who lives ANYWHERE. it's actually amazing when you think about it.

So, yeah, I won't be living at home for a few weeks... But please continue to read my blog. I would actually appreciate ANY comments. There is no certain date when I'll be back so I could be back next week or I could be back in two months. I don't know. But keep checking back and watch this space! I WILL update but my updates will be few and far between, so sorry about that.

Anyway, I hope you enjoy the rest of your weekend and I'll talk to you next time!

Emily

Monday 2 April 2012

Procrastination & Stress

Good evening!
Well, this is my first post for April 2012! How exciting! I never thought that I would last five minutes writing this blog! I guess I'm really enjoying it now! (:
First off, how do you like th new look? I decided I'd be adventurous and change the template and my profile picture!! haha! (I'm not totally sure that blue carnations even exist although i have heard that they do in Japan...)
It's also finally the Easter school holidays which means two weeks of rest! Ahahaa.. NOT! More like two weeks of worrying about assignments, portfolios and clinical placement and hardly being able to breathe!!! OK.. calm down... breathe...
In this post I'm gonna be talking about procrastination and stress and how to overcome them.
I know I haven't been doing much theory stuff but I'll get to that all later! I want to deal with the issues that are bugging me at the minute so here goes...

Procrastination

What is it?

Putting off work 'til a later date. Saying to yourself 'Yep, I'll do that later' and actually not getting around to doing it! I shamefully do this too much...

Why do we do it?
Because maybe it's easier to pretend it isn't there or it isn't actually happening rather than addressing it straight away. It keeps the stress at bay by pretending it doesn't exist... well, until you are a week before the deadline! Also, we all know the feeling of fearing failure. And perfectionism is certainly not uncommon!

How can we overcome it?
OK, here are my tips...
1. Plan ahead: Write yourself a day-by-day study plan over the school holidays and over the week/weekends including what you are doing, where and at what time. This way you will have time for adequate breaks and rest and you'll also get the important stuff DONE!
2. Write it where you'll see it: Write yourself reminders for the deadline. On the date two weeks before the deadline on your calendar, write 'two weeks 'til deadline' or something. This helps you to get the remaining time in your head and it also helps you not to forget!! Also, write your study plan up in a proper diary. Don't write it on your phone. I know so many people who wrote things on the planner on their phone and forgot anyway because they only use their phones for Facebook...
3. Make studying enjoyable: Or at least as enjoyable as it gets. Don't just copy things out of a textbook. Watch videos on Youtube on the subject, Draw pictures or diagrams, make a presentation on it or write a blog or journal like I do (:
4. Recognise that no-one is perfect: This might be the hardest to do and it also may take the most time. Recognising that everyone will make mistakes is hard but eventually it is one of the only ways to cure procrastination.

Stress

What is stress?

Feeling overly anxious about something or feeling powerless and hopeless. We feel that we've lost control of events in our life.

Why does it happen?
Unfortunately, stress affects us all and apparently is occurs because of a build up of 'cracks' over time. Little 'cracks' start to appear everytime something mkes us anxious which eventually leads to us 'crashing down' or getting totally stressed about it whether it's something to do with assignments or exams or something else.
Another explanation for stress in the 'fight-or-flight' response. If you studyed A Level Psychology, you'll probably know about this. This theory suggests that when someone perceives a threat, it quickly releases hormones to help it survive. We experince this almost everytime something unexpected happens or something happens that stops us from reaching our goals. However, it needs to be controlled in order to remain calm in the short term and to maintain good health in the long term.

How can we keep calm under pressure?
Here are a few tips I thought up...
1. Keep a journal or diary: Hmm... This one has come up twice now! I have kept a diary before and I found it did help me a great deal in controlling my emotions.
2. Breathe: There are a range of different breathing techniques you can do to maintain emotional control. Unsurprisingly, I'm a bit of a trekkie and I'm a huge fan of Vulcan Meditation. Try it for yourself. Also, Yoga it good for breathing techniques. Breathing techniques are great for helping you to control your emotions under pressure because it is easy to do and remember and you won't look weird for doing it!
3. Exercise: I love exercising! I have just started running again! The area in which I live is perfect for running because there are small pathways along the river and the fields near my house. So, it's great twice a week to go running amongst nature! It also encourages you to drink more fluids, breathe deeper, eat healthily and build up your physical and psychological strength.
4. Get a stress ball: These are great fun, if not helpful in relieving stress!
5. Watch a movie: I always watch anime when I'm in a mood. Dunno why... probably because it makes me laugh! So, watch a comedy, it really works!
6. Massage: This helps to relieve some of the tension stress causes in your muscles.
7. Have a relaxing bath: Having a nice warm bath always relaxes me! Grab some scented candles too!
8. Listen to music: Above all, I love listening to music especially when I'm stressed or frustrated. However, there are two problems with this. If you listen to music alone, it could make you feel more isolated because obviously you won't be talking to anyone. Secondly, depressing music will just make you feel worse! Why not try listening to classical music. I love classical. I'd suggest Ludovico Einaudi, Craig Armstrong, Loreena McKennitt or Two Steps From Hell. I know so many people think Classical is boring but try to be open minded. Classical is so underrated. If not, try more acoustic or country bands/artists such as Boyce Avenue, Rascal Flatts, Nickelback, Tracy Chapman or Carrie Underwood. Why not try movie soundtracks too. Most are classical but they are awesome! Have a look at Carter Burwell (soundtrack for Twilight), John Powell (soundtrack for How To Train Your Dragon), Yoshihisa Hirano and Hideki Taniuchi (soundtrack for Death Note anime), Stephen Flaherty (soundtrack for Anastasia) and Howard Shore (soundtrack for Twilight: New Moon). Also you could have a look at Christian music. The bands/artists I like include: Fireflight, Skillet, Flyleaf, The Devil Wears Prada, Paige Armstrong, Beckah Shae, Britt Nicole, Pillar, Plumb, Disciple, Superchick and RED. I could go on all day! Just try different types of music. It will calm you down and make you happier!

So, those are my tips!
I hope you enjoyed this post! I'll be back with more theory later on!
See you later!

Emily

Wednesday 28 March 2012

Nutrition

Hello everyone!
I have to say that the last post about 'Study Skils' was so much fun to write! It reminded me of my very first post! I hope you enjoyed it!
In this post I'll be taking about Nutrition. I'll be talking about the major food groups that we all need to eat from in order to maintain good health. Enjoy!

Keeping a balanced diet is important in keeping up good health and maintaining your bodily systems.

A balanced diet for most people should consist of:

60% Carbohydrates
30% Fat
10% Protein
Vitamins, minerals and water

Here, I'll go on to explain each food group a bit more in detail...

Carbohydates
These are found in starchy and sugary foods. Complex carbohydrates are mainly starchy foods, including potatoes, rice, bread and pasta and have additional nutritional value as they contain many other vitamins, minerals and fibre. Simple carbohydrates are the sugary ones, found in cakes, biscuits and sweets which are sometimes termed empty calories, as they provide no other nutritional benefits. Dr. Richard Marotta, headmaster of the Garden School in Jackson Heights, actually said that, "Eating excessively sweet foods gives you a rush and then you come crashing down. You want to keep your blood sugar at a steady pace." Which could not be more true.
Carbohydrates are our main source of energy, in fact, energy from the breakdown of carbs is the only type of energy the brain can use. Carbohydrates are broken down in the liver and muscles, by a process known as glycogenesis. It is then stored as glycogen until it is needed.

Fats
Fats serve several important purposes. They provide energy and when stored, provide protection to our vital organs.
There are two types of fats, saturated and unsaturated. Saturated fats are 'the bad fats' which are normally solid at room temperature, such as butter and meat fat. Unsaturated fat is more difficult to breakdown and so is mainly stored within the body. Unsaturated fats are generally better for us and are often liquid at room temperature, for example olive oil and sunflower oil, although they can also be found in avacados and nuts.
A healthy diet should not contain more than 30% fat, and a maximum of 10% should be saturated fat. Fat provides a secondary source of energy and once the relatively small carbohydrate stores are exhausted, fat metabolism becomes the primary source of energy.

Proteins
Proteins are large compounds consisting of amino acids. There are 20 amino acids which the body requires. 12 of these can be synthesised within the body, and the other 8 (essential amino acids) must be consumed through our diets.
Proteins are found in abundance in meats, eggs, fish, dairy products, nuts and seeds. Protein is essential for growth, repair and maintenance of our body tissues and for this reason, many athletes (mainly those requiring strength or size) will increase the amount of protein they consume, in order to help their muscles grow and develop strength.

Fluids
Fluids are vital to help prevent dehydration. During the day our bodies sweat to help cool us down. This results in a loss of water which must be replaced. Electrolytes such as sodium are also lost in our sweat. The presence of these electrolytes also helps the water to diffuse through the small intestine, back into the body. Research also shows that those who drink water before an exam actually perform better and score a third higher than those who do not. So, drink lots of water before exams you students!!

Vitamin and Minerals
Vitamins and minerals are vital in the diet for a wide range of functions, but only needed in tiny amounts. Providing you have a balanced diet as shown above, containing lots of fresh foods, there is no need for vitamin or mineral supplementation.

In more detail, Vitamins, one of the most essential nutrients required by the body, can be broadly classified into two broad categories namely, water-soluble vitamins and fat-soluble vitamins. Water-soluble vitamins (B vitamins and vitamin C) get flushed out from the body; therefore there arises a need to consume these vitamins on a daily basis. On the contrary, fat-soluble vitamins (Vitamins A, D, E, and K) get stored in the body's fatty tissues. There are distinctive kinds of vitamins and each vitamin play a unique role in promoting health fitness.

Here is a list of different vitamin types:

Vitamin A: it helps a great deal in improving your eyesight. Also it aids in maintaining healthy skin. Rich sources of vitamin A are: eggs, milk, apricots, carrots, spinach and sweet potatoes etc.

Vitamins B: vitamin B is a list of multiple vitamins like B1, B2, B6, B12, niacin, folic acid, biotin, and pantothenic acid. Vitamin B aids in generating energy that the body utilizes to carry out its activities. Vitamin B also participates actively in making red blood cells that carry oxygen to different parts of your body. Rich sources of vitamin B include whole grains, such as wheat and oats, fish and seafood, leafy green vegetables, dairy products like milk and yogurt, beans and peas etc.

Vitamin C: it helps in strengthening your gums and muscles. Vitamin C found in citrus fruits like oranges, also aids in healing wounds. It enables you to overcome infections. Foods rich in vitamin C, apart from citrus fruits are: tomatoes, broccoli, cabbage and strawberries etc.

Vitamin D: it works towards strengthening your bones and teeth. It also aids in absorbing the calcium required by the body. Foods rich in vitamin D are: fish, egg yolk, milk and other dairy products etc.

Vitamin E: It takes care of your lungs and also aids in formation of red blood cells. Good sources of vitamin E are: whole grains, such as wheat and oats, leafy green vegetables, egg yolks, nuts etc.

Vitamin K: vitamin K helps in the maintenance of normal levels of the blood clotting proteins. Good sources of vitamin K are: leafy green vegetables, dairy products, like milk and yogurt, pork etc.

Just like your body needs vitamins, your body needs minerals for growth and health.

There are two kinds of minerals in food: macrominerals and trace minerals. Macrominerals are minerals your body needs in larger amounts, yet your body needs just small amounts of trace minerals.

Macrominerals


Calcium

Actions:
•Needed for making bones and teeth
•Helps nerves and muscles function

Sources:
•Dairy products, such as milk, cheese, and yogurt
•Canned salmon
•Leafy green vegetables, such as Chinese cabbage, bok choy, kale, collard greens, turnip greens, mustard greens
•Broccoli
•Calcium-fortified foods — from orange juice to cereals and crackers

Chloride

Actions:
•Needed for keeping the right amounts of water in the different parts of your body

Sources:
•Salt
•Rye
•Tomatoes
•Lettuce
•Celery
•Olives
•Beef and pork
•Cheese

Magnesium

Actions:
•Needed for making bones and teeth
•Helps nerves and muscles function

Sources:
•Leafy green vegetables
•Nuts
•Bran cereal
•Seafood
•Dairy products, such as milk, cheese, and yogurt

Phosphorus

Actions:
•Needed for making bones and teeth
•Needed for storing energy from food

Sources:
•Dairy products, such as milk, cheese, and yogurt
•Red meat (beef, pork, and lamb)
•Poultry
•Fish
•Eggs
•Nuts
•Peas

Potassium

Actions:
•Helps nerves and muscles function
•Needed for keeping the right amounts of water in the different parts of your body

Sources:
•Bananas
•Broccoli
•Tomatoes
•Potatoes with skins
•Leafy green vegetables, like spinach, turnip greens, collard greens, and kale
•Citrus fruits, like oranges
•Dried fruits


Sodium

Actions:
•Helps nerves and muscles function
•Needed for keeping the right amounts of water in the different parts of your body

Sources:
•Salt
•Milk and cheese
•Beets
•Celery
•Beef and pork
•Green olives

Note: Many people get too much sodium.


Trace Minerals

Copper

Actions:
•Helps protect cells from damage
•Needed for making bone and red blood cells

Sources:
•Shellfish (especially oysters)
•Chocolate
•Mushrooms
•Nuts
•Beans
•Whole-grain cereals


Fluoride

Actions:
•Needed for making bones and teeth

Sources:
•Saltwater fish
•Tea
•Fluoridated water (water that has had fluoride added to it)


Iodine

Actions:
•Needed for your thyroid gland to function properly

Sources:
•Seafood
•Iodized salt (salt that has had iodine added to it)
•Drinking water (in regions with iodine-rich soil, which are usually near an ocean)


Iron

Actions:
•Helps red blood cells deliver oxygen to body tissues (If you don't get enough iron, you could get iron deficiency anemia.)
•Helps muscles function

Sources:
•Red meat, such as beef
•Tuna and salmon
•Eggs
•Beans
•Baked potato with skins
•Dried fruit, like apricots, prunes, and raisins
•Leafy green vegetables, such as spinach and turnip greens
•Whole grains, like whole wheat or oats
•Breakfast cereals fortified with iron


Selenium

Actions:
•Helps protect cells from damage
•Needed for your thyroid gland to function properly

Sources:
•Brazil nuts
•Fish and shellfish
•Red meat
•Enriched breads
•Eggs
•Chicken
•Wheat germ


Zinc

Actions:
•Needed for healthy skin
•Needed for healing wounds, such as cuts
•Helps your body fight off illnesses and infections

Sources:
•Red meat (beef, pork, and lamb)


So, we've seen what we need to eat in order to maintain a healthy, balanced diet. But how can we do this? By eating the right types of foods, of course! And what better way to do this than by eating your five-a-day!

Why 5 a day?
Fruit and vegetables are part of a balanced diet and can help us stay healthy. That’s why it so important that we get enough of them.
5 A DAY highlights the health benefits of getting five 80g portions of fruit and vegetables every day. That’s five portions of fruit and veg altogether, not five portions of each.
Five reasons to get five portions
• Fruit and vegetables taste delicious and there's so much variety to choose from.
• They're a good source of vitamins and minerals, including folate, vitamin C and potassium.
• They're an excellent source of dietary fibre, which helps maintain a healthy gut and prevent constipation and other digestion problems. A diet high in fibre can also reduce your risk of bowel cancer.
• They can help reduce the risk of heart disease, stroke and some cancers.
• Fruit and vegetables contribute to a healthy and balanced diet.

Fruit and vegetables are also usually low in fat and calories (provided you don’t fry them or roast them in lots of oil). That’s why eating them can help you maintain a healthy weight and keep your heart healthy.
5 A DAY is based on advice from the World Health Organization, which recommends eating a minimum of 400g of fruit and vegetables a day to lower the risk of serious health problems, such as heart disease, stroke, type 2 diabetes and obesity.

To get the most benefit out of your 5 A DAY, your five portions should include a variety of fruit and vegetables. This is because different fruits and vegetables contain different combinations of fibre, vitamins, minerals and other nutrients.
Almost all fruit and vegetables count towards your 5 A DAY. Potatoes and cassava don’t count because they mainly contribute starch to the diet.

So, when you think about it, eating your five a day is pretty easy really!
This motivates me to try to eat more healthily! Some days I just crave McDonalds! Which can be very hard to resist!!!
Hope you enjoyed this one! See you next time!

Emily

Tuesday 27 March 2012

Study skills

Good evening!
I know it's been a week but so much has happened! I've been so busy trying to make an effort on my assignment and portfolio that I've (almost) forgotten about this blog! So, i'm sorry about that! Also, I've been trying to get ready for my placement and everything which has been really stressful! The couple hours i get when I return from uni everyday is simply leisure (like lounging around watching The Walking Dead).
So, for this post no theoretical stuff. No A&P, no OBS, no IPL... NONE of that today! I'll be talking about study skills (and hopefully this will motivate me to want to study harder!!) This won't just apply to health and social care students (Nurses, social workers, radiographers, ODPs...) but it'll apply to ANY student - whether you are at GCSE level, Advanced level or degree level.
So, I'll be dividing this post up into sections: Who, what, where, when, why and how? So, lets begin!!

WHO?
Depending on your personality you will either work alone or in groups.

Alone
Personally I prefer to study alone. I actually CANNOT study with others. I'm not unsociable, in fact i'm the very opposite - if i study with others i will end up talking about something else. Like, shopping, gigs, piercings, food, music... stuff like that. Which obviously has NO relevance to the endocrine system whatsoever. Anyway, if you choose to go it alone then by all means do so. Don't think that you can't. Just because you're friends aren't gonna walk you to the library or whatever, you can still be independent and study on your own. Besides, if you study alone you can focus on the areas you specifically need to work on, you can stay as long as you want and take breaks when you want. You'd actually be surprised how many people study alone. Almost everyone! Plus, I always think that study groups are just EXCUSES to be together. To 'study'. Riiiiight. It's like a 'study date'. Dude, you're not going to study... Who would study on a DATE?! Hello?! Moving on, If you are going to study alone, make sure you have everything you need such as your study utensils and plan (we'll get to that bit later) and make sure you have a suitable area for study. Figure out if you work best in silence or with some background music or a little mummering from others in the background. I remember at A level I would always study in the library after four because most of the kids from years seven to eleven had gotten fed up by then and gone home. Therefore, the library was blissfully peaceful! I was friends with the librarian so she'd let me stay until six sometimes! Also, choose a computer or desk that is in a perfect position: either near the stacks in the library for quick referencing, or opposite a window for perfect ventilation; near the water fountain for hydration or in the corner for tranquility. It's up to you so at the beginning of the year seek out these little areas so you aren't squeezed elbow to elbow with other students at 'rush hour'!

In groups
Even though I don't really study in groups that often I still find it quite fun! (IKR! Bet you weren't expecting THAT!) Like they say: 'two heads are better than one' and in the case of studying, sometimes it works better to have a study-buddy or a couple other people to lay the snakes out flat, so to speak. Studying with others can be great because its not only a social thing but it's a peer-support thing. What I mean is, if 'you scratch my back, I'll scratch yours'. If you don't get something, someone else can clarify it for you and help you. If you get something they don't, then you can help them to understand so it works out by helping each other. Also, you can study in different ways, E.G. by presentations, discussion and debates ETC. Not only that, but you'll be improving your communication skills which is very important for any student - it will help you no end in university interviews, job interviews, on your CV, in the workplace, make friends in the future... the list goes on. So, don't dismiss the idea of working with others. it can be great fun. However, beware of digressing conversations and laziness. Some people may also try to get away with doing nothing while the 'smart ones' do it all. Which can be extremely annoying.

WHAT?
This section will talk about WHAT you should study. Again I'll divide this up...

Lecture notes
So many people write a ton of lecture notes in their notebooks but can be fussed to type the notes up and print them out for their folders. WHY?! It literally takes about ten minutes tops. Plus, going over what was covered in classes will motivate you to research more and will clarify to you what was said about a certain topic and what wasn't (I.E. what the lecturer expects you to do extra/individual research on).

Prioritizing
After typing up your lecture notes, try to ascertain what you DID understand and what you didn't. The stuff that you didn't understand is probably the stuff that is more pressing. Its the stuff you should study/cover first.

Resources
So when you've chosen the topic you don't get, you can choose where you'll get the informaion. So, where do you start? In most libraries you won't just have books. There will be internet access, journals, e-books, CDs, DVDs ETC. And you can use any of these (probably not the CDs and DVDs for assignments...) to aid your study. As long as it helps you to understand a topic. Thats the main thing. Also you can normally reserve and renew books online, whether its your local or university library.

Choosing the book/journal
So, lets say you've decided to just look in books for now. You are standing in the aisle for 'Nursing' and you have NO idea what book to pick out. What the heck do you do? Well, first off, scan the book spines for titles. If you are looking up something about ATP, it's no good looking at a book that is entitled 'Guide to clinical placements', is it? So, think logically. Look for an A&P book if you want to know about ATP. Look for student guides if you are looking up clinical placements.
So, now you've picked up a book and it looks kind of relevant. What do you do? Well, open the book and flip through it. Is it set out in a way that you'd easily learn from it. If you are a visual learner, does it have plenty of pictures? If you are a logical learner, does the book go into lots of detail or does it just cover the basics? Also, think about whether you'll be taking the book out or not. If you are, is it of suitable size to carry it around for a few hours (or at least your trip home)?

And once you've got it?
Sometimes I start typing up whats in the book, word for word. But then i just get bored and start watching anime. Which kinda defeats the object. So, perhaps scan through the chapter before writing notes and place post-it notes over the paragraphs that are most relevant? Then, why not leave the computer for a while and draw up a mind up, jotting down key points of important information and colouring it so the key bits stand out? you could also write up notes on it and then type. Sure it may take a bit longer but you'll be going over the information twice which makes the studying actually WORTH it and you'll definately understand it afterwards. You could also make little revision cards on the key info. By-the-way, they don't literally HAVE to be 'cards'. I studied using revision cards and just paper did fine for me.

WHERE?
Determining where to study really makes a difference. But you can either study at home or at your institution / university / school / college.

Home
This covers grandmas house, your student accomodation, your friends house ETC. I alwyas say 'oh, yeah, I'll just do it at home'. And then I don't. haha. But sometimes studying at home isn't that bad. You may be distracted but if you have the house alone you will, hopefully, be free from major distractions. Unless the TV is calling you... Remember that if you study at home you will have distractions like 'dinner time' which you think 'ahh i need a break anyway. You'll have brother and sisters screaming the house down. You'll have mummy popping in to put the washing away or if your bedroom is next to the bathroom like mine is, someone will flush the toilet and you're concentration will diminish rapidly. Oh and if your brothers or sisters call up to you telling you someones on the phone for you or that 'Alcatraz' is on TV and you really CAN'T miss an episode... Anyway, what i mean is, home has so many distractions. If you can take it, sure. But I don't have tonnes of breaks and prefer to study for like an hour or two at a time. But it's up to you.

University/college
Sometimes there will be cafes or studying areas you can just take a book to and read or take notes from quietly. However, obviously there is the library where more resources are available to you. Every institution is different though and some campus unis can get really crowded so the library at three is not the best place to go for peace and seclusion. Why not go slightly off campus so a small bar or cafe and just read for about thirty minutes and wait for the rush hours to die down. That way you can definately get a computer in the library later.

In bed
Okay, i can explain! Read a book before you go to bed. If you don't like reading, tough. Get used to it. You'll need to like reading in order to pass the course. Even if you dont read fiction before bed its always good to read something before you hit the hay. Research shows that reading for 15 minutes reduces your stress by 70%. Others say more. Also, reading just a couple pages a night is better than nothing. I've started doing this and i'm actually learning a lot. A lady in my classes mentioned something that I wouldn't have even known if i hadn't read it in the book i'm currently reading!

When travelling
Not just in bed. Yes, on the bus, in the car (if you're not driving!) and on the train just read a few pages. Not even that. It will help so much towards your knowledge!

Outside
You can actually study in the park, at the beach... anywhere! Outdoors is actually a great place to escape to if the house is too noisy or the library is jam-packed! It's stress relieving and almost fun! Just be careful you don't get sunburn or anything!

WHEN?
It's important to decide what time to study as it determines how much information you retain and how long you will study for.

In the morning
There's a girl in my classes who always says that she studies and prepares for classes in the morning before she goes to uni. Now, I personally wouldn't recommend this. Why? Because in the morning, generally you are probably rushing around to get ready. Therefor you'll have limited time to study. If you procrastinate and just sit at your desk thinking, then you'll have wasted precious sleeping time so theres no point. Some are more alert in the morning (I am, i know) but even so, save your energy for lectures and seminars. Give yourself more time to prepare. Don't get up early in order to do so. The mornings should be to allow for a hearty breakfast and to get your circulation and brain juices flowing! Also, NEVER study for exams in the morning! It only makes you panic. I know plenty of people who've done this in the past and have literally MUCKED UP the exam because of it. Study the night before but leave the books in the morning. Don't be tempted.

In the afternoon
Lunchtimes are actually good times to allow for study time! This may be difficult if you eat with friends because they might call you a geek.. my friends do... But don't let that deter you! If you are THAT worried, just read a couple pages from your book like we said earlier. Later in the afternoon, say three-ish, is probably the time I set out for study. It gives me time alone so I can focus and, even though I am tired, I have time to type and print out notes and print out research for tomorrows classes. I also have time to read around a topic and look for better books. I've even stayed at the library until about nine at night! Plus, if you want a break you can always go for a wander. Our campus shop at UCS is literally just under the library so it's perfect for getting late afternoon snacks! I also believe this is the case with University of Essex as well and a few other unis.

In the evening
The evening is great for study too! This is the time i have at home for myself or for extra study. I can update this blog or read from books or journals or e-books. Or I can do a bit more to my assignment or just watch anime! I try to get at least an hour a day study time in. Even if it's just scanning through internet pages for something. But I would say that past eleven, studying is not good. You'll be too tired to process the information and you do need sleep in order to keep up good grades.

WHY?
whats the point of studying and reading around a topic?

Grades
C'mon! If you don't study then your grades will obviously fail! But I guess many people do actually think that there is no need to read around a topic or do extra research, but there is! If, like me, you are studying to become a HCP, then you need to keep up-to-date with medical research and this entails reading around a topic. Also, to become a competent student you will need to UNDERSTAND a topic. Not just 'know'. I found this to be the case with many of my fellow sixth formers. Most thought they were okay just reading from the textbook a few minutes from the exam. Nope. They weren't. You need to understand what you are learning and make the knowledge your own. Don't just accept what the book says. Use other books and journals, written by different authors. Everyone has a different take on the world. Authors will disagree and maybe you will disagree with what they have written. In fact, in exams by pointing out research flaws you actually get the higher grades. This was certainly the case in psychology.

For your own competency
Kind of touched on this one. But if you study hard and really put in the effort, you will obviously have a better knowledge. This will set you up better for jobs and will aid in your future choices and decision making.

Confidence
No-one likes looking like a fool. So don't walk into a lecture without having some idea (at least) of what the lecture will be about. I don't just mean knowing what the title of the lecture is, I mean knowing what the title suggests.

HOW?
And finally, how can you study?

Written
You can study by writing notes from a textbook or drawing up diagrams or mind maps to help you retain the information. Revision cards or making a quiz for yourself and others.

Orally
You can have a group discussion or debate on a given topic which will allow for new ideas. You can also give presentations or just chat about a topic to someone who isn't on your course or knows nothing about the topic.

Technologically
By this, I mean using technology to learn. So, you can type up your notes. Make a slideshow presentation. Or just record your voice on a tape recorder. My A level PE teacher suggested that we record a fake-radio show once. He even suggested we make up a song! I thought it was a dumb idea at first but, thinking back to it now, it wasn't actually a bad idea in terms of remembering information!

Mnemonics
Just an easier and more fun way to remember stuff.

Reading
You get the idea by now (: read just a few pages a day of any book that relates to your course!

Practise exam questions
Exam questions are great because they are specific to most students needs and very relevant!

Role play
If you are doing a health and social care course like me, you could ask a sibling or family member to be a guinea pig so you can practice things like vital signs for instance.


Well, that is it for now! I hope this has helped! It has motivated me to keep studying hard, actually! Sometimes, i must say, i feel like giving up. Sometimes I think to myself that I'm never gonna improve or I think that others are so much better than I am but I know thats just me being underconfident. It's me undervaluing myself. I know I shouldn't but I just do. If you do this, don't worry! I can totally understand! It can be hard when you feel inexperienced and unworthy and you are not! Just keep trying hard! Enjoy what you are learning! you'll never be a student again! (unless you do post-grad -_-...) So enjoy the experience! But give yourself plenty of breaks and make the most of the time you have to learn!

Emily

Monday 19 March 2012

Clinical skills: Vital Signs

Hello again!
I'm not in the library anymore. Those Apple Macs drive me up the wall! I hate the mice and I hate the Caps Lock button because it keeps sticking!! Grr...
It's great to be back on my beautiful Dell Inspiron Q15R!
In this post I'll be covering clinical skills. In particular I'll be talking about Vital signs and how to take them! Enjoy!

Vital Signs (TPR)

Respiration Rate

Before taking a patients breathing rate (BR), they must have been relaxed for at least five minutes, not talking. The BR must be taken over one minute to ensure that we do not miss anything out. One breath is counted as one rise and fall of the chest.
It may also help to look at the abdominals as well as observing the depth of breathing.
If both sides of the chest do not rise (both sides moving is known as bi-lateral movement), for instance, the patient could be suffering from a collasped lung.
It is also important to observe and see whether breathing is...
* regular
* through the nose or mouth
* loud/quiet
* Allowing them to speak
* laboured

Pulse
When measuring a persons pulse, we are taking note of the number of times their heart is beating in a minute (BPM). The blood in the artery is at high pressure, this makes it easy to record pulse.
Where we can take pulse...
* Radial artery - Wrist - choosen as the 'easiest' to take because it does not restrict a patient of personal space
* Carotid artery - Neck - Big vessel that is closest so your heart
* Pedal artery - Foot - Choosen if the patient has a compliant that might compromise circulation in the leg or foot
* Femoral artery - Inner thigh
* Popliteal artery - Behind the knee
* Brachial artery - In crook of arm, Other side of the elbow
* Temporal artery - Temples at the side of the head

Small childrens radial arteries are smaller and therefore harder to find so a more accurate way of taking their pulse would be to use a stethoscope on the apex of the heart (just under the breast).

Technique
* When taking pulse, use two fingers (preferably the two middle fingers; not your thumb or index finger as, of course, you have a pulse which can give off inaccurate readings). Using two fingers instead of say, one, widens the surface area meaning you will get a more accurate reading.
* Push down gently for a few moments before counting
* What helps me to remember where to find the radial pulse, is that you will most likely find a pulse on your wrist in line with your thumb.
* Also, what helps me find the brachial pulse is that this pulse will be found on the side of the arm opposite the thumb!
* If you are not sure or get the reading wrong, don't guess. Do it again!
* If you cannot find the pulse, try the other arm or drop the arm so that it is haning down freely. This increases bloodflow.
* Also some people suffer from heightened anxiety before their blood pressure is taken. This is known as White Coat Syndrome (my nana says that she has this!!) which is fear of going to the doctors/to the hospital, basically!
* Bradycardia is a term meaning a HR under 60 BPM
* Tachycardia is a term meaning a HR over 100 (meaning that something has changed in their physiology. For instance, they may be losing a lot of blood so their body is trying to compensate for the lost blood and therefore increases HR).
* A normal HR would be approx. 60-100 BPM.

Temperature
Temperature is a good sign of infection as there are many metabolic functions going on in the body that affect temperature.
Normal body tempertature is approx. 37-36.5 degrees celcius. (Childrens might be slightly different).
It's important to recognise that you should know the internal (core) temperature instead of the external termperature.
A temporal reader can be used to take temperature by running the device from the middle of the head to the hairline at the temple and then to behind the ear.
A digital thermometer can also be used or even a Tympanic Thermometer.
Before taking temperaturecheck whether the patient is wearing a lot of clothes, has just had a hot bath, a hot drink or is covered with a lot of bed sheets as all these factors can contribute to higher temperature.

Terminology
Pyrexia is the term used to describe high temperature. A pyrexial (hyperthermic) patient would have a temperature above 38 degrees celcius. In the same way, hypothermia is low core temperature. A person is apyexial if they have normal core temperature.
Something else I found interesting is that if someone does not show the symptoms of a complaint (and therefore will not be treated) is said to be asymptomatic. Something else a little bit random I found interesting - any term ending in 'itis' such as 'bronchitis' describes an inflammation of something. E.g. bronchitis is an inflammation of the main air passages into the lungs.

Blood Pressure
When measuring blood pressure, it is important to remember that you are actually measuring the pressure of blood coming out of the heart. Also the patients may actually be aware of their own BP as they probably take it themselves at home if they have hypertension.
BP is measured in mmHg, by a sphygmomanometer.
A normal BP is considered to be 100/70. Hypertension is high BP is is said to be pressures similar to 140/80, for instance. However, always remember when taking TPRs that what is considered 'normal' may not be 'normal' for your patient. Everyone is different.
Blood pressures are made up of two different pressures. Systolic and Diastolic. Systolic pressure is pressure when the heart is contracting. Diastolic is pressure of the blood in the arteries when the heart is at rest between beats. So, in a BP of 100/70, a patients systolic pressure would be 100 and their diastolic would be 70. When measuring BP using a sphygmomanometer, you can refer to the little numbered gauge to find the systolic and diastolic pressure.

Technique
* Tell the patient to fully relax
* The rubber bladder inside the sphygmomanometer should cover 80% of their arm circumference.
* As well as a sphygmomanometer you will also need a stethoscope in order to find the systolic and distolic pressures.
* Inflate the cuff, listening carefully using the stethoscope. When you do not hear the pulse, or the pulse has seemingly stopped, record this as the systolic pressure. (Refer to the little gauge to record the number). Then slowly release the air, listening again for the pulse to stop. This is the diastolic pressure.
* Make sure that you document what arm you took the BP from.

Oxygen Saturation
02 saturation is the amount of oxygen carried in the blood.
'Normal' oxygen saturation woud be aprrox. 94-99. 02 saturation can easily be taken from the finger by a oximeter (which also can record your HR).
Oxygen saturation can be improved by regularly changing position.

Another random little note: pain is also seen as a vital sign as it indicates that a patient is conscious enough to recognise pain and that they still have feeling in an area.

Thats all folks!! Hope you liked this post! Thanks for reading!

Emily

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