Everyone's been there...

Everyone's been there. It's that time of your life where you don't know whats what. You don't know which way to turn. Or how. Or why. You try to figure out why things happened a certain way but its futile. You try searching for answers but instead get nowhere. Maybe I'm talking rubbish. I don't know. And maybe no-ones even reading this. But, hey, I'll just keep typing anyway. These past two years have been so hard on me. In more ways than one.
So in future, my posts will be of a slightly different nature. Not necessarily nursing. But about life in general. Because life is the most complex, confusing, and utterly surreal thing that has actually ever happened to me. So, this will be my online diary. I'll talk to you as a friend. A non-judgemental, online friend who I can be completely honest with. Right, so where exactly shall I start. I suppose I have to start somewhere.
Okay well here goes, I guess. I grew up and still live in a town in England. Still live with parents, sometimes see friends. But really my life at the moment can be summed up as this - Eat, sleep, work, repeat. Yeah, fun. Sometimes I wonder if theres more to life. I try talking to my parents about this but then the conversation always steers back to religion. And whilst don't mind religion, I just can't stand the way they shove it down my throat. Two years ago I chose a life of independence. Free from the shackles that I felt bound to. (I'll explain all this in time, I promise!!) Since then, I have one brother that tries hard to pretend I don't exist (Lets call him E) and another that I'm desparetely trying to rebuild a relationship with (and we'll call him W). I drive to an freezing cold office I work at almost everyday, filled with vacuous, self-absorbed people, every word they say having a double meaning.
Then there's the love life. which is pretty much non-existent haha.. well, I was left a bit broken hearted when the guy I'd been seeing posted a picture of himself on facebook with another girl.. since then I've been asked to move to bristol by a guy I barely know.. A newly single ex has reappeared and won't stop messaging me.. And a guy I've been talking to for a couple of weeks is suddenly talking commitment when we haven't even met face-to-face - Oh and he's in the military so he'll be leaving for Korea in a few months.. Yeah. messed up huh?
It doesn't stop there! I've got so much more to tell but I'll get to the juicy bits later! Think I've typed enough for now. But, like I say. everyone's been there. Haven't they?

Emily x

5 reasons why you should never give up!

Hello viewers!
Thanks for continually viewing my blog and seeing what i've been up to recently!! (Even though i have been VERY lazy in regards to updating this!) ^_^;;
I promise I will keep updating regularly from now on!!
Anyway now to start with the subject of my post - 5 reasons why you should never give up!!

1. You'll eventually achieve if you keep trying hard - Achieving your dreams may seem like a million years away but you have to keep trying otherwise you may never succeed!
2. People will see you in a different light - People will see you as a more accomplished person! And of course everyone wants to be around a positive and successful person as it motivates others!
3. Once you achieve one goal, it will motivate you more - Achieving your dreams helps you to understand that you really CAN go far in life! YOU are in control of your life! No one and nothing else!
4. You could potentially fail more if you do give up - Failing can lead to negativity which thus can lead to more failing!
5. You're life will be more interesting! - Ever seen the movie 'Yes man'? By saying 'yes' more and accepting challenges, you have more chance to change your life for the better!

So those are my five reasons!! Hope you enjoyed reading! Speak to you soon! xx

Free magic spell that really works

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

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

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

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