Colposcopy elective reflection

Reflecting on my experience as a student nurse in the colposcopy clinic, particularly regarding HPV (human papillomavirus), has been insightful and educational. The clinic provided an in-depth understanding of the clinical implications of HPV and its role in cervical cancer screening and prevention.

HPV is a prevalent sexually transmitted infection, and its connection to cervical cancer is significant. Before my placement, I had theoretical knowledge of HPV, but witnessing its impact in the clinic reinforced its importance. The colposcopy clinic is often a follow-up step after abnormal Pap smear results, where HPV is a common factor. Understanding the virus’s role in the progression of cervical dysplasia to cervical cancer deepened my appreciation for early detection and prevention.

One of the most valuable experiences was interacting with patients, who were often anxious about their diagnoses and the implications of having HPV. I observed how the nurses and healthcare team communicated with patients, explaining the nature of HPV, the purpose of the colposcopy procedure, and the potential outcomes. This experience underscored the importance of clear, compassionate communication, especially when discussing sensitive topics like sexually transmitted infections and cancer risk.

During these interactions, I learnt how to provide emotional support while delivering important health information. Many patients had concerns about the stigma associated with HPV, and it was crucial to address these worries with empathy and factual information. This helped patients feel more at ease and empowered them to take an active role in their healthcare.

The technical aspect of the colposcopy procedure was also an essential learning experience. Observing the nurses and physicians during the examination allowed me to appreciate the precision and care required in identifying abnormal cervical cells. The process of applying acetic acid to the cervix to highlight abnormal areas and taking biopsies was conducted with meticulous attention to detail. I observed how the healthcare team ensured patient comfort throughout the procedure, which is critical in an invasive and potentially distressing process.

I also assisted in some preparatory steps, such as setting up the equipment and preparing the patient for the procedure. This hands-on experience was invaluable in developing my practical skills and understanding the workflow in a specialised clinic.

This placement has been pivotal in shaping my understanding of the role of a nurse in specialised clinics like colposcopy. The experience highlighted the importance of combining clinical expertise with compassionate patient care. It also reinforced the significance of preventive healthcare and the role nurses play in educating patients about their health and encouraging them to participate in regular screenings.

My reflection on working with HPV patients in the colposcopy clinic has emphasised the importance of empathy, clear communication, and technical nursing skills. It has also deepened my understanding of the impact of HPV and the vital role of early detection and treatment in preventing cervical cancer. This experience has been instrumental in my development as a student nurse, and I am committed to applying these lessons in my future practice.

Reflection

During my elective placement in women’s units, I acquired knowledge of various treatment methods in the gynaecology speciality. I will be reflecting on my clinical experiences in colposcopy, hysteroscopy, endometriosis, and ectopic pregnancy during an elective placement, which can offer valuable insights into patient care, clinical skills, and personal growth.

During my elective placement, I had the opportunity to observe and participate in various procedures related to colposcopy, hysteroscopy, endometriosis, and ectopic pregnancy.

In the colposcopy clinic, I observed the procedure in which a colposcope was used to examine the cervix for abnormalities following an abnormal human papillomavirus (HPV) test. The speciality nurses emphasised patient comfort and clear communication to alleviate anxiety.

While in the hysteroscopy clinic, I assisted in preparing a patient for a hysteroscopy. This procedure involves examining the uterus using a hysteroscope and is typically performed when a woman experiences menstrual problems such as postmenopausal or irregular bleeding, polyps, and fibroids. The consultant explained the procedure to the patient and stressed the importance of managing pain and discomfort.

In endometriosis, I encountered a patient suffering from severe endometriosis, requiring both pain management and psychological support. The experience highlighted the chronic nature of the disease and the importance of long-term care planning. The patient has various birth control options to treat endometriosis, including mini pills, Mirena coils, patches, and surgery.

At the early pregnancy unit, we provide care for women who are 16 weeks pregnant and experiencing severe pain and heavy bleeding. Additionally, we provide support for women who have had previous early pregnancy complications such as recurrent miscarriage, ectopic pregnancy, and molar pregnancy.

During a critical ectopic pregnancy, quick decisions and teamwork by healthcare professionals were crucial in managing this life-threatening emergency.

At first, I was worried about taking part in these complicated procedures and handling serious conditions such as ectopic pregnancy. However, I was also excited about the chance to learn and help with patient care. Watching the team’s expertise reassured me, but I also felt the emotional burden of seeing patients in distress, especially those dealing with chronic conditions like endometriosis or facing emergencies such as ectopic pregnancies.

The experiences reinforced the importance of patient-centred care, particularly in maintaining clear communication and providing emotional support. The practical exposure to these procedures enhanced my understanding of the technical aspects and patient management.

The emotional impact of dealing with serious conditions was significant. Additionally, the complexity of procedures like colposcopy and hysteroscopy highlighted areas where I need further learning and practice.

These experiences have demonstrated the critical importance of balancing technical skills with compassionate care. For instance, in colposcopy and hysteroscopy, patients often experience high levels of anxiety, and the way healthcare professionals communicate can significantly impact patient comfort and cooperation. While managing cases of endometriosis and ectopic pregnancy, I have witnessed the significance of a multidisciplinary approach, which involves integrating pain management, surgical intervention, and psychological support.

I have learnt the importance of being prepared, not only technically but also emotionally, for the challenges presented by these conditions. I have recognised the need for continuous learning, particularly in developing communication skills and gaining a deeper understanding of the conditions that affect women’s reproductive health.

General clinic Fibriod, endomentorisis Reflection

I sat down with the gynaecology consultant to discuss a patient who underwent post-operative surgery. We introduced ourselves to the patient and her mother. We ask the patient to confirm her name and date of birth to ensure she is the right patient. The consultants went over the procedure and explained that the operation they had performed on her fibroid revealed that it was cancer rather than a fibroid. Hence, the consultant informed her that she needed other surgery to remove her ovaries because the pathology test had confirmed that the patient had cancer and needed to be removed, so she would have surgery on August 30th and begin chemotherapy. The patient burst into tears as the doctor told her the patient’s shocking news. She had arrived with her mother, so it was a huge surprise for both of them, and the room was filled with emotion. As a student nurse, I went to stand between the patient and her mother, holding both hands, and encouraging them that everything would be ok, but unfortunately, things turned out differently. The patient’s mother is a diabetes patient, and when she heard that her daughter had cancer, she felt shocked and shaken, so I had to take her to a side room to look after her blood sugar level. The mother has hypoglycemia and tachycardia, so I offer the woman a biscuit to boost her blood sugar level. The lady refuses to take the biscuit, but I encourage her to take the biscuit or the candy. I will reflect on the patient’s need to bring her mother to the clinic while she knows that her mother is a diabetes patient and anything can happen there with that new cancer. I learnt that patients need support from family members but not their mums because if caution is not taken, patients will lose their mum from this shocking new cancer of the cervix.

Furthermore, the patient calmed down a bit and now remembers that she came to the clinic with her sick mother, and her mother has very high blood sugar. I was there to look after her mom while the doctor was meeting with the patient, and I did well to take care of the mother and encouraged her that her daughter would be okay because she was in safe hands and they were doing their best for her daughter’s treatment.

Reflection on colposcopy clinic

Reflecting on my experience as a student nurse in the colposcopy clinic, particularly regarding HPV (human papillomavirus), has been insightful and educational. The clinic provided an in-depth understanding of the clinical implications of HPV and its role in cervical cancer screening and prevention.

HPV is a prevalent sexually transmitted infection, and its connection to cervical cancer is significant. Before my placement, I had theoretical knowledge of HPV, but witnessing its impact in the clinic reinforced its importance. The colposcopy clinic is often a follow-up step after abnormal Pap smear results, where HPV is a common factor. Understanding the virus’s role in the progression of cervical dysplasia to cervical cancer deepened my appreciation for early detection and prevention.

One of the most valuable experiences was interacting with patients, who were often anxious about their diagnoses and the implications of having HPV. I observed how the nurses and healthcare team communicated with patients, explaining the nature of HPV, the purpose of the colposcopy procedure, and the potential outcomes. This experience underscored the importance of clear, compassionate communication, especially when discussing sensitive topics like sexually transmitted infections and cancer risk.

During these interactions, I learnt how to provide emotional support while delivering important health information. Many patients had concerns about the stigma associated with HPV, and it was crucial to address these worries with empathy and factual information. This helped patients feel more at ease and empowered them to take an active role in their healthcare.

The technical aspect of the colposcopy procedure was also an essential learning experience. Observing the nurses and physicians during the examination allowed me to appreciate the precision and care required in identifying abnormal cervical cells. The process of applying acetic acid to the cervix to highlight abnormal areas and taking biopsies was conducted with meticulous attention to detail. I observed how the healthcare team ensured patient comfort throughout the procedure, which is critical in an invasive and potentially distressing process.

I also assisted in some preparatory steps, such as setting up the equipment and preparing the patient for the procedure. This hands-on experience was invaluable in developing my practical skills and understanding the workflow in a specialized clinic.

This placement has been pivotal in shaping my understanding of the role of a nurse in specialised clinics like colposcopy. The experience highlighted the importance of combining clinical expertise with compassionate patient care. It also reinforced the significance of preventive healthcare and the role nurses play in educating patients about their health and encouraging them to participate in regular screenings.

My reflection on working with HPV patients in the colposcopy clinic has emphasised the importance of empathy, clear communication, and technical nursing skills. It has also deepened my understanding of the impact of HPV and the vital role of early detection and treatment in preventing cervical cancer. This experience has been instrumental in my development as a student nurse, and I am committed to applying these lessons in my future practice.

Miscarringe Reflection in early pregnancy unit

During my placement in a gynaecological ward, I encountered patients who had miscarried pregnancies. I provided emotional support, assisted in medical procedures, and ensured the comfort of the patients. I observed how the nursing staff managed these situations and learnt about the medical aspects and the importance of empathetic communication.

I felt a mix of sadness, empathy, and anxiety. Seeing the grief of the patients and their families was heart-wrenching. I also felt a bit nervous, knowing how sensitive the situation was and not wanting to say or do anything that might exacerbate their distress. As I continued to support these patients, I began to feel more confident in my ability to provide compassionate care. However, the emotional toll was still significant, and I sometimes felt overwhelmed.

I remained calm and professional, providing support where needed. I noticed that my communication skills improved as I learnt to listen more actively and respond with empathy. There were moments when I felt unsure about the best way to emotionally support the patients. I could have benefited from more guidance on how to handle such emotionally charged situations.

The event highlighted the importance of a holistic approach to patient care, particularly in sensitive situations like miscarriages or ectopic pregnancies. Emotional support is just as critical as physical care, and the ability to provide both is essential in nursing.

I learnt the significance of being emotionally present with the patient and the importance of creating a safe space for them to express their grief. I also gained insight into the medical management of miscarriages and ectopic pregnancies.

I learnt that dealing with loss is an essential aspect of nursing. It’s important to approach these situations with empathy and professionalism. I also understood the importance of self-care in managing the emotional impact of these experiences.

I plan to pursue additional training in providing emotional support and discuss these experiences with a mentor to gain different perspectives. Furthermore, I will consciously engage in self-care practices to maintain my emotional well-being.

I am committed to seeking opportunities to improve my skills in providing bereavement support, such as attending workshops or training sessions. I will make sure to have a support system in place, including mentors and peers, with whom I can debrief after emotionally challenging situations. I will also continue to reflect on similar experiences in the future and use these reflections to inform my professional development.

Feedback in Medication Management.

 

This assessment must be undertaken by a Practice Assessor by the end of Part 2 where the student safely administers medicines to a group of patients/service users or a caseload of patients/service users in community settings.


During Part 2 the student should be developing their knowledge, skills and competencies in relation to the safe administration of medicines. This assessment should normally be undertaken with a small group of patients/service users or caseload. Professionalism underpins all aspects of the student’s performance.

The student must be allowed a number of practice opportunities to administer medicines under supervision prior to this assessment.

The student must work within the legal and ethical frameworks that underpin safe and effective medicines management and work within national and local policies.

Regulatory requirements: Future Nurse: Standards of Proficiency for Registered Nurses (NMC 2018), The Code (NMC 2018), A Competency Framework for all Prescribers (The Royal Pharmaceutical Society 2016)

The aim of this assessment is to demonstrate the student’s knowledge and competence in administering medications safely.

Learning outcomes

The student is able to:

1. Apply knowledge of pharmacology, how medicines act and interact in the systems of the body, and their therapeutic action.

2. Carry out an initial and continued assessment of people receiving care and their ability to self-administer their own medications.

3. Prepare medications where necessary, safely and effectively administer them via common routes, including all injection routes where appropriate, maintain accurate records and be aware of the laws, policies, regulations and guidance which underpin medicines management.

4. Safely and accurately perform medicines calculations for a range of medications.

5. Coordinate the process and procedures involved in managing the safe discharge, move or transfer between care settings of the person.

6. Maintain safety and safeguard the patient from harm, including non-adherence, demonstrating understanding of the Mental Capacity Act (DH 2005) the Mental Health Act (DH 1983, amended 2007), where appropriate.

Competency

 

Yes – Achieved

No – Not achieved

1. Is aware of the patient/service user’s plan of care and the reason for medication, demonstrating knowledge of pharmacology for commonly prescribed medicines within the practice area.

2. Communicates appropriately with the patient/service user. Provides clear and accurate information and checks understanding.

3. Understands safe storage of medications in the care environment.

4. Maintains effective hygiene/infection control throughout.

5. Checks prescription thoroughly: Right patient/service user; Right medication; Right time/date/valid period; Right dose/last dose; Right route/method; Special instructions.

6. Checks for allergies, demonstrating an understanding of the risks and management of these as appropriate: Asks patient/service user; Checks prescription chart or identification band.

7. Prepares medication safely. Check expiry date. Note any special instructions/contraindications.

8. Calculates doses accurately and safely: Demonstrates to assessor the component parts of the calculation; Minimum of 3 calculations undertaken.

9. Checks and confirms the patient/service user’s identity and establishes consent. (ID band or other confirmation if in own home).

10. Administers or supervises self-administration safely under direct supervision. Verifies that oral medication has been swallowed.

11. Describes/demonstrates the procedure in the event of reduced capacity and non-adherence.

12. Safely utilises and disposes of equipment.

13. Maintains accurate records: Records, signs and dates when safely administered.

14. Monitors effects and is aware of common side effects and how these are managed.

15. Uses appropriate sources of information e.g. British National Formulary.

16. Offers patient /service user further support/advice/education, including discharge/safe transfer where appropriate.

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Practice Assessor feedback

 

Bertha managed to give oral medications correctly to three patients with minimal supervision. On her next placement, she needs to be able to access Medusa on the intranet to she could prepare IV medications correctly.

The student must complete the Reflection on Meeting Medicines Management (Part 2) form following this assessment.

 

Reflection : Medicine Management.

As a student nurse, one of my primary responsibilities is medication administration. I administered a few medications under the supervision of the nursing staff. I have learnt about medication management and how important it is to avoid errors by arming myself with seven rights. One of which is the right patient, the right drug, the right dose, the right time, the right route, the right reason, and the right documentation. Before administering drugs, it is essential to obtain patients’ consent, as service users have the right to refuse. Permission is obtained from them to respect the patient’s autonomy.

The clinical nurse’s role includes a significant amount of drug administration. Doctors prescribe medications, which the pharmacist dispenses but is responsible for. Registered nurses are in charge of administration. As a student nurse, this has become my responsibility, which I must practice and become proficient at. This practice is part of preparing, checking, and administering medication, updating medication knowledge, monitoring treatment effectiveness, reporting adverse drug reactions, and teaching patients about the drugs they receive.

Accountability also applies to students; if I felt I was not competent enough to dispense a specific drug, I would be responsible for speaking up and informing the practice assessor so that I could shadow them and learn from them to help me in future practice and administration.

I was asked to administer a drug to a patient named Mr. Mark for confidentiality purposes. I had observed the clinical skill several times and previously administered medication under supervision. I was observed and supervised to administer oral medication to a patient. The drug has been dispensed and is ready to be administered with patient consent for me to administer the medication. My supervisor talked me through the procedure and told me they were struggling. The patient and his family have complied with the drug before, so I should keep an eye on him and ensure that he swallows his medication and that he does not support it in his mouth. The medication that the patient is on is bisoprolol. The decision to use bisoprolol is not taken lightly because of the potentially life-threatening side effects. Awareness of side effects is essential to primary care practitioners because they have the most contact with them.

I learnt that bisoprolol is used with other medicines to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Bisoprolol belongs to a class of drugs known as beta-blockers. It works by blocking the action of certain natural chemicals in the patient’s body, such as epinephrine in the heart and blood vessels. I advised the patient that the side effects of bisoprolol are tiredness, a slow heartbeat, diarrhoea, and dizziness. Also, I informed the patient to reduce the risk of dizziness and lightheadedness and to get up slowly when rising from a sitting position.

I was aware of being under the practice supervisor, which made me feel nervous and self-conscious, so I had to ensure that I was doing everything correctly and made no errors. Once my practice supervisor questioned my practice concerning whether I knew the side effects of the drug I was about to administer, I became even more aware of feeling nervous and under pressure. The patient was present, and I did not want the patient to think that I did not know what I was doing. So, before administering, I had to ensure that I was giving the medication to the right patient at the correct dose at the right time and route. All of these had to be done to guarantee that I was competent in administering medication under the supervision of the practice assessors. This also allowed me to carry out this task and get it signed off by my practice assessor in the essential skills cluster. The nurse-patient relationship is, by many, considered the core of nursing. This can be done to build a good relationship and rapport with the patient.

Administering medication and how this, combined with care, communication, and compassion, form the basis of a holistic approach to care, and with the knowledge I got from supporting literature, formed the foundation of my learning and practice.