Today I performed a bladder/catheter washout on a patient using a twin uro tainer solution I understand that Bladder/ catheter washouts are used to prevent the build-up of debris and sediment in the catheter. They are also used to clean and maintain the hygiene of the catheter as often they can become blocked.

There are many types of solution used to unblock a catheter the main one as mentioned above is the uro tainer solution which comes in two different types the first one is suby G which contains 3.23% of citric acid. the other type is the uro tainer solution R which contains 6% of citric acid.

Another type of catheter washout is optiflo irrigation there are three types. Optiflo G which contains 3.23% of citric acid, Optiflo R which contains 6% of citric acid and Optiflo S which contains 0.9% of saline.

It is important that this procedure is sterile to minimise the risk of infection. I feel I carried out the procedure well using aseptic techniques and making the patient feel comfortable at all times.

I had the opportunity to observe for the day with Reshma the heart failure nurse. I learned a great amount about regular medications and the procedures that patients with heart failure have to go through. I understand that pacemakers and implantable cardioverter defibrillators are sometimes an option for patients if “pumping action” is below 45-50%. This means that their heart rate is too slow and they may need this device inserted into them as support and backup for the heart.

I was taught the reason why 24-hour ECG devices are used for patients to wear around their necks. This is to check if the heart rate is regular or irregular and is usually used for patients with tachycardia. The heart failure nurse explained that an angiogram is a procedure that is done to check if the patient has any blocks in the heart. To my understanding, this means when the blood vessels are blocked and the heart is unable to pump enough blood around the body/ back to the heart.

I was taught some of the signs of heart failure which were, pericarditis which I understand is inflammation of the heart that can cause shortness of breath and chest pain. Medications such as candesartan, furosemide and dapagliflozin are often prescribed to patients long-term to manage heart failure. GTN sprays are also prescribed to help angina.

Observing and being able to ask the heart failure nurse questions has made me feel more positive in feeling like I have a better understanding of the possible reasons someone could have heart failure. The nurse explained that this could be due to having comorbidities or unhealthy lifestyle choices. Overall I feel like I gained a lot of knowledge and skills about heart failure that I can develop on and take into my career.

I would say that I feel a lot more confident in this speciality.

I had the opportunity to work at Crossways Nursing Home today (10/11/23). I had a really good experience and the Nurse Barbara was amazing. I learnt a lot about different types of dressings for wound care and what types of wounds they are used for. I was able to observe the nurse dressing a wound and was explained step by step what she was doing.

I learnt that Aquacel Ag+ is used when the wound is infected to pack the wound and Aquacel foam is a foam pad which absorbs fluid.

I understand the importance of having a sterile field to protect the patient from infections. I also was able to learn different types of medications such as Estradiol, which is used to treat symptoms of menopause and low estrogen. I was also able to observe the nurse administrating the medication inside the vagina of the patient.

I feel like I learned a lot in a short space of time at this care home however, I still don’t feel that confident in remembering all the dressings I was shown therefore, I am going to develop my knowledge further by doing self-directed study at home; as I realise that there are many more dressing types for different types of wound care.