Apprentice learning Log

Date: 09/06/2025

Time: 13:00-18:00

Title of Learning: Reflection: Caring for Tracheostomy Patients

Yesterday, I was responsible for looking after seven patients with tracheostomies in my ward. My main tasks included performing suctioning, changing the inner cannula, and accurately recording nursing notes. This was a very hands-on shift, requiring constant monitoring of patients’ airways and maintaining clear documentation. Some patients were alert and able to communicate, while others were more vulnerable and nonverbal, requiring extra care and observation. It was physically and emotionally demanding but also a valuable learning experience.

This experience helped me develop confidence in managing tracheostomy care, which can be complex and high-risk. I realised how important it is to act promptly when a patient shows signs of respiratory distress, such as coughing, agitation, or decreased oxygen saturation. Suctioning, when done correctly and timely, can help prevent complications like blockages or infections. I also learnt that communication and reassurance are vital, especially for patients who cannot speak. I had to rely on nonverbal cues and body language to understand their needs. Recording care accurately on the EPR system was essential to ensure continuity of care and safety. This shift pushed me to be more organised, calm under pressure, and aware of my patients’ individual needs.

I want to continue developing my skills in tracheostomy care by asking questions, seeking feedback, and observing experienced nurses. I will also review the latest guidelines and best practices to ensure I am following safe, evidence-based procedures. I plan to improve my communication with non-verbal patients by learning more about eye-gaze boards and other tools. In future shifts, I will pay more attention to small changes in patients’ behaviour, as early signs of deterioration can be subtle. Overall, this experience has strengthened my confidence and highlighted the importance of safe airway management, clear documentation, and compassionate, patient-centred care.

Knowledge

K 1, 4-13, 15-30, 33, 36, 39-41

Skills

S 1, 2, 5, 17, 18, 21, 23, 25-28, 30, 32, 35

Behaviour

B 1, 2, 3

Apprentice Learning Log

Date: 04/06/2025

Time: 17:00-20:00

Title of Learning: Vulnerable and Complex Care

Last Wednesday, we had a lesson focused on vulnerable and complex care, which is a key aspect of nursing practice. The session explored how to support individuals who are at increased risk due to factors such as age, disability, mental health conditions, learning difficulties, or social circumstances like homelessness or domestic abuse. We also discussed the importance of safeguarding, recognising signs of neglect or abuse, and how to respond appropriately by following correct procedures. The role of the multidisciplinary team (MDT) was highlighted, showing how collaboration between nurses, doctors, social workers, and allied health professionals is essential in delivering safe and effective care to people with complex needs.

This lesson helped me understand that being vulnerable isn’t limited to physical conditions it also includes emotional, cognitive, and social vulnerabilities. It made me realise how important it is to treat every patient as an individual, taking into account not just their medical diagnosis but also their environment, support system, and communication needs. I reflected on how easily some vulnerable patients can be overlooked or misunderstood if we don’t take the time to assess them holistically. The importance of safeguarding and advocating for those who can’t speak for themselves really stood out to me. I also learnt how complex care often requires coordinated support and clear documentation and how poor communication between healthcare professionals can increase the risk of harm.

In my future practice, I will take extra care to observe and assess for hidden vulnerabilities, especially in patients who may struggle to express their needs. I will apply person-centred care by adapting my communication, involving family or carers when appropriate, and always respecting the dignity and rights of the patient. I will also seek support from the MDT when needed and speak up if I have safeguarding concerns. This lesson has reminded me that compassion, attentiveness, and professional responsibility are crucial when caring for vulnerable individuals with complex needs.

Knowledge

K 4-13, 15-30, 33, 36, 39-41

Skill

S1, 2, 5, 17, 18, 21, 23, 25-28, 30, 32, 35

Behaviour

B 1, 2, 3

Apprentice Learning Log

Date: 30/05/2025

Time: 20:00

Title of Learning: Living with Long-Term Conditions and End-of-Life Care

In last Wednesday’s lesson, we explored the experiences of individuals living with long-term conditions and the importance of end-of-life care. The session covered the physical, emotional, social, and psychological impact of chronic illness on both patients and their families. We also discussed palliative care, the principles of holistic support, and the significance of person-centred care during the final stages of life. A key part of the lesson involved case studies and role-play, which helped us understand how to communicate compassionately and effectively with people facing life-limiting conditions.

This lesson helped me to realise how essential it is to treat patients as individuals, not just as people with medical conditions. Long-term illness often means a loss of independence, changes in identity, and emotional struggles. Recognising this reinforced how important it is to offer support that is not just clinical but also emotional and spiritual. I was particularly struck by how much difference good communication can make—being able to listen, show empathy, and offer comfort is just as important as administering medication.

Understanding end-of-life care also challenged some of my assumptions. It’s not just about death—it’s about helping people live as well as possible until the end. This includes managing pain, supporting families, and respecting patients’ choices. The lesson helped me appreciate how sensitive and skilled this area of care needs to be.

I will focus more on developing my communication and empathy skills. I plan to take more time to listen deeply to patients’ concerns and to understand their personal stories, especially those living with long-term conditions. I also want to learn more about advance care planning and the legal and ethical aspects of end-of-life care. In future placements or roles, I will aim to be a comforting presence for patients and families, helping to create a space where they feel heard, respected, and supported. This lesson has deepened my understanding of holistic care and the dignity every person deserves—right up to their final days.

Knowledge

K 1, 4-13, 15-30, 33, 36, 39-41

Skills

S 1, 2, 5, 17, 18, 21, 23, 25-28, 30, 32, 35

Behaviour

B 1, 2, 3

Apprentice Learning log

Date: 24/05/2025

Time: 16:00 – 19:00

Title of Learning: Care of the Child

During our class discussion last Wednesday, we focused on the care of children, including safeguarding and recognising signs of abuse. We talked about the different types of abuse—physical, emotional, sexual, and neglect—and how important it is for healthcare professionals to be alert to the signs. The class also discussed the long-term effects abuse can have on a child’s development, mental health, and trust in adults. It was upsetting to hear how many children in the UK experience abuse, often from people they trust the most. This made me reflect deeply on my own responsibilities when working with children and families.

This discussion made me realise how vital safeguarding is in all areas of health and social care. Children are vulnerable and may not always be able to speak up for themselves. As a student nursing associate, I must be observant and act professionally when I notice any signs of concern, such as bruises, changes in behaviour, fearfulness, or poor hygiene. It also made me think about how easily abuse can be hidden and how crucial it is to follow safeguarding procedures, even if it feels uncomfortable. Our duty is always to protect the child, no matter what.

I will make sure I am familiar with my workplace’s safeguarding policy and know how to report any concerns. I will not ignore any red flags or signs, no matter how small they may seem. I also want to improve my confidence in speaking up and documenting concerns clearly and professionally. I will take every opportunity to learn more about safeguarding, child development, and communication with children and families. This discussion reminded me that protecting children is not just a responsibility—it’s a moral and legal duty for all of us in healthcare.

Knowledge

K  1, 4-13, 15-30, 33, 36, 39-41

Skills

S 1, 2, 5, 17, 18, 21, 23, 25-28, 30, 32, 35

Behaviour

B 1, 2, 3

Apprentice learning Log

Date: 23/05/2025

Time: 15:00-18:00

Title of Learning: Drinking Alcohol

In a recent class discussion, we explored the impact of alcohol consumption on health, social well-being, and patient care. We learnt that the UK Chief Medical Officers recommend that both men and women should not regularly drink more than 14 units of alcohol per week, which is roughly equivalent to 6 pints of average-strength beer or 6 medium glasses of wine. The discussion highlighted how alcohol misuse can lead to liver disease, certain cancers, high blood pressure, mental health issues, and an increased risk of accidents or injuries. It also made me think about the number of patients I’ve encountered who were admitted due to alcohol-related conditions, sometimes combined with dehydration, malnutrition, or mental health crises.

This discussion made me realise the importance of understanding alcohol guidelines not just for myself but for supporting patients as a nursing associate. Many people are unaware of how quickly alcohol units can add up, especially with binge drinking or daily intake. It also helped me understand the long-term effects of excessive drinking, including dependency and its strain on families and the NHS. I learnt that asking about alcohol use in a sensitive, non-judgemental way is vital in building trust and helping patients feel safe enough to open up. It’s also important to promote safer alternatives and educate patients about staying hydrated, particularly since alcohol is a diuretic and increases the risk of dehydration.

 I plan to be more confident when addressing alcohol use with patients, especially during assessments or health promotion conversations. I will familiarise myself with local and national alcohol support services so I can effectively signpost patients. I also want to improve my communication skills when discussing lifestyle choices, using open-ended questions and motivational interviewing techniques to encourage positive change. On a personal level, I’ve become more aware of the importance of monitoring my own alcohol intake, especially in social situations, and modelling healthy behaviours. As part of a healthcare team, promoting safe drinking and hydration is essential in providing holistic, preventative care.

Knowledge

K 1, 4-13, 15-30, 33, 36, 39-41

Skills

S 1, 2, 5, 17-18, 21, 23, 25-28, 30, 32, 35

Behaviour

B 1, 2, 3

Apprentice Learning Log

Date: 22/05/2025

Time: 19:00-22:00

Title of Learning : SMOKING

During a recent class discussion, we explored the harmful effects of smoking on health, including its links to conditions such as chronic obstructive pulmonary disease (COPD), heart disease, stroke, and cancer. This made me think deeply about how often smoking-related illnesses come up in healthcare settings and how many patients continue to smoke despite knowing the risks. It reminded me of a patient I saw on placement who had been diagnosed with COPD but still struggled to quit smoking due to addiction and stress.

This discussion helped me understand that smoking is not just a lifestyle choice but often a complex issue influenced by addiction, mental health, and social circumstances. It reinforced the importance of my role as a future nursing associate in health promotion and patient education. I realised that brief interventions, even a short conversation, can make a difference in encouraging someone to consider quitting. It also highlighted the importance of approaching the topic in a non-judgemental and supportive way, recognising that patients may feel ashamed or defensive.

As I continue my training, I want to be more proactive in supporting patients who smoke. This includes building my confidence to raise the topic sensitively and knowing when and how to refer patients to local stop smoking services. I will also make time to read more about smoking cessation techniques and resources, including advice from NHS and NICE guidelines. By doing so, I can play a small but meaningful role in improving patients’ long-term health and quality of life. Promoting healthier choices is part of the holistic care we are expected to provide, and this discussion has motivated me to take that responsibility seriously.

Knowledge

K 1, 4-13, 15-30, 33, 36, 39-41

Skills

S 1, 2, 5, 17, 18, 21, 23, 25-28, 30, 32, 35

Behaviour

B 1, 2, 3

Apprentice Learning Log

Date: 19/05/2025

Time: 1800-20:00

Handover (Church Appointment & Ward Checklist)

During yesterday’s handover, the team discussed arrangements for all patients who wanted to attend a church service. As a Trainee Nursing Associate, I supported by helping identify which patients were interested, ensuring they were ready on time, and confirming that the necessary support and supervision were in place. We also went through the ward checklist to update care tasks such as personal hygiene needs, medication timings, risk assessments, and mobility support. This ensured all essential care elements were communicated to the next shift.

This experience helped me understand the importance of planning and communication in delivering holistic care. Supporting patients in attending church not only met their spiritual needs but also helped promote emotional well-being and social interaction. Updating the ward checklist reminded me how vital it is to maintain clear, accurate records to support safe, consistent care across shifts. As a Trainee Nursing Associate, it reinforced my responsibility in contributing to both the practical and emotional aspects of patient care and in being an effective link between the nursing team and patients.

I will continue to advocate for patient-centred activities, ensuring that individual needs—including spiritual and social interests—are considered during handovers. I will also be more proactive in checking and updating the ward checklist, recognising how it supports safe and organised care. As I develop in my role, I aim to become more confident in contributing during handovers and ensuring all relevant information is accurately passed on to maintain continuity of care.

Knowledge

K 1-8,12, 20, 26, 30, 33, 34, 36, 41

Skill

S 1,4

Behaviour

B 1, 2, 3,

Apprentice Learning Log

Date: 16/05/2025

Time: 18:00 – 20:00

Title of Learning: Promoting mental health across the life span

Last Wednesday, we learnt about promoting health across the life span. This means helping people stay healthy from birth to old age. We talked about how health needs change as people grow and how different stages of life—like childhood, adulthood, and old age—need different kinds of care and support. We also discussed ways to prevent disease, promote healthy habits, and improve quality of life at every age.

This lesson helped me realise that promoting health isn’t just about treating sickness—it’s about caring for people before they get sick. It showed me how important it is to understand each person’s stage in life because a baby, a teenager, and an elderly person all have different needs. Health is not just physical but also emotional, mental, and social. It made me more aware of the role I can play in helping others live better lives.

Now, I want to be more mindful about the health of people around me. I can start by encouraging healthy habits at home, helping family members go for checkups, or supporting mental health among friends. In the future, I hope to use what I learnt to care for people with more understanding and compassion, no matter what age they are. Even small actions can make a big difference in someone’s health and happiness.

Knowledge

K 1-20, 24, 30, 33,  36, 39-41, 43

Skill

S 1, 5, 7-9, 13-16, 35

Behaviour

B 1, 2, 3,

Apprentice learning Log

Date: 15/05/2025

Time: 17:00 – 20:00

Title of Learning: Communication Skills for Assessment and Caring. Record keeping

In our Wednesday afternoon lesson, one of our case study topics is patients with pressure sores and the essential role that communication, empathy, and accurate record keeping play in their care. We discussed how nursing associates assess pressure damage, provide wound care, and support patients who may be in pain or feeling vulnerable. A key part of the lesson was how we speak to and listen to these patients and how proper documentation supports their ongoing treatment.

This lesson made me think more deeply about how pressure sores don’t just affect the skin — they affect the person as a whole. Many patients feel embarrassed, frustrated, or even ashamed about having a pressure sore, especially if they rely on others for personal care. As nursing associates, it’s our job to treat them with dignity and compassion.

I realised that how we communicate can really shape a patient’s experience. Being gentle with our words, explaining what we’re doing during care, and making space for the patient to express how they feel can help build trust and reduce anxiety. Patients need to feel listened to — not just assessed.

We also looked at the importance of record keeping. Documenting the size, depth, and appearance of the pressure sore, the pain level, and any emotional concerns the patient shares helps the rest of the healthcare team stay informed and deliver consistent care. If we don’t record these details accurately, the patient’s care could suffer.

I will approach pressure sore care with greater understanding and sensitivity. I want to make sure I speak respectfully and clearly to each patient, especially when they might feel embarrassed or helpless. I’ll also ask open-ended questions to understand not just their physical pain but also how they’re coping emotionally.

When it comes to documentation, I’ll take more care in writing detailed, honest, and professional notes that reflect the patient’s condition and concerns. This helps keep the whole team informed and ensures the patient receives safe, person-centred care.

This lesson reminded me that caring is not just about the treatment we give — it’s about how we make people feel. As a nursing associate, I want every patient I care for to feel safe, respected, and supported — especially when they’re dealing with something as painful and personal as a pressure sore.

Knowledge

K 1, 4-13, 15-30, 33, 36, 39-41

Skills

S 1, 2, 5, 17, 18, 21, 23, 25-28, 30, 32, 35

Beahaviour

B 1,2,3

Apprentice Learning Log

Date: 23/04/25

Time: 20:30-23:30

Title of learning: Tracheostomy Change

Yesterday, during my shift, I observed and assisted a registered nurse in performing a tracheostomy tube change for a patient. My responsibilities included preparing the necessary equipment, ensuring the patient was in the correct position, and handing instruments to the RN during the procedure. I also monitored the patient’s vital signs and comfort levels throughout the process.

This experience highlighted the critical importance of teamwork, preparation, and adherence to sterile techniques during tracheostomy care. I learnt that having all necessary equipment ready and understanding each step of the procedure are vital to ensure patient safety and comfort. Observing the RN’s methodical approach and clear communication reinforced the significance of competence and confidence in performing such procedures. Additionally, I recognised the value of being proactive and attentive, as even small actions can significantly impact the procedure’s success and the patient’s well-being.

I aim to deepen my understanding of tracheostomy care by studying relevant guidelines and protocols. I plan to seek opportunities to observe and assist in similar procedures to build my confidence and competence. Engaging in discussions with experienced colleagues and attending training sessions will further enhance my skills. Ultimately, my goal is to provide safe, effective, and compassionate care to patients with tracheostomies, ensuring their comfort and dignity are maintained throughout their treatment.

Knowledge

K 1-20, 24, 30, 33, 36, 39, 41

Skills

S 1, 5, 7-9, 13-16, 35

Behaviour

B 1, 2, 3