Apprentice learning Log

Date: 22:04:25

Time: 21:00 – 23:00

Title of Learning: Safe Medication

Yesterday, during my regular shift, I administered medication to a patient under the supervision of an RN. We followed the 7 Rights of Medication Administration:

1.Right Patient: We confirmed the patient’s identity using two identifiers—their full name and date of birth.

2.Right Medication: We cross-checked the medication label with the prescription to ensure accuracy.

3.Right Dose: We verified the correct dosage as prescribed.

4.Right Route: We confirmed the medication was to be administered orally.

5.Right Time: We administered the medication at the scheduled time.

6.Right Reason: We understood the purpose of the medication for the patient’s condition.

7.Right Documentation: After administration, we accurately documented the details in the patient’s records.

This experience highlighted the importance of adhering to the 7 Rights to ensure patient safety and effective care. By meticulously following each step, we minimised the risk of errors and reinforced the critical nature of each right in the medication administration process. The supervision provided by the RN offered valuable guidance, enhancing my confidence and understanding of safe medication practices.

 I aim to consistently apply the 7 Rights in all medication administrations. I plan to deepen my knowledge of pharmacology to better understand the medications I administer, including their purposes and potential side effects. Additionally, I will seek feedback from experienced colleagues to continually improve my practice and ensure the highest standards of patient care.

Knowledge

K 1-20, 24, 30, 33, 36, 39-41, 43

Skills

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

Behaviour

B 1, 2, 3

Apprentice Learning log

Date: 21:04:25

Time: 17-20:00

Title of Learning: Reflection on Cuff Deflation Assistance

Yesterday, during my shift, the RN in charge asked me to assist with a cuff deflation for a tracheostomy patient. After checking that the patient was stable, I helped by deflating the cuff and attaching a one-way speaking valve to allow the patient to try vocalising. I worked closely under supervision and made sure I monitored the patient’s breathing and comfort throughout the process.

This experience helped me understand the importance of careful monitoring during cuff deflation. I realised how crucial it is to ensure the patient can manage their airway without the cuff inflated and to watch for any signs of breathing difficulty, oxygen desaturation, or distress. It also showed me how encouraging it can be for the patient to regain their ability to speak, even for a short time.

In the future, I will continue to develop my skills in tracheostomy care, especially understanding when a patient is ready for cuff deflation and use of a speaking valve. I plan to review local guidelines and ask for more opportunities to assist with similar procedures under supervision to build my confidence and competence safely.

Knowledge

K 1-20, 24, 24,30, 33, 36, 39-41, 43

Skills

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

Behaviour

B 1,2,3

Apprentice Learning log

Learning Log

Date: 08/03/25

Time: 16:00-1900

Title of Learning: Clinical judgement

In my afternoon class, I learnt about clinical judgement and its importance in healthcare. We discussed how clinical judgement involves using knowledge, experience, and critical thinking to make decisions about patient care. It’s not just about following protocols or procedures, but also about analysing situations, making informed decisions, and applying the best possible interventions based on a patient’s unique needs. We also explored how clinical judgement is essential for identifying potential problems, assessing risks, and evaluating outcomes.

This lesson helped me understand that clinical judgement is a key skill for any healthcare professional. It’s not enough to rely solely on textbook knowledge or predefined guidelines; each patient is different, and healthcare providers need to make decisions that are personalised and adaptable. I realised that effective clinical judgement requires both confidence and the willingness to ask questions or seek help when needed. This lesson also made me appreciate the complexity of decision-making in healthcare and the importance of staying calm, focused, and open to learning from each situation.

After this lesson, I plan to focus on developing my critical thinking and decision-making skills. I want to be more mindful of how I assess each situation and make decisions based on all available information. I’ll also try to involve patients in their care decisions, as I’ve learned that clinical judgement is often about collaboration. Moving forward, I will seek feedback from experienced colleagues to improve my judgement skills and continue practicing so that I feel more confident in making informed decisions.

Knowledge

K 1-20, 24, 30, 33, 36, 39-41, 43

Skills

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

Behaviour

B 1, 2, 3

Apprentice Learning Log

Learning Log

Date: 7/03/25

Time: 12:00-15:00

Title of Learning: Planning and Monitoring Care

Last Wednesday, I had the opportunity to learn about patient assessment, planning, and monitoring care. The session focused on understanding the importance of accurately assessing a patient’s condition, identifying their needs, and developing an appropriate care plan. It also emphasised the importance of continuous monitoring to ensure that the care plan is effective and adjusting it if necessary. We discussed various tools and methods for gathering information, such as patient history, physical exams, diagnostic tests, and the role of the multidisciplinary team in providing comprehensive care.

This learning experience was significant because it deepened my understanding of how critical a thorough patient assessment is to providing quality care. I realised that the planning phase is not just about deciding what to do, but it is also about creating a flexible approach that can be adapted based on the patient’s response to care. The monitoring aspect stood out to me, as it highlighted that the patient’s condition can change, and regular assessment is crucial to track their progress and adjust interventions if needed.

I also saw the importance of a holistic approach, where patient care isn’t limited to their immediate medical needs but also considers psychological, social, and emotional aspects. Furthermore, working as part of a healthcare team means that effective communication and collaboration are key in ensuring the success of the care plan.

I plan to apply this knowledge in my practice by focusing on more comprehensive assessments. I will aim to gather not only physical data but also consider the patient’s mental and emotional health to ensure a holistic approach. I also plan to be more proactive in monitoring care, understanding that things can change, and being ready to adjust the plan accordingly. I need to develop my skills in using assessment tools and documentation effectively to communicate the patient’s status with the healthcare team.

Lastly, I will focus on improving my communication with patients, ensuring that they feel heard and involved in their care planning and that I am able to collaborate more efficiently with other members of the healthcare team. This will enhance patient outcomes and provide more tailored care.

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

Learning log

Date; 03/03/25

Time: 1500-1600

Title of Learning; Tracheostomy Procedure Checklist

This morning, I participated in an online learning session about the procedure checklist for a tracheostomy change. The session covered the essential steps that should be followed to ensure a safe and effective tracheostomy tube change. The checklist includes preparing the necessary equipment (such as sterile gloves, suction equipment, and the new tracheostomy tube), checking the patient’s medical history, and assessing their current condition to ensure they are fit for the procedure. It also emphasised the importance of checking the patient’s airway before, during, and after the procedure, ensuring that sterility is maintained throughout, and monitoring the patient for any signs of distress or complications.

This learning session was particularly valuable because it reinforced the structured approach needed when performing a tracheostomy change. The checklist ensures that no steps are missed, reducing the risk of complications such as infection or airway issues. I realised that using a checklist can significantly enhance the safety and efficiency of the procedure, especially in such high-stakes situations. The focus on thorough preparation and patient assessment prior to the procedure also emphasised how crucial it is to maintain clear communication within the healthcare team and to keep the patient’s well-being at the forefront. As a trainee nursing associate, I understood that following such checklists not only helps maintain quality care but also supports clinical confidence in complex procedures.

I plan to integrate the procedure checklist into my practice when involved in tracheostomy changes. I will focus on ensuring that all the necessary equipment is prepared ahead of time and that I am familiar with the checklist steps to avoid any mistakes. I will also prioritise patient assessment and clear communication with the team to confirm that the patient is stable and ready for the procedure. Additionally, I will make sure to always work with a team member during the procedure to ensure that the checklist is followed precisely and that the patient’s airway is properly monitored. I will seek feedback from senior colleagues about my use of the checklist to improve my efficiency and accuracy in such procedures.

Kn owledge

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

Skills

S 1,4

Behaviour

B 1, 2, 3

Apprentice Learning log

Learning Log

Date: 03/03/25

Time: 13:00-14:00

Title of Learning: Tracheostomy Changed

This morning, as part of my training as a trainee nursing associate, I had the opportunity to observe a tracheostomy change under the guidance of the ward manager. They carefully demonstrated each step of the procedure, beginning with the preparation of the sterile field. The ward manager highlighted the importance of aseptic technique throughout, ensuring that sterile gloves, equipment, and suction apparatus were used to avoid contamination. The procedure involved removing the old tracheostomy tube carefully, maintaining the patient’s airway, and then inserting a new tube while ensuring correct placement. The ward manager also demonstrated how to secure the tube properly, check for correct positioning, and monitor for any complications.

This experience was valuable for my development as a trainee nursing associate. Observing the use of aseptic technique reinforced my understanding of its critical role in preventing infections during procedures like tracheostomy changes. I realised that maintaining sterility is not just about following a set of steps but also about having a high level of awareness and focus throughout the procedure. The ward manager’s emphasis on the aseptic technique showed me how important it is to maintain a sterile environment, avoid contamination, and minimise the risk of infection. I also recognised the importance of closely observing the patient’s response and providing reassurance during the procedure, as well as the need for clear communication and documentation.

I will apply the knowledge gained from this experience when I am involved in a tracheostomy change or similar procedures. As a trainee nursing associate, I need to continue developing my aseptic technique skills, making sure I am always aware of how to properly prepare and maintain a sterile field. I plan to practice the steps of the procedure under supervision and focus on the smaller details, such as checking that all equipment is sterile and monitoring the patient’s condition throughout the process. I will also seek more opportunities to ask questions and receive feedback to build my confidence in using aseptic technique effectively. In addition, I will pay attention to how I communicate with patients and colleagues to ensure that I am providing comprehensive care and reassurance, especially during such invasive procedures.

Knowledge

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

Skills

S 1,4

Behaviour

B 1,2,3

Apprentice learning Log

Learning Log

Date: 02/03/25

Time: 10:00 – 11:30

Title of Learning: Bumper Retained Tube and Rotate

Yesterday, I learned about the technique for advancing and rotating a PEG tube, which is a feeding tube inserted directly into the stomach through the abdominal wall. The process involves carefully advancing the tube into the stomach and rotating it to ensure that it is properly positioned and secured. I observed how the tube is carefully inserted through the abdominal wall and into the stomach using an endoscope to guide the placement. The rotating technique helps in ensuring that the tube doesn’t cause irritation or damage to the surrounding tissue. The importance of confirming tube placement using X-rays or clinical signs was emphasised to ensure that the tube is positioned correctly before securing it.

Learning the technique for advancing and rotating a PEG tube was a significant learning moment for me. It highlighted how crucial the proper technique is for ensuring the tube is correctly positioned and that the patient experiences minimal discomfort. I realised that it’s not just about inserting the tube but also about ensuring its stability and avoiding any potential complications like tube dislodgement or injury to the surrounding tissue. The rotating motion, for example, helps prevent kinking or excessive tension on the tube, which can lead to discomfort or functional problems. This reinforced the importance of being meticulous and cautious when performing such procedures. Additionally, it reminded me of the need for patient monitoring to ensure that there are no immediate complications after the procedure.

I plan to refine my skills with the PEG tube advancement and rotation technique. I will focus on ensuring that I follow the steps carefully and work with the multidisciplinary team to ensure the patient is appropriately monitored during and after the procedure. I’ll pay close attention to the tube placement and how to check for signs of complications, such as discomfort or leakage. I will also seek feedback from my mentors and senior colleagues to improve my technique and to make sure I am consistently following best practices. This experience will guide my future practice, ensuring that I approach similar procedures with a clear understanding of the technique, the patient’s needs, and potential risks.

Knowledge

K 1, 4-13, 15-30, 33, 36, 39-41, 43

Skills

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

Behaviour

B1, 2, 3

Apprentice Learning Log

Learning Log

Date: 28/02/25

Time: 9:30-13:00

Title of Learning: Behavioral Change and Motivational Interviewing

During the session, we explored the principles of behavioural change and the application of motivational interviewing techniques. MI is a collaborative, person-centered counselling method designed to elicit and strengthen motivation for change by helping individuals explore and resolve ambivalence. We practice core MI skills, including:

Open-ended question; encouraging clients to express their thoughts and feelings without restrictions.

Affirmations: recognising and acknowledging the client’s strengths and efforts.

Reflective listening: demonstrating empathy by accurately reflecting the client’s statements.

Summarising: recapping discussions to reinforce understanding and progress.

These techniques are collectively known as OARS and fundamental in guiding clients towards recognising and implementing behavioural changes.

This training highlighted the significance of adapting a client-centred approach to facilitate behavioural change. By employing MI techniques, I learned the importance of resisting the righting reflex, which is the tendency to correct clients or push them toward change. Instead, understanding the motivations, listening with empathy, and empowering them to take ownership of their change process are crucial. Practicing these skills made me aware of my own communication patterns and the need to create a supportive environment where clients feel understood and motivated. I realised that facilitating change is less about guiding clients to articulate their reasons for change, thereby enhancing their commitment.

To integrate these insights into my practice, I plan to:

Enhance my MI skills: engage further training and seek feedback to refine my use of open-ended questions, affirmations, reflections, and summaries.

Apply MI techniques: incorporate MI strategies into client interactions to better support their behavioral change journey.

Reflect regularly: engage in self-reflection after client sessions to assess the effectiveness of MI techniques and identify areas for improvement.

By committing to these steps, I aim to foster more collaborative and empowering relationships with clients, facilitating meaningful and self-directed behavioural changes.

Knowledge

K 1-20, 24, 30, 33, 36, 39-41, 43

Skills

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

Behaviour

B 1, 2, 3

Apprentice Learning Log

Learning Log

Date 26/02/25

Time: 13:00-16:30

Title of Learning: Subcutaneous Injections

Last Wednesday, I participated in a practical session focused on administering subcutaneous injections. The training involved understanding and appropriate techniques, selecting suitable injection sites, and adhering to safety protocols. I had the opportunity to practice the procedure on simulation models under the supervision of an experienced instructor.

This hands-on experience was crucial in enhancing my confidence and competence in performing subcutaneous injections. Initially, I felt apprehensive about causing discomfort or making errors during the procedure. However, the guidance provided helped me understand the importance of proper technique to minimise patient care, as subcutaneous injections are commonly used for administering medications like insulin and anticoagulants.

To build upon this experience, I plan to seek additional opportunities to practice subcutaneous injections in clinical settings under supervision. I will also review current guidelines and best practices to ensure my technique remains up-to-date. Furthermore, I intend to engage in reflective practice after each procedure to identify areas for improvement and consolidate my learning.

Knowledge

K 1-20, 24, 30, 33, 34, 36, 39-41, 43

Skills

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

Behaviour

B 1,2,3

Apprentice Learning Log

Learning Log

Date of learning: 25/02/25

Time of learning: 15:00-1800

Title of Learning:  Delivery of  Safe and effective Person-Centred Care

Person-centred care is a holistic approach that treats individuals as unique beings, respecting their preferences, needs, and values. it emphasises collaboration between patients and healthcare professionals to develop personalised care plans. The goal is to ensure that care is not only clinically effective but also aligned with what matters most to the patients.

Implementing person-centred care is crucial because it leads to improved patient satisfaction, better health outcomes, and more efficient use of healthcare resources. By involving patients in decision-making, they are more likely to adhere to treatment plans and engage in self-care. This approach also fosters trust and strengthens the therapeutic relationship between patients and providers. It addresses the ethical imperative of respecting patient autonomy and dignity.

To enhance the delivery of safe and effective person-centred care, healthcare organisations and professionals can take the following steps:

Training and education provide continuous education for healthcare professionals on person-centred practices, communication skills, and cultural competence.

Policy and development establish policies that prioritise patient involvement in care planning and decision-making processes.

Environment optimisation creates a welcoming and accessible healthcare environment that accommodates diverse patient needs.

Feedback mechanisms implement systems to regularly gather and act upon patient feedback to improve care quality.

by adopting these measures, the healthcare system can move towards a model that not only treats illnesses but also honors the individual experiences and preferences of each patient, ensuring care that is both safe and effective.

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