Apprenticeship Learning Log

Date of Learning:06/11/24

Time: 9:30 – 16:30

Title of learning activity: The Renal System. BLS

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

The Renal System contains:

• Kidneys
• Renal pelves
• Ureters
• Bladder
• Urethra

The Renal System also known as Urinary System is important in excreting waste and plays a vital role in maintaining homeostasis of water and electrolytes.

Kidneys – produce urine, which is mainly water but also contains waste products:

– urea,

– uric acid

– excess ions

Kidneys also plays an important role in red blood cell production and the control of blood pressure.

Ureters – carry urine from the kidneys to the urinary bladder.

Bladder – collects and stores urine before its excreting through the urethra during urination.

Has a shape of pear when is empty, when is filled with urine is a shape of ballon.

Major renal functions/ formation of urine process:

1 Filtration of water

2 Secretion

3 Reabsorption

Healthy adult passes 1000 – 1500 ml of urine per day.

Urine contains:

– water

– urea

– uric acid

– creatinine

– ammonia

– sodium

– potassium

– chlorides

– phosphates

– sulphates

– oxalates

Second part of the day was dedicated to Basic Life Support.

Basic life support starts with a safety assessment of the environment, with the aim of minimising the risks to the rescuer and reducing further harm to the casualty. In hospital such risks could be fluids on the floor. It is important to protect yourself with the appropriate personal protective equipment.

D – danger

R – response

S – shout for help

A – airways

B – breathing

C – circulation, compression

We went to the simulation room to practice BLS.

Today’s session helped me to understand the function and importance of The Renal System.

We established how important is Basic Life Support on our daily basis. Within 10 seconds we can save another human life. If we want to escalate patient deterioration, we should always be based on NEWS2 and personal experience. As a Healthcare professional we are obligated to provide evidence-based practice.

Each session at Roehampton University enhanced my knowledge and desire to learn more to provide better care and support for NHS Patients.

KSBs addressed:

Apprenticeship Learning Log

Date of Learning: 1/11/2024

Time: 9:30 – 16:30

Title of learning activity: 199 CLASS Oliver McGowan Training (Learning Disabilities & Autism) Tier 2

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Today I have attended Mandatory Training – Oliver McGowan Training (Learning Disabilities & Autism) Tier 2

During today’s session we learned about Makaton Language, is the language which blends signs with speech to give an extra understanding and expression of Makaton Language. We learned how to introduce ourselves and say Hello, my name is…in Makaton language.

We were studying Oliver McGowan case. Oliver was chemically restrained by administered medication, which caused his fatal deterioration.

The aim of this session was to learn more about Autism, Learning Disabilities and Learning Difficulties and support people with certain disabilities.

Autism is defined as a neurological disfunction or difference. Lifelong, sometimes invisible condition. Clinically defined as disorder.

AUTISM + ENVIRONMENT = AUTCOME

Learning Disability is defined as lack of general adjustment. Neurological development disorder. Its hard to diagnosed and classified as Learning Disability or Learning Difficulties.

1.5 million people within UK lives with Learning Disabilities.

People with Learning Disabilities also suffer from:

• Mental health problems
• Epilepsy
• Autism
• Cerebral Palsy
• Sensory impairments

Criteria of Learning Disabilities:

• Impaired intelligence (the way, how we process information)
• Impaired social functioning (started before childhood with lasting effect on development)

Learning difficulty is a condition in the brain that causes difficulties comprehending or processing information and can be caused by several different factors.

Dyslexia is the one of the example of Learning Difficulties.

Session improved my understanding of Learning Disabilities, Learning Difficulties and Autism. Training helped me to understand the life’s and experience of people with learning disabilities, their strengths and contribution.

KSBs addressed:

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

K17: Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care

K28: Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions

S11: Report any situations, behaviours or errors that could result in poor care outcomes

S28: Support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain

S30: Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed

NEWS Certificate

Apprenticeship Learning Log

Date of Learning: 30/10/2024

Time: 9:30 – 16:30

Title of learning activity: Developing Professional Relationship in Nursing (Equality, Diversity, Inclusivity)

A + E Assessment (Can Nurses Save Life’s)

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Today we were discussing how to develop professional relationship in nursing. We identify the meaning of equality, diversity and inclusivity.

Professional relationship in nursing is defined as a group of work activities which leads towards the same, common goal, putting patient in centre care, promoting wellbeing of the person using the service.

Professional relationship should be maintained at workplace between colleagues and service users/ patients. Within clinical environment is important to work as a team, being respectful and listen carefully what others would like to say in certain subject.

Nurses must maintain objective, respect the client’s choice and make sure their personal values do not conflict with professional practice.

Effective communication is a key in developing professional relationship in nursing between patients and colleagues to enhance patient’s safety and improve teamwork.

Equality is the state of being equal, especially in status, rights and opportunities. Equality means each individual or group of people is given the same resources and opportunities, regardless of their circumstances.

Diversity is defined as differences in racial and ethnic, socioeconomic, geographic and academic professional background. People with different opinions, backgrounds (degrees and social experience), religious beliefs, political beliefs, sexual orientations, heritage, and life experience.

Inclusivity is the fact of including all types of people, things or ideas and treating them all fairly and equally.

Nurses must treat people as individuals, avoid making assumptions about them, recognised diversity and individual choices, respect their dignity and human rights.

In conclusion diversity, equality and inclusivity are very important at workplace especially in our nursing fields, because they help to promote better patient’s outcomes. Makes everyone included, valued and important. Giving each individual equal opportunities to develop their care and wellbeing.

Second part of the session was dedicated to the A + E Assessment.

We discussed ABCDE Approach Assessment and answered the following question: Can Nurses save lifes?

A – Airway and Oxygenation

B – Breathing and Ventilation

C – Circulation and Shock Management

D – Disability and Neurological Deterioration

E – Exposure and Examination

ABCDE Assessment will reveal abnormal physiology.

A – patient airways at risk (abstractive or clear)

B – respiratory rate, saturation O2

C – heart rate, blood pressure, CRT (cardiac resynchronization therapy)

D – blood sugar, glucose, disability/BM, drugs, allergies, PMH (Past Medical History such us disability)

We went to the simulation room to practice ABCDE Assessment.

Today’s session helped me to develop my knowledge about ABCDE Assessment. Answering the question: Can Nurses safe life’s? With confidence my answer is YES. If we approach ABCDE Assessment with good knowledge, skills also with proper attitude that we are there for a patient to preserve life. If we escalate abnormalities to the medical healthcare professional, deterioration can be tackled at the early stage.

KSBs addressed:

K2: Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health

K19: Know how and when to escalate to the appropriate professional for expert help and advice

S10: Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments

S11: Report any situations, behaviours or errors that could result in poor care outcomes

Tri – Partite Review Form,Copy of Theory Hours Log Sheet

Apprenticeship Learning Log

Date of Learning: 23/10/24

Time: 9:30 – 16:30

Title of learning activity: The Endocrine System.

Developing Professional Relationship in Nursing.

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

The Endocrine System is made of glands, which are widely separated without physical connection with each other.

Endocrine glands are group of secretory cells surrounded by extensive network of capillaries that facilitate diffusion of hormones (chemical messengers) from the secretory cells into the bloodstream.

The Endocrine System is maintaining partly homeostasis.

The main endocrine glands:

-Pineal body

– Pituitary gland

– Thyroid gland

– Parathyroid glands

– Thymus gland

– Heart

– Stomach

– Adrenal glands

– Kidneys

– Pancreatic islets

– Adipose tissue

– Ovaries in female

– Teates in male

The Endocrine system affects:

• Growth
• Development
• Metabolism
• Sexual function
• Mood

If your hormones levels are too high or too low, you may have an endocrine disease or disorder. Endocrine diseases and disorders also occur if your body does not respond to hormones the way it is supposed to.

The most common hormonal disorders are:

• Diabetes
• Thyroid disease
• Growth disorders
• Sexual disfunction

Endocrine Disorder Symptoms:

• Bone fractures.
• Changes in heart rate.
• Eye and skin changes.
• High blood glucose levels.
• High calcium levels.
• Low or high blood pressure,
• Infertility
• Menstrual cycle disorders

Afternoon session was dedicated to – Professional Relationship in Nursing.

Professional relationship involves group of people working together to achieve a common goal for the benefit of the organisation.

In nursing professional relationship is defined, as a purpose to promote wellbeing of the person using the service, based on trust, respect, professional intimacy, empathy and power.

A Nurse-Patient Relationship is defined as a complex interpersonal process which influence clinical outcomes and is grounded in the nurse’s personal, ethical, and moral foundations, shaped by education, professional experiences, and individual life experiences.

According to the NMC Code, all Healthcare Professional’s must always uphold reputation of their profession. Display a personal commitment to the standards of practice and behaviour set out in the Code. Should be a model of integrity and leadership for others to aspire to.

Today’s session, especially The Endocrine System seems to be very interesting, however quite confusing. It will require more attention during my revision to understand the endocrine system correctly. However, all diseases or disorders are quite common in our society these days. We are all concern about the endocrine system either from our personal life experience or we deal with them on the daily bases, providing care to our patients.

Developing professional relationship in nursing is a quite important skill, as we all want to be successful in providing care to our patients. Working towards the same goal and success of the organisation.

KSBs addressed:

Apprenticeship Learning Log

Date of Learning:16/10/2024

Time: 9:30 – 16:30

Title of learning activity:  Ethical and legal aspect in Nursing.

Mental Capacity Act.

Vital Signs and New’s

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Today, we were discussing three mentioned above subjects.

All Nurses are legally obligated to provide care to their patients. They have higher duty of care, rather than someone who has limited or has no medical knowledge at all.

If Nurses fail in their duty of care and the result of the failure is harm, which patients experienced. Patients can legally require or expect redress for caused harm.

We discussed four Ethical Principles:

1. Autonomy
2. Beneficence
3. Non – Maleficence
4. Justice

Autonomy – in nursing means, that patients have the right to make their own decisions based on their beliefs and values if they have capacity to make decisions.

Beneficence – means, that Nurses should be kind, providing positive “force” actively doing good for a patient. Putting patients in Centre Care.

Non – Maleficence – means to avoid or minimalised the harm. This principle is the most difficult to uphold. Where life support is stopped, or patients has chosen to stop taking medication, which can save their life’s. The Nurse has been put in morally challenging position.

Justice – fairness or an equal distribution of benefits. In nursing relates to impartiality regarding the patient’s age, ethnicity, economic status, religion or sexual orientation. This includes impartiality when assigning clinical or prioritising patients care.

Second subject discussed on today’s session was a Mental Capacity Act

The Mental Capacity Act 2005 is a direct decision – making on behalf of adults who may not be able to make their own decisions.

Having mental capacity, means being able to understand and store information and to decide based on that information.

DOLS – Deprivation of Liberty Safeguards has been intended to protect people who are lack of mental capacity from being detained when it is not in their best interest.

In the afternoon we were discussing Vital Signs and News’s

Vital Signs are the measurements of the most basic body functions. They are useful in detecting and /or monitoring health.

They consist of:

• Blood pressure
• Heart Rate
• Respiratory Rate
• Oxygen Saturation (pulse oximetry)
• Temperature

Normal values for a healthy adult:

• BP (Systolic: 100 – 140, Diastolic: 60 – 90)
• Pulse: 60 – 100 per minute
• Respiratory Rate: 12- 20 per minute
• Pulse oximetry: 94% – 98 %
• Temperature: 36 – 37.5 (low grade pyrexia 37.6 – 37.9’C, pyrexia 38’C +

Pyrexia or fever is the elevation of an individual’s core body temperature above a set point regulated by the body thermoregulatory centre in the hypothalamus.

The hypothalamus – an area of the brain that produces hormones that control:

• Body temperature
• Heart rate
• Hunger
• Mood

We were also discussing National Early Warning Scores NEWS2

National Early Warning Scores NEWS2- is the system for scoring the physiological measurements, which are routinely recorded at the patient’s bedside. First produced in 2012 and updated in 2017 Its purpose, is to identify acutely ill patients, including those with sepsis, in hospitals in England. The NEWS2 scoring system measures 6 physiological parameters:

• Respiration rate
• Oxygen saturation
• Systolic blood pressure
• Pulse rate
• Level of consciousness or new – onset confusion
• Temperature

A score of 0, 1, 2 or 3 is allocated to each parameter. A higher score means the parameter is further from the normal range. Appropriate clinical responses are given for threshold (trigger) levels, with a recommendation to review and agree these locally:

Low risk (aggregate score 1 to 4) – prompt assessment by ward nurse to decide on change to frequency of monitoring or escalation of clinical care.

Low to medium risk (score of 3 in any single parameter) – urgent review by ward-based doctor to determine cause and to decide on change to frequency of monitoring or escalation of clinical care.

Medium risk (aggregate score 5 to 6) – urgent review by ward-based doctor or acute team nurse to decide on escalation to critical care team.

High risk (aggregate score of 7 or over) – emergency assessment by critical care team, usually leading to patient transfer to higher-dependency care area.

In the afternoon we went to the simulation room, and we learned how to check the blood pressure manually.

Today’s session helped to develop my knowledge, regarding subjects which are already do on the daily basis on the ward.

On my next shift at hospital, I will be able to confidently present it gained and developed knowledge, saving patients life’s.

Session helped me to understand the importance of Ethical and Legal aspect of my occupation.

Mental Capacity Act and DOLS helped me understand, how important is to consider patients capacity and always act on the behalf of the patient, reducing harm in patients care.

Each session at Roehampton University makes my work more interesting.

Helping me to develop confidence, that my future occupation is important for the nation and for the future development of the organisation. With high confidence I can state that, there is always room for improvement. Every day is a lesson and is always beneficial to develop our knowledge to put patient in centre care.

KSBs

K1: Understand the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and how to fulfill all registration requirements

K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice

K18: Understand and apply the principles and processes for making reasonable adjustments

K19: Know how and when to escalate to the appropriate professional for expert help and advice

K26: Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld

K40: Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services

S10: Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments

S19: Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent

S35: Accurately undertake risk assessments, using contemporary assessment tools

  Apprenticeship Learning Log

Date of Learning: 09/10/24

Time: 9:30 – 16:30

Title of learning activity: Anatomy and Physiology of the Nervous System.

The importance of communication and professional values relating to Nursing Practise.

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

The nervous system is a complex network of nerves and nerve cells (neurons)

System carries signals or messages to and from the brain and spinal cord to the different parts of the body.

Is made of the:

• Central Nervous System (brain, spinal cord)
• Peripheral Nervous System (ganglia, nerves)

The Central Nervous System (CNS) is made up of the brain and spinal cord. The brain controls most of the body functions such as: awareness, movements, sensations, thoughts, speech and memory. The spinal cord is connected to the brain at the brain stem and is covered by the vertebrae of the spine. Nerves exit the spinal cord to both sides of the body. The spinal cord carries signals back and forth between the brain and the nerves in the rest of the body.

The peripheral nervous system (PNS) is the part of the nervous system outside of the CNS. It is made up of the nerves and ganglia, that send signals to CNS and received signals from the CNS. The PNS is divided into:

1. The somatic nervous system
2. The automatic nervous system.

The somatic nervous system controls body movements which are under our control such as:

– walking.

The automatic nervous system controls involuntary functions, which body does on its own such as:

• Breathing
• Digestion

The autonomic nervous system is further divided into:

– sympathetic nervous system

– parasympathetic nervous systems.

The sympathetic nervous system prepares the body for situations that require strength and heightened awareness or situations that arouse fear, anger, excitement or embarrassment. This is called the fight-or-flight response. It causes the heart to beat faster, makes you breathe quicker and more shallowly, dilates the pupils and increases metabolism.

The parasympathetic nervous system has a calming effect on the body. It returns heart rate and breathing to normal, constricts the pupils and slows down metabolism to conserve energy.

Second part of the day was dedicated to the communication and professional values related to Nursing Practise.

We defined the meaning of the communication term.

Communication – exchanging, transferring information between group of people. Communication could be verbal, written or sing language.

Good communication helps prevent errors.

A good communicator, always listen carefully, respect other’s opinion. Brings a new idea to the table with good body language. Very important in communication is proper voice tone, body language and appropriate choice of words.

We discussed professional values related to Nursing Practice.

Professional nursing values are defined, as important professional nursing principles such as:

• Dignity
• Integrity
• altruism

Professional values provide a positive image of the organisation and helps to build up a trust, which makes organisation a reliable in public use or opinion.

Today’s session brought me to the very important reflection regarding values in my profession.

There is always a room for improvement. Feedback from our work colleagues, especially from the patients is very important. Helps us to improve a quality of care, which we provide on the daily basis.

Being selflessness and concern for the well-being of others can increase the feelings of happiness, satisfaction and optimism for us a healthcare professionals and patients, who count on our professional values.

We learn every day, how to become a better person. More supportive with less judgment and fear to approach individual patient.

KSBs addressed:

K1: Understand the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and how to fulfill all registration requirements

K21: Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care

K24: Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain

K31: Understand how inadequate staffing levels impact on the ability to provide safe care and escalate concerns appropriately

S2: Keep complete, clear, accurate and timely records

S4: Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills

Apprenticeship Learning Log

Date of Learning:02/10/2024

Time: 9:30 – 16:30

Title of learning activity: The structure and function of blood.

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

For today’s session, each student was obligated to bring a printed hard copy of Tri – Partite Review Form.

We received a plenty of support and guidelines from our teacher, regarding the correct way to filling the form and present it on the upcoming meeting.

Another part of the day, was dedicated to the following subject:

The structure and function of blood.

Blood is one of the body fluids.

It has four main components:

• Plasma is a liquid part, over half of human blood 55 % – made of water, salts and protein.

Other three parts such us:

• Red blood cells RBC
• White blood cells WBC
• Platelets

Are solid parts of human bloods 45%

Each component has a different function:

Plasma – Carries the blood cells and platelets around the body

Red Blood cells – carry oxygen from the lungs to every cell of the body

White Blood Cells – fight infection by pathogens and stop disease

Platelets – are made in the bone marrow and helps the blood to clot. Platelets are responsible for wound healing.

Blood helps to maintain homeostasis by stabilizing pH, temperature, osmotic pressure and eliminating excess heat.

Common blood cells disorders included:

• Anaemia
• Haemophilia
• Blood clots
• Blood cancers (leukaemia, lymphoma, myeloma)

After lunch break, we went to the simulator room.

We were demonstrating and discussing the main aspect of providing personal care and using relevant equipment – Hoist to correctly transfer patient from the chair to bed and opposite way.

Session gave me an overview of the structure and function of the cardiovascular system.

In my opinion we went through the most important and difficult to understand module.

However, it’s very important to define all structures and functions correctly.

Blood performs fundamental functions for our body. Transports oxygen and nutrients to individual tissues and ensures the formation of clots, preventing excessive blood loss. It fights infections, carries hormones in the body and allows to maintain a constant temperature inside the body.

KSBs addressed:

B1: Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

S33: Maintain safe work and care environments