Date: 30/10/2024

Time: 09:30 -04:30

Title: Equality, Diversity, and Inclusivity / A-E Assessment

During the lesson i learnt in nursing, equality, diversity, and inclusivity are essential in ensuring that all patients receive, fair, individualised, and respectful care regardless of their age, sex, race, disability, religion/belief, marriage/civil partnership, pregnancy/maternity, sexual orientation, gender re-assignment.

Understanding patient’s diverse needs is critical for delivering high quality care. Equality in nursing means ensuring that all patients are being given equal opportunities and treated fairly while diversity involves recognising and valuing the unique background of each patient such as race and sexual orientation. Inclusivity is about creating a healthcare environment where everyone is included, valued, and respected irrespective of their differences. A failure to consider equality, diversity and inclusivity can lead to misunderstanding, reduced patient satisfaction and health disparities.

In future, I will avoid making assumptions and create safe environments for patients to express their needs and make an effort to understand and respect diverse cultural practices. I will also commit myself in attending workshops and training sessions.

During the afternoon, we looked at A-E Assessment which is an approach used evaluate a patient’s condition and respond promptly to any life-threatening issues.

A-Airway (Patent)

B- Breathing (Respiratory rate and oxygen saturation(spo2))

C- Circulation (Heart rate, blood pressure and capillary refill time (crt))

D- Disability (debrain, blood sugar, drug & allergy and disability)

E- Exposure (Check every surface of the body)

Each step is a systematic check, often repeated as necessary, to assess and prioritise life saving interventions. Using this structured approach helps Nursing Associates quickly identify and respond to changes in a patient’s condition, ensuring patient safety and effective care.

Moving forward, I will aim to practice more with experienced staff, refresh my knowledge on specific interventions for each step and attend more stimulations to build confidence.

KSB addressed:

K11: Understanding the factors that may lead to inequalities in health outcomes

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

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

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

S39: Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately

Date: 23/20/2024

Time: 09:30 – 04:30

Title: Endocrine System / Introduction to Multi professional working

The endocrine system is a messenger system that has a network of glands which secrete hormones directly into the bloodstreams. These hormones regulate bodily functions such as growth, metabolism, and reproduction. The glands include the hypothalamus, pituitary, pineal, thyroid, parathyroid, thymus, pancreas, adrenal, testes/ovaries. Hormones are critical for maintaining homeostasis, and imbalances can lead to various diseases like diabetes.

Understanding the endocrine system is crucial because hormonal imbalances can affect many patients especially those with diabetes or thyroid issues. for example, insulin produced by the pancreas plays a vital role in controlling blood sugar levels for patients with diabetes. Recognising symptoms of endocrine disorders like fatigue, weight changes or abnormal thirst enables early intervention and better patient outcomes.

Going forward, my goal as a nursing associate is to deepen my understanding of endocrine disorders and their management. I will also focus on building skills to monitor patient’s hormone levels such as glucose monitoring in diabetes and learn more about the medications used to treat these conditions. This will enhance my ability to provide effective care and support for patients.

At the later hours of the day, I learnt all about multi professional working. In multi professional working, healthcare professionals from various disciplines collaborate to provide patient care. For instance, in a hospital setting, nurses, doctors, physiotherapists, social workers, and pharmacists might work together on a patient’s care plan. One of the key benefits is improved patient outcomes. However, challenges such as communication barriers or role confusion might arise and so understanding these dynamics is crucial for developing teamwork skills.

Going forward, I plan to improve information sharing, communication skills and recognise how different team member’s contributions can enhance patient care.

KSBs addressed:

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

K33: Understand how to seek appropriate advice to manage risks and avoid compromising quality of care and health outcomes

K35: Understand own role and the roles of all other staff at different levels of experience and seniority in the event of a major incident

K36: Understand the roles of the different providers of health and care

K41: Know the roles, responsibilities, and scope of practice of different members of the nursing and interdisciplinary team, and own role within it

K42: Understand and apply the principles of human factors and environmental factors when working in teams

S21: Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes

S23: work in partnership with people, to encourage shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate

S32: Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams

S40: Support and motivate other members of the care team and interact confidently with them

Dated: 09/10/2024

Time: 09:30 – 04:30

Title: Ethical and Legal Aspect of Nursing/ Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS)/ Vital Signs and NEWS

The day started with learning about the ethical principles in nursing, mental capacity act (2005), deprivation of liberty safeguards (DoLS), concept of consent, capacity and confidentiality and the four-quadrant approach to decision making.

Autonomy – This is the right of a person to make informed decisions about their care, support and treatment.

Beneficence – This is the act of doing good; be kind

Non-Maleficence – The desire to do no harm

Justice – This is equality and fairness

Mental Capacity Act (2005)

This is an act whose primary purpose is to protect and make decisions on behalf of adults who are unable to due to lack of capacity.

Deprivation of Liberty Safeguards (DoLS)

This is an amendment of the Mental Capacity Act (2005) which protect people receiving care whose liberty has been limited. There are six assessments that needs to be completed for a decision to be taken and they include age, mental capacity, mental health, best interest, no refusal, and eligibility.

Consent

This is when a person must give permission before they receive any form of care, medical treatment or an examination. Consent can either be written or verbal.

Confidentiality

This refers to the ethical and legal duty to protect an individual’s personal information. And making sure that they are informed about their care and that information about them is shared appropriately.

Quadrant Approach to Decision Making

·      Medical implications

·      Patient preferences

·      Quality of life

·      Contextual factors

It is crucial for Nursing Associates to understand the implications of capacity assessments and decision-making processes. Capacity assessments are crucial to ensure that patients are involved in their care and that their rights are uphold. Obtaining consent ensures that healthcare professionals respect the patient’s autonomy and legal rights.

Confidentiality is not only a legal obligation but also essential for building a trusting therapeutic relationship. Breaking confidentiality could lead to serious consequences such as loss of trust, harm to the patient, or legal actions against the healthcare professional.

Moving forward, I will strengthen my communication skills to better explain treatment options and outcomes, ensuring patients fully under their decisions before they give their consent. I will ensure that’s patient information handled with the highest level of discretion. I will also stay informed about the latest legislative updates, participating in training on capacity and consent and promoting person centred care.

During the afternoon I learnt about vital signs and how to use NEWS. Vital signs are crucial indicators of how the body functions. They help healthcare providers assess the overall health of a patient and detect any changes that could indicate a problem. These vital signs include respiratory rates, pulse, blood pressure, oxygen saturation, temperature. Afterwards, we all went to the clinical area to perform manual blood pressure on ourselves with consents approved.

NEWS refers to national early warning signs and it is a scoring system used to identify patients at risk of deterioration. A higher NEWS suggests that the patient is at greater risk of acute illness, which may require immediate attention.

This learning highlights the importance of understanding and recognising abnormal vital signs early. By interpreting the NEWS correctly interventions can be made early enough to prevent further deterioration of the patient. The experience of the practical work helps to guide me on how to take manual blood pressure accurately. Additionally, it taught me how to be more observant and proactive. While the nurses often lead decision making, the Nursing Associates can play a vital role in first line detection, raising alarms when necessary.

In the future, I will ensure I remain vigilant when measuring and interpreting vital signs. I will practice using NEWS regularly to improve my confidence in identifying patients at risk. If I notice abnormal readings, and will not hesitate to escalate them immediately, ensuring the patient receives appropriate care.

KSBs addressed:

K1: understand the code: Professional standards of practice and behaviour for Nurses, Midwives and Nursing Associates (NMC, 2018) and how to fulfil all registration requirements

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

S1: Act in accordance with the Code: Professional standards of practise and behaviour for Nurses, Midwives and Nursing Associates in (NMC, 2018), and fulfil all registration requirements

S10: Provides, promotes, 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 where capacity has changed and a how person’s capacity affects their ability to make decisions about their own care and to give or withhold consent

S22: Take personal responsibility to ensure that relevant information is shared according to the local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated

S23: Work in partnership with people, to ensure shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate

S38: Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers, and family members

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

Dated: 09/10/2024

Time: 09:30 – 04:30

Title: Neurological System/Importance of Communication and Professional Value relating to Nursing Practice

The day started with learning about the neurological system, it’s functions, components of the nervous systems, structure and function of the brain and nerve cell. The neurological system sends messages from various parts of the body to the brain, and from the brain back out to the body, to tell the body what to do. It gives fast response. There are two components of nervous system, and they include:

Central Nervous System

The central nervous system acts as the control system. It consists of the brain and the spinal cord. The brain processes sensory inputs, initiates responses and stores memories. The spinal cord acts as a communication link between the brain and the rest of the body.

Peripheral Nervous System

The peripheral nervous system consists of all the nerves that carry messages to and from the central nervous system. There are 12 pairs of cranial nerves.

1.    Sensory Nervous System (Afferent)- This goes from the point of action to the spine. It includes touch, nociception (pain), temperature and special senses.

2.    Motor Nervous System (Efferent)- This goes from the spine to the point of action.

• Somatic (Voluntary)- This controls voluntary movement such as skeletal muscles.
•  Autonomic (Involuntary)- This regulates involuntary functions like heart rate, digestion, and respiratory rate.

        ·      Sympathetic- This is responsible for fight or flight responses.

        ·      Parasympathetic- This is responsible for rest and digestion.

We also discussed about the different regions of the brain which include the cerebrum (thinking and memory) the cerebellum (coordination and balance) and the brainstem (heart rate and breathing).

The nervous system’s functioning is crucial for survival and well-being. Understanding it’s components and how they work together can help in diagnosing and treating neurological conditions. Understanding the structure and function of the brain is essential because it influences how we treat and manage patients, and it also helps in understanding patient’s behaviour, motor control, and cognitive functions which are critical when providing holistic care.

Going forward, I can apply this knowledge to improve patient outcomes by recognising early warning signs of nervous system issues to prompt timely interventions, educate patients on lifestyle changes to promote nervous system health like stress reduction or exercise for rehabilitation and assist in the management of neurological disorders.

At the later part of the day, we talked about the importance of communication and professional value relating to nursing practice, barriers of communication. Everyone had one or two things to say. Effective communication is important in nursing practise. Good communication ensures that patient’s needs are understood, treatment are properly explained, and any concerns or complications are addressed. However, there are barriers to effective communication such as language differences, environmental factors and emotional distress. These barriers can result in misunderstandings, errors in care and diminished patient satisfaction.

Communication is fundamental for building trust and rapport with patients. Understanding the barriers helps to develop strategies to overcome them, improving patient care and teamwork. For example, active listening, use of nonverbal clues, or providing translation services can mitigate communication issues.

To improve communication, it is essential i develop strong listening skills, be patient centred and adopt communication techniques based on individual needs. And reflecting on past communication challenges can help me learn and apply better strategies in future interactions.

KSBs addressed:

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

K20: Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met

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

S2: Keep complete, clear, accurate and timely records

S7: Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with the range of mental, physical, cognitive, and behavioural health challenges

S9: Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues

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

S18: Applying knowledge, communication and relationship management skills required to provide people, families and carers with accurate information that meets their needs before, during and after a range of interventions

Dated: 02/10/2024

Time: 09:30 – 04:30

Title: Blood/Cardiovascular System/Infection Control/Personal Hygiene/Moving and Handling

At the early hours of the day, we looked at blood and cardiovascular system, I learnt that the cardiovascular System comprises the hearts, blood vessels, and blood. The heart pumps oxygenated blood to the body and returns deoxygenated blood to the lungs. The main components of blood include red blood cells (which carries oxygen), white blood cells (which Fight infections), platelets (which helps in clotting), and plasma (which transports nutrients, waste products). The cardiovascular system’s primary function is to deliver oxygen and nutrients to tissues and to remove waste products and regulates blood temperature. I also learnt about the different blood groups and different types of blood vessels which includes arteries, veins, capillaries and their roles in circulation.

This learning is crucial to my development because understanding the blood and cardiovascular system is essential to providing holistic patient care. And by understanding the fundamentals of how blood circulates and supports body functions I can better monitor patients.

Moving forward, I will continue to enhance my knowledge of the cardiovascular system by engaging in clinical practice and applying what I have learnt to real life scenarios. I will focus on developing practical skills such as measuring blood pressure, understanding electrocardiograms (ECGs).

At the later hours of the day, we all went into the clinical area, where I learnt about infection control, personal hygiene, moving and handling. These are essential practices in healthcare. Infection control are procedures used to prevent the transmission of infectious diseases. It involves various measures aimed at minimising the risk of infections such as hand washing, use of personal protective equipment (PPE), cleaning and disinfection etc. Personal hygiene plays a crucial role in infection control and as Nursing Associates we are constantly exposed to various pathogens. Moving and handling involves supporting patients to move safely, weather from bed to chair, turning in beds, or assisting with walking.

Hand hygiene is essential in breaking the chain of infection and preventing the transmission of microorganisms. And I understand maintaining a patient’s dignity while providing personal care is as important as the task itself. The moving and handling experience taught me that improper technique can lead to injuries such as back pain for both the patient and myself. It is not all about physically assisting the patient but doing so in a way that ensures safety for everyone involved. I also realised how crucial communication is during these processes to maintain the patient’s comfort and cooperation.

Moving forward, I will ensure that I consistently follow strict infection control measures especially hand hygiene to protect patients and myself. In terms of personal hygiene, I will focus on providing care that respects the patient’s dignity while also preventing infections or other complications. And for moving and handling, I plan to continue practicing safe techniques and using equipments such as hoists, slide sheets where necessary. I will also seek additional training or guidance to refine my trainings ensuring that I can safely support patients without causing injury to them or myself.

KSBs addressed:

K20: Know how people’s needs for safety, dignity, privacy, comfort, and sleep can be met

K30: Understand the principles of health and safety legislation and regulations and maintain safe work and care environments

S17: Protect health through understanding and applying the principles of infection prevention and control, including communicable disease surveillance an antimicrobial stewardship and resistance

S25: Meet people’s needs for safety, dignity, privacy, comfort, and sleep

Date: 25/09/2024

Time: 09:30 – 04:30

Title: Respiratory System/Introduction to academic writing

At the early hours of the day, we looked at the functions, key structures of the respiratory system, diffusion, process of gas exchange and the role of the respiratory system in homeostasis. The respiratory system is responsible for the process of gas exchange, enabling oxygen to enter the body and taking out carbon dioxide. Gas exchange is important because it maintains homeostasis by regulating blood levels necessary for circular respiration and ensuring the removal of carbon dioxide, a waste product.

The respiratory system consists of different structures which include:

Nose/Mouth: This is where air enters the respiratory system through these openings

Pharynx and Larynx: These passages direct air into the lungs

Trachea: A tube that spits into the two bronchi

Bronchi and Bronchioles: These branching tubes carry air into the lungs

Lungs: The main organs of the system where gas exchange takes place in tiny air sacs called alveoli

Diaphragm: A muscle that contracts to allow inhalation and relaxes to support exhalation

Diffusion

Diffusion is the movement of substance from an area of high of concentration to an area of low concentration. Diffusion Is essential for the survival of cells as it allows the transport of oxygen, nutrients, and waste products.

Understanding the respiratory system is crucial because it directly impacts life sustaining processes and if any part of the system is compromised, it can lead to serious health issue

Moving forward, this will help me in clinical practice, to assess and monitor patient’s respiratory function, recognise normal and abnormal breathing patterns, detect signs of respiratory distress or failure. Knowing how respiratory system works I will be able to support emergency situations like choking.

At the later hours of the day, we looked at the academic writing skills, requirements for writing at level 4, stages for writing an assignment and importance of referencing. The essay writing skills includes planning, thinking, researching, writing, and editing. The stages of writing an assignment should include-

Introduction: This is the opening session that provides can context, establish the topic and engage the audience.

The body: This is the main session where i develop my arguments, present evidence with referencing and analyse the topic in detail.

Conclusion: This is the last section where I summarise the main points and reinforce my arguments without introducing any new ideas.

Action plan: This is the step taken to improve issues mentioned in the body of the essay

Referencing: This is acknowledging the sources of information, ideas that I have used in my writing.

Referencing allows readers to see the original sources I have used and follow up on them. It also improves my writing and help me learn more.

After learning about academic skills and referencing, in future assignments and projects I would prioritise accurate referencing to enhance my work’s credibility and integrity. I would also make referencing a habitual practice in my academic and professional writing to consistently supports my arguments and maintain ethical standards.

KSBs addressed

K4: Understand the principles of research and how research findings are used to inform evidence-based practice

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care.

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

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

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

Date: 24/09/2024

Time: 09:30 – 04:30

Title: Developing Professional Values and Behaviour/Introduction to Anatomy and Physiology, Systems, Cells, and Homeostasis

At the early hours of the day, we talked about the Nursing and Midwifery Council Code, purpose of the code, who the code is useful to and value. The NMC code was introduced in 2017 and updated in 2018 because of the Nursing Associate position. It outlines the professional standards that Nurses and Midwifery must adhere to in the Uk and Nursing Associate in England. They include:

1.        Prioritise People: Always put in the care of people first, treating them as individuals and respecting their dignity.

2.        Practise Effectively: Providing high quality care based on the best available evidence.

3.        Preserve Safety: Minimising risk, raising concerns, and protecting patients.

4.        Promote Professionalism and Trust: Maintaining the reputation of the profession and always act in a manner that reflects the integrity of the role.

The NMC code is useful to patients, registered professionals, employers, and educators. The importance of this code is that it reinforces the need to always take responsibility for safety, uphold professional standards, maintain competence, and prioritise patient wellbeing.

Moving forward, i will need to actively reflect on the principles and apply them in every patient interaction. This will ensure my care is patient centred, safe, effective, and professional. I will also lead by example in promoting professionalism and trust in my workplace.

We also talked about value which is the belief and principle that people consider important. It reflects on what we believe whether right or wrong. We were later paired in twos to discuss about the values we have and what values we have in common.

At the later hours of the day, we talked about body systems, types of cells, homeostasis, and characteristics of life.

Understanding how my body systems work together highlights the complexity of life and emphasises the importance of system integration and by studying cells, I gain insights into how life functions, the processes within the cells such as energy production. Homeostasis is essential for the survival of organisms because it keeps internal conditions within a range that is suitable for life. And these characteristics of life is necessary for survival.

After learning how my body works today, it encourages me to think about my lifestyle choices such as diet, exercise and how it can influence my body’s ability to maintain equilibrium. I also plan to apply this knowledge in practical scenarios.

KSBs addressed

K1: Understand the Code: Professional standards of practice and behaviour for Nurses, Midwifes and Nursing Associates (NMC, 2018), and how to fulfill all registration requirements.

K3: Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and wellbeing required to meet people’s need for mK16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care.

K7: Understand the importance of courage and transparency and apply the duty of candour

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

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

S1: Act in accordance with the code: professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements

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

S25: Meet people’s needs for safety, dignity, privacy, comfort, and sleep

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

S36: Respond to and escalate potential hazards that may affect the safety of people.

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

B2: Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice