Date: 12/05/2025

Time: 11:30am – 03:30pm

Title: Caring for women during pregnancy

During my self-study on caring for women during pregnancy, I explored various part of their care including antenatal care, emotional support, patient-centered communication and risk assessment. Assessment tools like MEWS (Maternity Early Warning System) sometimes referred to as MEOWS (Modified Early Obstetric Warning Score) is used to carry out basic observations. Risk assessment such as identifying hypertension, diabetes or mental health concerns are carried out. There are professionals who may be involved in person cantered care during pregnancy and they include midwives, obstetricians, general practitioners, Nurses, mental health professionals etc.

This learning has made me understand that risk assessments are crucial at all stages of antenatal and postnatal care. These include physical assessments like blood pressure monitoring, urine testing for protein and glucose and screenings for conditions such as preeclampsia or anemia. Providing care goes beyond physical assessments, it involves building trust, actively listening and supporting women’s choices.

Moving forward, I aim to become more confident and compassionate when supporting women throughout their pregnancy journey. I will continue to study case scenarios to improve my clinical decision-making and seek opportunities for shadowing or simulation practice.

KSB addressed:

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

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being

K14: Understand the important of health screening

K15: Understand human development from conception to death, to enable delivery of person centred safe and effective care

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

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

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

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being

S15: Identify people who are eligible for health screening

S16: Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity

S20: Recognise people at risk of abuse, self harm and/or suicidal Ideation on the situations that may put them or others at risk

S35: Accurately on the tick risk assessment, using contemporary assessments tools

Date: 07/05/2025

Time: 09:30am – 04:30pm

Title: Care of the child

I was able to study what assessment in children entails and how it differs from that of the adult. In healthcare, assessment refers to the collection and interpretation of information to understand a patient health status. In children, it involves more than just medical data. Other things to consider include age, gender, cultural and religious beliefs, family history, parental responsibility etc. Child assessments often use tools like the paediatric early warning score (PEWS)

Understanding how child assessment differs from adult assessments is important. With adults, verbal communication plays a central role in the assessment process. Adults can describe symptoms, feelings and history clearly. In contrast, assessing a child especially infants or toddlers relies heavily on non-verbal clues, behavioural observations and inputs from parents or guardians. Additionally, children undergo a rapid physical and psychological development, which means that normal ranges for vital signs vary widely with ages and signs of illness can present differently.

Reflecting on this, I understand the importance of improving my knowledge and skills in paediatric assessment and so I plan to practice interpreting paediatric vital signs more confidently. I also aim to strengthen my communication with both children and their families to gather accurate assessments.

KSB addressed:

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

K9: Understand the aims and principles of health promotion, protection, improvements and the prevention of ill health when engaging with people

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being

K14: Understand the important of health screening

K15: Understand human development from conception to death, to enable delivery of person centred safe and effective care

S6: Act as an ambassador for their profession and promotes public confidence in health and care services

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

S13: Apply the aims and principles of health promotion, protection and improvements and the prevention of ill health when engaging with people

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being

S15: Identify people who are eligible for health screening

S16: Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity

S18: Apply 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

S20: Recognise people at risk of abuse, self harm and/or suicidal Ideation on the situations that may put them or others at risk

S35: Accurately on the tick risk assessment, using contemporary assessments tools

Date: 07/05/2025

Time: 09:30am – 04:30pm

Title: Health promotion for babies, children and young people

Health promotion for babies, children and young people comprises of a wide range of strategies which include immunisation, nutrition advice, mental health support in schools and physical activity programs. Some concerns affecting this age group include childhood obesity, increasing mental health issues among young people, housing instability, education gaps and vaccine hesitancy in some communities.

Promoting health for these group could help in preventing long term health issues such as obesity, tooth decay and mental health problems. It can also play a key role in safeguarding like identifying issues e.g malnutrition, neglect, emotional distress during routine health interventions. Health habits formed in childhood often extend into adulthood. Therefore, promoting health early can help improve overall quality of life.

Moving forward, I will continue to build my skills in effective communication especially with diverse families and young people ensuring I promote inclusive, non-judgmental care. In future placements and practice I will take every opportunity to engage in health promotion whether it is through one-to-one education during routine checks, supporting immunisation campaigns or advocating for children’s health needs.

KSB addressed:

K3: Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care

K9: Understand the aims and principles of health promotion, protection, improvements and the prevention of ill health when engaging with people

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

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being

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

K14: Understand the important of health screening

S6: Act as an ambassador for their profession and promotes public confidence in health and care services

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

S13: Apply the aims and principles of health promotion, protection and improvements and the prevention of ill health when engaging with people

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being

S15: Identify people who are eligible for health screening

S16: Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity

Date: 02/05/2025

Time: 10:00am – 02:00pm

Title:  Assessment Tools in Practice

I was able to explore assessment tools and their uses in practice. Some of the tools include Waterlow score (for pressure ulcer risk), MUST (Malnutrition Universal Screening Tool), NEWS2 (National Early Warning Score) and the Abbey Pain Scale (for assessing pain in patients with dementia). These tools are designed to support early identification of patient deterioration, nutritional deficits, skin integrity risks and pain levels in nonverbal individuals.

Using these tools has really influenced my prioritisation of care. For example, the NEWS2 score has helped in the timely escalation of care for deteriorating patients by identifying subtle changes in vital signs. The MUST tool allows for early dietitian referral and nutritional intervention especially for elderly, ill patients or those who have difficulties in swallowing. Waterlow Score promotes preventative care by highlighting patients at risk of developing pressure ulcers, prompting repositioning, pressure relieving equipment and skin monitoring. While the Abbey Pain Scale is extremely useful in managing pain for patients with communication barriers.

Moving forward, as a student Nursing Associate I will practice more to improve my consistency and accuracy with these tools. I will also ensure these tools are integrated with holistic patient assessment

KSB addressed:

K14: Understand the importance of health screening

K19: Know how and when 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

K22: Know how to meet people’s needs related to nutrition, hydration, bladder and bowel health

K23: How to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity

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 when to seek appropriate advice to manage a risk and avoid compromising quality of care in health outcomes

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

S2: Keep completes, clear, accurate and timely records

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

S35: Accurately undertake risk assessments, using contemporary assessment tools

Date: 30/04/2025

Time: 09:30am – 04:30pm

Title:  Social determinants of health, Epidemiology and Demographics/ Oxygen therapy

We looked at the social determinants of health which refer to social and economic factors influencing health, such as wealth, education, housing, ethnicity, social status. We also looked at epidemiology and demographics. Epidemiology is the study of the distribution and determinants of health-related events in populations while demographics involve statistical data on populations, including age, gender, ethnicity, and socioeconomic status, which help in understanding health trends.

This are all important in understanding health inequalities. With epidemiological data, patterns of disease, risk factors across different population groups can be identified, while demographic data helps pinpoint groups that are affected. Addressing health issues without considering the social determinants would be insufficient.

Moving forward, I will continue to advocate for a more holistic approach in my practice, one that does not just treat symptoms but seeks to understand the root causes of ill health. As I progress in my training, I will continue to evaluate how I can contribute to reducing health inequalities and promote equitable care across diverse populations.

We had a skill session on oxygen therapy during the later part of the day. During the session I was told that oxygen therapy can be administered through different delivery systems such as nasal cannula, Hudson mask, Venturi mask and non rebreathe mask depending on the patient’s condition and these different masks were shown to me. Physical positions while standing, sitting and lying that would improve oxygen levels was also demonstrated. The aim of oxygen therapy is to support patient’s oxygen saturation. I was shown a peak flow meter which is a device used to measure how quickly air can be blow out of the lungs.

This session was important because it enhanced my confidence and understanding the various oxygen delivery systems. I realised how critical it is to choose the right delivery device based on patient’s oxygen saturation levels, respiratory rate and underlying conditions. For example, giving high flow oxygen to a COPD patient without considering CO2 retention risks could be dangerous. Practicing peak flow measurements helped me appreciate how this simple test can provide quick insight into patient’s airway status.

Going forward, I will consolidate this learning by practicing more in clinical settings, most especially in real patient scenarios to reinforce my skills. I will review my place of work protocols on oxygen therapy and peak flow use. I will continually seek feedback from professionals when applying these skills in practice.

KSB addressed:

K10: Understand the principles of epidemiology, demography, genomics and how this may influence health and well-being outcomes

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

K14: Understand the importance of health screening

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

S15: Identify people who are eligible for health screening

S16: Promotes health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity

Date: 05/03/2025

Time: 09:30am – 04:30pm

Title: Planning and Monitoring Care/Clinical Judgment and Shared Decision Making

At the start to the lesson we discussed about comprehensive patient assessment. This is gathering essential information about a patient to create an holistic understanding of their physical, mental, emotional and social wellbeing. This assessment is done considering the Roper Logan Tierney activities of living. They include maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing/hygiene, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and dying.

We were later shared in three groups and given a case study to create a care plan for. By creating a comprehensive assessment for the case study I gained an insights on the importance of holistic care where the physical, mental, emotional and social factors interact and contribute to the patient’s wellbeing. Moving forward, I will further explore more on conducting patient assessment to refine my practice. I also plan to engage in reflective practice regularly to assess how I can improve the assessment process, particularly in terms of making patients feel more comfortable and willing to share sensitive information and finally I aim to use the knowledge gained from the assessment to prioritise and personalise care plans ensuring that they align with the patient’s unique needs and goals.

During the later part of the day we discussed about clinical judgment and shared decision making. Clinical judgement is essential in guiding healthcare decisions and this could be influenced by experience, intuition, ethics, research, evidence base, environment, resources, shared decision making and so on. Shared decision-making reinforces the idea that healthcare is not a one way delivery of service but rather a collaborative process between the patient and the clinician. This empowers patients, giving them autonomy in their treatment choices.

Moving forward, as a  Nursing Associate I plan to incorporate shared decision making as a standard practice in my clinical interactions and continue to improve my communication skills to ensure that patients fully understand their options and feel confident in their ability to make informed choices.

KSB addressed:

K1: Understand the code: Professional standards of practise and behaviour for Nurses, Midwives and Nursing Associates in ( NMC, 2018) and how to fulfil 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

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

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

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

K41: Know your rules, responsibilities and scope of practise of different members of the nursing and interdisciplinary team and own role within it

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

S2: Keep complete, clear, accurate and timely records

S3: Recognise and report any factors that may adversely impact safe and effective care provision

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

S6: Act as an ambassador for their profession and promote public confidence in health and care services

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

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and well-being

S18: Applied 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

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

S24: Perform a range of nursing procedures and manage devices to meet people’s need for safe, effective and  personal centred care

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

S33: Maintain safe work and care environments

S35: Accurately undertake risk assessments, using contemporary assessment tools

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

S41: Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others