Date: 20/08/2025

Time: 09:30am – 04:30pm

Title:  External Placement Evaluation/Preparation for Year 2

In class, everyone had an opportunity to give a brief reflection on their experiences from the concluded external placement focusing on both positive and negative aspects. I developed new clinical skills, gained confidence and felt supported by mentors. And even though there was always shortage of staff, I made every effort to do the best I could to support the team. Our lecturer also briefly discussed modules to expect in year two

This discussion allowed me to process and articulate my experiences. Hearing from my classmates helped me realised that some of the challenges I faced in my own placement area were a common part of placement experience.

Moving forward, I will prepare better for placements, not only technically but also emotionally. I will continue to seek feedback and communicate my needs more effectively.

KSB addressed:

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

K33: Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes

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

S43: Contribute to team reflection activities to promote Improvements in practice and services

Date: 02/07/2025

Time: 09:30am – 04:30pm

Title: Nutritional Support/Bowel Care

During the class we covered the various types of nutritional support such as enteral feeding via nasogastric or PEG tube, understanding the different screening tools such as BMI (Body and Mass Index), MUST (Malnutrition Universal Screening Tool), importance of monitoring and recording dietary and fluid intake. In bowel care, I learnt how to assess bowel patterns, how to use Bristol Stool chart, the different types of stoma bag, identifying constipation or diarrhoea and the use of interventions such as laxatives or enemas safely.

This teaching is important in overall health and recovery. Poor nutrition can lead to complications such as delayed wound healing, pressure ulcers and increased risk of infection. Similarly, in bowel care, unmanaged constipation can lead to pain or even bowel obstruction. This aspect can be sensitive and embarrassing for patients and that is why communication, empathy and respect is needed when carrying out these tasks. I also had the opportunity to observe how nasogastric tube is inserted into the stomach via the nostril.

Moving forward, I will continue building my knowledge around nutritional assessments such as MUST score and how to use them. I will pay close attention to fluid intake, food chart and bowel chart on future placements. I will also continue practicing safe and hygienic techniques when assisting with feeding or bowel care, maintaining patient’s dignity.

KSB addressed:

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

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

S2: Keep complete, clear, accurate and timely records

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

S26: Meet people’s needs related to nutrition, hydration, bladder and bowel health

Date: 25/06/2025

Time: 09:30am – 04:30pm

Title:  ANTT, Wound Assessment and Management

In class, we were taught ANTT (Aseptic Non-Touch Technique), wound assessment and management. The session covered the principles of maintaining asepsis during wound care, the importance of identifying different type of wounds, wound dressing and signs of infection. This was followed by a practical demonstration in the clinical area where the lecturer demonstrated the standard ANTT protocol which includes hand hygiene, use of sterile gloves, the correct procedures for wound cleansing, dressing application and documentation.

This session helped me understand why ANTT is important in wound care. It also showed me how lapses in technique can compromise patient safety, leading to increased infection risk. Communication and documentation are key elements of wound management and being able to accurately describe wound characteristics such as size, depth, exudate and signs of infection is essential.

Going forward, I will apply what I have learnt by being more cautious of aseptic technique in all clinical procedures, carry out thorough wound assessments using the TIMES (Tissue, Infection/Inflammation, Moisture, Edge, Surrounding skin) framework and document clearly and accurately. I will make sure to avoid unnecessary contacts and use sterile equipment appropriately. In future placements, I will observe and learn from experienced nurses, ask questions when unsure and review policies and guidelines on wound care regularly.

KSB addressed:

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

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

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

K33: Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes

S2: Keep complete, clear, accurate and timely records

S27: Meet people’s needs related to mobility common hygiene, oral care, wound care and skin integrity

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

Date: 18/06/2025

Time: 09:30am – 04:30pm

Title:  Sexual Health and HIV Pre-Exposure Prophylaxis PrEP

During the class, we looked at what sexual health is all about, sexually transmitted infections (STIs), contraception, Pre-Exposure Prophylaxis (PrEP), how PrEP works, who is eligible for it and the four (4) groups who do not need PrEP.

This session deepened my understanding of sexual health, especially as it relates to HIV prevention. Before this session I had a little knowledge of PrEP but after this, I see how crucial health education is, in preventing disease and I am more aware of the barriers such as lack of awareness, stigma and accessibility that can prevent vulnerable populations from benefiting from PrEP. Pre-Exposure Prophylaxis (PrEP) is a preventative treatment for individuals who are at risk of contracting HIV.

Moving forward, in my practice placements i aim to observe and learn from experienced colleagues about how they approach sexual health discussions and I hope to contribute to creating a healthcare environment where all patients feel comfortable seeking help and advice. When I decide to go towards this field, I will seek further training on sexual health literacy to ensure I can offer safe and non-stigmatising care.

KSB addressed:

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

K33: Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes

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 behaviour health challenges

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

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

Date: 11/06/2025

Time: 09:30am – 04:30pm

Title: Promoting Mental Health across the Lifespan/Social Prescribing

During my self-study, I looked at what good mental health looks like, how mental health needs differs at each stage of life and how as a Nursing associate I can intervene to promote wellbeing, prevent mental illness and support those living with mental health conditions. I also looked at the concept of social prescribing, a non-clinical approach to health and wellbeing.

I learned that there are positive and negative factors that could contribute to mental health and that different life stages present different risks and protective factors. In childhood, supportive parenting and safe environments are crucial. During adolescence, peer relationships and identity development play major roles. While adults often face stress from work, family or financial responsibilities, making early identification of anxiety or depression key. In older adults, isolation, physical illness, and loss can lead to decline in mental health. That is why promoting mental health will go a long way to impact people’s physical health and lifestyle.

Social prescribing has made me recognise its benefits for patients experiencing loneliness, mental health challenges or chronic illnesses and how it aligns with a more model of care. It also empowers individuals to take control of their own health, leading to improve self esteem, reduce isolation and better mental wellbeing.

As a Nursing associate, I will engage more actively in mental health awareness initiatives. I will stay vigilant to look out for signs of mental health issues like depression, self harm or anxiety. I will also keep updated with training on mental health and safeguarding and reflect on how I can integrate social prescribing into my future practice especially when working with vulnerable populations.

KSB addressed:

K3: Understand the professional responsibility to adopt the 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 principles of health promotion, protection and improvement 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

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

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

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

Date: 04/06/2025

Time: 09:30am – 04:30pm

Title: Vulnerable and Complex Care

During my self study on vulnerable and complex care, I explored complex care, vulnerable populations such as elderly with dementia, people experiencing homelessness, individuals with learning disabilities, those with mental health challenges and my role as a Nursing associate within integrated care.

Understanding all these is essential for promoting health equity and improving patient outcomes. Vulnerable populations such as those experiencing poverty, chronic illness or homelessness often face systematic barriers to accessing quality care. And so, by understanding their unique needs, professionals can provide more effective, compassionate and coordinated services.

Moving forward, I will apply this knowledge in both clinical practice and advocacy. I aim to continue taking a person-centred, holistic approach to care ensuring I consider not just the patient’s medical needs but also their environment, mental wellbeing and social context. I will deepen my communication strategies with vulnerable populations and safeguarding procedures. I will also actively engage in multidisciplinary team meetings to better understand the roles of other professionals in complex care scenarios.

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

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

K37: Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs

K38: Understand the complexities of providing mental, cognitive, behavioural and physical care needs across a wide range of integrated care settings

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

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

S8: Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health

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

S42: Support, supervise and act as a role model to nursing associate students, health care support workers and those new to care roles, review the quality of the care they provide, promoting reflection and providing constructive feedback

Date: 28/05/2025

Time: 09:30am – 04:30pm

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

During my self study, I looked at some long term conditions such as dementia, diabetes, chronic obstructive pulmonary disease (COPD), Parkinson’s disease and multiple sclerosis, the impact it has on individuals and making decisions in end of life care. I also went through some videos of service users and carers experiences living with a variety of different long term conditions which gave an insight on how they were able to scale through with their daily activities, with the help of families, therapy sessions and constant use of their medications.

I understand that managing long-term conditions is not just about medical treatment, but also about holistic, person-centred care, which includes psychological, emotional, physical and social support. I learned that early identification of a patient approaching the end of life allows for better planning, coordination, and advanced care planning. However, these processes are often delayed due to prognostic uncertainty or discomfort in discussing death but with proper support and preparations, teamwork and communication between the families and health care professionals, transitioning becomes easy.

I plan to develop greater confidence in supporting patients with long term condition especially as they approach end of life and to do this, I will engage in simulation training and workshops focused on communication at the end of life. I will practice recognition and early identification of palliative needs using evidence-based tools. Observe or shadow members of the palliative care team, including Nurses, General Practitioners and hospice staff, to understand how they approach care coordination, symptom control, and emotional support. And finally, I will reflect more regularly on my practice to ensure continuous professional development.

KSB addressed:

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

K25: Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life

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

K37: Understand the challenges of providing safe Nursing care for people with complex co-morbidities and complex care needs

K39: Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives

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

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

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

S29: Give information and support to people who are dying, their families and the bereaved and provide care to the deceased

Date: 24/05/2025

Time: 12:30am – 03:30pm

Title: Smoking Health Promotion, Alcohol Consumption and Safe Drinking, Child Safeguarding

During my self-study on smoking health promotion, alcohol consumption, safe drinking practices, and child safeguarding. I reviewed online modules, session resources, case studies, articles and statistics. I learned that smoking is one of the leading causes of preventable death in the UK, and that health promotion strategies are crucial. Regarding alcohol, I explored the risks of excessive consumption, including liver disease, mental health issues, and that as a Nursing Associate I need to calculate my own intake so I know I am within the safe limit. And in terms of child safeguarding, I examined different types of abuse, signs of neglect, the legal responsibilities of professionals, and the importance of early intervention. I studied how alcohol and smoking in the household can indirectly impact children’s welfare as well.

I realised that health promotion is not only about informing people but about addressing behavioural, social and environmental determinants. This study has enhanced my understanding of the broader implications of smoking and alcohol use. I also recognise the critical role I can play in raising awareness, identifying concerns and referring to appropriate services when there is hidden harm in the home.

Moving forward, I will apply brief intervention techniques in practice to support smoking cessation and alcohol reduction. I will maintain up to date safeguarding training and be proactive in discussing concerns, following appropriate protocols. Reflect regularly on my interactions and seek feedback to continuously improve my communication and intervention skills.

KSB addressed:

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

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

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 feedback to develop professional knowledge and skills

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

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

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 and the situations that may put them and others at risk

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

Date: 23/05/2025

Time: 12:30am – 03:30pm

Title: Delivering care in alternative settings

During my self-study on delivering in alternative settings like hospitals, Nursing homes, community care and hospice settings I explored needs and challenges associated with each environment. In hospitals, care is typically acute and medically intensive. Nursing homes focus on long term support for individuals with chronic conditions. Community care emphasis health promotion, early intervention and support at home while hospice care prioritise comfort, dignity and holistic support during end-of-life stages.

This study enhanced my understanding of person-centred care, communication, intervention and collaboration with multidisciplinary teams based on the care environment. In Nursing homes and hospices, there is a strong need for family involvement and interdisciplinary teamwork whereas in hospitals, rapid decision making and specialised interventions are more common.

Moving forward, I will apply this knowledge in practice by being more aware of the environmental factors influencing care delivery. This includes tailoring my communication styles, being proactive in coordinating care and advocating for patient’s preferences and dignity especially in community and palliative settings. I will also seek more clinical exposure in these alternative settings and pursue further training in various health promotion.

KSB addressed:

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

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

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

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

K25: Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life

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

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

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

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

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

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

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

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

S32: Work collaboratively and in partnership which professionals from different agencies in interdisciplinary team

Date: 14/05/2025

Time: 09:30am – 04:30pm

Title: Health Promotion in older people/Communication in Nursing Practice

During the early hours of the day, we had our group activity where each group had to come in front of the class to present a particular demographic area. My group presented the royal borough of Greenwich, where we talked about age demographic, religion, ethnicity, health and education in Greenwich.

And then we had our first teaching on health promotion in older people, we explored key strategies aimed at improving the well-being and quality of life for ageing populations. We talked about physical activities, nutrition, fall prevention, mental health support. We also discussed how ageing increases the risk of chronic conditions and how many of these risks could be reduced through proactive health promotion.

This topic helped me understand that promoting health in older people is not just about treating illness, but about empowering them to maintain independence and quality of life. Although mobility issues, health literacy, and social isolation could be a potential barrier, motivating, supporting, advising them and giving them access to appropriate screening would go a long way.

Moving forward, I will apply this knowledge in both practice and communication. I also recognise the importance of tailoring health messages to the needs and preferences of older individuals, taking into account factors like cognitive changes, sensory impairments, and cultural values. I will also continue learning ways to promote health in older people.

At the later part of the day, we discussed communication in Nursing practice using case studies. The session covered effective communication using the APIE (Assessment, Planning, Implementation, Evaluation) framework, activities of daily living where applicable, ensuring patient’s preferences, values and needs were central to our communication and care planning.

Understanding this teaching made me more aware of the importance of the Nursing process. It ensures that all aspects of the patient’s condition were considered and that interventions were targeted. Using effective communication helped in building trust and delivering patient-centred care ensuring patient felt heard and respected.

Moving forward, I will refine my communication skills especially in adapting language to suit the patient’s level of understanding, which will not only improve patient care but also strengthen teamwork with my colleagues, use the APIE process more deliberately especially incorporating the patient’s voice in planning and evaluation stages. I plan to reflect regularly on my patient interactions to identify areas of strength and areas for development.

KSB addressed:

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

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

K10: Understand the principles of epidemiology, demography and genomics and these may influence health and wellbeing outcomes

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

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

K14: Understand the important of health screening

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

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

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

S35: Accurately undertake risk assessments, using contemporary assessments tools