Date: 05/02/2025

Time: 09:30am – 04:30pm

Title: Continence Management and Urinalysis/Medicines Management

During the early hours of the day we had skills session where we talked about fluid balance both input and output, incontinence and urinalysis. Fluid balance is the process of maintaining a balance of water intake and output. This is important in managing hydration levels. Fluid balance is done by observing intake such as fluids consumed, IV fluids and outputs such as urine, vomit etc. As a student Nursing Associate, understanding the principles of fluid balance ensures that I can respond promptly to deviations and alert the necessary care professionals. I can also be able to identify signs of dehydration or fluid retention early. Moving forward, as a Nursing Associate I will prioritise regular fluid balance assessments especially in high risk patients such as those with renal impairment. I will also ensure accurate documentation is done to help prevent errrors and ensure timely administration of interventions.

Urinary incontinence is the inability to hold urine in the bladder due to loss of voluntary control over the urinary sphincters while faecal incontinence is the involuntary loss of faeces that is a social or hygienic problem. This is where continence management comes in  to help maintain control over their bladder and bowels. This could be through lifestyle, exercises or the use of continence products such as pads, conveen or catheters. But before all these is done an assessment needs to be carried out to reach a diagnosis and to decide the most appropriate treatment. Continence management is not only important for maintaining hygiene and comfort but also for promoting dignity and independence. A failure to address incontinence can lead to skin breakdown, urinary tract infections and psychological dust such as loss of self esteem and embarrassment. Moving forward, as a student Nursing Associate I will be more mindful of the emotional impact of incontinence on the patient and approach personal care with sensitivity, always maintaining their dignity. I will also communicate effectively with the team, sharing observations and concerns.

Lastly, we talked about urinalysis which involves testing urine for various parameters such as specific gravity, ph, glucose, protein the presence of substances like blood or bacteria. It is an essential tool that provides quick and important insights into a patient’s health. Abnormal result can indicate issues such dehydration or infections. In future, I will improve my ability to interpret urinalysis results. I will ensure that I am familiar with the signs of urinary issues such as UTI or renal impairment so I can act quickly if abnormal results are found.

After the lesson we all went into the clinical area to practicalise all what that has been taught such as how to input datas on the fluid chart (input and output), how to insert a male and a female catheter, how to take out urine from a catheter, testing urine and interpreting.

At the later part of the day, I did a self study on medicines management, the different categories of medicines, controlled drugs, rights of medication, routes of administration and reporting medication errors. Medication management is the safe, effective and appropriate use of medications. It includes prescribing, dispensing, administering and monitoring the use of medication to ensure that the right  patient receives the right medication, in the right dose at the right time via the right route. This is important to prevent advanced drug reactions and medication errors. And if an error should occur, the safety of the patient should be put first, then reporting it quickly, writing an incident report, then an incident investigation may occur and finally reflecting on the incident.

Clear communication, careful documentation and verification process such as checking allergy, drug interactions, indication and contra-indictations are essential in the medication management process. Moving forward I will take regular refresher courses on medicines management that can keep me up to date to reduce errors and improve patient care. I will also increase my vigilance in medication checks, this includes cross referencing patients allergies, current medications and medical history before administering any new medication.

KSB 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 care

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

K20: Know how people’s need 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

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

K27: Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies

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

K29: Understand the different ways by which medicines can be prescribed

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

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

Date: 29/01/2025

Time: 09:30am – 04:30pm

Title: Pharmacology/Communication with Learning Disabilities

I learnt about pharmacology, its principles, factors that affect drug metabolism in the body, different routes of medication which include tropical, oral, intravenous, sublingual, transdermal etc

Pharmacology has significant implications for patient care and safety . By understanding the effects of drugs on the body (pharmacodynamics) and the movement of drugs through the body (pharmacokinetics), healthcare professionals can anticipate and prevent potential side effects, drugs interactions and other risks associated with medications. With pharmacological knowledge, treatment plans can also be adjusted based  on the patient’s specific needs. This ensures that patients are receiving medication that are most likely to benefit them, with minimal risks of harm.

Moving forward, I will enhance patient safety and improve clinical practise, and we deep in my understanding of pharmacology, especially in terms of drug interactions and adverse effects. I will also ensure that I assess each patient’s medication  carefully, considering any potential interactions, contra interdictions and individual health factors. Furthermore, I will aim to participate in continuous professional development activities such as attend pharmacology related workshops so I can remain up-to-date on new pharmacological advancement.

At the later part of the day, I did a self study on communication with learning disabilities where I looked at the meaning of learning disability, what causes it, conditions associated with learning disabilities and how to communicate with anyone with learning disabilities. Learning disability is a condition that affects how a person process, understands and retain information. Some of the causes are infections before birth, genetic factors, brain injury before and after birth. Signs of learning disability can include memory loss, communication problems, difficulty focusing, timing troubles etc. Some conditions associated with learning disabilities include epilepsy, down syndrome, cerebral palsy, autism and Aperger syndrome.

Understanding the importance of communication with patients with learning disabilities is paramount. Communicating with them is not only essential for their safety and wellbeing but also for ensuring they are able to participate actively in their care.

Moving forward, I will ensure I broaden my knowledge on learning disabilities and how well to communicate with them. I will also engage in further trainings to enhance my competence and confidence in delivering care.

KSB addressed:

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

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

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

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

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

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

K27: Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies

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

K29: Understand the different ways by which medicines can be prescribed

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

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

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

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

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

Date: 26/01/2025

Time: 10:30pm – 02:30am

Title: Genomics

I did self study on genomics, this refers to the study of genomes the complete set of genes present in an organism. Genomics studies the genetic makeup of individuals, uncovering variations that contribute to health, disease and individual’s traits. All living things has a genome. It is written in a chemical code called DNA.

Deoxyribose Nucleic Acid (DNA): This is the molecule that carries the genetic instructions for the development, functioning, growth, and reproduction of all living organisms. It is often described as the blueprint for life. It is a long, double-stranded helix. The two strands of DNA are complementary:

Adenine(A) always pairs with Thymine(A)

Cytosine (C) always pairs with Guanine (G)

These base pairs are held together  by hydrogen bonds, and the sequence of these bases encodes genetic information.

Chromosomes: Chromosomes are structures within cells that contain the genetic material (DNA) essential for biological inheritance. They are long thread like structures made of DNA and proteins (mainly histones) that are found in the nucleus of eukaryotic cells. In humans, most cells contain 46 chromosomes (23 pairs), where one chromosome in each pair comes from the mother and the other from the father.

1.        Autosomal: These are 22 pairs of chromosomes that are the same in males and females.

2.        Sex Chromosomes: The 23rd pair determines biological sex. Females typically have two X chromosomes (XX), while this males have one X and one Y chromosome (XY)

Protein Synthesis: This is essential for cell function because proteins are involved in almost every process in the body. This includes cellular structure, immune responses, enzymatic reactions transport of molecules and more.

Genomics plays a crucial role in understanding the origins of diseases, such as cancer, where mutations in the DNA can cause abnormal cell growth. By identifying the genetic markers associated with these conditions, researchers can develop targeted therapies that directly address the molecular causes of diseases such as using specific drugs to inhibit the new talent stated proteins

Moving forward, I will ensure I deepen my understanding of genomics and its implications to allow me as a student Nursing Associate understand a patient’s genetic predisposition to certain diseases, which can help with personalized care plans including preventive measures, diagnosis, treatments and medication management. And also ensuring the information is used for the benefit of the patient.

KSB addressed:

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

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

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

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

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

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

S37: Participates in data collection to support audit activity and contribute to the implementation of quality improvement strategies

Date: 24/01/2025

Time: 10:30pm – 02:30am

Title: The Integumentary System

I did self study on integumentary system which is the body’s outermost layer of protection. It consists of the skin, hair, nails and various glands such as sweat and sebaceous glands. The skin is the largest organ in the body and serves many functions including protection from pathogens, regulation of body temperature, sensation and vitamin D synthesis. The different layer of skin include epidermis, dermis and hypodermis. The hair, nails, sweat and sebaceous glands are also protective barriers for the body, composed of keratin and contribute to maintaining homeostasis

The Integumentary system does not only serve as a defence against external threat but also has crucial sensory functions. As a Nursing Associate understanding the skin and its functions is essential especially when treating dermatological issues and how the integumentary system’s ability to regulate temperature affects the body’s response to external stressors, or how poor skin health can signal nutritional deficiencies or weakened immune system.

Moving forward, I will ensure I promote skin health through proper hydration, hygiene and using of sunscreen for protection. I will also consider learning more about dermatological conditions and their management. And lastly working in a care home where most residents are immobile  or have compromised health learning more about wound care and pressure ulcer prevention would be crucial for me.

KSB addressed:

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

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

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

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

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

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

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

Date: 22/01/2025

Time: 09:30am – 04:30pm

Title: Reproduction / Growth and Development / Emotional Intelligence and Resilience

We had two separate lessons today. First was reproduction, growth, and development where we talked about the male and female reproductive systems, the various structures, and their functions, understanding child’s growth and development. The reproductive system is made up of organs involved in sexual reproduction. It plays a key role in the continuation of life. Organs like the ovaries, uterus and breasts are found in the female reproductive system while the testes, penis are found in the male reproductive system. Growth refers to the physical changes in the body while development refers to the progression in cognitive, emotional, and social capabilities. This process occurs in stages throughout life starting from the foetal development, throughout infancy, childhood, adolescent, adulthood and into old age.

Understanding human reproduction can help inform decisions around family planning, sexual health, and addressing challenges like infertility or reproductive disorders. Growth and development also highlight how individuals progress from birth to adulthood and this understanding can inform medical practices and education. For instance, knowledge of adolescent development can help healthcare providers address issues like puberty related health changes and emotional well-being.

Moving forward, it will be useful to deepen my understanding of how factors like nutrition, stress, and societal influences impact growth and reproductive health. Knowing this can help in the prevention, diagnosis, and treatment of issues related to reproductive health. Additionally, continued reflection on this topic can influence how I approach education, ensuring young people are informed about their bodies in a holistic, supportive way.

Second, we talked about emotional intelligence and resilience where we discussed about the elements to balancing emotional intelligence which include empathy, social skill, self awareness, self regulation and motivation.

Emotional intelligence helps in maintaining stability and achieving success in challenging situations. Emotional intelligence would not only help me manage my own emotions but also understand and navigate the emotional states of others. Resilience on the other hand is an essential tool for staying adaptable and focused rather than being paralysed by setbacks.

Moving forward, I plan to focus to further developing my emotional intelligence, particularly in stressful situations. I will take the time to check in with my emotions more regularly and practice self care. I also want to be more proactive in supporting my team by recognising their emotional needs early on and offering empathy, which will build stronger relationships.

KSB 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

K5: Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care

K12: Understand the importance of early years and childhood experiences and the possible impacts 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

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

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

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

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

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

S7: Communication 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

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

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

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

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

B3: Be adaptable, reliable, and consistent, show discretion, resilience, and self-awareness

Date: 15/01/2025

Time: 09:30am – 04:30pm

Title: Mock Exam Review / Musculoskeletal System

The day started with reviewing all the questions from the mock exam, assessing each question and options given. It went well and I saw the mock exam as an opportunity to know how to prepare and what to expect during the main exam.

I learnt about the musculoskeletal system, functions of the skeleton, key bones of the human skeleton, bone mass, types of bones and bone diseases. Understanding this system is important in assessing patient’s mobility, preventing injuries, supporting recovery, and having knowledge of musculoskeletal disorders.

Moving forward, I will engage in clinical scenarios and simulations to apply theoretical knowledge in practice. Also, I will continue learning about common musculoskeletal conditions, focusing on rehabilitation and pain management.

KSB 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 care

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

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

S7: Communication 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

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

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

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

Date: 08/01/2025

Time: 09:30am – 04:30pm

Title: Digestive System / Referencing

I learnt about the functions of digestive system, the different components responsible for digestion which include the alimentary canal and the accessory organs. I also learnt about the steps of digestion starting from the mouth and ending at the anus and some common issues related to digestive system.

Understanding the digestive system is crucial because digestive health affects overall well-being. Being familiar with common digestive problems allows me monitor and respond appropriately for example recognising signs of dehydration in patients with diarrhoea or knowing when to escalate concerns about chronic constipation.

Moving forward, I will continue studying the anatomy and physiology of the digestive system including how diseases like gastroenteritis affects the system. I will also apply the knowledge in critical practice by assisting patients with feeding, monitoring their intake and output, and reporting digestive issues to the nurse in charge.

At the later hours of the day, we discussed about my assignment, using the Gibbs model of reflection we talked about each heading starting from the description, feelings, evaluation, analysis, conclusion, action and most especially referencing.

Referencing plays a crucial role in academic writing. Poor or incorrect referencing can result in loss of marks, or even failure in assignment. To improve my referencing skills, I will attend more referencing workshops to strengthen my understanding of proper citation techniques and use referencing tools to help manage and format citations consistently.

KSBs addressed

K4: Understanding 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 and improvement and the prevention of ill health when engaging with people

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

S4: Take responsibility for continuous self- reflection, seeking and responding to support and 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

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

S43: Contributes to team reflection activities to promote improvements in practice and services

Date: 04/12/2024

Time: 9:30am – 04:30pm

Title: Placement Experience / Assignment Discussion

We were all given an opportunity to speak about our placement and how it is going. For me I spoke about how well the nurses and healthcare assistants has been so helpful and supportive. I have been able to learn a lot from the team because it is quite different from what I do at my place of work. Both my practice assessor and supervisor have been doing their best to ensure I learn as much as possible from this placement.

Having this discussion is a great way of easing all the stress, sharing positive and negative experiences. And again, what could be done to help with the negatives. And knowing where mistakes have been made on the Epad and how to correct them. Going forth in my placement, I will ensure I continue to be a great support to the team and again communicate to my practice assessor on areas on the Epad where he needs to assess.

Assignment was also discussed specifically on the episode of care. Reminding us on the model of reflection to use which is the Gibbs model. Points were made on each of the headings starting from the introduction, description, feelings, evaluation, analysis, conclusion, and finally the action plan. Having this discussion gives me a better understanding of the assignment, enables me to ask questions on areas I am not quite sure about. With the understanding I had today I will be able to correct areas of my assignment I already started that does not go in line with what I was taught today.

KSB addressed:

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

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

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

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

K34: know and understand strategies to develop resilience in self and know how to seek support to help deal with uncertain situations

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 rules of the different providers of health and care

S2: Keep complete, clear, accurate and prompt records

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