The learning disability and Autism CPD activity started on Monday, 10^th of July, at 9:30 and ended on Friday, 14^th of July 2023, at 12:30 pm. On Monday morning, we began with a brief introduction to what the week would be like. We had the opportunity to learn from a learning disability nurse and service users and careers about caring for autistic people. On Wednesday, my group (B2) and other groups have to go for skills and simulation sections face-to-face in the Mary Secole building and the community rooms GH014. I enjoyed volunteering for the autistic patient’s wound care at the hospital with her mother after an accident. My feedback was very encouraging, and I will work on the negative and positive aspects.

Autism spectrum disorder (ASD) is a developmental disability resulting from neurological disparities. An autistic person or people’s brain works differently from other people. People with ASD frequently struggle with social communication, interaction, and limited or repeating activities or behaviours. ASD is a developmental disorder characterised by atypical methods of learning, moving, and paying attention. For example, they may avoid or not make eye contact. One of the videos on BBC iPlayer that I watch strake me the most; the lady who said when she is talking to someone face to face, she only looks at your nose and not the eyes was shocking. After listing and watching the videos, l realised that Autistic persons are all different and unique, which is why it is a spectrum. Some autistic people may need little or no support. Others may need more support from parents or careers every day. The Autistic Spectrum Disorder, there is Asperger’s Syndrome. Asperger’s Syndrome is a form of autism who are either below or above-average intelligence. Autism affects individuals in a variety of ways and to varying degrees. There are similarities between Asperger’s Syndrome and autism, but individuals with Asperger’s Syndrome have fewer difficulties with communication and are frequently of average or above-average intelligence. They have sensory overload.

As a student nurse, I will come across learning disability patients and or autistic patients. The essential duty is education, raising awareness of the difficulties the physical environment can pose for individuals with autism. Always ask and listen to family members, specialise teams and careers about the individual using person-centred care, their preferences and needs. As an educator and a link, providing care for autistic patients must be accessible, available, and knowledgeable. I should be able to encourage, boosting zeal by giving positive reinforcement and showing empath and compassion to the autistic patient. I should, however, be aware that some autistic patients may  Always keep in mind that autistic patients will carry their hospital or autistic passports at all times to check for any triggers when the need arises.

To improve health and well-being, all nurses must offer educational assistance, facilitation skills, and therapeutic nursing interventions. They must promote self-care and self-management whenever possible, assisting individuals in determining their healthcare requirements and involving family members and guardians to maximise their capacity to care for themselves. When a patient has a disability, nurses must be able to collaborate with service users and others to obtain the necessary information to make reasonable adjustments that promote optimal health and enable equal access to services.

The nature of the CPD activity was creative arts therapy. I have learnt from this week’s activities that innovative treatment uses art forms, such as dance, drawing, music, or visual art, to treat specific conditions. The function of the arts in the community highlights the ability of the arts to transform lives and support new modes of working and learning. The activities was online (zoom meeting) with over 100 student participating. I will say this is my first time having a zoom meeting with over 100 student with their cameras on. There were health care professionals coming from various background to explain the different types of creative art therapy that are available in our health care settings.

Creative arts therapists are typically specialised practitioners who have received training in a particular form of creative arts therapy. Qualified professionals can direct innovative treatment to assist people with mental, emotional, and physical difficulties. Movement, for instance, can be a potent form of expressing oneself by connecting with the body’s built-in knowledge and recovery potential. Movement can alleviate a patient’s anxiety and is a powerful instrument for self-regulation. Additionally, music can be used in mental health facilities, with patients suffering from mental health disorders, depression, or post-traumatic stress disorder (PTSD), and in palliative care. Music can alleviate pain and enhance the well-being of patients. Furthermore, drama therapy is a friendly, risk-free approach to exploring these roles. This drama therapy activity allows patients to examine things they don’t like, roles they hope to play in the future and roles they’d like to expand in the present. In interventions designed to improve consciousness of oneself, one’s identity, and connections. Dance, art, drama, and music therapists evaluate their patients’ psychological health, physical health, social functioning, communication skills, and cognitive capacities. Based on their assessed requirements, they use imagery art, dance performance, drama sessions, and music improvisation for individuals and groups. Therapists are crucial members of the healthcare staff.

As a student nurse, I must establish rapport with patients to earn their trust. Using any form of creative therapy will help a healthy therapeutic relationship. The art of nursing has been defined as the nurse’s capacity for compassion, care, and communication. These behaviours will enable me to interact with patients personally, an essential skill for providing quality patient-centred care that patients and their families will value. Watching the video and the power points from Moodle, I have realised the power of music in nursing, especially with patients with dementia, cognitive impairment and palliative care. As a student nurse, supporting patients and allowing them to have the opportunity to be heard concerning their care (person-centred), helping to recognise the expression as a step towards health through minimising loneliness and validating feelings and experiences is essential to their healing. Through responding to and discussing creative works that convey meaning about the felt experience of distress and illness, this course helps nursing students gain insight into the emotional aspects of ailing health.

Caring consists of upholding the humanistic values of trust, building relationships, preserving hope, and acknowledging the significance of spiritual, physical, and mental support. Linking creative acts to the Code entails the distinctive duty of nurses to be physically and mentally present constantly, allowing them to develop compassionate, effective patient relationships. As an art form, communication incorporates both verbal and nonverbal interaction, as well as attentive listening. To give optimal patient care, nurses employ valuable and practical communication skills. One of the competencies encourages nurses to build partnerships and therapeutic relationships through safe, effective and non-discriminatory communication. Nurses must always consider individual differences, abilities and requirements. Under 3.1-, all nurses must use therapeutic principles to establish, maintain, and, when necessary, terminate professional, caring relationships and always respect professional boundaries.

When individuals consider domestic abuse, domestic violence typically comes to mind. Domestic violence, however, encompasses any attempt by one spouse or intimate partner to dominate and control the other. A perpetrator of abuse uses dread, remorse, humiliation, and intimidation to break you down and maintain control over you. However, you dread that it will occur again. You sometimes question if you’re hallucinating the abuse, but the emotional and physical anguish you experience is genuine. If any of the above sounds familiar, you may be a victim of domestic violence

Domestic violence/abuse is any incident of controlling or threatening behaviour, or violence or abuse between those age 16 or over who have been intimate partners or family members regardless of their agender or sexuality. It is estimated that about two million adults in England and Wales aged 16 and 59 experienced DVA in March 2018 (Office of National Statistics (ONS), 2018). Domestic violence is not always reported, and while it can affect individuals from all walks of life, women are significantly impacted. Intimate partner and sexual violence is a significant public health issue, affecting 30% of women worldwide and 27% of 15-49-year-olds (WHO,2021). This can negatively impact women’s health, mental, sexual, and reproductive well-being. Globally as many as 38% of all murders of women are committed by intimate partners. In addition to intimate partner violence, globally, 6% of women report being sexually assaulted by someone other than a partner, although data for non-partner sexual violence are more limited. Men against women mostly perpetrate intimate partner and sexual violence.

Lockdowns during the COVID-19 pandemic and its resulting social and economic effects have increased women’s exposure to abusive partners and known risk factors while restricting their access to services. Humanitarian crises and displacement may worsen pre-existing forms of violence, such as intimate partner and non-partner sexual violence, and contribute to new violence against women. Intermate partner and sexual violence results from individual, family, community, and societal factors that interact to increase or decrease risk protectiveness. Some are associated with perpetrating violence, others with experiencing it, and others with both.

The following are some risk factors for both intimate partner and sexual violence:

• Poor educational attainment
• Previous exposure to juvenile maltreatment
• Unequal gender representation
• Community norms accord men a privileged position or an inferior status to women.
• Among the specific risk factors for intimate partner violence are:
• A history of previous exposure to violence
• Marital discord and dissatisfaction
• Partner-to-partner communication difficulties
• Male companions who exhibit controlling behaviour.

Mainly associated with sexual violence perpetration are beliefs in family honour and sexual purity, ideologies of male-oriented sexual a right, and poor legal sanctions for sexual violence. Gender inequality and norms regarding the legitimacy of violence against women are fundamental causes of violence against women.

Sexual violence results in severe short- and long-term physical, mental, sexual, and reproductive health issues for women. Additionally, they impact the health and well-being of their families. This violence has substantial social and economic repercussions for women, their families, and societies. Such violence can:

• Resulting in fatalities such as homicide or suicide.
• 42% of women who have experienced intimate partner violence have reported sustaining an injury.
• Contribute to unintended pregnancies, abortions, gynaecological issues, and sexually transmitted diseases, including HIV.
• These forms of violence can result in depression, post-traumatic stress disorder and other anxiety disorders, difficulty sleeping, eating disorders, and suicidal attempts.
• Sexual violence, especially in infancy, can increase smoking, substance abuse, and unsafe sexual behaviours.
• Children raised in violent households are susceptible to various behavioural and emotional disorders. These factors have also been linked to perpetrating or experiencing violence later in life.

Prevention and response

There is growing evidence on what works to prevent violence against women; based on well-designed evaluations, in 2019, WHO and UN Women, with endorsement from 12 other UN and bilateral agencies, published RESPECT Women – a framework for preventing violence against women aimed at policymakers. Each letter of Respect stands for one of seven strategies:

R – Relationship skills strengthening

E – Empowerment of women

S – Services ensured

P – Poverty reduced

E – Enabling environments (schools, workplaces, public spaces) created

C – Child and adolescent abuse prevented

T – Transformed attitudes, beliefs and norms.

Interventions for intimate partner violence in low- and high-resource settings include psychosocial support, economic and social empowerment programs, and working with couples to improve relationship and communication abilities. Curriculums that challenge gender stereotypes and promote equality and consent should be incorporated into school programs to increase safety, reduce severe punishment, and improve safety. Enacting and enforcing legislation, developing policies, allocating resources to prevention and response, and investing in women’s rights groups are essential for enduring change.

Preventing violence against women is possible. As a student Nurse, there is the need to be able to identify domestic violence victims through screening and facilitating their access to assistance and support. However, the health sector is vital in providing comprehensive medical care to women subjected to violence and acting as a referral hub for women who may require additional support services. Provide comprehensive services, sensitise and train health care providers in responding to the needs of survivors holistically and empathetically.

The SPLP skills learning model introduced students to understanding midwifery care’s concepts and areas—good practice around domestic violence/abuse and promoting a safe environment for pregnant women and their babies: there was a PowerPoint presentation on infant feeding practicalities, a game on sepsis which was highly competitive and drama on domestic violence/abuse.

The skills aimed to describe the nursing students’ perspectives on breastfeeding, the need to understand maternal and infant attachment and how to refer to when problems arise. During the skill, I leant the benefits breastfeeding brings to the child’s development, ranging from allergy prevention to overall good health, not to mention a better mother-child connection, which is essential for the future relationship, how to help women with babies who want to be able to breastfeed during a hospital stay.

One of the skills I find challenging is domestic violence/abuse towards women. Domestic violence is not always reported, and while it can affect individuals from all walks of life, women are significantly impacted. As a student Nurse, there is the need to be able to identify domestic violence victims through screening and facilitating their access to assistance and support.

The sepsis game was very insightful. Even though it was a game, I learnt how sepsis impacts the human body when one gets it. Sepsis is a life-threatening disease that requires early recognition and immediate management.

My participation in the skills practice has been positive and beneficial for future courses as it has highlighted important issues that do not often occur in practice. As a student nurse, I need to be mindful of my environment. There are some signs to look out for regarding domestic violence and abuse. In addition, there should be more training to increase confidence and knowledge in addressing domestic violence and abuse, infant feeding, and sepsis. Promoting breastfeeding and maternal and infant attachment is essential for healthcare personnel in the United Kingdom. Looking at the number of people developing sepsis in England alone, more campaigns should exist.

As a student nurse, I will work with a multidisciplinary team (MDT) to ensure we do the best for the people in our care. Student nurses must have a broad knowledge of understanding of the people who come to seek help. According to the NMC code (2018) 1.1, adult nurses must be able to recognise and respond to the needs of all people who come into their care, including babies, children and young people, and pregnant and postnatal women. This multifaceted promotion demands the ongoing development of knowledge and competence in healthcare. So therefore, it is expected of me as a student nurse to use up-to-date knowledge and evidence to assess, plan, deliver and evaluate care, communicate findings, influence change and promote health and best practice.

As a student nurse, I have a professional obligation and duty of care to ensure the safety of my patients. For some of the patients in the ward, protection entails my commitment to administering care as safely and conveniently as possible.

I conduct a covid test and screen for covid 19 when Miss A was admitted to my bay. If a patient is admitted with covid, an isolation ready room will be made available in the bay to prevent the spread of infection from bay to bay and or from person to person.

I know the NMC Code requires me to balance risks in relation to the people dependent on care services with my own safety. I have a duty to keep does in my care and myself safe by ensuring that the number of visitors are reduced to prevent the spread of the vires.

In addition, to reduce the risk of exposure between patients, visitors, and staff, all visitors must wear a mask covering while in the ward. At the ward entrance hand sanitiser is available for visitors and personnel to use before and after each patient interaction. Hand washing after coming into contact with a patient is most important. Miss A was able to recover quickly even though she is COPD patient. The bay was still a contact bay up to a specific number of days before it will be cleared as a non covid bay.

Today, I spent time in the theatre following a patient’s journey to the theatre. However, I spent time the anaesthetist first and secondly the Surgeons.

I observed how the anaesthetist ensured the patient received a general anaesthetic safely and remained unconscious and pain-free throughout the operation. In addition, she ensures that the patient’s level and temperature are maintained throughout the process in the operating room. Anaesthetist’s role and how closely they collaborate with the surgeon to ensure patient safety throughout the procedure.

In the operating room, I learned the significance of the checklist we complete on the ward and how the patient’s safety is ensured by the numerous tests performed in the operating room before the patient’s surgery. The operation was fascinating and enhanced my understanding of the human anatomy with regards to bones. The patient’s recuperation was fascinating. particularly the staff’s efforts to maintain privacy and dignity while the patient is unconscious. In addition attempting to talk to her by calling her name. I will consider how to assess a patient’s pain, mainly if they can not communicate effectively

The nurse’s primary responsibility is drug administration. The doctor and the pharmacist are responsible for prescribing and dispensing medications, while the registered nurse is responsible for administering them properly. As a result, this is now my responsibility as a nursing student, and I must practice and become good at it. The procedure entails medicine preparation, allergen screening, and administration. I undertake all of this with the guidance of a trained nurse. However, if I do not feel skilled enough to administer, I speak up and allow the registered nurse handle it while I shadow and observe, which will be beneficial in the future. As part of my orientation to the ward, I studied the patients’ notes to gain a better understanding of the patients and their sickness.

I was asked to administer a medication to Mrs. A for reasons of confidentiality. I have observed this professional expertise on multiple times and gave drugs under supervision in the past. Mrs. A agreed to have a student administer the medication because the drug had been dispensed and was ready to be administered. The nurse walked me through the process step by step. Mrs. A must also be observed to ensure that she takes her medication. Having a built a good relationship with Mrs. A enables me to encourage and explain the purpose of the medication. Medication administration, in combined with care, compassion, and communication, provides the foundation of a holistic approach to care.

Prioritisation is a key tool for good time management, therefore I ensured that I arranged my chores from highest to lowest priority. During the last days of my placement, a staff member questioned my ability to manage time when I assisted a patient who used a Zimmer frame to get to the restroom rather than a patient who was laying in a dirty bed while the staff waited for me to change the patient in bed. This incident prompted me to re-evaluate how to prioritise people. I believe I did the proper thing by providing the patient with a Zimmer frame. If the same situation came again, I do not believe I would do anything differently but speak up and defend my choices.