While in the placement with District Nurse in community, I have acquired knowledge about different categories of the wound and assessed the wound and dressing that need to be applied. I have also gain knowledge on how to administer insulin subcutaneously for diabetic patients And also gain knowledge how important it is to check the pressure areas for palliative care or End of life care to prevent from pressure sores and checked what kind controlled drugs are used if needed and the use of syringe drive to the patient.

I have got an opportunity to observe PICC line flush as prescribed and observe intermittent urinary catheters. I have also gained knowledge on how to get organised prior to visiting order to work efficiently and complete the patients correct documentation electronically according to trust policy. I also got an opportunity to observe a change of water in the balloon to RIG tube.

I have also gained knowledge on using different kinds of blood drawn bottles while doing venepuncture, which colour bottle to use accordingly to the test that is needed.

In my community placement, I have confidently participated in wound dressing with bandages, assessed the wound, and differentiated different categories of the wound. Monitor blood glucose and administer insulin. Good team work and understand the patients’ needs and promote their well-being, which allows continuation of care. Taking vital observations such as blood pressure, oxygen saturation, temperature, respiration, and heart rate, which allows to identify if patient is deteriorating.

I have confidently participated in taking bloods from the patients , preforming ECG, removal of catheters, administration of medicine intramuscular, subcutaneous, removal of sutures under supervision.

Always act professionally and carry out instructions seek clarification safely which has increase my confident. I have always put my patient first and maintain a safe practice under supervision of the assesors and always work as a part of team. Gain consent before providing care and communicate with patient clearly and slowly to ensure that they are well and orientated before providing care. Always listen to the patient and show kindness and compassion.

Whilst on the placement, I had outreach placement at GP surgery with nurse. In this outreach, I got an opportunity to see patients with different needs. GP practice nurse are responsible for the delivery of practice nursing services, working together with multidisciplinary team, delivering care within their scope, identify manage and support patient at risk of develop long-term conditions, provide routine nursing care to the patients as required in accordance with clinical based evidence, provide vaccination, wound care, referring patients to specialist care as required, chaperone patients where necessary, assist GPs with minor surgery when required.

This outreach with GP was very insightful as I got an opportunity to develop my skills such as taking bloods, management of the wound dressing, removal of the sutures, doing ECG, giving vacancies and injections such as B12 under direct supervision. Before doing each procedure introduced myself and my role to the patient, consent was gained and privacy and dignity was maintained and act professionally all the time.

I also got an good chance to observe how the smears test was done, and also attended minor surgery clinic where skin tags, cysts, ingrowing toe nails, skin mole were been removed under local anaesthesia.

While in this placement gained a lot of knowledge on how to take a holistic history from the patient.I got an opportunities to go an outreach with different specialist nurses in the community and learn a lot from the team such as identifying categories of the wound, attended cardiac rehabilitation.During my placement at home team, I have increased my knowledge by taking holistic history taking from the patient according to joint assessment form, doing mobility assessment by using different types mobility aids.

I have gained a better understanding of documentation process and communicating with Multi Disciplinary Team.

I feel confident in taking the history according to joint assessment form and assessing patient under supervision of the practice assessor. whilst on the outreach with specialist team, I got an opportunity to develop my skills such as manual blood pressure check and heart rate reading, listening to heart rate and breathing sounds and do the wound assessment and refer to district nurse accordingly. I am also able to perform urine analysis using urine dip stick.

I continue to develop skills on communicating patient efficiently, confidently and clearly with the patient and engaging them in every steps of the care.

I have always act professionally and act in the best interest of the patient all the time. Always gain consent from the patient and treat patient with respect, kindness and compassion. Always work according to trust policy and think the well being of the patient once the patient is discharged.