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.

Whilst on my placement, I got an opportunity for an outreach with diabetes dietitian clinic. I got a chance to learn how they usually work and help patient to improve their knowledge and confidence in managing their diabetes. Diabetes dietitian helps the patients to know how their diet affects their diabetes and consider the options available for them so that the patient can make a plan and changes to achieve the goal to improve the diabetes.

Also provide the leaflet to the patient that has informations about the diet how to live well with the diabetes and control it. Provide patient education about how important the role of diet, exercise, weight loss for diabetes patient. I also learn how diabetes can affects your kidney and can lead to heart problems. Healthy balance meal, regular exercise helps to control diabetes and keep kidney healthy.

Whilst on the placement I had an outreach with respiratory nurse clinic. I got an opportunity to see the patient that had come to the clinic for the follow up review/ first time to the respiratory clinic how they were doing with theirs breathing and inhalers medication. I introduce to myself and my role to the patient.

Respiratory nurse supports patients with a range of lung conditions including asthma, chronic obstructive pulmonary diseasea, bronchiectasis and pulmonary fibrosis. They provide a range of advice and support. Nurse then do the assessment like taking the history of the patient, taking vitals signs, listen to the chest of any abnormalities sound such as wheezing/ crackling sounds.

I had an opportunity to observe the techniques how to use the different types of inhalers with spacers which helps patients not to be breathlessness and the breathing techniques of the patients while using the inhalers which was really helpful for learning.

Also I got an lovely opportunity to observe patient for the pulmonary rehabilitation where patients do exercise and education programme for those patiens with lung disease or experience symptoms of breathlessness. It focuses on tailored physical exercise and information that helps patients to better understand and manage their symptoms.

It was a lovely opportunity to build up my knowledge and the techniques how to use the inhalers.

Whist on the placement I had an outreach with podiatry team. I had an opportunity to learn how podiatrist team work in providing the care or support to the patients. While seeing the patients in the clinic I introduced myself and my role to the patient.

Podiatrist treat the patient who have injuries involving the lower extremities. They support primary care by providing expertise in foot and ankle health. They also help to prevent, diagnos and treat a eude range of conditions such as ingrown toenails, heel, knee and arch pain. They will be helping patients with a variety of different issues such as children with lower limb pain or walking problems, diabetes suffers with circulation problems who may be at risk of amputation, people with sports injures or putting more pressure on their feet causing injury. Podiatrist work with different health team professionals such as physiotherapists, dietitians, GPs and nurses and in a range of settings from hospitals and community clinics to the home of patients

I got an opportunity to see the patient of different age in the podiatry clinic. Patients had come to the clinic with different problems such as pain in lower extremities, ingrown toenails, to remove the dry skin from feet. I also got an opportunity to see patient with charcot foot that had come for the follow up clinic with the special shoes that helps to keep patient foot protected and prevent developing from foot ulcers.

Whilst on the placement I had an outreach with Heart Failure Nurse. I had an opportunity to see the patient at the clinic. The patient came for the follow up. I introduce myself to the patient and my role.

Heart Failure specialist nurse provides supports, advice, medication and clinical reviews for patients diagnosed with Heart Failure. They support cardiologist with diagnosis, providing support and information to people newly diagnosed with Heart Failure and supervising patients starting a new medicine. They also refer the patient to the Cardio rehabilitation.

I got an opportunity to see the patient at the clinic and develop my clinical skills such as taking manual blood pressure and Heart rate of the patient. I also got chance to listen to the Heart rate and breathing sounds.

Whilst on the placement I had an outreach with Care Home Support Team in community. I got an opportunity to see patients in residential home. While visiting the patients I introduced myself and my role to the patient.

The Care Home Support Team is comprised of experienced specialist nurses (Liaison and palliative care nurses) including advanced physiotherapist, rehabilitation physiotherapy assistant and occupational therapist. The team plays a vital role in supporting the residents in the residential and nursing homes.

I had an opportunity to company the liaison nurse who visited two different residential homes to do assessment and review those residents who were prescribed antibiotics due to chest infection. I introduced myself to the manager, carers, and residents we met and explained my role to them.

While I was with the liaison nurse I got an opportunity to analyse the urine results. I attended face to face training with admiral nurse who came to talk to Care home support team her role in Sutton community. She specialises with dementia care and supports the family members looking after their member of the family with dementia. They also help family carers to gain the necessary skills to assist people with dementia, promoting positive approach to a person living with dementia and improving quality of life to these people.