Apprenticeship Learning Log

Date of Learning: 26/07/2024

Time: 09:30 to 12:30

Title of learning activity: Care Delivery 2: Section 7: Wound care: suture/clip/drain removal

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Learning outcomes:

• To be able to list the structures of the skin.
• To explain the stages of wound healing.
• To identify different varieties of wounds and how to manage them.
• to demonstrate removal of sultures or clips.
• to be able to list the various types of skin closure devices.
• To be able to explain what defines a chronic wound
• To summarize use of the TIME method to assess a wound in a systematic manner
• To recognise tissue types using the correct terms
• To plan dressing selection based on tissue type

This session, the lecturer discussed the structure of the skin, progression of wound healing from haemostasis to the maturation stage, the importance of utilising the TIMES model (Tissue, Inflammation/Infection, Moisture, Edges and Surrounding Skin) to evaluate wounds the ways in which these components help wound management strategies, various kinds of wounds, the distinction between acute and chronic wounds and the significance of accurate wound reporting.
I practised in removing clips and cutting sutures on a dummy based on my theoretical understanding, keeping everything sterile, and making sure the wound is well inspected before beginning any treatment.

I become aware of the complexity and significance of good wound care. I was able to learn how to classify and manage various wound types using the TIMES model, which is a clear and systematic approach for wound assessment. It helps me understand how to categorise and manage different wound types.
Practicing on the dummy was beneficial because it gave me hands-on experience with the removal of clips and sutures, which is a critical skill in wound care. It also taught me the importance of choosing the correct dressing based on the wound’s current state and the need to assess factors like infection and moisture balance. I also became aware of how improper assessment or action could lead to delayed healing or infection.
In the future, I intend to improve my ability to asses wounds accurately using the TIMES model. My objectives is to refine my practical skills in wound care, particularly on the removal of clips and sutures. I will make sure I take into account all aspects of the wound environment when choosing appropriate interventions. I will also aim to improve my wound documentation ensuring that I record all necessary details like wound location, condition, size, and the dressing used. Additionally, I will focus on effectively communicating the signs of infection and care procedure to patients, ensuring they are involved in their care and understand what to expect as the wound heals. Continuous reflection on my actions will help me grow, ensuring better patient outcomes in wound management.

KSB addressed:

Knowledges:

K1, K4, K6, K7, K9, K13, K16, K18, K19, K21. K23, K24, K26, K28, K35, K37,

Skills:

S1, S2, S3, S6, S7, S23, S35,

Behaviour:

B1, B2, B3

Apprenticeship Learning log

Date of Learning: 26/07/2024

Time: 13:30 to 16:30

Title of learning activity: Care Delivery 2: Session 10: Simulation Consolidation of History taking and assessment skills

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Learning outcomes:

• To demonstrate an understanding of communication in providing person-centred care.
• To analyse and assess non-verbal cues, and their impact on communication.
• To discuss and illustrate the importance of active listening, and its role in successful communication.
• Demonstrate awareness of barriers to communication and how to overcome them where possible.
• To explain appropriate communication strategy selection in different situations.

During this session, we covered the importance of history taking and the skills necessary to gather a comprehensive patient history, such as active listening, observation, communication, and questioning. The session emphasized that history is the patient’s story of their condition and that it is critical in supporting diagnosis and evaluating the impact of symptoms on their life. We also covered various methods to overcome communication barriers and the importance of non-verbal communication. Furthermore, we learned how to structure history taking by asking about the presenting complaint to assessing family history, social history and the use of SOCRATES mnemonic which is a tool for pain assessment.

This session made me realised the critical role of history taking is in establishing a diagnosis and comprehensively understanding patient condition. Proficient history-taking involves not only asking the right questions but also being attentive to the patient verbal and non verbal signals. This session taught me that communication barriers such as language differences or cognitive challenges, can significantly impact the process. Therefore, it is vital to plan ahead, use appropriate aids, and be patient. Additionally, employing framework such as SOCRATES mnemonic for pain assessments ensures a meticulous and systematic in understanding the patient’s symptoms. The experience demonstrated how crucial it is to involve the patient actively and allow them space to express their concerns.

In the future, I will focus on refining my communication and assessment skills by practicing active listening and questioning techniques, especially in situations where there might be barriers to communication. I will make sure to remain mindful of the significant of body language and non-verbal signals while interacting with patients. I also intend to utlise the use of SOCRATES mnemonic to guide my assessments in ensuring I coer all necessary aspect of the patient condition. I will continue to work on being more patient-focused by considering the social, familial, and occupational aspects of their history to provide a more holistic approach to care. Furthermore, I will seek opportunities to practice history-taking with real patients and review documentation to ensure a complete and accurate understanding of each patient’s background and needs.

KBS Addressed:

Knowledge:

K1, K4, K6. K7, K9, K13, K14,K18, K24,

Skills:

S1, S2, S4, S6, S7,

Behaviour:

B1, B2, B3

Apprenticeship Learning Log

Date of Learning: 19/07/2024

Time: 09:30 to 12:30

Title of learning activity: Care Delivery 2: Session 5: ECG and Neuro Observations

1. Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Learning outcomes:

1. Understand the indications for cardiac monitoring;
2. Demonstrate how to set up cardiac monitoring and undertake an ECG; and
3. Interpret ECG readings to identify normal or abnormal heart rhythms

During this session, we explored the process of recording and interpreting ECG, a crucial tool for evaluating cardiac rhythm and electrical activity. We examined the basics of the heart’s electrical conduction system, the significance of various waves (P, QRS, T) and the necessity of understanding normaL and abnormal pattern on the ECG.  We were introduced to a 6-step method for ECG interpretation, which includes evaluating heart rate, rhythm, atrial and ventricle activity, and the relationship between the P waves and QRS complexes. Additionally, I engaged in practical exercises regarding the correct placement of ECG leads and the recording of an ECG, ensuring patient comfort and dignity throughout the process.

 This session emphasized how vital it is to properly record and interpret an ECG, as it provides real-time insights into a patient’s heart function. Practicing the correct placement of ECG leads reinforced the importance of accuracy, as improper placement can lead to incorrect readings, potentially impacting diagnosis and treatment. I realized how critical attention to detail is in both the technical and interpersonal aspects of this procedure. The six-step method for ECG interpretation helped me understand how to break down the data systematically and detect issues like arrhythmias, heart block, or other conduction abnormalities. This hands-on experience was essential for building my confidence in performing ECGs correctly and interpreting their results.

In the future, I will continue practicing the proper placement of ECG leads and use the six-step method for systematic interpretation. I plan to review more ECG patterns to familiarize myself with both normal and abnormal findings. Additionally, I will focus on improving my patient communication, ensuring that I explain the procedure clearly, maintain their comfort and dignity, and obtain informed consent each time. Understanding the limitations of ECGs is also important, so I will work on further developing my ability to identify when additional tests or follow-ups are necessary. Continuous reflection on my technique and interpretation will be key to improving my clinical skills in ECG recording and analysis.

KBS addressed:

Knowlege:

K1, K6, K19, K20, K36,

Skills:

S1, S2, S4, S5, S6, S7, S10, S17, S21, S24, S33, S34, S42, S44

Behavious

B1, B2, B3

Apprenticeship Learning Log

Date of Learning: 19/07/2024

Time: 13:30 to 16:30

Title of learning activity: Care Delivery 2: Session 6: Neurological Assessments

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Learning outcomes:

1. Understand the principles of neurological assessment;
2. Use these in a clinical simulation environment; and
3. Identify why these assessments are important in patient care

In this session, I acquired knowledge regarding the aims and techniques of neurological assessments, with particular emphasis on the Glasgow Coma Scale (GCS) and assessments of the limbs. The GCS serves as a tool to assess a patient’s level of consciousness through eye, verbal, and motor responses, while limb assessments are instrumental in identifying neurological irregularities by measuring motor strength and responsiveness to stimuli. The session also addressed pupil observations and the necessity of regular monitoring for any signs of deterioration.

This session highlighted the importance of accurate and timely neurological assessments in influencing patient outcomes. The Glasgow Coma Scale (GCS) provides a structured and objective method for identifying early signs of neurological deterioration, where even minor alterations in the score can indicate a significant shift in the patient’s condition. Additionally, I recognised the importance of the limitations of the GCS, particularly in patients with conditions like aphasia or those with mechanical obstructions affecting eye closure. Moreover, understanding limb assessments helped emphasis how differences in motor responses between limbs can indicate localised brain injury, such as in strokes. This session reinforced my comprehension that careful and repeated observations is essential in preventing secondary cerebral injuries that may exacerbate patient outcomes.

In the future, I will apply the GCS and limb assessments more confidently and will ensure that I communicate even the slightest alterations in scores to the medical team. I will also observe the appropriate techniques in administering painful stimuli. Additionally, I will establish a routine of regularly evaluation and documenting both neurological and vital signs especially for patients who are at a heightened risk of rapid deterioration. I will make sure to seek help and escalate to right person to ensure patient safety. These steps will help me improve the accuracy of my clinical assessments and contribute to better patient outcomes in neurological care.

KBS addressed:

Knowledges:

K1, K4, K6, K13, K17, K18, K19, K20, K24, K26, K30, K38,

Skills:

S1, S2, S4, S6, S7, S22,

Behaviours:

B1, B2, B3

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Apprenticeship Learning Log

Date of Learning: 12/07/2023

Time: 9:30 to 12:30

Title of learning activity: Session 9: Working with menthal health crisis psychotic and mood disorders

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Learning outcomes:

• Explore the meaning of deterioration and different presentations of psychological distress
• Utilise different tools and techniques to assess the needs of someone presenting in a mental health crisis.
• Communicate effectively with people in distress

We had a guest lecturer that discussed about working with mental health crisis psychotic and mood disorders. The lecturer discussed the definition of deterioration of mental health, assessing change on individual’s current mental state while relying on the availability of individual’s baseline information, signs of deterioration, the manifestation of psychological distress. We had the chance to discussed psychosis and psychotic disorder. We did some activity where we were group into three and distract one person while having a conversation with another person. We also had a group activity where we research and presented psychotics and mood disorders

According to Medical dictionary in 2009, deterioration in mental health is the process of changing to an inferior state. And the process in which our mental and physical health becomes progressively worse over time is called deterioratin of health. Causes of People who has biological vulnerability or predisposition and stress are more likey to have mental illness. Mental illness can be psychosis, depression, bipolar mania, post-traumatic stress disorder (PTSD) and anxiety disorders. Deterioration can be manifested by anxiety, mood disorders, psychosis and psychotic disorders, personality disorder, substance misuse and delirium.  The mental state examanination (MSE) is a structured way of assessing a patient’s current state of mind.

Psychosis is a set of symptoms caused by certain conditions that make individuals perceive their surrounding differenty. This change in perception affects thoughts, emotions, and behaviors, making it hard to distinguish between reality and imagination. Schrizophrenia, a type of pyschotic disorer, involves recurring episodes of symptoms like hallucination, delusion, and disorganized thinking and behavior. Hallucinations are snesory experiences like seeing or hearing things that others don’t while delusion are strong beliefs not grounded in reality. People with schizophrenia may seem out of touch with reality, making it tough to function in daily life. People with schrizophrenia are cared for by Community Mental Health Team that includes; social workers, community mental health nurses – who have specialist training in mental health conditions, occupational therapists, pharmacists, counsellors and psychotherapists and psychologists and psychiatrists – the psychiatrist is usually the senior clinician in the team. A person suffered first episoded of schrizophrenia will be referred to an early intervention team.

Individuals with complex mental health conditions are often enrolled in a program known as Care Programme Approach (CPA). This involves assessing their health and social needs, creating a personalized care plan, assigning a keyworker, and regularly reviewing the treatment plan for any necessary adjustments. For those experiencing acute schizophrenic episodes, treatment options include Crisis Resolution team intervention or home treatment to avoid hospitalization. Treatment for schizophrenia may involve antipsychotic medications, talk therapy, famil therapy, arts therapy, and cognitive behaviour therapy. In cases where hospitalization is deemed necessary but the individual refuses, the Mental Health Act (2007) may be used to detain them for their own safety and the safety of others.

Depression is a common mood disorder that can have serious effects on a person’s daily life. Symptoms include low mood, lack of energy, feeling hopeless, difficulty concentrating, changes in sleep and appetite, and thoughts of suicide.

As a learner, it is valuable to learn about the mental health crisis, psychotic and mood disorder so that I know my role in providing hollistic care to patient which includes addressing the physical and mental health needs. It is essential in early detection and intervention, patient safety, communication and support, improving patient outcomes, reducing stigma, interpersonal collaboration, knowing legal and ethical responsibilities and personal and professional development.

KBS addressed:

Apprenticeship Learning Log

Date of Learning: 12/07/2023

Time: 13:30 to 16:30

Title of learning activity: GI emergencies + pre & post operative care

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Learning outcomes:

• Understand the importance of pre operative care
• Learn how to use pre-op check list
• Discuss post-operative care and common considerations
• Explore a few common surgical cases with pre- & post operative care.

The session today focuses on gastrointestinal emergencies and the pre-operative and post-operative care approaches utilising the ABCDE method. It emphasises critical considerations and potential danger in managing patients undergoing surgery, especially those with gastrointestinal emergencies. The importance of thorough pre-operative assessment, monitoring vital signs, recognising and responding to patient deterioration, and maintaining effective communication and teamwork are highlighted.

Importance of a structured approach:

Pre-operative care: The ABC approach ensures a comprehensive evaluation of the patient condition before surgery. This includes assessing the Airway (using LEMON criteria), Breathing (considering OSA, respiratory history, and recent infections), and Circulation (identifying infection risk, cardiac history and drug interactions). This systematic approach is essential in identifying potential complications that may arise during and after surgery.

Post-operative care: Utilising the ABCDE approach and regular monitoring of vital signs allow for early detection of complications such as infections, respiratory issues, or cardiovascular problems. For example, opioids and nitrous oxide used during anaesthesia can contribute to post-operative nausea and vomiting, a common complication that requires careful monitoring and management.

Addressing several challenges in practice will ultimately give optimal patient care

1. Teamwork and effective communication are very important in surgical settings to ensure prompt interventions and referrals, reducing risk of patient harm due to delays.
2. Inadequate monitoring of vital signs can result in missed early warning signs of deterioration, leading to adverse outcomes. Prompt recognition of deterioration is essential to prevent critical escalation.

As a trainee nurse associate, learning about the gastrointestinal emergencies and pre-operative and post-operative care is crucial as well as use of systematic assessment, effective communication and timely action that play a critical role in improving patient outcomes. Addressing the identified gaps through targeted training, enhanced communication and use of checklist and technology can ensure high-quality care and better patient safety.

KBS addressed:

Apprenticeship Learning Log

Date of Learning: 26/04/2024

Time: 9:30 to 12:30

Title of learning activity: Complex Genomics: Cancer and Sickle Cell

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Learning outcomes:

• To understand what is cancer including pathophysiology, genetic consideration/counselling, and management.
• To discuss the condition cancer, types of cancer, and the cell mutations in cancer
• To explain the difference between benign and malignant tumours
• To understand what a metastasis is
• To explore the survival/living with cancer.

• define sickle cell disease (SCD)
• explain the genetics of SCD
• understand a little bit of history and how this is passed on to generations and its mechanism
• discuss the S/S, diagnosis, treatment, and complications.

The session focused on cancer that provided me with an in-depth understanding of the disease, encompassing its pathophysiology, genetic factors, and various management strategies.

The session covered a wide range of topics, including the difference between benign and malignant tumours, the process of metastasis, and the complex biology underlying cancer development. The discussion also explored the impact of lifestyle factors, infections, radiation, and genetic mutations on cancer risk.

It also highlighted the psychological, social, and physical consequences of cancer treatment and emphasized the importance of personalized care in supporting patients living with and beyond cancer. I have come to appreciate the importance of many sided nature of cancer, recognising it as a collection of diseases rather than a singular entity, each with distinct causes, presentations, and prognoses. This complexity necessitates that healthcare professionals utilise a comprehensive approach in the diagnosis, treatment, and support of cancer patients.

The session reinforced the critical role of early detection in enhancing survival rates, thereby emphasising the importance of routine screenings and public education. Understanding of the differences between benign and malignant tumours, along with the mechanisms of metastasis, has enriched my awareness of the difficulties associated with cancer treatment, especially in cases where the disease has disseminated to other regions of the body.

The exploration of the effects of cancer treatment was particularly enlightening. It brought to light the extensive impact that cancer and its therapies can have on patients’ physical and mental health. Issues such as the anxiety of recurrence, concerns regarding body image, and long-term physical challenges like fatigue and neuropathy are vital factors in post-treatment care. This has reinforced the necessity for a tailored approach to patient care that addresses not only the physical dimensions of cancer but also the emotional, social, and spiritual needs of individuals affected by the disease.

In the future, I will apply this knowledge by adopting a more holistic approach in my practice when working with cancer patients. I will prioritise early detection and be more vigilant in identifying symptoms that may indicate cancer, understanding that early intervention can significantly improve outcomes.

I will also be more attentive to the psychosocial and spiritual needs of cancer patients, recognising that these aspects are just as important as managing the physical symptoms of the disease. This includes engaging with patients to understand their personal values, beliefs, and concerns, and ensuring that their care plans reflect these aspects.

I will also work on improving my communication skills to effectively discuss complex topics such as the nature of cancer, treatment options, and the potential consequences of treatment with patients and their families. This will involve being clear, compassionate, and supportive, ensuring that patients feel informed and empowered to make decisions about their care.

Lastly, I will advocate for a multidisciplinary approach to cancer care, involving not just healthcare professionals but also social workers, psychologists, and other support services to provide comprehensive care that addresses all aspects of a patient’s well-being. This reflection has highlighted the need for continuous learning and adaptation in my approach to cancer care, ensuring that I am providing the best possible support to patients and their families throughout their cancer journey.

Sickle Cell Disease

In this session focused on Sickle Cell Disease (SCD), I acquired knowledge into various aspects including genetics, pathophysiology, historical background, clinical manifestations, complications, and therapeutic strategies associated with this hereditary blood disorder.

SCD is marked by the presence of sickle-shaped erythrocytes, which can obstruct small blood vessels, resulting in significant complications due to compromised oxygen transport. The session also discussed into the historical context of SCD, tracing its earliest documented instances, and examined the genetic underpinnings that contribute to the disease, particularly its mode of inheritance.

I acknowledge the significant impact that SCD has on the lives of those affected, especially considering the chronic nature of the condition and the severe complications that may ensue. The genetic basis SCD, characterised by a singular amino acid substitution that results in the production of abnormal haemoglobin (HbS), highlights the critical role of genetic counselling for couples at risk.

It is essential for both patients and healthcare professionals to understand the inheritance patterns and the likelihood of transmitting the disorder to subsequent generations. The thorough examination of SCD’s clinical manifestations, including pain crises, anaemia, and recurrent infections, highlighted the complexity of controlling this illness.

The discussion surrounding the complications associated with SCD, such as stroke, acute chest syndrome, pulmonary hypertension, and organ damage, further reinforced the necessity for diligent monitoring and proactive management to avoid life-threatening situations. The historical perspective on SCD offered a significant understanding of how the comprehension and treatment of the disease have progressed over time. This historical context also illuminated the racial and geographical factors linked to the prevalence of SCD, particularly its increased occurrence among individuals of African descent. The social and cultural implications of this aspect are important to consider in patient care and education.

In the future, I intend to use this knowledge by adopting a more holistic and compassionate approach when engaging with patients diagnosed with sickle cell disease (SCD) or those at risk of having offspring affected by the condition. My focus will be on enhancing patient education, ensuring that both individuals and their families comprehend the genetic implications, inheritance mechanisms, and the critical nature of early detection and intervention.

I will also maintain heightened awareness in identifying the initial indicators of SCD-related complications and will advocate for prompt interventions, including blood transfusions, effective pain management, and preventive strategies such as vaccinations. Additionally, I will stress the significance of consistent follow-up appointments to track the disease’s progression and to manage any arising complications proficiently.

Moreover, I will integrate the historical and genetic dimensions of SCD into my interactions with patients, leveraging this understanding to facilitate discussions regarding the disease’s effects on various populations and the necessity for culturally competent care. This approach will involve addressing prevalent misconceptions surrounding SCD, particularly those linked to specific racial or ethnic demographics, and ensuring that all patients receive fair and equitable treatment, irrespective of their background.

KBS addressed:

Knowledge

K1, K4, K5, K6, K7. K9, K10, K13, K14, K16, K17, K18, K21, K24, K26, K30, K36, K37, K38, K39

Skills:

S1, S2, S4, S6, S7, S15, S22, S33, S34 S42, S43, S44,

Behaviours:

B1, B2, B3

Apprenticeship Learning Log

Date of Learning: 26/04/2024

Time: 13:30 to 16:30

Title of learning activity: Session 7: Decision Making in Care for NA Session 6: EOLC

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Learning outcomes:

• To understand the concept of End-of-Life Care in the context of the dying adult person in their last days of life.
• To discuss communicating for end-of-life care and recognise when a person is entering the last days
• To gain awareness of management of symptoms:
• how to manage common symptoms without causing unacceptable side effects
• maintain hydration in the last days of life.
• To gain knowledge of the nurse’s role within individualised person-centred care
• To gain an overview understanding of Advance Care Planning

The session is about on end-of-life care, I learned about the clinical care provided to adults in their last days of life, focusing on maintaining their comfort and dignity while managing common symptoms without causing unacceptable side effects. The session highlighted how important it is to communicate with dignity, including the patient and their loved ones in the decision-making process, and be aware of the different paths people can take in their last days. The role of healthcare professionals, particularly those without specialist training in palliative care, was emphasised, along with the need for individualised care plans that address the patient’s physiological, psychological, social, and spiritual needs.

I realise the profound responsibility healthcare professionals carry when caring for patients at the end of life. The emphasis on communication and shared decision-making resonates deeply with me, as it highlights the need to honour the patient’s wishes and involve their loved ones in the process. This approach ensures that the patient’s dignity is maintained, and their comfort is prioritised, even when they may not be able to actively participate in the decision-making due to reduced mental capacity.

The discussion on recognising the signs that a person is entering their last days of life was particularly impactful. It underscored the need for continuous monitoring and reassessment, recognising that some patients may stabilise or even temporarily improve. This aspect of care requires healthcare professionals to remain vigilant and responsive, adapting the care plan as the situation evolves.

The exploration of symptom management, including pain, breathlessness, nausea, and anxiety, highlighted the importance of both pharmacological and non-pharmacological interventions. Understanding that not all patients experience the same symptoms, and that care must be tailored to individual needs, reinforces the necessity of a personalised approach to end-of-life care.

I will incorporate this knowledge into my practice by prioritising clear and compassionate communication with patients and their families. I will ensure that I actively involve them in the decision-making process, respecting their wishes and preferences while providing accurate information about the prognosis and available care options. This includes being mindful of the patient’s cultural, religious, and spiritual needs, which are integral to their overall well-being.

In clinical practice, I will be more attentive to the signs that a patient may be entering their last days of life, ensuring that I monitor their condition regularly and update care plans as needed. I will also be prepared to seek advice from more experienced colleagues when faced with ambiguous or conflicting signs, ensuring that the patient receives the most appropriate care.

When managing symptoms, I will strive to balance the use of pharmacological treatments with non-pharmacological methods, recognising that both play a vital role in maintaining the patient’s comfort. I will also be vigilant in reassessing the effectiveness of treatments and adjusting them as necessary to avoid unnecessary side effects.

Additionally, I will place a stronger emphasis on advance care planning, ensuring that patients are supported in expressing their wishes for future care. This includes discussing advance statements, decisions to refuse treatment, and appointing a lasting power of attorney if necessary. By doing so, I can help ensure that the patient’s preferences are respected, even if they lose the capacity to make decisions later on.

KBS addressed:

Knowledge

K1, K4, K6, K7, K9, K18, K19, K22, K23, K24, K25, K26, K27, K29, K34, K36, K37

Skills

S1, S2, S4, S5, S6, S7, S10, S11, S14, S19, S28, S32, S33, S42, S43, S44

Behaviours

B1, B2, B3

Apprenticeship Learning Log

Date of Learning: 03/05/2024

Time: 9:30 to 12:30

Title of learning activity: Session 6: Complex CVS conditions

Diary of Learning activity

(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)

Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):

Learning outcomes:

1. explain the normal anatomy and physiology of the Heart
2.  Describe ACS including pathophysiology, S/S, management, and complications
3. Name the CHD, its presentation, pathophysiology, and management.

 In this session, I learned about the pathophysiology of common cardiovascular conditions, their management and the impact they have on individuals with long-term conditions. The session emphasised how the cardiovascular system functions, including the heart’s anatomy, its role in the systemic and pulmonic circulation, and how it communicated with other bodily systems. A specific focus on acute coronary syndromes (ACS), congenital heart defects, and the management of conditions like myocardial infarction (MI), as well as strategies for integrated care across different stages of life. Ethical and legal considerations were also discussed, making sure that care is delivered in a patient centred and accountable manner.

This session made me realize how crucial to understand both the physiological and psychosocial aspects of complex care. Cardiovascular conditions such as ACS and congenital heart defects can significantly impact a patient’s quality of life, especially when integrated care is not adequately addressed. This knowledge is essential for me as a future nursing associate because it helps me appreciate the complexity of delivering tailored care for individuals with multiple health conditions. The session also reinforced the importance of early detection and effective communication with patients, families, and carers in decision-making processes to ensure holistic care that promotes optimal independence. I now better understand how legal and ethical perspectives play a role in managing long-term conditions, particularly regarding patient consent and the delivery of evidence-based interventions.

In the future, I will aim to improve my understanding of cardiovascular pathophysiology by engaging in more detailed case studies, especially those concerning congenital heart defects and ACS. Additionally, I will focus on developing my communication skills to better involve patients and their families in care decisions, ensuring their preferences and needs are considered. I will also make it a priority to stay updated on the latest evidence-based practices and guidelines, as this will help me provide safer, more effective care. Furthermore, I plan to explore ethical dilemmas in nursing more deeply, reflecting on how I can apply ethical principles in complex care settings to safeguard patient autonomy while providing high-quality, integrated care.

KBS addressed:

Knowledges:

K1, K4, K6, K12, K37, K39, K41.

S Skills

S1, S2, S4, S6, S7, S13, S40

B             Behaviours

B1           Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

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

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