Apprenticeship Learning Log

Date of Learning: 25/01/2024

Time: 9:30-16:30

Title of learning activity: Simulation Assessment

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)

During the stimulation exercise with my academic tutor, we discussed various assessment tools such as MUST, PAIN, Peak flow and etc. We are then presented with a scenario and proceeded to the simulation area where we interacted with different simulated patients. Working alongside another TNA, we conducted assessments, interventions and developed a plan of care.

Utilizing assessment tools and collaborating with a pretend MDT team, we applied the knowledge gained from our module and also practice person-centred care. A phone call inquiring about my patient’s condition prompted me to priorities confidentiality, although I realized the importance of retaining information to better understand my simulated patient’s situation.

While I felt confident in my ability to perform assessment and communicate with patients, establishing rapport with the simulated patient proved challenging due to their pain. However, through building trust and effective communication, I was able to gather necessary information to provide assistance.

Handling over patient details, medical history and medication requirements to the pretend doctor, I ensured that the prescription was signed before seeking assistance from the Nurse in Charge for medication administration. As a Tranee Nursing Associate, we are not allowed to dispense or administered medication so I seek the help of a registered nurse. This collaborative effort resulted in the patient feeling relieved and supported, allowing for a comprehensive assessment and care plan to be developed.

This scenario highlighted the potential challenges that my arise during patient admissions. As a trainee Nursing Associate, it is important to stress the significance of maintaining confidentiality, following prescribing and administering protocols, and being proficient in medication administration. Practicing effective communication and team collaboration is also key in providing quality patient care. All this adhere to the standard and practices including proficiency of the Nursing and Midwifery Council.

KBS addressed:

Apprenticeship Learning Log

Date of Learning: 08/01/2024

Time: 9:30-16:30

Title of learning activity: Last day of Year 1 (finalizing progression)

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)

This marks the final session of the year, during which we revisited the topics of British Values, PREVENT awareness, and the NMC code. Additionally, we had the chance to exchange our personal experiences from our recent placements, discussing both the positive and negative aspects we encoutered. We assess our ePAD to determine any deficiencies in our theory hours, practice hours, and protected practice learning hours. Furthermore, we received guidance on the necessary steps to take in the event of failing to pass the resubmission of our assignemtns including completing our learning logs.

Apprenticeship Learning Log

Date of Learning: 12/01/2024

Time: 9:30 to 12:30

Title of learning activity: Nutritional support

Learning outcomes:

1. Gain an overview of malnutrition
2. Understand the impact of  malnutrition on the individual
3. Understand and gain an insight into using malnutrition screening tools
4. Understand how you can assist patients with their nutritional needs
5. Understand the importance of monitoring and recording dietary and fluid intake.
6. Understand how to measure and record weight and weight
7. Understand the relevance of BMI calculation and how to perform it

This session gave me the knowledge and understanding how important nutritional support.

Malnutrition occurs when there is an imbalance in the intake of energy, protiens, and other nutrients, leading to negative effect on the body tissues, size and funtion. People who are malnourished are more prone to diseases and have a slower recovery from illness due to thier poor nutritional status.

It is important to conduct an assessment at the beginning, such as during hospital admission. This includes measuring the individual’s height and weight to calculate their BMI and using the MUST tool to determine the risk of malnutrition and obesity. Other factors to consider are oral health (such as wearing dentures or difficulty swallowing), dietary requirements (such as being on a texture modified diet), any trauma that may prevent them from eating independently, their food preferences, allergens and intolerances, and whether they can see properly or require eyeglasses. It is important to respect their belief and ensure they can eat as normally as possible.

Monitoring and documenting the individual’s food intake, especially for those at risk of malnutrition or experiencing weight loss, it is essential. It is vital to encourage and educate the individual about the importance of nutrition for their recovery and provide assistance when needed. If there are concerns about their weight or food intake, it is important to seek advice from other members of the multidisciplinary team, such as dieticians and speech and language therapist. They can provide guidance on whether the individual requires any supplementary food or juices. as a trainee nursing associate, it is important to understand and learn to address nutrition deficiencies in individuals. I must also know how to effectively encourage and educate them about the importance of nutrition and the risks it poses to their recovery. It is crucial to use appropriate language when discussing weight issues with individual, as it is not a simple matter.

Time: 13:30 to 16:30

Title of learning activity: Bowel care

Learning outcomes:

1. Gain knowledge of how to perform a holistic assessment of bowel function
2. Understand the causes and treatments of constipation
3. Understand the rationale for a patient requiring a stoma (Including the different types)
4. Know the basics of stoma care and which appliances are most suitable.

In this session I understand the importance of bowel care.

In assessing bowel function it is imporatnt to condider the patient’s overall health, diet, fluid intake, mobility, cognitive abilities, and usual surroundings. The patient’s typical bowel patter and bowel function must also be documented since they may vary from individual to individual. Any medications that may affect normal bowel routine should be identified. Using a Bristol stool chart can help identify and monitory bowel movements and develop a care plan as needed.

Constipation occurs when there are alterations in your bowel movlements, such difficulty passing of stool.

Demonstratioon of proper administration of  suppository was shown  on a dummy. In doing Digital Rectal Examination, always explain the procedure to the patient and obtain their concent.

As a trainee nursing associate, following  NMC requirements for bowel care is important. Demonstration of knowledge, skills and abilities in provideing evidence-based nursing care to meet people’s needs related to nutrition, hydration, bladder and bowel chart is vital.

KSB  addressed:

K1 Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements.

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.

K3 Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care.

K22 Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health.

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.

K25 Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life.

K26 Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld.

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.

K30 Understand the principles of health and safety legislation and regulations and maintain safe work and care environments.

K33 Understand when to seek appropriate advice to manage a 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.

K36 Understand the roles of the different providers of health and care.

K39 Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives.

K40 Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings, or services.

K41 Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it

S1 Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements.

S2 Keep complete, clear, accurate and timely records.

S3 Recognise and report any factors that may adversely impact safe and effective care provision.

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

S5 Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018)

S6 Act as an ambassador for their profession and promote public confidence in health and care services.

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.

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

S9 Develop, manage, and maintain appropriate relationships with people, their families, carers, and colleagues.

S10 Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred, and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments.

S11 Report any situations, behaviours or errors that could result in poor care outcomes.

S12 Challenge or report discriminatory behaviour.

S13 Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.

S14 Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing.

S15 Identify people who are eligible for health screening.

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

S17 Protect health through understanding and applying the principles of infection prevention and control, including communicable disease surveillance and antimicrobial stewardship and resistance.

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

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

S20 Recognise people at risk of abuse, self-harm and/or suicidal ideation and the situations that may put them and others at risk.

S21 Monitor the effectiveness of care in partnership with people, families, and carers, documenting progress and reporting outcomes.

S22 Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated.

S23 Work in partnership with people, to encourage shared decision making, to support individuals, their families, and carers to manage their own care when appropriate.

S24 Perform a range of nursing procedures and manage devices, to meet people’s need for safe, effective, and person-centred care.

S25 Meet people’s needs for safety, dignity, privacy, comfort, and sleep.

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

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

S28 Support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain.

S29 Give information and support to people who are dying, their families and the bereaved and provide care to the deceased.

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

S31 Act in line with any end-of-life decisions and orders, organ and tissue donation protocols, infection protocols, advanced planning decisions, living wills and lasting powers of attorney for health.

S32 Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams.

S33 Maintain safe work and care environments.

S34 Act in line with local and national organisational frameworks, legislation, and regulations to report risks, and implement actions as instructed, following up and escalating as required.

S35 Accurately undertake risk assessments, using contemporary assessment tools.

S36 Respond to and escalate potential hazards that may affect the safety of people.

S39 Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately.

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.

Apprentice Activity log

Date: 06/10/2023

Time: 09:30 to 12:30

Learning outcomes:

• To understand the rationale behind helping individuals make healthy lifestyle choices.
• To gain some knowledge of the definitions of behavioural changed and how models help explain this.
• To gain an understanding of how as nurses can influence behaviour change using motivational interviewing techniques.
• To practice these skills using scenarios provided.

We started the lesson on giving feedback on our poster assignment, a lot of good examples was shown but needing improvement to follow the learning outcomes required for the poster assignment.

We discussed about what NMC required as a future nurse

We had an opportunity to practice these skills using scenarios and we presented our scenarios. I used the techniques of motivational interviewing, I follow the open ended questions, affirmations, reflective listening and summarizing but I jumped into recommending a solution to the service user (pretend) and learned that I should have supported the service user to come up a solution that they are comfortable. I should have not suggested it without consulting the service user.

transactional analysis

It is important to how to treat patients, build relationships, and be in partnership with the patients. Treat them the same and never talk down to them.

KBS addressed:

Date: 06/10/2023

Time: 13:30 to 16:30

Title of the Activity: Clinical Judgement and Shared Decision Making

Learning outcomes:

• Define clinical judgement and discuss its use in practice
• Understand the influences on our ability to make clinical decisions
• Identify ethical considerations in the decision-making process
• Identify the principles of shared decision making and apply these to practice
• Explore the barriers and facilitators to shared decision making
• Identify how shared decision making is advocated through policy and regulated by law.

I have learned that clinical judgment and decision-making are essential skills and key processes in nursing. Clinical judgment requires accurate assessments in order to deliver safe and effective nursing interventions. However, assessment, clinical judgment, and decision-making are all subject to change. The lesson covered the following patterns; assess, systematic nursing diagnosis, plan, implement, recheck, and evaluate.

Intuition is a sixth sense or feeling that a nurse uses to empathize with and communicate with service users. It is also important to reflect on experiences and determine the best course of action based on them. In the discussion of ethical sensitivity, autonomy, beneficence, justice, and nonmaleficence were discussed. There was a discussion about accountability and responsibility, as well as their differences.

As a health professional, I learned that shared decision-making involves providing different choices to the service user, supporting them, and working with them to decide on the treatment plan for the service user, making sure they are at the center of the decision-making process for their treatment. It is beneficial to gain an understanding of what’s important to the service user. They will feel supported and empowered to make informed choices or decisions. And in an ethical and legal perspective, shared decision-making will respect the service user’s autonomy, we as a healthcare professionals are not causing any harm but doing good instead, it is a legal requirement and also it requires healthcare professionals to take reasonable care to ensure the service users are aware of any material risk involved in any recommended treatment or any alternative treatments. Shared decision-making is like a partnership that enable service users and healthcare professionals to work together and share expertise equally in the decision-making process.

I have learned what to know before informing the service user including decision support, decision aids, and recording decisions. Barriers to shared decision-making were also included in this lesson which are: time, resource, standardized approach to practice, attitude, lack of decision aids, service users not wanting to be involved, service users unable to be involved, and decision-making capacity.

This lesson enables me to understand clinical judgment and decision-making and understand the importance of providing quality care to service users.

KBS addressed:

Apprenticeship Learning Log

Date of Learning: 08/09/2023

Time: 9:30 to 12:30

Title of learning activity: Health Promotion in Older People & Benefit of Physical Activity

Learning outcomes:

1. Understand the impact that ageing has on physical and mental health
2. Identify health promotion/public health activities that can enhance wellbeing in older people
3. Recognise the challenges experienced by this age group and understand how you as a nurse might help.
4. Understand the benefits of exercise for all ages groups within health promotion.

This session made me understand how ageing affect physical and mental health.

Some of the conditions can be hearing loss, neck/back pain, cataracts and refractive erros, heart failure & CKD, diabetes, menopause, arthritis,immobility and loss of balance, incontinence, hypertension, dementia, and Alzheimer’s, deression, anxiety and loss of confidence. This conditions can affect a person’s daily living and it impact on their lives.

Ageing well and health promotion in older adults is important because it reduce risk of condition related to aging, reduces stress and elevating moods to help prevent issues, prevents premature death, reduce socio-economic burden and health aging improves mental and physical well-being.

There are health promotion/ public health actitives that can enhance wellbeing of older people such as TTT (Think, Test and Treat), There’s no excuse for elder abuse, end PJ paralysis, falls prevention, Exercises and benefits of muscle and bone strenghtening activities at different ages, boost your immunity this winter with flu and covid booster, age uk,malnutrition in older people,campaign to end loneliness.

There challenges and barriers that older people experiences like poor and mental health, poor functional ability affecting daily living and lifestyle, ageism, financial insecurity, caregiving, access to health care services, social isolation and end of life preparations.

As a nursing associate we can play a big impact in educating older people and advocating for them to assist them to do exercises or attend social gatherings in promothing good health and wellbeing,

Exercise is a health promotion that is beneficial to all ages group as it ageing well start from a young age.

KBS addressed:

Date of Learning: 08/09/2023

Time: 13:30 to 16:30

Title of learning activity:Delivering Care in Alternative Settings Workshop

Learning outcomes:

• Share own experiences to understand working in different settings
• To gain an understanding of person-centred care in different settings
• To gain an understanding of shared decision making in different settings

We had a discussison about our own experiences and how we understand the person centred care, how we make sure that the patient or individual is being cared for according to their wishes and preferences, treated with respect and dignity and included in the shared decision making which includes the MDT and carers or families.

Delivering care in different settings differ in each one but still should be person centered care. This is according to the fundamental standards of Care Quality commisions.

KBS addressed: