Apprenticeship Learning Log
Date of Learning: 02.07.2025
Time: 0930 – 16.30
Title of learning activity: Naso Gastric insertion and Bowel Care.
Diary of Learning activity
Today’s lectures were held in the simulation centre, where we learnt about Naso-gastric tubes, how to measure correctly for each patient and tips on insertion. To measure, go from the tip of the nose, around the ears and down to the xiphoid sternum. You must then consult with the trust you are employed with to determine how much longer you must allow to ensure you insert it into the stomach. Some trusts stipulate a range of 5 cm to 10 cm. Once you think you are in the stomach, you would aspirate and test the fluid with litmus paper to check the acidity of the fluid. This should be less than 5 to indicate the presence of gastric acid.
Once you are satisfied that the tube is correctly placed, tape the external tubing to the cheek. Be aware that the adhesive can rub the skin and cause pressure ulcers. Consider foam padding and Tegaderm to secure the tubing.
Regarding bowel care, we discussed the Bristol Stool Chart. What would be appropriate to send as a sample for bacterial infection, and what wouldn’t? We also discussed constipation and its causes, stoma bag care, and why these are often used in conjunction with ileostomies. Additionally, we gained insight into skin integrity and how to protect it from breaking down. The Tutor also walked us through the process of manual evacuation; however, this is now an outdated practice.
K1: Understand the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and how to fulfill 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
K4: Understand the principles of research and how research findings are used to inform evidence-based practice
K5: Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care
K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice
K7: Understand the importance of courage and transparency and apply the Duty of Candour
K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care
K20: Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met
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
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
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
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
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