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 The Tutor also walked us through the process of manual evacuation; however, this is now an outdated practice.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

Apprenticeship Learning Log

Date of Learning: 25.06.2025

Time: 0930 – 16.30

Title of learning activity: ANTT, wound assessment and management

Diary of Learning activity

Today we learnt about types of wounds, how to assess them, treatment strategies and the antiseptic non-touch technique.

We discussed pressure sores, including their development, leg ulcers, and other wounds, as well as how to grade them. Appropriate dressings to help the scars heal FROM THE INSIDE OUT. It is no good for a wound to heal on the surface and leave a hole underneath, as this will cause the wound to break down again. We learnt about tissue viability nurses and their role in assessing and healing wounds. We learnt terminology like sloughy, which means the gunk that is emitted from the wound as it heals. If it has a very offensive smell, it is more than likely infected with bacteria.

Diabetes and smoking will impact how quickly a wound will heal due to the restriction of oxygenated blood reaching the areas to heal.

We then had the experience of trying the ANTT technique using dressing packs and the mannequins in the experience centre.

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

K19: Know how and when to escalate to the appropriate professional for expert help and advice

K20: Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met

K23: Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity

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

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

K35: Understand own role and the roles of all other staff at different levels of experience and seniority in the event of a major incident

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

K37: Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs

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

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

K42: Understand and apply the principles of human factors and environmental factors when working in teams

K43: Understand the influence of policy and political drivers that impact health and care provision Skills

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

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

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

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

S23: Work in partnership with people, to encourage shared decision making, in order 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

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

S37: Participate in data collection to support audit activity, and contribute to the implementation of quality improvement strategies

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

S40: Support and motivate other members of the care team and interact confidently with them

S41: Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others

S42: Support, supervise and act as a role model to nursing associate students, health care support workers and those new to care roles, review the quality of the care they provide, promoting reflection and providing constructive feedback

S43: Contribute to team reflection activities to promote improvements in practice and services

S44: Access, input, and apply information and data using a range of methods including digital technologies, and share appropriately within interdisciplinary teams

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

Apprenticeship Learning Log

Date of Learning: 18.06.2025

Time: 0930 – 16.30

Title of learning activity: Sexual Health and Health Promotion. PREP (Pre-exposure prophylaxis)

This was taught by an external teacher who talked us through STIs, signs and symptoms and treatment available. We spoke about HIV and PREP medicine, and the reasoning as to why it is effective in the control of HIV. Anyone who is diagnosed with HIV must manage to obtain a trackable history of sexual partners so that we can test them too.  Some trusts will test for HIV routinely when a blood test is taken. You do have the choice to opt out of this, but as stated, most of the cases nowadays are people who do not know they have been at risk of contracting the disease. We discussed who was suitable for PREP and who wasn’t, and when using contraception such as condoms would be sufficient.

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

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

K9: Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes

K11: Understand the factors that may lead to inequalities in health outcomes

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

K14: Understand the importance of health screening

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

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

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

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

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

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

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, in order to support individuals, their families and carers to manage their own care when appropriate

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

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

Apprenticeship Learning Log

Date of Learning: 11.06.2025

Time: 0930 – 16.30

Title of learning activity: Discussion and guidance for case study assessment

Today, we took the opportunity to discuss how to write the care planning assignment using the learning outcomes. We were divided into small groups and given the opportunity to read anonymised papers and to grade them on their merit. This exercise was worthwhile as it clarified our expectations for our work and how to achieve higher grades.

It was easy to identify the best paper by the way it was written and laid out. However, it did leave me a little daunted that that was the level needed to achieve higher grades and whether I was competent enough to write to that standard.

Apprenticeship Learning Log

Date of Learning: 28.05.2025

Time: 0930 – 16.30

Title of learning activity: Long-term conditions and end-of-life care.

Diary of Learning activity

Today’s lectures focused on individuals who live with long-term health issues (chronic), meaning they last for more than a year and have a significant impact on the individual’s life. They cannot be cured, but can be controlled with drugs and management plans.

They can be physical, neurological or cognitive (mental health).

We looked at the amount of NHS money spent on long-term conditions and how this affects budgets. It is essential to remember that these conditions could be idiopathic (no symptoms), some develop from lifestyle choices, i.e. smoking, obesity, etc. Roper, Logan and Tierney introduced a nursing model on the 12 essentials for daily living. This model is helpful in the planning of care for patients; however, bear in mind that not every one of the twelve categories needs to be utilised on all patients. Multimorbidity and comorbidity are the presence of one or more long-term conditions.

We looked at the stages of grief and how they can contribute to someone coping with a long-term illness – denial, bargaining, depression, acceptance and anger. We discussed how to suggest coping mechanisms and strategies we can provide to MECC.

The Liverpool Care Pathway ensures needs are addressed with end-of-life care. They suggest that nutrition, mental health, pain relief and comfort are requirements that need to be met.

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

K9: Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes

K11: Understand the factors that may lead to inequalities in health outcomes

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

K14: Understand the importance of health screening

K15: Understand human development from conception to death, to enable delivery of person-centred safe and effective care

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

K17: Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care

K18: Understand and apply the principles and processes for making reasonable adjustments

K19: Know how and when to escalate to the appropriate professional for expert help and advice

K20: Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met

K21: Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care

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

K37: Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs

K38: Understand the complexities of providing mental, cognitive, behavioural and physical care needs across a wide range of integrated care settings

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

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

K42: Understand and apply the principles of human factors and environmental factors when working in teams

K43: Understand the influence of policy and political drivers that impact health and care provision Skills

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

Apprenticeship Learning Log

Date of Learning: 21.05.2025

Time: 0930 – 16.30

Title of learning activity: Smoking cessation, Safeguarding children and end of life care.

Diary of Learning activity

Following on from health promotion topics, we tackled the subject of smoking and the effect it has on the lifespan of a person, practical strategies to offer smoking cessation (MECC) and diseases that relate to smoking. Diseases included COPD, Cancer and Heart disease. Mainly affecting the respiratory system due to damage to the lungs and Bronchioles, but a contributing factor to lung cancer, mouth cancer, etc.

MECC is a valuable way to bring into conversation the offer of smoking cessation services available to patients. Using this valuable time to reach out to your patients is a vital tool that should be optimised on every occasion. For MECC to work, the patient needs to be in the right headspace to take the advice on and act on what is suggested; otherwise, the opportunity is wasted. However, do not see this as a downfall but a further opportunity in the future for MECC.

Safeguarding children was self-explanatory, as I work in paediatrics and hold a level two in this subject. What was interesting was the opportunity to share experiences of when I have had to deal with child safeguarding issues and signs to watch for with my fellow students. We looked at a few examples of photographic evidence of child abuse, and I was shocked at how many of the class were in denial that this abuse presents daily in paediatric A&E.  We discussed the red flag system and that it only requires one flag to make a referral to safeguard a child from harm.

End-of-life care focuses primarily on providing dignity to the person who has passed away and the family who has lost the relative in question. We discussed the last offices and what those entail. It was a brief piece of work, as we would gather more details from being in placement. This would be our opportunity to experience end-of-life care or at least speak with nurses who regularly deal with this form of nursing.

K9: Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes

K11: Understand the factors that may lead to inequalities in health outcomes

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes

K14: Understand the importance of health screening

K15: Understand human development from conception to death, to enable delivery of person-centred safe and effective care

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

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

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

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

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

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