Part B Podcast
Voices from students and Newly Qualified Practitioners
Ethical dilemmas-Charlie Clisby –pg 66
Ethical dilemmas are difficult; everyone has their own views and principles of what they would do, but as a nurse, we have to be non-judgemental and unbiased. We must support our patients/clients and their families and carers with their choices and decisions even if they are not the choices we would necessary choose.
Negligence – Sarah Parkes, learning disability nursing student
I always believed that negligence in nursing was because of an accident, but after recent press articles I am shocked that anyone could treat someone like that let alone a nurse. Why would a person go into a job that needed care, compassion and understanding of people’s needs and hurt and abuse then, I am just horrified.
Confidentiality – Siân Hunter, child nursing student
I always ensure I never, ever talk about any patients, even to colleagues if it is not appropriate ‘outside the workplace, canteen’ for example. Should I need to discuss a patient with another member of staff/professional, I ensure we are in an area where we cannot be heard by other patients or their families. It can be difficult on a busy word but it is not impossible. Being aware when talking to patients in a bay should be considered, talking loudly so that everyone can hear breaches their right to confidentiality and can also be incredibly embarrassing and un-dignifying for them. Always using a pseudonym if you refer to patients/families/colleagues in essays so they cannot be recognized is equally important.
Leadership – Siân Hunter, child nursing student
I had used elements of leadership skills in theory at uni. When I have been in my enquiry-based learning skills group and have presentations, sometimes things can get cloudy and confusing and no one knows what they are supposed to be doing so I speak up, and start asking someone what they think, then ask others if they think it is a good idea, and continuing with this approach and just by doing this the group returned to being focused on the task at hand. I have encountered difficulties with group dynamics but I always try to think of the individual. Are they okay? Are they struggling and need extra support? Are there problems at home, I feel it is always important to be mindful.
Communicating with patients who do not speak the national language-- Julie Davis, learning disabilities nursing student
I would ensure I used a translator if one was available, if I had to communicate complicated or detailed information. However on a 1:1 basis I have used facial expressions, body language, gestures and pointing. I have also used photos to enable the patient to communicate their needs to me. I have also learnt simple body part names in their language when I have built up a relationship with them, to enhance communication.
Communicating with patients who do not speak the national language-- Laura Grimley, adult nursing student
Thinking outside the box helps with this situation. It’s important where possible not to rely on relatives to interpret for the patient. Red cross emergency translation handbooks can help identify people’s languages and help with basic questions. Telephone interpreters are the best method for interpretation. However gestures and google translator has also been in situations I have witnessed.
Voices from Nurses
Holistic care, ask questions – Victoria Lynne, children’s nurse
I am a neonatal staff nurse.
I deliver a high standard of nursing care for babies and families on the unit, supporting each neonate and family from admission through to discharge. As a neonatal nurse, I encourage parents in all aspects of caring for their baby, including their physical and emotional needs. I participate in collating data for research studies and support other staff members and healthcare students.
I have been a nurse for six months. Nursing provides a very special opportunity to be involved in people’s lives, and no matter how small my input I wanted to make a real difference to a child and their family. There are very few jobs that can offer the same level of personal achievement and satisfaction.
I thoroughly enjoy the privilege of being able to hold a baby’s hand and their parents through very challenging and exciting times when a baby is in intensive care. One of the challenging aspects about nursing is dealing with the outcomes of management trying to balance finances and patient care.
Holistic care is fundamental in nursing practice and whilst on the neonatal unit I helped a first time mother feed and change her baby for the very first time. I felt I was in a very privileged position to help the mother develop a bond between her and her child and through this task I was able to demonstrate my commitment to delivering compassion and kindness for a vulnerable family. This particular task required lots of encouragement and support; yet, it was a success the baby fed well and I witnessed a memorable interaction between a mother and child.
What one piece of advice would you pass on to a student nurse today?
My advice to a student nurse would be: never be afraid to ask that ‘silly question’ – we have all thought of it! If you have got what it takes to be a nurse go for it! There will be times that challenge, excite and upset you but it genuinely is the best job in the world and we need more nurses to share the passion, ignite ambition and provide outstanding care!
Patient education, working with families, changing practices and outcomes, professional networks – Pamela Shaw, Health Visitor/ Practice Educator, Queen’s Nurse 2014, Health Visitor of the Year 2012
I am a Health Visitor/Practice Educator. My clinical role involves responsibility for a defined caseload of children aged 0–5 years and proving advice and support to parents. I am involved with planning and evaluating packages of care through health promotion, screening and safeguarding children. The Practice Educator part of my role entails providing workforce development and training packages as well as leading on preceptorship and reviewing clinical practice and policies. My involvement with student nurses and health visitors requires provision of an effective learning environment through the facilitation and assessment of their learning.
I qualified as a general nurse in 1991 and worked as a staff nurse for two years before embarking on a career in midwifery. I later trained as a health visitor and then after two years of qualifying I completed a Practice Teacher course as well as a postgraduate certificate in education.
I became a nurse to support patients and their families to have a positive impact on those I encounter. I also wanted to increase patients’ and their families’ satisfaction of the health service regardless of what background, race, gender, and ethnicity they are from. I believe nurses are in a very privileged position that enables them to reach many people from all parts of society. Nursing involves more than providing care, it entails good communication and building relationships with clients so that they can maintain or achieve independence. It also entails a large element of health promotion through education, as well as actively influencing policies at the frontline and at strategic levels throughout the NHS.
I enjoy enabling clients to be aware of their health needs and encouraging them to seek out ways they can enhance theirs and their families’ health. The most challenging aspect of being a nurse is managing the change process by questioning established practice and suggesting improvement ideas. This has been difficult at times as it requires good negotiation to get the best outcomes, and then to turn negatives into positives, whilst keeping everyone on board with why change was needed. Managing change teaches you the importance of good communication. Ways to manage resistance to change are by continuously re-evaluating your approach and balancing this with effective leadership.
A nursing experience I remember was when working with Family X. They had a history of not attending health appointments and a poor punctuality record with school. I had not been working with the family long when it became apparent that person X’s lack of engagement with professionals was due to her poor literacy and numeracy skills. Person X admitted that she could not read or tell the time very well and that often resulted in a lot of stress for her family and missed appointments.
We discussed the benefits of accessing help and support as well as the disadvantages of not addressing the issues. We also discussed what was available for free locally and how to access the services. I agreed to go with person X on her first enrolment at the literacy class. All health appointments were arranged so that Ms X attended immediately after school thus ensuring good attendance/up-take. A referral was made to a Book Start worker and regular joint visits were made to enable Ms X to enjoy sharing picture books and simple text with her children. Over time we noticed an improvement in the children’s behaviour. Ms X started attending the ‘family enjoying everything together’ (FEET) group at her children’s school and has made many friends at the literacy group, which reassured her that she was not alone. She regained her confidence by actively engaging more with her children’s education, contributing to their schooling by helping with activities. My involvement with the family taught me that we should not presume an individual’s lack of engagement is linked to idleness, but if we take the time to listen and ask key questions in a non-judgemental way, we may enable real progress to be made that benefit the individual, their family and in this case the community.
My advice to nursing students would be to seek out opportunities to reach personal goals, and cultivate professional networks with people who are prepared to offer unconditional support to enable you to develop and grow. Always be prepared to work hard, read widely and stay informed about nursing and politics. Set your own limits and don’t allow others to set your limits for you!!!! Always make time to take care of yourself, ensure you exercise, eat a balanced diet and get plenty of sleep. Set time aside for your family and friends and never lose your sense of humour – it will enable you to build resilience.
Voices from Patients
Stroke and mental health problems – Anonymous, 60 years old
I am a poet and composer of Somali songs. I am currently writing a book on the anatomy and physiology of the human body in Somali language.
I can remember a specific instance of nursing care when I was in hospital. I was used to taking medication beforehand and felt that the nursing staff treated me well. I was treated with dignity and respect and was well cared for during my admission.
I was administered with oral medication for a mental health condition. The staff explained everything to me and I felt comfortable.
Delusional disorder – Anonymous, 46 years old
I am unemployed and have delusional disorder. I can recall a specific positive experience of nursing care in Chase Farm Hospital. I had a test for blood sugar levels and was nervous beforehand. The nursing care made me feel safe, secure and dignified. The nurse helped me by being friendly and kind. I felt relieved afterwards.