8 months down the line as a newly qualified nurse

I can’t believe how quickly it has flown by since I have qualified as a children’s nurse. I should probably start with an update on what happened after the last blog post as at that current moment in time I was in a bit of a quandary and jobless.

So, I passed my driving test and was accepted onto the Specialist Community Public Health Nursing course having a missed a week. In true chaotic fashion that is reserved for me only, my driving test was cancelled days before I was due to start the course because of staff sickness. I had to really fight for the powers that be in the NHS trust to give me another chance and allow me to commence the course late and the pressure was now obviously huge. I had to do my test in an area I did not know (not that I knew the area I was living in at the time as I had just moved!) and I was so lucky to have the nicest driving instructor ever that day. So I passed on the Thursday and had a commute to contend with on Monday which involved the motorway, roundabouts, weird road markings and roads I do not know, as well as start a course not knowing anyone or anything. My partner had to pick up my portfolio from the university (as I was at home for a funeral – yes it was all going on at the time) as I went straight into placement 30 miles away on the Monday! It was a bit stressful.

To cut a long story short, the course has been ridiculously hard. I have found doing block placement and academic work difficult to juggle as it makes it hard to grasp the job role. As well as this, I think I have had the underlying issue that I was not loving life like I should be. After years of working my arse off in various settings before nursing, then doing the nursing degree, then moving to Hampshire, doing my driving test in a short space of time and learning a new way of life (I’m going to be frank, the change from London life to Hampshire life is massive) I think I just burnt out.

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After desperately wanting to leave London for a better life – bigger accommodation (you know, not a rabbit hutch), better air quality, not as squished – I have started feeling homesick for my London roots. I wonder whether this is because I am not enjoying my career like I thought I would or simply because moving back here is not how I imagined (I used to live in Southsea but now live in a sleepy suburb outside of Portsmouth). I don’t know the answer.

I still haven’t found myself like I thought I might doing health visiting. I struggled from the middle of second year until qualification with the nursing course – it was a long “second year blues” episode – and thought on qualification things might start to make sense career wise. I am now strongly considering not being a health visitor after this because it just is not what I want to do now. I had a breastfeeding assessment which was appalling (me, not the actual assessment) and the person assessing me asked if I should have maybe considered school nursing. I wonder if I would have felt like this had I done it in London? It is not just me that is feeling like this – others on my course also feel as dismal about the future of health visiting (and nursing in general) and their futures in the profession. It is doom and gloom and with the impending general election and current political agendas, it is hard to keep your head above the water at times.

It has taken me a long time but I have started to dust myself off of the negativity I was starting to drown in. I am proud to be a nurse. I have worked really hard to get to where I am. It came down to me examining why I went into nursing in the first place which has led me to where I may go next in my nursing journey. Watch this space.

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Epilogue: Newly qualified children’s nurse.

I did it. It took blood, sweat, tears (a lot of tears) and an iron will to get through 3 years of paediatric nurse training. Would I do it again? Absolutely not. Was it worth it? I desperately hope so.

I went into nursing because I wanted to make more of a difference in children and families lives than I did as a support worker – not that support workers don’t make a difference, but for me I wanted to be the one who made the decisions rather than the one who was doing all the work, spending the most time with a child/family and feeding back information to others who would then make important decisions. I often felt extremely frustrated with the hierarchy in my workplace because I knew what needed to be done for a particular child or family but would be met with derision from some professionals. I think having the experience on the other side has been really valuable for me to reflect on as a student nurse when working with other staff. (What is funny is that I then chose to enter a profession which had an extremely clear cut hierarchical system!)

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I digress. My last blog post was in my first weeks of my final placement. Unfortunately, that placement was the final nail in the coffin for me regarding hospital nursing. The ward was particularly tough and wrought with staffing issues although the team were absolutely amazing. I really admired their resilience because there were some weeks which were incredibly difficult. I think I was lying to myself in the hope that I would eventually enjoy working in hospital but I just know deep down that I won’t. A lot of nurses and other people have said to me that I should do a year in a hospital for experience but I just cannot see myself surviving the wards. Would it be worth taking the chance? I don’t know.

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I did apply for a student health visiting post and I was due to start next week but that has collapsed because I need to pass my driving test to start the course. I am nearly at test level, but quite frankly the enormous amount of pressure on me to pass has rendered me into a blithering mess every time I step into the car. It has been non stop since I finished the nursing course – we moved to Hampshire and I needed to learn to drive in a short space of time. It has made me feel like a failure and my confidence has been knocked. However, onwards and upwards, I do feel much better this week because I am not settling for any old job just because I am newly qualified. I have worked for many years before nurse training and I undertook the training in order to have better job satisfaction. If I went through three years of hard graft to end up in a job I disliked then I just think none of it would have been worth it and I’d be doing my patients and their families a disservice.

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Maureen from Driving School. Pretty close to her level of driving at the moment.

The good thing about nursing though is that there are a lot of opportunities to branch off into different areas and environments. I am looking into children and adolescent mental health services (CAMHS) and other community nursing type roles. I developed an interest in policy , legislation and sociology during my degree which has really shaped how I want to nurse. I have always had an interest in CAMHS having liaised with them in my previous job  in social services and constantly trying and failing to organise placements in a CAMHS service during my training. It is funny that I have come round full circle to wanting to go back to working with children with autism, severe learning disabilities, challenging behaviour and mental illnesses. I really miss the satisfaction of working in a disability/mental health service, despite the slashes to services, because I just found it so challenging and extraordinary to work with such amazing children and families.

So I have found myself in the laughable position of being unemployed when there is a nurse shortage. What I have found is that it is not as simple as a “nurse shortage” it is more a “money shortage” with many places wanting the nurses but not having the money for the job post needed and if they do they then do not have the money to train staff when they are employed. Anyway, I keep banging on doors in the hope that one may open!

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Channelling the crystals like Spencer when I feel like I’m going round in circles.

I will be interested to see what happens by Christmas. I am very bored of being off and would love to be working! Then I may have a cheerier blog post in which I navigate the newly qualified nurse transition…!

Has anyone else had the same issue where they haven’t gone straight into employment after completing their nurse training?

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Nearly there – making some decisions about nursing

I haven’t blogged in quite a while. It has been pretty busy academically with essays and dissertation to complete as well as placement hours. Alongside this, I’ve been involved with the #bursaryorbust campaign which has been incredible.

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So, I’ve nearly made it to the end. It feels as though the last 3 years have both flown and dragged. Training to be a nurse has been so much harder than I ever imagined. I was warned and I heeded those warnings but until you go through it, you have no idea how you will cope with the demands of this course! Coming towards the end of second year and most of third year, I just didn’t enjoy it like I had done. Even the placements I had I just felt were not for me (which is a good thing to know!) and the pressure of academia as well as simultaneously undertaking a placement in an intensive care setting really did me in. I was really looking forward to it but it turns out that ICU simply isn’t for me, having been lucky enough to be placed in both NICU and PICU. All my academic work is now finished and I am pleased to say that I have a safe 2.1 degree with a first in my dissertation (shocker!). I never thought that I could achieve this.

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With all of this going on, I am also moving away from my home town of London to semi-rural Hampshire. Not having plans or a job (or even interviews at this point) was stressful. However, it is all sorted now with a place to live and a job offer at a DGH doing a general paediatric rotation. But here lies my dilemma: I adored my health visiting placement and plan to be a health visitor in the future but I am conflicted as to whether I should work in hospital for a year to begin with. It is funny because I had a retrospective read of my blog and it is so obvious how much I prefer social nursing rather than the physical, medical nursing you often get in hospital (Of course, hospital nursing requires that you have both social and medical skills and this is no way a criticism of hospital nurses. They are amazing, it just isn’t my passion). Attending a social prescribing conference last year seriously changed everything for me. It made me realise that working in the community shouldn’t be ridiculed as it is just as important, in different ways, as acute care. I found myself reading a journal a few months ago about how in medicine, those who go into general practice or psychiatry felt they were mocked by their peers for choosing a “less” acute area. That is simply not the case of course and both GP’s and psychiatrists are absolutely integral to medicine and the wider society. This is how I feel about health visiting and community children’s nursing because I like the aspect of early intervention and continuing care. I have been lucky enough to be offered an interview for a student health visitor programme which is equally terrifying and exciting and also completely unexpected. I have to do a presentation so fingers crossed I don’t say anything ridiculous or reveal my clumsy side. Either way, I will have a job as a nurse in a place I really wanted to work if health visiting is not to be.

So that’s me in a nutshell. Constantly in a quandary and forever indecisive. Let’s see what happens in the next few months – I need to get through my final placement first and foremost!

 

 

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In defence of our NHS: scrapping of NHS bursaries and what it really means. (To me, anyway)

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In the last month, student nurses, midwives, junior doctors and other healthcare disciplines have been organising and liaising with each other in response to the cuts to the NHS bursary in the Autumn spending review by George Osborne. At the adjournment debate regarding the cuts to the NHS bursary, Wes Streeting MP gallantly defended and spoke with great clarity of how cuts would affect the NHS workforce. From this, we found out that there are plans for a two pronged route into nursing; degree and apprenticeship. Suddenly, the plan has been exposed – associate nurses as a cheaper alternative to degree level registered nurses. For me, I am proud to have been given the opportunity to study at degree level to be a children’s nurse. It is a really tough course with 50% of my studies in university and the other half in clinical settings and I have often had to work weekends, nights, bank holidays and regularly miss social events. If I happen to be sick, I have to make those hours up or I will fail to progress onto the next year of study. This means for three years, it is very difficult to plan anything at all as there is the very real possibility of failure. Healthcare students live, eat and breathe what they are studying as there is just no time to do, or think, of anything else. We are fully immersed into the NHS and we have a prime seat in observing what is actually happening in hospitals, communities and other settings and how this directly affects those using healthcare services.

Nursing has advanced over the years where entry level newly qualified nurses need to have a very good underpinning of theory to practice safely and initial studies from RN4Cast have shown that patient mortality has decreased since graduate nurses have been introduced in Europe. Nurses who have been trained before the degree education route are integral to the NHS as they have progressed, evolved and seen the changes that have occurred in hospitals and the community. Experience and the ability to embrace change is what makes a truly remarkable practitioner. I am well aware that there is an argument about us degree educated nurses being “too posh to wash” but this is not an argument that needs to be had and is entirely unsubstantiated; there are no short cuts in nursing. Having factions within nursing is exactly what the government wants in order to divide and conquer.

Many healthcare students are in full support of the campaign to stop the NHS funded bursary becoming a repayable loan from student finance. From the way in which this government has decimated social care, health care, emergency services and education, I admit that when I first heard the news about the bursary being cut I was cynical. Loan repayments have been estimated to be over £50,000 with a freeze on student loan thresholds meaning that while healthcare professionals enter the rigid Agenda for Change banding (which has been frozen at a 1% pay rise cap until 2020) and the cost of living rises with inflation, they will still have to pay off their student loans at the same threshold creating a fiscal drag situation. Yes, sneaky George has put in the small print in the review that this will now happen rather than the promise of repayment thresholds rising with cost of living. It is starting to become apparent that healthcare professions are becoming privatised and are not valued for the work that they do – this also applies to the current junior doctor contracts dispute.

When healthcare courses can be up to 50% in clinical settings, theory needing to be condensed and completed in 18 months rather than three years, there is little time to work to subsidise living costs alongside such a demanding course. For example, student nurses are expected to complete 2300 hours over three years in order to become a registered nurse in line with the Nursing and Midwifery Council. Currently, the bursary, although a small amount of funding, is a lifeline for many and travel to clinical placements can be refunded if the placement is further than the journey to university. The loan system could mean that travel reimbursements are stopped. Other degree courses do not have the intensity of work as those that are in healthcare and social work. As student nurses on placement, we are expected to be responsible and safely look after the patients we are allocated. In our final year of study, we are expected to take our own caseload of patients under observation from a registered nurse mentor. If loans were then to replace bursaries, we would essentially be paying to work. Adjacent to this, nurses and other healthcare professionals have the wider issues of safe staffing ratios, threats to unsociable hours pay, threats to close down invaluable services such as A&E and maternity, lack of service provision and/or funding and the constant diatribe from certain media outlets and governmental organisations. For people who simply want to go to work and care for patients in the best way they can, these issues are ever present as a precursor for privatisation and dilution of our professions.

In September this year, it was proposed that junior doctor contracts would be changed which meant that their pay was slashed and their hours of work would be unsafe. The response from junior doctors to this was, and is, incredible with a strong sense of unity especially as other healthcare professionals and the public rallied behind them. I certainly feel with the relentless onslaught of short sighted cuts, revisions and demonization in the press of “greedy” doctors and nurses who “think they are special” that actually the relationship between healthcare professionals has been strengthened as we face manipulated statistics and generalising statements together. I, and the rest of us who believe that the NHS is being privatised piece by piece, are still yet to be proved wrong after a category of questionable choices instigated by the government.

Join the Twitter storm and discuss the bursaries on 4th Jan here.

On the Saturday 9th January, we will be assembling at St Thomas’ Hospital at midday and marching to Downing Street to defend our NHS and save our NHS bursaries. If you care about the future of the NHS, you must care about the NHS bursaries. Please march with us.

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NHS BURSARIES ABOLITION: it isn’t about the money, it is about the patients.

 

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Protesting alongside junior doctors.

“The budget review has come out and as you may have seen bursaries for students hoping to train to be nurses or midwives has been abolished and are to be replaced with standard tuition fees and loans.

Yesterday, while I was working to subsidise my nurse education may I add, I was outraged and also sad. I feel sad that nurses aren’t valued by the government. I feel sad that me and my amazing student nurse friends are entering a profession that is just about keeping it’s head above the water. As a newly qualified nurse, the minimum wage is 21k plus unsocial hours (another thing the government want to take away from us) I don’t think there’s any point in talking about how dedicated and how hard we work as students because it should go without saying. Anyone who trains to be a nurse isn’t doing it for the money or the accolade but are doing it because they care about looking after people.

The profession has progressed loads education wise with nurses taking on lots of responsibilities and operating equipment and technology which keeps people living. Hospitals with a majority of university educated nurses are more likely to have better mortality rates because we are taught extensive skills in identifying deteriorating patients and in doing so can better assist our doctor colleagues.

The idea that cutting the bursary will encourage 10,000 more prospective students into nursing is quite frankly ludicrous. In a few years time (and this is a known issue) many nurses will be retiring and there will therefore be a deficit anyway. As is well covered in the news, wards are full to bursting and staffing levels are dangerous. You may think we are simply moaning about cuts to bursaries but it goes deeper than that – this move is dangerous and more people will die as a result. This government doesn’t care about its people, they are trying to spin that the NHS doesn’t function 24/7, that we kill people more at the weekend and that maternity services are unsatisfactory. Yet, who are the ones cutting essential essential health and social care services, pushing junior doctor contracts and getting rid of education funding for nurses and midwives and telling us this is good? It is an insult.”

I posted this on social media yesterday not knowing everything there is to know about the cuts to the NHS bursary for students. My little rant focuses on nursing because I am a student nurse. However the bursary cuts will affect nurses, midwives, physiotherapists, speech and language therapists, podiatrists, ODP’s…..the list goes on. The long term effects of this is what is truly worrying.

Before I began my foray into the world of nursing, I worked with children and young people with disabilities and mainly children with autism and challenging behaviour. The effects of the cuts to speech and language services, lack of specialist school places, inability to obtain a statement of special educational need and not getting any form of respite at all, all contributed to breakdown of families and failure to meet the needs of the child or children in the family. This was only 4 years ago and things have only got worse and will now get worse with the short-termist changes that the government are making.

Back to the subject at hand…bursaries being replaced with loans will not encourage people to train in these important professions. It will mean that the range of people who want to train as healthcare professionals will become rather unvaried and, unfortunately, will be only for people who can pay. It seems pretty silly to be charging fees and using loans for professions who have rigid pay scales and therefore will not be able to actually pay it back in their lifetime. (111 years has been the figure bandied around).

Not only does it mean that us, the people from all different backgrounds who want a career within the NHS/healthcare are penalised, but it also means that those who need these services are the ones who will be suffering the most. Just like the junior doctors reiterated time and time again – it isn’t about the money, it’s about the patients. Not having enough healthcare professionals causes children and adults to suffer, and in the worst case scenario, even die. It sounds dramatic but it is true.

Yes I feel sad that I am going into a profession that is at breaking point, that is the backbone of the NHS and running on goodwill but I am even sadder for the people who rely on these services to support them in their lives. Life is already hard for these people (it will be people on the poverty line who will feel this the most) so it breaks my heart to know that things are going to get worse for them and that I feel powerless to do anything more than I already am to help them.

 

I will be marching on Wednesday 2nd December in London. I urge anyone who can to please attend. It would be great to get more protests going around the UK – let’s unite and save our NHS. Don’t let the government divide and conquer.

SAVE OUR NHS BURSARIES DEMO

If you can’t make it in person, go here and post your selfie:

SUPPORTING THOSE MARCHING – POST A SELFIE!

 

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I quite like the concept of social prescription.

I was lucky enough to attend the College of Medicine Summer School at UEA earlier in September. I had never been to a conference before that lasted longer than a day (and I got to stay in student accommodation so I was feeling circa 2006!) so was unsure of what to expect. I was also dubious – would I be one of the only student nurses? Would people mix? Would it be relevant to me?

I was pleasantly surprised. I thoroughly enjoyed every single lecture and key note speaker who presented there. The theme of the summer school was healthy communities and much of the conference was centred around the concept of social prescription. Social prescription is a term that I had never heard of before the conference but an ideology which I am definitely going to research into. In a nutshell, social prescription is the linking of people up to activities in the community that they might benefit from and connecting people to non-medical sources of support.

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Particular highlights were from Dr James Fleming who spoke about the concept of salutogenesis and his social enterprise model Green Dreams Project based in Lancashire (more of which you can read about here). To me, James came across as a really genuine and warm person and his passion to help people outside of the prescribed health world was truly inspiring. Paraphrased: “Does an antidepressant make someone’s house nicer?” “Does a sick note make it easier to return to work?”. It was really refreshing to hear someone think outside the box. Dan Hopewell, director of knowledge and innovation at the Bromley by Bow centre also emphasised the need for social prescription. He expressed the importance of the Marmot report as a must-read for all healthcare students and illustrated this by presenting a Bromley by Bow diabetes prevalence map of today compared to a poverty map by Charles Booth in 1889 – shockingly the same but demonstrating perfectly the very important issue of health equity. We also had Dame Donna Kinnair speak about the importance of having a political voice as a healthcare professional and having expert patients voicing their experiences of care and how we can change; James Wood, superintendent pharmacist, who spoke about effective medicines management and putting the patient central to this to improve quality of life; Anna Minton, journalist, who spoke about cities and public spaces and how constant CCTV and extra precautionary measures to prevent crime and anti-social behaviour actually exacerbates it; and finally Dr Michael Dixon, chair of the College of Medicine, who spoke about his own embodiment of social prescription at his practice, thanking us for attending and inspiring the us to go forth and keep working hard! A lot of very interesting subjects which were varied.

The next day of the conference we had expert patients come in to speak about their experiences of services and how they have helped improve them, including one from a man who suffered for many years with undiagnosed mental illness. It was quite humbling to hear this man’s story and I admired his courage to talk about his life with brutal honesty. City Reach, a healthcare provider for people who find it difficult to access GP services, also attended with patient experts. People who may find it hard to access services might be those that are homeless, at risk of homelessness, asylum seekers, refugees, sex workers, Gypsies and Travellers or anyone else for any other reason. A simple but effective phrase which was used was “hard to reach or easy to exclude” which I felt was very thought provoking. It is easy to forget about these groups of people when you are not directly involved with them but we should still be giving choices and support to them as much as possible. This was also interesting because it identified where I lacked knowledge. I felt that I had some knowledge of mental health because of previous work I had been in, but to be honest I had no idea how difficult services are to access especially in a rural area. Homelessness was also touched upon, again, another area which I did not know much about. I have since shadowed a homeless team and researched more about mental health and well-being but still feel I would probably benefit from more exposure to this in my training perhaps.

What was refreshing were the people who attended the conference. They were all like-minded students of healthcare or similar and were all fantastic. It was nice to have “inter-professional learning” but not in such a forced manner in which it happens at uni. It was great to hear how our experiences differed but were similar in various ways despite training towards different professions; we still had the same goal which was to improve patient experience and quality of life.

From the perspective of a student nurse, I really liked the social prescription model. I couldn’t help but think it was a slightly extended version of medical model vs social model of disability however it is leaps and bounds into the right direction. Even though it was from a medicine, general practitioner perspective it inspired me to think about social enterprise. From working with children and young adults with disabilities for years and being exposed to the difficulties families faced, I used to have lots of ideas about services that could be implemented and this conference made them seem like less silly, idealistic ideas and more “let’s do this”. Maybe one day. Who’s with me?

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This blog is a really simple and short overview of the conference. If any of these areas of care interest you then you can read the presentations from the speakers here.

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Now it’s the third year blues.

I thought it wouldn’t be me writing a post like this. Sorry, but this is probably going to be negative.

The nursing degree is hard. Being a student nurse is hard. There is no other way to sugar coat that. How you cope with it is what is important in this. I don’t think I am coping particularly well at the moment as it has been a week at uni and a week in placement and I still don’t feel my usual enthusiasm for nursing returning. In all honesty, I feel quite lost.

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I will never quit nursing. I can see the bigger picture and qualification is only 10 months away. I have worked prior to this degree and have completed another, unrelated, degree. I am 27 years old. It has been tough not having my own identity – I just feel like “the student nurse” and my whole life rotates around studying and practical placements (sometimes placements I really do not want to undertake). I also feel this course has impacted my social life and my relationship – my poor partner has often had to coach me through times I have found really difficult, midnight tears and the monotony of listening about nursing when you have no interest or are involved in healthcare at all. Poor sod.

There is a light at the end of the tunnel in the form of qualification but then what? I become a nurse demonized by the press, suppressed and suffocated by the government. There only thing that gets me through is my passion to help others. When everything is getting on top of me, all I think about is how to make someone’s life better – I was really lucky to be sponsored to attend the College of Medicine Summer School which focused on healthy communities. This conference helped me gain some perspective regarding my own personal beliefs, morals and ethics and made me think about a future career in primary care. (I will write a separate post about the summer school soon).

I have had amazing opportunities and I feel like it is a little bit of a fluke that I am in one of the most renowned nursing schools in the UK and I would do well to remember that. I know I am lucky to even be studying nursing as some people apply for years before they are accepted. However, right now I feel like I am treading water and just keeping my head above the waves. I haven’t really enjoyed many of my placements (I mean like LOVED) I have had which has made me doubt myself, my abilities and my career.

I am hoping this feeling passes or else I am in for a rough ride the next year.

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