It is a different experience and no matter how good of an HCA you are or
were, being a nurse means you’re accountable and as a student nurse, so are
you. I did work some shifts and as a HCA you go in, do your work and go home.
People want to complain, refer them to the nurse. Patients want their
medication, refer them to the nurse. Patients want to know something about
their care, refer them to the nurse. They don’t know if they should eat or
drink, refer them to the nurse – I think you get the picture. That doesn’t mean
that you’re rubbish as a HCA – it’s just a different role. As a student nurse,
you’re going to need to know these things (but don’t worry, things start
slowly).
I had no experience when I started – I had only done consultancy based
work in offices or working from home. So when I stepped into a ward, it was
like being in another planet. Of course, you have skills labs before placement
and you have a lot of preparation but nothing quite prepared me for the fast-paced
environment of a ward. Wow! It was baptism by fire, to borrow the old phrase. I
very quickly decided that I needed extra support so I did some research and
found a book that I could go to for help with the more practical aspects of
nursing skills. Some people swear by the Royal Marsden – I found it too stuffy,
oddly sectioned and didn’t like it much. I fell in love with another book –
Kozier’s ‘Fundamentals of Nursing: Concepts, Process and Practice’ (I think
Pearson publish it). In my years of nursing training, I have probably used
every section it’s got. Nursing isn’t just doing what doctors want or knowing a
few clinical skills. It isn’t an extension of the doctor’s role – it is a
profession apart. If you’re nursing passively – i.e. merely following orders –
eventually you will find yourself in a whole world of trouble which may end
with you being struck off the NMC register. Knowing the nursing process and the
frameworks we provide care from, knowing the legal and ethical dilemmas, the
importance of advocacy, infection control and health promotion – this is vital
information to know and operate from. There is also section after section about
the clinical skills that you will need to know.
Take vital signs, for instance. This will probably be one of the first
skills you’re going to learn (if doing adult nursing). If you’ve HCA
experience, you’ll know how to strap on the BP cuff and the sats probe into a
finger and you only need to see it once to have a fairly good idea about how to
do it. However, as a student nurse you need to know about the correct positioning
of it (same level as heart) and why, what the readings actually mean, what it
is the sphygmomanometer is measuring and what the systolic and diastolic
pressure actually mean. As a nurse, you will be accountable for all the
decisions you make. So if you didn’t know (and got away with never knowing it
during your 3 years training) that cardiac output is heart rate x stroke/volume
and that there many factors that influence that and consequently the patient’s
BP, and something happens to a patient and it just so happens that it was your observations
that weren’t up to standard (or you failed to act), you will have a hard time
justifying your actions.
You can get all stressed about the
many things you will need to know or you can get a good book that you will
always be able to refer to. For me that was ‘Fundamentals of Nursing: Concepts,
Process and Practice’. I highly recommend it.
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