STUDENT COLUMN
A very different kind of nursing Selina Reyes looks back on her latest placement, this time in the fast-moving world of accident and emergency. She explains why, despite initially feeling out of her depth in unfamiliar situations, she would relish the chance to go back
© 2014 MA Healthcare Ltd
W
hen I first found out that my last placement of my second year was going to be in the accident and emergency department I felt slightly overwhelmed, among other things. I remember feeling very nervous and anxious as the perception I had of an accident and emergency department was a particularly scary one. I was expecting cardiac arrests left, right and centre and did not feel confident about being in this kind of situation, as working on the general wards is completely different. That said, I was also feeling excited and looking forward to working without knowing what could come through the doors. As my first day began I approached it with an open mind and a positive attitude as I knew I would learn a lot on this placement. The first day was very hectic but I got a feel for each different section of accident and emergency. I stuck by the same nurse all day as I was finding my feet and honestly did not want to get in the way! I spent the whole day on my feet and realised just how busy and tiring it was to be a nurse in accident and emergency. It was a completely different rhythm and routine from the general wards and it took some days to get used to it. As the first week passed I was slowly becoming more confident and was beginning to triage patients under supervision. I found triage quite an eye-opening experience as usually on the general wards there would already be a care plan in place for patients and it was a matter of following this and giving them their prescribed treatment. In contrast, in triage it was up to the nurses to present the patient’s condition to the doctors and be their advocate and also decide if the patient needed pain relief. Triage was a good experience as I was able to see many different patients and their reactions to being in the accident and emergency department. Some patients were apprehensive about explaining their problems so I tried my best to make them
British Journal of Nursing, 2014, Vol 23, No 17
feel comfortable and tried to be empathetic at all times. As the weeks went by I found that I enjoyed working in all the different areas of accident and emergency. I was also curious to know what it would be like to take part in resuscitation for a cardiac arrest. Every morning I would check the resus trolley and the resus room with another member of staff and always wonder if in a cardiac arrest all the equipment would actually be used.
Accident and emergency was a completely different rhythm and routine from the general wards and it took some days to get used to it. One morning we had an emergency situation in which a patient was having a myocardial infarction. I told my mentor I would just watch as I had never been involved in an emergency situation. So I stood by and watched everyone rushing around, preparing drugs, setting up IVs and hooking up the machinery. I felt really useless in that situation as I just stood there and took it all in; I wanted to help but I didn’t feel I was ready for that step yet. The only thing I felt capable of doing was holding the patient’s hand to let him know he was not alone. One of the nurses asked me to check the patient’s blood sugar and I had never felt so nervous before. Thinking about it now it seems silly but in that moment, in the middle of all the rush, I felt completely incapable of even checking a blood sugar! During my last week of placement I went on to do night shifts with my mentor. I was feeling apprehensive as I had never done a night shift before but I was also looking forward to it. On my last night I was quite disappointed that I had not been able to take part in any cardiac arrests during my six-week
placement. An hour later the resus line rang and that was it, a cardiac arrest was coming in via ambulance—I could finally see what it was like. We all rushed into the resus room and prepared everything; one of the doctors delegated to me the task of writing every detail on the board. In that moment I panicked. I had never done this before; I didn’t know what to write down or when to write it.The doctor explained briefly what he wanted me to do so when the patient arrived I began writing. I was told that after every three-minute cycle I was to let the team know and write down any drugs that were administered. It was just my luck that my watch’s battery had run out that same night so I was using an analogue clock that was hanging on the wall. I have never stared at a clock so hard in my life, counting down the seconds to when the three-minute cycle was over. When it was all over I felt exhausted and I hadn’t even participated in the CPR. Unfortunately the patient passed away and I later discovered he was on holiday, which made the whole experience even sadder as his family were not around. That resuscitation attempt was a real eyeopener and a great learning experience. It was like nothing I had ever participated in before and was such a different kind of nursing from the type I was used to. After my six-week placement I definitely feel that accident and emergency is a department that I would enjoy working in—I learnt so much every day because there was always something new BJN coming through the doors.
Selina Reyes
Third Year Student Nurse (Adult Field), School of Health Studies, Gibraltar Health Authority 953
British Journal of Nursing. Downloaded from magonlinelibrary.com by 137.189.170.231 on November 19, 2015. For personal use only. No other uses without permission. . All rights reserved.
A very different kind of nursing Selina Reyes looks back on her latest placement, this time in the fast-moving world of accident and emergency. She explains why, despite initially feeling out of her depth in unfamiliar situations, she would relish the chance to go back
© 2014 MA Healthcare Ltd
W
hen I first found out that my last placement of my second year was going to be in the accident and emergency department I felt slightly overwhelmed, among other things. I remember feeling very nervous and anxious as the perception I had of an accident and emergency department was a particularly scary one. I was expecting cardiac arrests left, right and centre and did not feel confident about being in this kind of situation, as working on the general wards is completely different. That said, I was also feeling excited and looking forward to working without knowing what could come through the doors. As my first day began I approached it with an open mind and a positive attitude as I knew I would learn a lot on this placement. The first day was very hectic but I got a feel for each different section of accident and emergency. I stuck by the same nurse all day as I was finding my feet and honestly did not want to get in the way! I spent the whole day on my feet and realised just how busy and tiring it was to be a nurse in accident and emergency. It was a completely different rhythm and routine from the general wards and it took some days to get used to it. As the first week passed I was slowly becoming more confident and was beginning to triage patients under supervision. I found triage quite an eye-opening experience as usually on the general wards there would already be a care plan in place for patients and it was a matter of following this and giving them their prescribed treatment. In contrast, in triage it was up to the nurses to present the patient’s condition to the doctors and be their advocate and also decide if the patient needed pain relief. Triage was a good experience as I was able to see many different patients and their reactions to being in the accident and emergency department. Some patients were apprehensive about explaining their problems so I tried my best to make them
British Journal of Nursing, 2014, Vol 23, No 17
feel comfortable and tried to be empathetic at all times. As the weeks went by I found that I enjoyed working in all the different areas of accident and emergency. I was also curious to know what it would be like to take part in resuscitation for a cardiac arrest. Every morning I would check the resus trolley and the resus room with another member of staff and always wonder if in a cardiac arrest all the equipment would actually be used.
Accident and emergency was a completely different rhythm and routine from the general wards and it took some days to get used to it. One morning we had an emergency situation in which a patient was having a myocardial infarction. I told my mentor I would just watch as I had never been involved in an emergency situation. So I stood by and watched everyone rushing around, preparing drugs, setting up IVs and hooking up the machinery. I felt really useless in that situation as I just stood there and took it all in; I wanted to help but I didn’t feel I was ready for that step yet. The only thing I felt capable of doing was holding the patient’s hand to let him know he was not alone. One of the nurses asked me to check the patient’s blood sugar and I had never felt so nervous before. Thinking about it now it seems silly but in that moment, in the middle of all the rush, I felt completely incapable of even checking a blood sugar! During my last week of placement I went on to do night shifts with my mentor. I was feeling apprehensive as I had never done a night shift before but I was also looking forward to it. On my last night I was quite disappointed that I had not been able to take part in any cardiac arrests during my six-week
placement. An hour later the resus line rang and that was it, a cardiac arrest was coming in via ambulance—I could finally see what it was like. We all rushed into the resus room and prepared everything; one of the doctors delegated to me the task of writing every detail on the board. In that moment I panicked. I had never done this before; I didn’t know what to write down or when to write it.The doctor explained briefly what he wanted me to do so when the patient arrived I began writing. I was told that after every three-minute cycle I was to let the team know and write down any drugs that were administered. It was just my luck that my watch’s battery had run out that same night so I was using an analogue clock that was hanging on the wall. I have never stared at a clock so hard in my life, counting down the seconds to when the three-minute cycle was over. When it was all over I felt exhausted and I hadn’t even participated in the CPR. Unfortunately the patient passed away and I later discovered he was on holiday, which made the whole experience even sadder as his family were not around. That resuscitation attempt was a real eyeopener and a great learning experience. It was like nothing I had ever participated in before and was such a different kind of nursing from the type I was used to. After my six-week placement I definitely feel that accident and emergency is a department that I would enjoy working in—I learnt so much every day because there was always something new BJN coming through the doors.
Selina Reyes
Third Year Student Nurse (Adult Field), School of Health Studies, Gibraltar Health Authority 953
British Journal of Nursing. Downloaded from magonlinelibrary.com by 137.189.170.231 on November 19, 2015. For personal use only. No other uses without permission. . All rights reserved.
