Download Student Welcome Pack - Ward E4

WELCOME TO E4
INFORMATION FOR
STUDENT NURSES
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Expectations of Mentors
As a student you can expect …….
 An appropriately qualified nurse to act as your mentor/ associate
mentor
 A minimum of 3 formal meetings per placement to complete your
assessment documentation
 Time and patience to facilitate your learning at a comfortable pace
appropriate to your particular stage of experience
 Respect for your individual learning needs and capabilities
 Learning opportunities to achieve the objectives assigned by the
University
 Help liaising with the different MDT to achieve appropriate
learning experiences
 Assistance arranging spoke placements appropriate to the
placement
 Openness and honesty regarding your progress both clinically and
professionally
 Reporting to and liaison with the university regarding any
untoward incidents
Expectations of student nurses
As a practice placement, we would expect you ……….
 To treat patients with dignity and respect
 To work as a team member, demonstrating respect for your
colleagues through respect, honesty and a willingness to learn
 To be punctual
 To work a 37.5 hr week (excluding breaks) or appropriate part time
hours
 To experience 24 hour cycle of care via a variety of shifts e.g.
early, late, weekends and nights appropriate to your stage in the
course
 To complete assignments in your own time.
 To arrange any part-time work around your placement shift
patterns, not visa- versa
 To adhere to Trust and University dress codes
 To take responsibility for reporting sensitive information disclosed
by patients
 To work within your own capabilities and if in doubt ask
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 Acknowledge the work load of staff and appreciate your needs
cannot always be met immediately
 Acknowledge that you have supernumery status but you are
expected to work as part of our team and be involved in patient
care
An Introduction to Ward E4 for Student Nurses.
Welcome to ward E4, the ward specialises in vascular surgery, as well as
dealing with general surgical patients. We do take other specialities but
this is dependent on the bed situation within the hospital. It is an
extremely busy ward as we have theatre lists nearly every day and can
receive patients from list admissions, clinics and emergency admissions
at any time of the day.
The ward has a multi-disciplinary approach and utilises many specialities
to give the best patient care we can. We are committed to an education
programme and to a high standard of nursing care and we hope that you
find this allocation an enjoyable and rewarding experience.
We are a 25 bedded mixed sex ward comprising of 3, 7 bedded bays and
4 side wards. The ward is divided into 3 areas
SW 1 &SW 2 and Bay 1 = Red Team
SW 3 and Bay 2 = Blue Team
SW 4 and Bay 3 = Green Team
The ward staff have excellent knowledge base to teach during your
surgical experience on E4, they have a variety of clinical experiences and
all doing or completed further courses of studies in their areas of interest.
There are also packs available to explain each speciality specific to the
ward.
Current staff members are:
Consultants: Vascular: Mr G Ferguson and Mr M Onwudike.
Colorectal: Mr D Smith, Mr P Harris and Mr H Michie.
Miss G Faulkner.
Upper GI: Mr J Varghese, Mr B. Smajer and Mr U Uzair
Urology: Miss Lee, Mr Pantelides, Miss Gall
Senior Sister/Ward Manager: Julie Power
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Junior Sister: Louise Gill and Helen Millward
Staff Nurses:, Terri Wareing, Beverley Talbot, Emma Skett, , Hannah
Leather, Jyothi Gomes, Andrea Breithaupt, , Kelly Binks, Louise Day,
Ruben Escobar, Janet Hodson and Kerry Sturrock.
HCA: Chris Smith, Sheila Potter, Chelsea Foley , Stephanie Tootill,
Amy Thornhill, Gill Urmson, , Prav Vara, Katie Gibney , Caroline
Pendlebury, Robert Aspinall, Alison Butler, Kellie Pollard , Michela
Eweka and Alex Shone.
Ward Clerk: Carole Bolton
Current Shifts:
Early:
Late:
Night:
Long Day:
07.30 – 15.30.
12.00 - 20.00.
19.30 – 20.00
07.30 – 20:00
There is a request book and all requests will be taken into consideration
when the off-duty is done. You will be able to negotiate your off duty, as
long as it meets your statutory requirement to complete your training.
There is a variety of literature and information available on the ward for
you to access if you choose.
You will have an assessor/mentor assigned to you during your allocation.
It will not always possible to work with your assessor, therefore you will
work with another member of staff, who act as associate assessor.
You will also have the opportunity to complete a theatre induction (if not
already done so) and follow a patient to theatre during your allocation on
E4.
If there is anything else you want to see or do whilst on E4 then please let
your mentor or assessor know and we will do our best to arrange this.
BASIC HOUSEKEEPING
 The uniform policy must be adhered to at all times.
 A locker room is located off the ward for your personal belongings.
Please ask a member of staff for the security code for the door.
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 Staff breaks are allocated between 10:00 and 11:00 on an early
shift and 15:00 and 16:00 on a late shift.
Emergency and Fire procedures will be explained to you at the start of
your allocation as well as the emergency equipment and fire exits.
Spoke placements
ENT clinic
Bereavement
and organ
donation
team
Theatre
E4
F6 admission
ward
Night duty
Acute pain
team
Infection
control
(Year 3 only)
(Year 3 only)
Students are encouraged to participate in spoke placements – above is a
selection of what is available. Please discuss with your mentor which
would be beneficial for your learning.
Spoke placements should link in with the placement – please discuss with
your mentor if you wish to spend time with a speciality not listed above.
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From Sept 2011 cohort – spokes will be formalised and will take place
during the middle four weeks of placement.
IMPORTANT NUMBERS
CARDIAC ARREST
FIRE
FAST BLEEP
WARD
2222
2222
2222
01204 390623
TO BLEEP A DOCTOR – Dial 8 then the bleep number then the
extension number from which you are calling.
Your Practice Education Lead for the ward is Terri Warring. Please feel
free to speak to us or your allocated mentor anytime if you have any
questions or concerns. Alternatively you can contact the Practice
education Facilitator on 5984.
We want you to feel relaxed and enjoy your placement on E4 and will
ensure that your supernumerary status is maintained whilst on placement.
We hope that you have an enjoyable allocation on E4 ward and utilise the
ward as an excellent acute surgical experience. If you should have
difficulties please lets us know.
Emergencies
It is important that you are aware of the following in the event of an
emergency:Emergency phone numbers
Location of crash trolley
Location of defib machine
How to fast bleep a doctor
What to do in the event of a fire
Location of fire exits
If you haven’t had your local induction checklist completed within 24
hours of starting your placement, please inform the PEF team.
ABOUT THE WARD
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E4 is a busy acute surgical ward, comprising of 25 beds. The staff on E4
are committed to giving a high standard of patient care and provide
students with a learning environment to fit their needs. This profile will
describe E4 and the learning experiences available to you.
NURSING PHILOSOPHY
Caring is a major focus of nursing within the directorate of General
Surgery. By using a recognised Model of Nursing and the Nursing
Process, the appropriately trained qualified and unqualified staff aim to
fill the self deficits within patients’ activities of daily living, brought on
by ill health.
All relevant aspects of hospital care will be explained to ensure informed
consent is obtained and a duty of care is achieved. Whenever possible
promotion of health will be emphasised.
Where death is the expected outcome, we will endeavour to ensure that it
is dignified, peaceful and pain free.
All care will be delivered with respect regardless of age, race, culture,
gender, sexuality and social status.
Staff of all grades will be encouraged to develop their professional skills
and are accountable for nursing care that they give in accordance with the
Nursing and Midwifery Council.
ORGANISATION OF CARE
The organisation of Ward E4 reflects the beliefs and values, which we on
E4 hold. It puts patients and their families at the centre of care helping to
promote individualised holistic care. This takes into account the person as
a whole and places a greater value on the psychological components of
care, rather than just the physical needs. Nurses are assigned to a group of
patients and are completely responsible for their care. A philosophy of
care and our organisation designs a patient centred approach to the
delivery of care and gives the individual nurses responsibility for the care
that they give. All nurses exercise freedom to practice and are
autonomous and accountable.
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The philosophy of care promotes enhanced interaction between patients
and nurses. All nurses set their own priority of care and are accountable
for patients as well as being answerable for their own decisions.
Nurses are allowed to professionally develop and enhance their
communication skills and their interpersonal skill. There is an antihierarchical structure, and responsibilities are often shared with all the
multidisciplinary team.
Communication
Communication with patients and relatives form a large part of a nurses’
role, how we communicate with people reflects upon the whole
profession.
Good communication helps to promote patient confidence at what can be
a very difficult time for them; poor communication can lead to
impressions of incompetence and loss of confidence in nursing staff.
While it is important to keep relatives informed of a patients progress, it
must be remembered that confidentiality is an important issue, always
confer with a qualified member of staff before disclosing any
information. Never give any information out over a telephone.
Remember that it is very easy to give misleading information which can
lead to disastrous results.
If in doubt ask – but make sure the time is appropriate to do so.
Students who speak more than one language must be mindful that they
must not utilise these skills to act as a translator – official Trust sources
should be utilised.
No Smoking Policy
Students are advised that of 1st July 2009 Royal Bolton NHS Foundation
Trust became a no smoking site. This covers the entire hospital site,
including cards parked in the grounds. Uniforms must be fully covered
when off hospital grounds
Visiting times
Visiting times are 2-3:30pm and 6:30-8pm each day.
Visiting out of these times is at the discretion of the nurse in charge of the
shift and should be done by prior arrangement.
Visiting during meal times is not permitted.
Guidelines regarding uniform
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Students are reminded that they must follow the university’s guidelines
regarding uniform.
 Uniform must be complete and presentable as supplied
 Cardigans must be removed when in clinical areas
 Black low heeled quiet soled plain shoes should be worn. Trainers
and boots are not permitted
 Trust identity badges must be worn when on duty, no other badges
 Hair should be tidy. Long hair should be tied back and off the face
and collar.
 Head scarf worn for cultural purposes must be black of white, no
large adornments or tassels
 It is not permitted to wear a long sleeved garment under uniforms
 Finger nails should be clean, short. No nail polish or false nails
 Make-up should be discrete. Aftershave or perfume should be used
sparingly
 No jewellery other than wedding ring and one plain small stud per
ear
 Dark coloured overcoat which covers length of tunic must be worn
when off hospital grounds.
Students who do not comply to uniform policy will be sent home and
marked as absent
WHAT CAN YOU LEARN
On a surgical ward we nurse patients before and after surgery. Not all
patient need surgical intervention, but most are admitted with problems
that may require surgery. The consultants on E4 specialise in vascular
surgery and urology surgery, however we also have patients who require
surgery that is not necessarily related to these specialities. If during your
allocation there is anything you wish to see or do, please feel free to ask
and we will endeavour to ensure your request is met.
As you go through your allocation you will see patients with a variety of
surgical conditions, below is a list of surgical conditions, investigations or
surgery performed that you may witness whilst you are on the ward.
The list is provided so if you wish you can do some background reading.
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Abdominal Aortic Aneurysm
Angiograms /Angioplasty
Arteriograms
Bowel Resection
Carotid endarterectomy
Cholecystectomy
Cystoscopy
Femoral Bypass Graft
Gastrectomy
Incision & Drainage of abscesses
Pancreatitis
Thyriodectomy
TURP
Vascular conditions.
Amputation
Appendectomy
Bowel Obstruction
Cholecystitis
Colonoscopy
EVAR
Gastrointestinal Bleeding
Gastroscopy
Leg Ulcer
Repair of Hernia
TURBT
Urinary Infections
These are only a few you will come across more. If you come across
anything you do not understand please ask.
INTERPERSONAL SKILLS
On E4 you will be able to develop your own role as a student in a
comfortable and secure supportive environment. You will observe staff
using their decision making skills in a number of situations and you will
be able to develop your problem solving skills whilst on the ward.
Surgical patients have a number of communication problems. Some of
these are listed below and you will be able to develop your skills in this
area.
Hearing problems
Speech problems
Sight problems
People who do not speak the same language
People with learning disability
People with mental health illness
All patients with communication problems need more help and may cope
well in their own environment, but hospitals are unfamiliar to them.
On E4 you will observe and be able to use verbal and non-verbal
communication and will be able to develop your own skills.
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Admission to hospital can increase anxiety in people, (Franklin 1974)
Patients and relatives need support. As a student on E4 you will witness
staff use communication skills to ease anxiety and support patients
through what can be a very stressful experience. As a student you be
encouraged to be involved in this process.
Example of when anxiety is heightened:
On admission
Immediately before going to theatre
When a malignancy is suspected or diagnosed
Relatives get anxious when a loved one is very ill
On discharge, patients wonder if they can cope at home
Alter body image i.e. stoma, amputation etc
RESEARCH AND ITS APPLICATION
Research based practice is an important aspect of health care and research
into the needs of the surgical patient is ever changing. We try to provide
up to date evidence based care on E4 and to do this we use a number of
resources.
SPECIALIST NURSES
The Trust employs a wide range of Specialist Nurses of which all wards
and departments have access to. Their roles vary, but it includes
education of staff and patients and implementation of the research. We
have link nurses from the ward who attend meetings with the specialist
nurses/teams and disseminate new knowledge and information, which in
turn cascade to ward level. The aim of this is to continually improve and
develop the service we offer.
Here a list of some of the Specialist nurses/teams
Vascular Nurse: Paula Thompson
Acute Pain Team: Janet Roberts & Trudy Hadcroft
Bereavement Team: Julie Bramwell and Dave Walker
Stoma Nurses:Janette Saunders & Sharon Corbett
Tissue Viability: Kate Lewis
Critical care outreach: Kay Lythgoe & Sarah Carden
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Please feel free to ask who the link nurses are for each topic/speciality on
the ward and ask for any up to date information they may have. We also
have a selection of files and teaching resources such as books, policies,
articles and research papers available in the Day Room specific to each
topic/speciality which are available for you to use, these are located in the
dayroom.
There is other material available you may find of use is
Health and Safety policies (YELLOW BINDER)
Infection Control polices (RED BINDER)
Quality Standards (PINK BINDER)
Intranet on computer system which includes the Royal Marsden
There is more available, please have a look and see what is useful to you.
HEALTH PROMOTION
“Health Education and promotion should be a recognised part of health
care. All Practitioners should develop skills and use every opportunity for
health promotion”. (DOH 1989).
It is also part of rule 18 on the Nursing and Midwifery Council Code of
Conduct for 1st level nurses.
Information on Health promotion can be found on the ward and intranet.
MANAGEMENT
Management on a busy ward like E4 is very important. You will be able
to observe different management styles on the ward and from these you
will formulate your own style. You will be able to manage the care of a
patient or a whole team depending on your stage of training and
experience. You will be under supervision and receive feedback from
your assessor. Any staff will be happy to discuss management issues with
you.
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CARING AND CLINICAL SKILLS
There is a vast amount of skills you can develop during your allocation.
Please use this opportunity to gain them or work towards gaining them.
Utilise all the resources available including members of the
multidisciplinary such as physiotherapist, Specialist nurses, they are only
happy to impart their wealth of knowledge.
The team on E4 want to make your learning experience as good as we
can, however, we encourage each student, along with their assessor to
organise and plan what you want from this allocation, only you know
what you want to learn and if you communicate your learning needs, we
will do our best to meet them. If however you feel unhappy about
anything or you think we can make improvement in our approach in
learning, than tell us, please, we can’t change if we are not told.
Please enjoy your placement, feel free to ask questions and try to enjoy
your time with us!
COMMON ABREVIATIONS
AAA – Abdominal Aortic Aneurysm
AXR – Abdo x-ray
COPD - Chronic obstructive airways disease
CSU- Catheter specimen of urine
CXR – Chest x-ray
ERCP – endoscopic retrograde cholangiopancreatography
HR – Heart Rate
INR – International ratio
IVAB – Intravenous antibiotics
IVI – Intravenous fluids
MI - Myocardial Infarction
MRCP – magnetic resonance cholangiopancreatography
MRI – magnetic resonance imaging
MSU- Mid stream urine
NAD – Nothing abnormal detected
NBM – Nil by mouth
NWB – Non-weight bearing
O2 – oxygen
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OGD- Gastroscopy
ORAL ABX – Oral antibiotics
PCA – Patient controlled analgesia
PR – Per rectum
PV- Per vagina
RESPS – Respirations
RWT – routine ward test
SOB – Shortness of breath
TPN – Total parental Nutrition
TTO- Discharge medications
TWOC- Trial without catheter
USS- Ultrasound scan
UTI – Urinary tract infection
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E4 ward learning experience feedback sheet
Did you feel the placement/ mentors lived up to their roles?
Please could you complete this feedback sheet and return it to TERRI WAREING, it may be
anonymous if you wish.
Competencies
Mentor
achieved
Mentor not
achieved
Ward
achieved
Ward not
achieved
Contribute to a supportive learning
environment and quality outcomes for
students
Be approachable, supportive and aware of
how students learn best
Have knowledge of the students programme
of study and assessment tool
Be willing to share knowledge of patient care
Identify specific learning opportunities
available in the placement area
Ensure that the learning experience is a
planned process
Ensure that time is identified for interviews
to assess and identify learning needs
Identify with students their core
competencies and outcomes to be achieved
Make time to observe students undertaking
new skills
Encourage enquiry based learning and
problem solving
Build into learning opportunities the chance
to experience the skills and knowledge of
specialist practitioners
Ensure students have adequate break times
Offer encouragement to students
Provide effective orientation
Work with the student at least 2 out of 5
shifts per week
Recognise the students supernumery status
Provide time for reflection, feedback and
monitoring progress
Work in a multidisciplinary team to provide
holistic care
Seek evaluation feedback from the student at
the end of the placement
Be willing to take pride in sharing the
students journey on the path to becoming a
registered nurse
Feedback sheet developed using RCN Role of a mentor (2002)
Thank you for taking the time to complete this questionnaire.
Completed by – leave blank if wish
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Cohort – leave blank if wish
Mentor – leave blank if wish
Associate – leave blank if wish
Any other comments
Date received back to ward ………………………………
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