05.

30
I zip up my coat, wrap my scarf tightly around me and
step out into the dark, freezing cold morning for my
twelve and a half hour shift at a busy hospital in the
Midlands. Sitting alongside the other early morning
commuters on the first train of the day I wonder what
today will bring.

06:30
I arrive at the hospital and pass cleaners humming in
the empty corridors as they go about their vital
business of maintaining the cleanliness of every inch
of the place, Good morning an elderly porter nods at
me and I return his greeting and smile. I walk on to the
ward, which has 42 patients in total and make my way
to the staff room.

07:00
All of the day staff are here for the handover from the
night staff. The night shift nurse comes in and looks
absolutely shattered. It has been a tough night. She
updates us on how each individual patient has been;
those who have slept and those who havent; those
who have needed extra pain relief; those who have
been distressed and anxious; those due to see the
doctor today and those due to go home. This is one of
the most important parts of the day missing
handover is like trying to work in a fog.
 07:30
The shift begins. As a third year student I am assigned
a bay of six patients to look after under the
supervision of a senior nurse who is my mentor for
the time I am here. The first thing I do is go and
introduce myself to each patient individually, ensure
they all have a glass of water and ask how they are
feeling and how they slept overnight. It is a bay of
ladies of mixed ages.

Two of them have dementia and the others are very

poorly indeed. All are elderly and seem pleased to
have me there. I assist two ladies to the bathroom and
ask my fellow student (who is in second year) and a
healthcare assistant to assist our ladies with washing
and dressing where necessary.

08:00
I join my mentor on the medication round. It is
important that each patient gets their medication on
time, not least to relieve any symptoms of pain but it
is a time consuming process that has to be done right
with strict guidelines to follow. I notice as we move
through the ward and into my bay that one of my
ladies with dementia is tearful and upset. I ask my
mentor if it is OK if I leave the rest of the medication
round to her and go and comfort my lady, holding her
hand and talking gently to her. It soothes her and she
calms down but it scares me to think that in just a few
months time, when I am a qualified nurse, there may
not be time to do this.

08:30
Breakfast time. All of my patients have their
breakfasts in front of them and most are tucking in. I
quickly whizz around the six beds and check their
notes are up to date. I notice one lady is struggling to
eat her breakfast and ask if she would like some help.
For just ten minutes, I sit beside her while helping her
with her breakfast and she tells me a bit about herself
and her family and we joke about the British weather.
It feels we have formed a bond and is good feeling. In
the back of my mind the whole time my list of things
to do grows longer, but for now, they can wait.

09:00
I check the observations of all six patients, check their
temperatures, blood pressures, pulses and make sure
again all their charts are up to date. More slow trips to
the bathroom with ladies who are slightly wobbly on
their feet, one tells me she used to be a dancer,
looking sadly down at her shaking legs. I tell her she
has the poise and grace of a dancer still and on the
walk back to her bed her head is just a little bit higher.

10.00
The doctors arrive on the ward for their daily round
where they visit each patients bedside. I will join them
when they come to my bay and my patients. I again
check all of the notes make sure charts have all
been filled in correctly and check each patient to make
sure they are drinking enough. One of my ladies is
quiet and just gazing at the grey skies out of the
window - I hadnt even noticed it was no longer dark. I
ask if she is in any pain, if theres anything she needs
and she tells me her pain is not the kind a tablet can
fix. She was widowed six weeks ago after nearly 50
years of marriage. I tell her how sorry I am for her loss
and that I am here if she needs anything at all. The
doctors whizz into the bay and I join them. They spend
five to ten minutes with each patient and two ladies
are over the moon they are going home, while two
are devastated their stay will continue. The two ladies
with dementia are sleeping peacefully. I make notes of
everything that is said as this information will need to
be handed over to the night staff.

11:00
All is well in my bay, the ladies are settled either
sleeping or watching television so I make my way to
the main desk and begin the discharge process for
those going home. They need medication from the
pharmacy, discharge papers and one needs a referral
to the district nursing team for home visits from
tomorrow onwards these processes take time but
eventually it is done. I hear a buzzer from my bay and
go to answer it. It is the dancing lady who needs
assistance to the bathroom.

11:30
On our return I notice one of the ladies is slightly
breathless and the lady with dementia has woke up
crying softly to herself. I wish I could split myself in
two at times like this but I have to prioritise and check
the breathless ladys observation. Her blood pressure
is low and her heart is racing and I go and inform the
nurse in charge and manage to catch the doctor
before he leaves the ward. A decision is made she
must be monitored every fifteen minutes, and any
further deterioration and the doctor must be called. I
return to the bay, check my poorly lady is OK and then
for just two minutes this time, hold the hand and
comfort the lady with dementia. Once again she is
soothed but as I stand to leave, she becomes
distressed once more. I ask a colleague to sit with her
and go to finish my discharges.

12:00
Lunchtime. All of my ladies are eating lunch, those
that need help have it and I return to the main nursing
desk and finish my discharges. I could really do with
the toilet myself but a buzzer from the bay rings and I
answer it myself. Its a good job my bladder is made of
steel.
 13:00
Visiting time. Relatives begin arriving and all of my
ladies have family around their beds. I check in with
my mentor, fill her in on what is happening with the
poorly lady and then take a quick break. The cafeteria
is a ten minute walk from the ward so I just make a
quick coffee in the staff room and go to the bathroom
mentally ticking off my checklist of things still to do.

14:00
Speak to anxious relatives who want to know how
their Mum/Grandma/Aunt/Sister are. More trips to the
bathroom; our poorly lady is worse than she was,
inform my mentor and put in a call to the doctor.

15:00
Our poorly lady has deteriorated rapidly. The curtains
are drawn around her bed as she is examined by the
doctor and there is a hushed quiet in the bay. All of
the patients sense something is wrong, those waiting
to go home are sitting with their bags packed
frustrated it is taking so long for them to be
discharged and I reassure them that they will be going
as soon as everything is ready.

Put in a call to pharmacy to chase medication for the

ladies going home. I can pick it up in half an hour.
Brilliant, I tell the ladies it wont be long now. More
trips to the bathroom. I am so hot and my head is
spinning. I have not eaten properly and have had only
one drink.

17:00
Teatime. I make sure everyone has something to eat
and then check with my mentor, a senior nurse with
20 years experience if it is OK to take a quick break.
This time I walk to the canteen, gram a warm sausage
roll and eat it walking back to the ward. My feet are
beginning to ache but as long as I keep moving, it
should be OK.

18:00
The two ladies have gone home and there are now two
empty beds on the bay. They left a card thanking us
for the care they received which is a little thing that
means a lot to all of us. The beds will soon be filled. I
check the documentation, make sure everyone has
had enough to eat and drink and that they are not in
any pain and prepare for the evening handover.

19:00
I hand over to the evening staff. Our poorly lady has
deteriorated further and her family have been called
in. It is a sad time and I feel a lump in my throat at
what they are going through. I say good night to all of
the patients and let them know the night staff are
coming on duty now.

19:45
I fill in my mentor on what has happened during the
day in my bay and we reflect on events as we grab our
coats and leave the ward. She has been with me every
step of the way and we make our way out into the
darkness once again.

20:00
On the train home I gaze out of the window as the
exhaustion I have held at bay seeps in. My feet are
absolutely throbbing and I know when I take off my
shoes my ankles will be swollen and sore but
tomorrow, I will be up before the sun I wont see,
ready to do it all again.

To have an opportunity to apply our knowledge, skills and attitudes in giving

service to different individuals with their different communicable diseases
and as well as to acquire more learning from such diseases Specific:

To orient us to their own rules and regulation inside the ward To encounter
the unique attitudes of people and to enhance our ability to adjust and have a
therapeutic relationship with them To educate patients about their disease for
 them to be aware and learn how to prevent and manage the disease through
health education Learnings: The other week, we all work as functional.
Everyone has its own assignment-the medicine nurse, the charge nurse and
the bedside nurse. I was assigned to be the bedside nurse on the first day. I
learned to look out or monitor the patients assigned to us. Though it was
really hard because my patient is very suspicious, but because I know some
therapeutic techniques I was able to get his trust. On the second day, I was
then assigned to be the medicine nurse. I prepare and give medicines to our
patients, I did some health teaching also to patients. It is an overwhelming
feeling to do this job. During our functional group, I feel excited and happy
all the time and I also learned a lot because weve been test on how we are
responsible to our designated assignment. On how to be resourceful and
active all the time.

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COMMENTS (3)

As nurses and student nurses we get used to being put in some quite
extraordinary places.

There are times when we can become almost immune to these unique
situations. However, my first real experience in an operating theatre was
certainly one of the most exceptional things I have done as a student nurse.
From the strange process of scrubbing up to get myself completely clean to
the preparations made on the unconscious patient - everything was so far
removed from what I was used to.

I was worried how I would react. I like to think Im fine around blood and open
wounds but Ive never been in a situation where a wound has been created.

What also concerned me is that I couldnt take a back seat.

I was one of the few people that could interact with the patient and surgeon. I
would be expected to help out and to pass instruments. This made me feel a
little bit of pressure but I was also extremely grateful.

Having spoken to other students there is a risk that all you get to see is the
back of a surgeon or a nurse peering into a cavity. I was going to get the
opportunity to get a fantastic view at an important and varied part of nursing
and I didnt want to waste it.

The operation went on for about 30 minutes and we were repairing a hernia
on a middle-aged man. It wasnt the most extensive of surgeries but it was a
great introduction and as I have another four weeks left on this elective
surgical placement Im looking forward to many more experiences in the
operating theatre.

Ill leave you with the advice given to me by the nurse in charge: Make sure
you have some breakfast and if youre going to faint make sure you faint away
from the patient.

How did you find your first time in an operating theatre?

If you are yet to go, what concerns you most or what are you most looking
forward to the most?