The End of the Beginning.

First placement ended a couple of weeks back. Along with it came two assignment deadlines and an exam coupled with a giant lump of pure exhaustion and a vomiting bug. Looking back over my first placement, there were some absolutely fantastic memories - I never thought I would love stroke quite as much as I did, but the highlight definitely came on my final shift.

For 8 weeks, I attended every acute stroke call that occurred on my shifts in the hope of seeing a specialist procedure called thrombolysis. A few years ago, almost everyone who had a stroke was thrombolysed, but as research has continued it's use has become more limited because it has significant risk factors and contraindications. By the final week of placement I had essentially given up on seeing the procedure...but I lost hope too soon!

I arrived early for my final shift of this block to hear that a patient was in CT having had an acute deterioration overnight - probably a stroke. The patient had been assessed within minutes of the onset (timings is really key in the treatment of stroke!) and was in the CT scanner within 20 minutes. When they returned to the ward it became apparent that he was a candidate for thrombolysis and I was fortunate enough to be present and then have the privilege of nursing the patient for the day.

It was an utterly incredible experience where I really feel I made the progression from HCA to student nurse. For the first few hours after he was given the specialist drug I had to conduct neurological observations and check his vital signs every 15 minutes to ensure there was no deterioration and assess for improvement. This felt like a huge responsibility to be trusted with but I felt perfectly safe in the knowledge that the thrombolysis nurse, alongside the nurse in the bay were there to countersign my observations and would be there if I was at all concerned.

The patient survived and as far as I am aware is making good progress. I think this was such a pivotal moment for me for a couple of reasons. Firstly, this was "my patient". I was assigned as his nurse for the day - I couldn't give drugs alone, I can't do IV's but ultimately the majority of his care was down to me. It was also a really good chance for me to learn to trust my own competence. Throughout the placement, the nurses I worked with were continually praising me - but I just couldn't believe that I was as good as they suggested. With this patient, I was able to work right up to my limits in the knowledge that as soon as I got stuck, there was help very near by. I honestly feel that I gave the absolute best care I possibly could on that day. And finally, it was definite point at which I truly fell in love with nursing again. Even when it's hard, even when you really don't want to get up at 4:45am to commute, even when you're short staffed for the fourth shift in a row, even when you can't imagine ever getting through yet another 13 hour shift?

Nursing is still THE best job I have ever had and I feel truly blessed to be part of the NHS.

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