Looking for a friend in the UK

lsunurse · Apr 7, 2005

Hi Jen,
Thanks for the information. At the moment I am in a pretty low mood because yesterday I had the worst day at placement in my whole 3 years. The good news is no one died but some of my so called mentors are real witches!! One of my main worries is that I will not be up to the USA standard in theory knowledge. For example we are not taught to ausuclate the lungs/heart/ bowel sounds. How is this taught to you all in the USA system? Despite UK training being very hands on most of the theory is self directed study and there are no quizes etc. to let you know if you have understood the information correctly. Furthermore how were you taught pharmology and how did you learn to write care plans? Did they give a hx. of a patient and then have you all go away to write about it? I will travel where ever in the south to take a review class. Do you know what part?
Hope you are having a great day. On an off note I really miss sweat tea. Alexis

Alexis,

Sorry I took so long to reply I am having the worst week. I have two test, two papers, teaching and care plans due and to top it off I had the worst day in clinicals today, I actually cried! To answer your questions we had a health assessment class our second semester that taught us how to assess a patient. For the lungs we listen to hear if they are clear,crackles, wheezes, rales, wet, or bilateral.we describe if they are easy or labored. the normal lung sound is describes as clear, bilateral breath sounds present throughout the lung field. bowel sounds are assessed in all four quadrants: Right upper quad., right lower quad., left lower quad, and left upper quad. Our teacher wanted us to start in the right lower quadrant and move counter clockwise. Bowel souds are described as active, hypoactive, hyperactive, or not present. for the heart we listen for murmurs, check the apical pulse for one minute. We sometimes listen for S1, S2, S3, and S4 sounds. these are more difficult to explain and go into more detail than you probably need. As for care plans, I would email you one of mine but I don't now how to send an attachment on this message board. What we do is look at the patient's diagnosis or chief complaint and determine a nursing diagnosis of our own and come up with interventions that best suit the patient's care. We go the day before and pick up our patient information and spend several hours doing research on the patho. of the disease, revelant labs and how they affect your patient and numerous other things that they make us do, it drives me crazy doing all this work. I hope all of this helps. I'm sure with all you training you will do a great job in the states, don't worry. I'm just praying I survive, only one more year to go.

Have a great day :)

Jen

expatnurse · Apr 7, 2005

Alexis,
Sorry I took so long to reply I am having the worst week. I have two test, two papers, teaching and care plans due and to top it off I had the worst day in clinicals today, I actually cried! To answer your questions we had a health assessment class our second semester that taught us how to assess a patient. For the lungs we listen to hear if they are clear,crackles, wheezes, rales, wet, or bilateral.we describe if they are easy or labored. the normal lung sound is describes as clear, bilateral breath sounds present throughout the lung field. bowel sounds are assessed in all four quadrants: Right upper quad., right lower quad., left lower quad, and left upper quad. Our teacher wanted us to start in the right lower quadrant and move counter clockwise. Bowel souds are described as active, hypoactive, hyperactive, or not present. for the heart we listen for murmurs, check the apical pulse for one minute. We sometimes listen for S1, S2, S3, and S4 sounds. these are more difficult to explain and go into more detail than you probably need. As for care plans, I would email you one of mine but I don't now how to send an attachment on this message board. What we do is look at the patient's diagnosis or chief complaint and determine a nursing diagnosis of our own and come up with interventions that best suit the patient's care. We go the day before and pick up our patient information and spend several hours doing research on the patho. of the disease, revelant labs and how they affect your patient and numerous other things that they make us do, it drives me crazy doing all this work. I hope all of this helps. I'm sure with all you training you will do a great job in the states, don't worry. I'm just praying I survive, only one more year to go.
Have a great day :)
Jen

Dear Jen,

Do not give up you are going to be a good nurse. All of this information does help me alot. I will look into how you attach stuff. Don't let them get you down. You have gotten this far and you will make it. Remember it won't kill us we just think it will. I have placement today and again I am in charge :uhoh21: I had a problem last week I learned that if I am in the right and defend it the sister (over the ward) will listen and deal with it. I was being bullied by other staff and not treated as a nursing student about to finish. Remember if you can not stand up for yourself when you are in the right how will we ever learn to stand up to doctors. Over here the question is always asked why are nurses treated so badly the answer is we let them. What do you think of Unions? I will keep praying for you. Alexis

madwife2002, BSN, RN · Apr 7, 2005

Call me stupid but as a UK nurse i have often listen to bowel sounds, especially post surgery, or if i was worried about obstruction so I find it hard to believe no other Uk nurses have performed this proceedure.

I accept that we dont do lung or heart sounds unless that is our speciality but my view is that it can't be that difficult or else why do all the US nurses do it as a matter of course, remembering the high litigation they have over there.

:)

expatnurse · Apr 7, 2005

Call me stupid but as a UK nurse i have often listen to bowel sounds, especially post surgery, or if i was worried about obstruction so I find it hard to believe no other Uk nurses have performed this proceedure.
I accept that we dont do lung or heart sounds unless that is our speciality but my view is that it can't be that difficult or else why do all the US nurses do it as a matter of course, remembering the high litigation they have over there.
:)

During my training I have had only at one time listened to heart/lung sounds in ICU however I do not feel that at this point in my training about to finish I could call what I am listening to and this worries me. When I have been on the wards no nurses listen for sounds heart,lung or bowel unless they are PAR nurses ie. ICU nurse background. Perhaps since you are a midwife your experience is different I don't know.

madwife2002, BSN, RN · Apr 8, 2005

During my training I have had only at one time listened to heart/lung sounds in ICU however I do not feel that at this point in my training about to finish I could call what I am listening to and this worries me. When I have been on the wards no nurses listen for sounds heart,lung or bowel unless they are PAR nurses ie. ICU nurse background. Perhaps since you are a midwife your experience is different I don't know.

I no longer practice as a midwife I work s a nurse but i am going on my past experiences as a nurse. When i worked on surgical wards and after abdominal surgery had been performed we always listened to bowel sounds, do we no longer do this?

safewaygreenbox · Apr 8, 2005

In all honesty we tend to leave it to the DRs. :rolleyes: I think I might make a start in listening to lung and bowel sounds - I should imagine that it is all down to practice. Like most things in life - if you have to do something you do it, if you are really busy and there is someone else who normally does it and who will be making an ultimate decision you leave it to them.

Kay the 2nd :)

expatnurse · Apr 8, 2005

I no longer practice as a midwife I work s a nurse but i am going on my past experiences as a nurse. When i worked on surgical wards and after abdominal surgery had been performed we always listened to bowel sounds, do we no longer do this?

What area of nursing do you work in now? Also why do you no longer work as a midwife? Like I said in all of my three years of training it has not been pushed even now when NG tubes are put in a regular basis. However they do get xray ordered so maybe there is no need to. Look forward to hearing from you. The good news is I metioned to my mentor today if we could go over these aspects she is happy to do so but she is the exception and not the rule. Also she at one time was also a midwife.

madwife2002, BSN, RN · Apr 9, 2005

It was a long hard decision not to practice as a midwife because I loved the actual job if I was allowed to practice my job.

Initially I had been qualified for a short period when I became aware that a midwife who i worked closley with, who believed in natrual childbirth against all odds ,practiced midwifery sailing very close to the wind. One day i had two in labour and she went to see one of my ladies who I had caseloaded and who had had an abnormal pregnancy and needed a hospital delivery for safety reasons, to cut a long story short I had to resu this lady after mal practice by this other midwife. This other midwife got away with it with even less than a slap on the wrist, but went on to doing it again less than 12 months later and is now suspended. I left that trust.

I worked in the community, connected to a birthing centre and a main hospital. 3/4 of midwives were off on long term sick due to stress of overwork and no staff it was a vicious circle. And because of my previous experience where I saw a woman almost lose her life I was very much the advocate for the women who were being short changed, I took my concerns to head of midwifery but despite promises to help ( I had a caseload of 120) it just got worse til my health was affected by constantly worrying I had to go. On new years eve 2003 I was the only midwife on call for all of portsmouth/ gosport and east hants! No pressure.

Just a little bit of insite into how short of midwives we are and how awful it is on the rest of them, unfortunatly I couldn't do it any longer

expatnurse · Apr 9, 2005

It was a long hard decision not to practice as a midwife because I loved the actual job if I was allowed to practice my job.
Initially I had been qualified for a short period when I became aware that a midwife who i worked closley with, who believed in natrual childbirth against all odds ,practiced midwifery sailing very close to the wind. One day i had two in labour and she went to see one of my ladies who I had caseloaded and who had had an abnormal pregnancy and needed a hospital delivery for safety reasons, to cut a long story short I had to resu this lady after mal practice by this other midwife. This other midwife got away with it with even less than a slap on the wrist, but went on to doing it again less than 12 months later and is now suspended. I left that trust.
I worked in the community, connected to a birthing centre and a main hospital. 3/4 of midwives were off on long term sick due to stress of overwork and no staff it was a vicious circle. And because of my previous experience where I saw a woman almost lose her life I was very much the advocate for the women who were being short changed, I took my concerns to head of midwifery but despite promises to help ( I had a caseload of 120) it just got worse til my health was affected by constantly worrying I had to go. On new years eve 2003 I was the only midwife on call for all of portsmouth/ gosport and east hants! No pressure.
Just a little bit of insite into how short of midwives we are and how awful it is on the rest of them, unfortunatly I couldn't do it any longer

Thanks for sharing. I am very sorry to here about what you went though. I knew we were extermly short of midwifes worse than nurses I didn't know why before now I understand. Would you advise anyone else to do midwifery training? When I went out with the midwives I really enjoyed it to the point I have thought about training for it later in life. Furthermore all nurses I have every come across who are nurses and also midwives have extermly hight standard of practice. What are your views on the new style of training? :balloons:

madwife2002, BSN, RN · Apr 9, 2005

Thanks for sharing. I am very sorry to here about what you went though. I knew we were extermly short of midwifes worse than nurses I didn't know why before now I understand. Would you advise anyone else to do midwifery training? When I went out with the midwives I really enjoyed it to the point I have thought about training for it later in life. Furthermore all nurses I have every come across who are nurses and also midwives have extermly hight standard of practice. What are your views on the new style of training? :balloons:

I agree midwives have very high standards, but they have to have considering the level of responsibility they have in this country. They are practioners in their own right and may make life saving decisions on a daily basis. Before i was amidwife i used to wonder why they get paid more money initially than newly qualified nurses but once you undertake the job it soon becomes very obvious why they earn more. Doing CPR on a new born baby brings home the stark reality of life.

I would recommend midwifery training, just because it wasn't for me doesnt mean it is not for others, I make a much better nurse than a midwife because I cared too much for the women I looked after and because of the shortage of staff and support this affected my life. As a nurse i still care for the patients I look after and become very involoved in their care but I have others who feel the same way and we share the responsibility.

I can leave my ward in the safety of others, but often i felt i couldn't walk away from a labouring woman because it wasn't always possible or the right time in her labour.

I hope this makes sense

expatnurse · Apr 9, 2005

I agree midwives have very high standards, but they have to have considering the level of responsibility they have in this country. They are practioners in their own right and may make life saving decisions on a daily basis. Before i was amidwife i used to wonder why they get paid more money initially than newly qualified nurses but once you undertake the job it soon becomes very obvious why they earn more. Doing CPR on a new born baby brings home the stark reality of life.
I would recommend midwifery training, just because it wasn't for me doesnt mean it is not for others, I make a much better nurse than a midwife because I cared too much for the women I looked after and because of the shortage of staff and support this affected my life. As a nurse i still care for the patients I look after and become very involoved in their care but I have others who feel the same way and we share the responsibility.
I can leave my ward in the safety of others, but often i felt i couldn't walk away from a labouring woman because it wasn't always possible or the right time in her labour.
I hope this makes sense

It does. Thanks for the information. I have considered midwivery training later. Is it true that some places pay for a nurse to do the midwivery conversion training of 18 months? If so what are the important thngs to look for when looking at a place of study. Any that you would recommend? :balloons:

madwife2002, BSN, RN · Apr 9, 2005

I believe you would have to have at least 12 months post reg experience. Yes it is true they protect your pay and you would be paid at the grade/band you had recieved as a RN. It is mainly done as a degree I dont know if they do it at a diploma now, which wont be a problem for you as i presume you will have either a diploma or an advanced diploma when you qualify as a minimum.

There are few places offered through the country as it is generally felt that because you dont need to be a nurse to be a midwife. I think they are looking at retention and nurses have a tendency to go back to nursing after doing their midwifery. So it is expensive to train you as a nurse and then re train you as a midwife.

You would have to check with the universities, I know Southampton still do it but I am unsure about the rest of |UK. They have around 30 places each year divided into two intakes sept and jan.

I wish you well i enjoyed my training, it was very hard work because you dont get much time to meet criteria, and the direct entry studets get the full 3 yrs to get all their births ect, and their study done. We had to do 6 level 2/3 assignments as well as a final exam and 12,000 word dissertation. When you qualify you will get E grade automatically and within a year F grade or the AFG equivilent.