Student nurse, Claire Aubrey, found a placement on A&E helped to solve her second year blues
My three days on A&E were short, to say the least.
The days disappeared despite the long shifts and the continual trail of patients through the door. However, the time spent there was golden and it was one of the most valuable and well-timed placements I have ever experienced.
I have heard the tale of ‘second year blues’ running around the rumour mill and, thinking they were just that, a rumour, was surprised when they hit me personally. Full pelt in my second year I started to doubt everything I knew and how competent I could really be in nursing.
However, thankfully, a week in A&E put me back on the straight and narrow. My mentor was fabulously knowledgeable, as were all the staff I came into contact with, and they were not going to let me get away with being an idle bystander.
I was quizzed and questioned from the word go, a frightening thought for most, but ultimately it really allowed me to understand what I knew and did not know. I suddenly became very aware of how well-equipped I was from my theoretical training and past experience, and also my self-limitations in terms of knowledge-deficit.
The thing that hit home the most from theory was the way of looking at the patient from head to toe and recognising all the body systems in play. We looked at every patient through A, B, C, D, E and, for me, everything clicked into place. The more assessment I undertook, the more I could see how this model could be applied rapidly and functionally, and how simply looking at the patient without even speaking could reveal so much in terms of the priority issues.
Although I look at my patients on the ward, I never realised how simple and effective the A, B, C method could be. As A&E is the only placement where I have seen this act being performed so routinely and openly, it made me question whether it is being critically applied in other areas. It is a tool which I will now carry with me from placement to placement and on into my career and so I hope that every student can access this skill at some point.
The basis is so simple that, when I was questioned, I went too far and too deep. The premise is to pull back and make things as straight-forward as possible. When asked about ’airway’ I immediately launched into an answer about looking for objects and trauma and so on. All she wanted me to say was that I would listen. As for circulation, I immediately spoke about all the standard observations I would undertake but, again, all she wanted was colour of the patient, anything immediately observable before any testing even began.
It has certainly made me critically question my attitude with patients because, although I have always felt that I look at them as I approach them, I clearly have not been analysing their overall state as directly as I thought.
Perhaps because of the variety of conditions in A&E and the time constraints, getting to the point certainly seems to be their objective, although this is clearly in the best interests of the patient and at no point did the patients’ holistic care seem compromised. My experience in A&E unified a person with their body systems and it was possible to see a patient in all their presenting conditions but also as a person in their own right. Matching presenting symptoms with a system and then the knock-on effect onto other systems is a highly useful skill as this promotes preventative rather than reactive nursing.
I greatly value my time in A&E and am grateful to all the staff who nurtured and promoted learning.