Student Nurse Information Pack

Ward 7

Acute Surgical Receiving Unit

Ninewells Hospital

Information Pack for Student Nurses

Developed May 2006

Updated may 2016

Responsible Persons: CN Gemma Gauld

STUDENT NAME:

YEAR OF STUDY:

PLACEMENT DATES:

MAIN MENTOR:

ASSOCIATE MENTOR:

Student Nurse Information Pack

Ward 7

Ninewells Hospital

This pack has been designed to provide information regarding your placement in ward 7.

The pack provides information on:

1. Introduction to ward 7.

2. Your first day.

3. Reasons for admission to ward 7 and admission routes.

4. Common Investigations.

5. Early Warning Score (SEWS).

6. Off duty.

Welcome to Ward 7

Ward 7 is a 24 bedded Acute Surgical Receiving Unit. In addition to this we have a 6 bedded assessment bay and a further 2 assessment rooms. The workload is very unpredictable due to the nature of the ward. Each trained nurse is allocated a caseload of patients for the shift and there is also a shift coordinator. There is an am and pm ward round and medical staff based on the ward review new admissions.

On your first day please report to the nursing station. On arrival to the ward you will be introduced to one of your mentors and you will receive an orientation pack. A ward handover is given to all the nursing team followed by an individual handover on a patient caseload. The shift co-ordinator or ward assistant will show you around the ward and introduce you to members of the nursing team. We aim for you to work within a supernumerary capacity for the first two weeks and will assign you 2 mentors.

Location- Ward 7 is located within the main part of the building and is well sign posted

Travel to and from hospital either by bus, time tables are available or car but please be aware parking facilities are limited during the day.

Shift pattern-

· Early 07:00-15:00

· Late 13:00-21:00

· Night shift 20:30-08:00

Students will be expected to work occasional weekends during the placement to enable them to gain experience of the full 24 hour, 7 days per week care of patients

Dress code- as per NHS Tayside Policy must be followed

Changing facilities for students are available please contact area for information.

Contact details – 01382 633807

Sickness/Absence must be reported to the ward and the university

Acute Surgical Admission

When a patient is admitted to ward 7 there are many considerations when prioritising their initial care. You will have the opportunity to work with your mentor admitting patients to the ward and the following diagram illustrates the many aspects of care to take into account.

Origins of Abdominal Pain

1. Epigastric: Including oesophagitis, peptic ulcer disease, pancreatitis.

2. Right Upper Quadrant: Including bilary colic, cholecystitis, hepatic origin, renal

origin

3. Left Upper Quadrant: Including splenic origin, renal origin, pancreatitis

4. Left Iliac Fossa: Including diverticulitis, gynae origin, urinary tract infection

5. Right Iliac Fossa: Including appendicitis, crohn's disease, gynae origin

6. Central Abdominal Pain: Including aortic aneurysm, obstruction, mesenteric

ischaemia.

Adapted from: Fox C, Lombard M and Lam E (Eds) (2004) Gasteroenterology (2nd Edition) London Mosby

Common Conditions and Procedures

The following are common conditions and procedures for patients on ward 7. There will be opportunities to observe patients undergo these procedures. This can be arranged through your mentor.

Conditions / Procedures
Abdominal Aortic Aneurysm
Abscesses
Acute Abdominal Pain
Appendicitis
Chest Trauma
Crohns Disease
Constipation
Diverticular Disease
Dysphagia
Ischaemic Bowel
Jaundice
Large/small Bowel Obstruction
Large/small Bowel Perforation
Pancreatitis
Rectal Bleeding/ Malaena
Ulcerative Colitis
Ulcers (oesophageal/gastric)
Vascular Emergencies / Abdominal Ultra Sound Scan
Abdominal/Chest X-Ray
Arterial Blood Gases
Barium Enema
Barium Swallow
Cholycystectomy
Computed Tomography (CT Scan)
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Flexi Sigmoidoscopy
Hartmans Procedure
Laparoscopy
Laparotomy
Magnetic Resonance Imaging (MRI Scan)
Upper GI Endoscopy

Learning Opportunities / Objectives within Ward 7

Nursing Care / Referrals
Admission Procedures
Assessments
Catheterisation
Discharges
Drain care
Drug administration
Fluid balance
Intravenous infusions
Naso Gastric tube care
Oxygen therapy
Pain assessment/Management
Pre/post-op care
Stoma care
Transfers to other wards / Acute pain team
Diabetic specialist nurses
Dietician
District nursing services
Palliative care team
Pharmacists
Physiotherapists
Stoma nurse specialists
Visits
Endoscopy
Radiology
Theatres

Abbreviations

The following is a table of commonly used abbreviations on the ward.

AAA

Abdominal Aortic Aneurysm

MRI

Magnetic Resonance Imaging

AF

Atrial Fibrillation

MRSA

Methicillin Resistant Staphylococcus Aureus

AXR

Abdominal x-ray

MSSU

Mid Stream Specimen of Urine

BM

Blood Glucose Monitoring

NG

Naso Gastric

Bowels Open

NBM

Nil By Mouth

Blood Pressure

NIDDM

Non Insulin dependent Diabetic

C&S

Culture and Sensitivity

NOK

Next of Kin

C DIFF

Clostridium Difficile

OGD

Oesophageal Gastric Duodonoscopy

CAT/CT

Computerised Tomography

Pulse

COPD

Chronic Obstructive Pulmonary Disease

PCA

Patient Controlled Analgesia

CPR

Cardio Pulmonary Resuscitation

Pulmonary Embolism

CSU

Catheter Specimen of Urine

PEG

Percutaneous Endoscopic Gastrostomy

CVP

Central Venous Pressure

PMH

Past Medical History

CXR

Chest x-ray

Passed Urine

DNS

District Nursing Service

PVD

Peripheral Vascular Disease

DOB

Date of Birth

Respiration

DVT

Deep Venous Thrombosis

RIF

Right Iliac Fossa

ECG

Electrocardiogram

RTA

Road Traffic Accident

ERCP

Endoscopic Retrograde Cholangiopancreatography

RUQ

Right Upper Quadrant

FBC

Full Blood Count

Seen By

GCS

Glasgow Coma Scale

Subcutaneous

Haemoglobin

SALT

Speech and Language Therapist

HNPU

Has Not Passed Urine

SPO2

Saturation Pulse Oximetry

IDDM

Insulin Dependent Diabetic

Temperature

IHD

Ischaemic Heart Disease

TEDS

Thrombo Embolic Deterrent Stockings

Intra Muscular

TIA

Transient Ischaemic Attack

Intravenous

TPN

Total Parenteral Nutrition

IVI

Intravenous Infusion

Us&Es

Urea and Electrolyte

LIF

Left Iliac Fossa

USS

Ultrasound Scan

LUQ

Left Upper Quadrant

UTI

Urinary Tract Infection

MDT

Multidisciplinary Team

/ /

MEWS

Modified Early Warning Score

/ /

Myocardial Infraction

/ /

(Adapted from Ninewells Hospital Admission Pack)

Early Warning Score

The Early Warning Tool (SEWS) is an observation chart designed to identify patients who require closer observation and intervention. It takes into account respiratory rate, oxygen saturation, temperature, systolic blood pressure, heart rate and neuro response. Each parameter will determine a score depending on which coloured category it presents in. The scoring is from zero to three (white to red) and a total score is calculated. This is one of the first assessment tools used when a patient is admitted and its importance should not be undervalued.

Learning Contract

A learning contract will be developed between yourself and your mentor. This is an agreement which will help to identify your learning needs and how to get the most out of your placement (Welsh and Maslin-Prothero 2005). A learning contract is flexible, individualised and will be regularly evaluated. It will take into consideration variables including your experience and the length of your placement (Lowry 1997). A learning contract is printed in the orientation pack you will receive on your first day on the ward.

Think about what experience you have and what can you build on:

· What have I done before?

· What do I know now?

· What do I want to learn?

· How will I do this?

· What help/resources do I need?

· How do I assess my learning?

(Learn Direct 2006, Nursing Times Learning Curve 1999)

You and your mentor will identify objectives, plan how they are to be achieved, identify what resources can be utilised and how to show evidence of learning (Welsh and Maslin-Prothero 2005).

References:

Learn Direct (2006) Learning Contract http://www.learndirectltw.co.uk/ep/web/home/topics_2/scr24/ 17th April 2006

Lowry M (1997) Using Learning Contracts in Clinical Practice Professional Nurse Vol.12 No.4 pp280-283

Nursing Times Learning Curve (1999) Using a Learning Contract Nursing Times Vol.3 No.7 pp12-15

Welsh I and Maslin-Prothero S (2005) Learning Skills and Learning Styles in Maslin-Prothero S (Ed) Study Skills for Nurses and Midwives (3rd edition) London Bailliére Tindall

Off Duty

The following guidelines will help you with your off-duty. If you have any queries or problems with your off duty please let your mentor know as soon as possible.

Dundee University Guidelines (May 2006):

Guidelines
First Year
Second Year / 2 late shifts/week
2 weekends for short placement (5-6 wks)
4 weekends for long placement (10-12 wks)
Third Year / On shift 2 out 4 weekends
CAN WORK NIGHTSHIFTS WITH MENTORS

Useful Texts/Journal Articles

Collett K (2002) Practical Aspects of Stoma Management. Nursing Standard 17, 8, 45-52

Elliot D (2002) The treatment of peptic ulcers. Nursing Standard. 16, 22, 37-42

Fawcett T and smith G (2005) Acute pancreatitis: pathophysiology and patient care. Gastrointestinal Nursing 3, 8, 31-39

Field J and Bjarnason K (2002) Feeding patients after abdominal surgery. Nursing standard. 16, 48, 41-44

Fox C, Lombard M and Lam E (Eds) (2004) Gasteroenterology (2nd Edition) London Mosby

Long B, Phipps W and Cassmeyer V (Eds) (1995) Adult Nursing A Nursing Process Approach London Mosby

Metcalf C (2002) Crohn’s disease: an overview. Nursing Standard 16, 31, 45-52

O’Callaghen N (2002) Pre-operative fasting. Nursing Standard. 16, 36, 33-37

Orientation Checklist

Must be completed within first 48 hours commencing placement

Mentor / Student / Date
Introduction to
· Mentor(s)
· Other members of nursing/midwifery staff
· SCN/SCM/Team Leader and key members of team
Show
· Location of emergency equipment
· Location of other placement equipment
· Location of key guidelines/policies/procedures
· Orientation to placement layout including fire exits
Discuss
· Uniform policy (or dress code)
· Changing facilities
· Shift patterns
· Philosophy of care
· Philosophy of education
· Reporting sickness/absence
· Fire and safety procedures
· Emergency procedures
· Lines of communication (including emergency numbers)
· Manual handling policies and procedures
· Incident reporting procedure
· Daily routine of placement (e.g. meal breaks )
Educational opportunities and agree learning outcomes (document in assessment booklet)
Date of midway assessment
Date of final assessment

Mentor Signature ______

Student Signature______

Orientation completion date ______