Talking skills – A nurse must be a bit like a chatter box. She must speak calmly, not too fast and not too slow. She must also consider changing the tone of her voice if it sounds angry. She must answer questions asked by a patient fluently, this means no stuttering. All questions must be answered fully and all advice given by the nurse must be friendly. Example, ‘why not use a smaller bandage? You’ll feel more comfort wearing it’.
Required qualifications
Reference: GCSE applied additional science – life care Ruth Homes, Merryn Kent, Mike Kent (Authors.)
Any applicant wishing to become a nurse must have:
A minimum of 5 GCSEs above or equivalent if they are wishing to enter onto a Dip HE
(Diploma higher education).
A minimum of 5 GCSEs and 2 A levels (including English language or literature and a science subject) if an applicant wishes to enter a degree course.
For graduates
Any graduates who decide to become a nurse will need to hold a first or second class honours degree in a subject that is relevant to nursing.
Age
There is no minimum age requirement or upper age limit for entry onto nursing programmes although some reports, suggest that teenagers as young as 15 can start training at the age of 15.
Standard Procedures carried out by a nurse
Standard procedures are a set of instructions scientists follow for nearly everything they do. Nurses also follow standard procedures to keep each procedure the same as last time. By following these, a nurse knows that she has kept everything the same each time she performs a procedure.
Measuring body temperature
Diagnosing illnesses is all part of a nurses role. One problem a nurse may have to confirm is if a person has hypothermia or pyrexia. This is the procedure a nurse may have to follow to out if a person has hypothermia or pyrexia (fever).
Equipment a nurse needs
Clinical thermometer – inside one of these thermometers is chemical called mercury. As the temperature rises, the mercury expands going up the glass tube, but when the temperature falls, the mercury goes down the tube. Where the mercury stops is the actual temperature. The bottom (mercury bulb) of the thermometer is always placed on the object that needs measuring.
Liquid crystal – this is a thermometer which changes colour to show the temperature. It measures the temperature of the skin.
Digital thermometer - this is a thermometer which has a body core temperature probe attached to it. It shows body core temperature on an LCD display which is simple to read and use.
Procedure
Approximate temperatures can be taken by placing the temperature probe or mercury bulb inside the mouth, under the arm in the armpit, or with a special probe inside the ear.
If a more accurate reading is to be required then the probe would be placed inside the oesophagus (tube going into the stomach) or rectum. The thermometer must be adjusted to give reliable readings. The clinical thermometer must be shaken to return the mercury to the bulb. The same body site (the same place in which the temperature was taken) must always be used to monitor body temperature varies over the body. The body core temperature is best recorded in degrees Celsius (°C).
Interpreting the reading (results)
For body core temperature to be normal it must range between 36 and 37.5°C.
Children have a higher temperature due to their higher metabolic rate.
A nurse may also have to follow a procedure when measuring a person’s Body Mass Index (BMI).
On the next page is the procedure they will need to follow to do this.
Measuring the body mass index (BMI)
A nurse may also have to follow a procedure when measuring a person’s Body Mass Index (BMI).
On the next page is the procedure they will need to follow to do this.
Introduction
To calculate a person’s BMI, a nurse must do the following calculation:
=
The index is used to estimate whether a person’s weight is at a desirable level, or too high or too low.
Equipment
Accurate weighting scales and height rule, stadiometer.
Procedures
- Place a scale on a flat and level floor making sure that the scale is not balancing on an object.
- Make sure the person being weighed is wearing light clothing and is not wearing any jewellery. Footwear must be removed.
- Record the mass in kilograms to one decimal place.
- A stadiometer combines a weight scale with a height measurer. For this procedure it is recommended for a nurse to use a stadiometer.
- The person being measured should face forwards. Effort should be made to ensure the person is standing straight and facing forwards.
- Mark the measurement on highest point of the head.
- Record the height in metres again, to one decimal point.
The following formula can be used to calculate BMI:
=
Interpreting the result
A nurse will use the following as guidelines for BMI:
Guidelines for BMI referenced from: GCSE Additional Applied Science - Authors: Ruth Homes · Mike Kent · Meryn Kent – Publisher: Oxford university press Date Published: 2006
Many risks are involved with being overweight. Heart disease is a risk. A BMI of 27 is classified as being overweight. There is a big risk of a person having heart disease if his BMI is over 35. The person has a greater risk of attaining premature heart disease. A nurse must help the patient (if BMI is over 25) to decrease their BMI to the advisable range.
How a nurse can help patients to stay healthy
A nurse may visit the patients home to help them overcome their weight. A set of exercise programs may be arranged. For example: on Mondays a nurse may come and help the patient do running on a treadmill, Tuesdays she might come and help the patient do stretches, on Wednesday she may come and help the patient to aerobics. As well as helping the patients do exercise; a nurse may also help the patient to eat healthily. He/she may well even do the shopping for the patient depending on their condition. Nurses will have to be flexible if they are to help patients inside their homes.
A Life of a nurse
Jane loader is a nurse in Worcester. As Jane Crooke, she was in the pupil nurse group of September 1984 at Gloucester Royal Hospital. She describes a bit of her life as a nurse. I began my enrolled nurse training at Gloucester Royal Hospital in 1984 at the age of 18. I was homesick even though the hospital was only a short distance from home, but my Memories of that time are happy.
Students were not supernumerary, but part of the workforce – we learned on the job. I was naive and enthusiastic about all aspects of my work. On one particular shift in my first year, I was working a late and the nurse in charge asked me to escort some relatives down to the mortuary so that they could see their loved one who had passed away. I felt fine about doing this, but I did not realise that there would be at least ten relatives following me down to the mortuary. Unfortunately, I was only vaguely aware of where it was. Trying to make conversation on this long walk was very awkward.
Nursing students lived in the hospital in those days. The cheap accommodation was like something out of Prisoner Cell Block H, with a small room, few home comforts and shared wash blocks down the corridor. As we knew no different, it was fine. Later in my training I decided to move to a flat, still within the hospital grounds. This seemed like pure luxury- I had my own room with a sink and only had to share a bathroom and kitchen with three other people.
First patients
I still remember the first patients I nursed all those years ago and wonder what became of them. On my first medical ward there was a woman in her forties who was hospitalised for a long time as she had MS and pressure sores. It took ages for her to trust the nurses and form a relationship with them, but this was achieved through good nursing care and a great deal of humour. I remember feeling so strong after managing to put a patient in a bath single-handedly, using an ambichair. I am short and, compared to me, the patient was a giant. This would not happen now, of course, for health and safety reasons. I particularly enjoyed building up a rapport with older patients - the geriatric ward was a hoot. Although the work was hard, there seemed more time to spend with patients. At change-over
There was a greater overlap of staff, so the sisters had time to go to meetings and things that had not been done in the morning could be finished. The tutors actually came to work on the wards with the nurses and assessed their competence for specific tasks, such as aseptic technique.
There was a great atmosphere in the training group and for a time it felt Like a family. On reflection, there is a lot to be said for starting nurse training at a more mature age. Life experiences can be brought into learning and greater sense can be made of subjects such as psychology, cultural studies and spirituality. I felt the difference when, in 2003, I joined the enrolled nurse conversion course. Studying and writing assignments were difficult at first, but the course gave me more confidence. I am only computer literate now because of the conversion course - computers did not exist in my original training. Even so, I would not change the way I was trained in the 1980s - I enjoyed it too much.
The National Health Service (NHS)
Hospitals are run by the NHS in the UK. The NHS also known as the National Health Service is responsible for running hospitals and other health care services. There are many services controlled by the NHS. Some services that are provided (by the NHS) are: Pharmacy services, General practitioners, Health centres, midwives and health Visitors NHS has important features:
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The NHS provides free healthcare to everyone living in the UK (most countries do not provide free health care)
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It provides specialist care that isn't available locally - local hospitals can't treat every medical condition so there are specialist hospitals that provide care nationally, one example is the London hospital for tropical diseases, which treats all sorts of infections.
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It monitors national trends, for example the spread of infectious diseases.
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The NHS also plans how resources should be distributed - e.g. where to build new hospitals or clinics, how many new staff are needed in an area, what machinery and equipment needs replacing
Information about the NHS referenced from: CGP Additional Applied Science · OCR 21ST Century, Page 1
A nurse’s role within the NHS
Nurses care for the sick and injured in hospitals, where they work to Restore health and reduce suffering. Many people are sent home from the hospital when they still need nursing care, so nurses often provide care in the home that is very similar to the care they give to patients in the hospital. In clinics and health centres in communities which have few doctors, nurses diagnose and treat common illnesses, prescribe and dispense medications and even perform Minor Surgery. Nurses are also increasingly working to promote people's health and to prevent illness in all communities.
Safety regulations
Safety is the most important aspect of our everyday lives. Safety regulations are strict and important inside the NHS. An article was taken from the Nursing Standard magazine, which is an example of how strict they can get.
Use of fresh needles – HIV and aids is a disease which can quickly spread through needles. It can spread if a needle is used twice i.e. the same needle being used one person and then another person. To stop the spreading of such diseases, Nurses are to use a fresh needle each time they inject a person (even if it is injecting the same person twice.
Tidy and clean – A nurse must keep her ward tidy and clean, she must clean her patient’s tables and the tables the patients have eaten from to stop the spread of infectious bacteria. She has to wear gloves to protect her hands from catching anything from the patients. Failure to do so could make her, her colleagues and patients severely ill.
Hand protection – Hand protection such as gloves must be worn to protect against infectious disease. Diseases are most commonly spread in winter and autumn. It is also recommended (for everyone, not just nurses) to spend a minimum of at least 3 minutes washing hands to stop the spread of pathogens and germs. There is a method which must be followed to keep hands as clean as possible.
Money in the NHS
The NHS like any other organisation or business needs money to survive. Money is needed to buy equipment in the NHS. If money is short inside the NHS, hospitals close down.
General information about pay in the NHS
Most jobs in the NHS are covered by Agenda for change (Afc) pay scales. This pay system covers all staff except doctors, dentists and most senior managers.
In AFC the NHS job evaluation system determines a point’s score which is used to match jobs to one of the nine pay bands and determine levels of basic salary.
Each of the nine pay band has a number of pay points. Staff will normally progress to the next pay point annually until they reach the top of the pay band. In addition to basic pay, there is also extra pay for staff who work in high cost areas such as around London.
A career in nursing and/or midwifery could start at an agenda for change band 2 as a clinical support worker (nursing) rising to nurse consultant at a band 8a-c. Examples of other roles, with typical agenda for change pay bands include: maternity care assistant (band 4); midwife entry level (band 5) rising to band 6; health visitor (band 6); nurse team leader (band 6); nurse advanced (band 7); midwife team manager (band 7); modern matron (Band 8a; and nurse consultant (band 8a-c).
What do nurses and midwifes earn
The following information gives an indication of which agenda for change pay bands certain job titles fit into and is based on the nationally produced job profiles. It can be used as a guide to the levels of pay, but please note that some jobs vacancies advertised in the NHS may carry very slightly different job titles to those provided here.
Pay information Referenced from:
Science knowledge
Much of nursing involves a lot of science knowledge. A nurse will need knowledge as backup when they come across a situation where science knowledge is required. A good example is when a nurse is taking a blood test; the nurse will need to know where they are to take the sample of blood from i.e. the nerve. Another example is when a nurse is trying to diagnose a foot injury; a nurse will need to know what bone is broken. A nurse will need to know every single bone inside the body in case of an accident anywhere else in the body. Below is some information which is an example of the kind of knowledge a nurse will need.
The Musculoskeletal system
The musculoskeletal system comprises bones muscle and joints, and makes up most of the body’s mass. It performs a number of essential functions including:
- Maintenance of body shape.
- Support and protection of soft tissue structures such as the brain, heart and lungs.
- Movement
- Breathing
- Storage of calcium phosphate in bone
- The manufacture of red blood cells, white blood cells and platelets in the bone marrow.
Table 1
Bones – Bone is a rigid structure ideally suited for its supportive and protective function. Bones contain sites for muscle attachment, the mechanical basis for movement. Based on their shape, bones are classified into five categories as shown in table 1 (above).
Muscle – Muscle tissue is made up of contractile cells which have the ability to shorten in length or contract. It is this characteristic that is responsible for movement, maintenance posture and heat production.
Joints - A joint is the site at which two or more bones are united, providing the mechanism that allows movement. There are three major groups of joint based on the structure and type of tissue that connects the bones. Fibrous joints unite bones by fibrous connective tissue and allow very little movement, for example, sutures within the skull. Cartilaginous joints unite bones by a plate of hyaline cartilage or fibrous cartilage and allow slight movement, for example, the pubic symphysis in the pelvis or the veritable bodies. Finally, synovial joints contain synovial cavity, articular capsule, synovial membrane and synovial fluid. Synovial joints enable an extensive range of movement (ROM), for example, the hip and shoulder joint. Further classifications of synovial joints are shown below.
Information about the musculoskeletal system Referenced from: NURSINGSTANDARD, Volume 22 · No 1 · September · 12-18 2007
Questionnaire
Miss Briggs is a school student mentor. Before working as a mentor she was a nurse. At the age of sixteen, she decided to become a nurse and for twenty years, she has helped people with medical problems. She retired at the age of thirty-six. In My questionnaire I will be interviewing Miss Briggs.
Q1. What key qualities must you hold? “You must be caring, good at listening, and co-operative, be able to make quick decisions and also must be fit.
Q2. How much does a nurse get paid? “Nurses are paid like teachers on a grading system. A nurse would receive about £15,000 - £27,000 a year. The higher band a nurse is, the more money she earns.
Q3. Is your job stressful? Yes, it is a very stressing job and requires a strong heart. It was really hard for me to try not to give up the job.
When I was staying at a hospital in Huddersfield, I created a small questionnaire; I took this with me so that I could acquire more information on my chosen topic. I was at the hospital to have 4 teeth extractions. This operation would require the surgeon to inject general anaesthetic. General anaesthetic is not allowed to be used in a dentist anymore, so I was for forwarded towards the hospital. Whilst I waited 3 hours for the operation to take place, I gave a questionnaire to one of the nurses. She said she’d complete it before I leave the hospital. This is the Questionnaire:
Q1. What's a typical workday like for you? ”I have three to five patients per day. I review my assignments and patient information, medications and needs, discuss them with the previous shift, and then meet my patients. I do a full assessment, including heart, lungs, surgical site, pain levels and IV fluids, then deal with patient issues such as low blood pressure, oxygenation and temperature. I chart my findings, review lab work, patient history and doctors' orders, and consider which complications may arise. I also administer IV and oral medication, change dressings, care for surgical pins, and take care of individual needs such as tube feeding, diabetes care and education. At the end of my shift, I report to the nurses and nursing assistants who are coming in”.
Q2. How does your role fit into the bigger healthcare picture?”The RN's role is huge. We advocate for and mediate between patients and physicians. We also get social services involved to work with insurance companies and we give the patient the care that they deserve”.
Q3. Who do you cooperate with during the course of the day?” I cooperate with patients and their families, other nurses, nursing assistants, unit secretary, doctors, nurse practitioners, physician assistants, laboratory, radiology, spiritual care and healing healthcare staff, and social workers.
Q4. Why did you become a registered nurse?” I had a family member in the hospital and the nurses treated her so well that I wanted to be in that role for other people's families”.
Q5. What do you like about your work?”I love my work. I love taking care of patients, advocating for them, seeing them get better and walk out the door feeling better than when they came in. I love being there for their families. I like the staff, the facility - I like everything about my job”.
Interviewer: Sohaib Saleem
Bibliography
Introduction – About the NHS
Website(s) -
Personal skills and qualities
Website(s) -
http://www.nhscareers.nhs.uk/nursing_skills.shtml
Vocational Skills
Website(s) -
Required Qualifications
Website(s) -
Book(s) - GCSE Additional Applied Science - Authors: Ruth Homes · Mike Kent · Meryn Kent – Publisher: Oxford university press - Date Published: 2006 – Page 12
Standard Procedures carried out by a nurse (body temperature & BMI)
Book(s) - GCSE Additional Applied Science - Authors: Ruth Homes · Mike Kent · Meryn Kent – Publisher: Oxford university press - Date Published: 2006 Pages 46 & 50
A life of a nurse
Nursingstandard12: vol22no1::2007 – Pages 24-25
The National Health Service (NHS)
Book(s) - CGP Additional Applied Science · OCR 21ST Century, Page 1
Nursingstandard12: vol22no1::2007 – Page 5(Article on banning crocs)
GCSE Additional Applied Science - Authors: Ruth Homes · Mike Kent · Meryn Kent – Publisher: Oxford university press - Date Published: 2006 Page 12
Website(s) - (Diagram of hand cleaning method)
www.thh.nhs.uk/documents/_Departments/Research/InfoSheets/9_health_safety.pdf
Money in the NHS
Website(s) - http://www.nhscareers.nhs.uk/details/Default.aspx?Id=4
Book(s) - GCSE Additional Applied Science - Authors: Ruth Homes · Mike Kent · Meryn Kent – Publisher: Oxford university press - Date Published: 2006 Page 12
Science Knowledge
Book(s) - Information about the musculoskeletal system Referenced from: NURSINGSTANDARD, Volume 22 · No 1 · September · 12-18 2007
