Transitioning Into A Ward Based Role

Having recently changed roles, Prescribing Nurse, Sophie, offers her tips and advice for working in a ward environment, and highlights the pressures that hospitals are currently faced with.

Introduction

Hi, guys. I'm here today to talk to you about transitioning into the ward environment. Now, this video might be helpful for any of those who are perhaps apprehensive as a nurse to work on the wards, because of what you may have heard, or seen, or you've never done it before.

Or you may be a student nurse and your first job, post qualified, is on ward. Wards can be very rewarding environment, but they can also be very difficult. So we have to think about what challenges we might face going into a ward environment.

The Current Pressures Within The Ward Environment

One of the things is bed pressures, winter pressures, as we're coming now into winter. So these things are not in our control. They're with bed management team.

Obviously, it's good to be mindful of those things, but we have to remember that those are not within our control. But we need to know who to escalate to where necessary.

Another difficulty when working on the ward is that a patient, a relative, a staff member, sees you in a uniform, and assumes that you know everything about what's going on and about every patient.

But that may not be the case, and that is okay. We can't be expected to know everything, as long as you know about the patients that you're taking care of and who you are assigned to.

After the team briefing in the morning, you'll be assigned to a bay side rooms, or a bay in a couple of side rooms.

So you need to know everything about those patients, following the handover and reading the notes.

But it's also good to know about your team and who the nurse in charge is so that you can escalate properly if you are asked about another patient who's not in your care but is on the ward.

Or any questions that you might be asked, you need to know where to signpost that person.

Communication Is Key

Another thing to think about is we have families and patients who are often very worried about their relative being in hospital or themselves being in hospital. And as nurses, it's our job, and we see these things every single day.

And to us, they don't worry us because it's our natural environment. But for someone coming in, it's very clinical, it's very noisy, there's alarms going off. Sometimes, other patients are upset, or angry, or all different types of emotions.

It's a very busy environment. So this can be a scary and worrying time for patients and their relatives, and not to mention their health is not doing so well as to why they're there.

So those things are good things to keep in mind. And think about how you may overcome those worries of patients and their families. So communication is a great thing.

We always talk about communication in nursing, but it's one of the things that we underestimate, but it's a key in nursing. And we also need to be empathetic to patients and their families as well, and answer the questions that they may have as best as we can with what we have.

Ward Shifts Tend To Be Long (12 hours)

Historically, ward nurses are known to have to work long hours on the wards. Now, long hours might not be for everyone, and that's okay. And if you try them and they're not, then you need to speak to your line manager.

And perhaps there's something they can do about that. They could perhaps change your hours to suit you. If you are working long hours, you may feel burnt out if the hours don't suit you.

So it's a really good idea that if you are feeling burnt out, you must try and manage your self-care. So doing things that relax you, that make you feel happy.

And if self-care is not working, and you don't have the time to do things to relax you outside of work, then you need to speak to your line managers and occupational health. And things can be done to help you.

Make sure you speak up if you are struggling with the hours and the workload.

All of those things sound really challenging. And you may think, "Well, why do I want to work on the ward when I have to think about all of those things?".

As I said before, ward working is really rewarding. You have a poorly patient who comes in and, as a team, you can make them feel better physically, emotionally, feel better.

And you are part of the team that nurses them back to health. And there is nothing more rewarding than that. So it is a lovely place to be when you see someone poorly, and when they're discharged, they're so much better.

And the family and relatives are really grateful to you. There's no better feeling than that.

Brush Up On Medications

So other things to think about, which is a good idea before you start the ward, is to brush up on the commonly used medications that they use on the ward. Because, as a nurse, in our NMC Code of Conduct, we need to know about the pharmacology and the medication that we're giving before we give it.

That's a legal requirement. So brush up on those. And you'll know the type of medications, based on the type of ward that you're going to.

So, for example, if you're going to a cardiac ward, then you know, predominantly, it's going to be cardiac medications that you'll be administering. So it's a good idea to look those up.

And you may not find out all of what they are before you go. But your first week, at the end of the week, sit down, keep a note of the medications that you've come across, and find out more about the information about those medications.

Another thing to think about is that it's a really good idea to be open to learning, so any new learning opportunities. Just because you're a qualified nurse doesn't mean that you know everything and there's always an opportunity to learn.

If there's something going on that you haven't seen before, you might've be qualified for a long time or you may not have, tag along and see if you can learn something, or pick up something, or go into the doctor's consultation and see if you can pick up anything.

You may not learn anything, but you might learn something about yourself. You might learn, "Oh, actually that's what I was thinking." And, "Oh, I was right in that case."

And it will affirm your current knowledge and that will be really rewarding for you.

Escalate Your Concerns If You’re Not Comfortable

Remember to escalate, as I said before, so let your line manager know, or the nurse in charge, if you're not happy to do something, if you're not competent to do so.

That's also part of our Code of Conduct. If we're not competent to do something, we must not carry that out. So it's no good just not doing it. We have to let the nurse in charge know, or your line manager, so that they can find the best way to support you and get you trained.

Make The Most Of Being Supernumerary

And another thing when starting the wards is that you'll probably be supernumerary, which is a really helpful tool, even if you've been qualified for a long time.

Supernumerary is great because you're not counted in the numbers. And it can really help for you to feel more relaxed and not just another number for another pair of hands.

You actually get a bit of time to settle in, with enough staff working so you can learn from them.

Another thing to think about is communication, as I briefly touched on before.

So when doing handovers, or when communicating in nursing, we should use SBAR, which is situation, background, assessment, and recommendation. And that will really help when you're doing your handovers and that will make you feel more confident as well.

Bank Work Can Help You To Upskill

Another thing as well is, I know it's quite daunting again, but if you are on the bank, so if you are registered to work other places in the hospital, that can help you to be more adaptable to change.

If you're going into a new trust, things are different, policies and procedures are different, so it's a good idea to brush up on those. But with the bank work, I found, personally, that it helps me feel more relaxed when I'm going into a new environment because I'm not dreading it because I haven't moved in a long time.

I haven't done anything different in a long time. And it adds another string to our bow. And, ultimately, the knowledge makes us feel more confident.

It’s Important To Be Sociable And Network

As well as brushing up on our clinical skills, it's a really good idea to be sociable with your team and be friendly. And get to know the people in your team and what their skills are.

Because as one nurse, we can't do everything. We don't know everything. We don't have all the skills for every single clinical situation. So if we get to know what our team skills are, the multidisciplinary team as well as the nurses, then we can signpost, we can refer, we can ask for advice.

It's really good to utilise our networking. And it's not just about the old phrase that goes, it's not just about what you know, it's about who you know, which is true.

Obviously, your clinical skills and your nursing knowledge is number one, but it's a good idea to branch out so that you can signpost and network as well. So that's a really good thing to do.

So, guys, I hope you've enjoyed my video and I hope it's given you some tips. And I hope you're thinking about working on the ward soon. Thank you. Bye.