Transcription
We follow students in Birmingham and Manchester. I listen to your chest, juggling academic study. Nothing's going in with home life and work on the wards. You're never gonna learn how to be a nurse until you're out there doing the nursing job. This time, hard graft. I don't know how nurses do it. When they say long days, they're not joking either. They are long days. High emotion. If I can do it for him, there's a good chance that I can do it for somebody else. And child's play. The fun, the laughter, just makes your day's worth worth it. As our nurses to be, step up to the challenge of 21st century nursing.
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I'm also quite experienced at hospital corners now. Don't get too close, you might get cut by the corner. In Birmingham, second year, TK spent six years selling beds before changing career. Now he's making them as a children's nurse. With young children of his own, TK finds the long hours a particular challenge. My day starts roughly about 6:30, and I'm on a long day. In the first year, I struggled with timekeeping, so this year my plan was to be early for any shift. TK is on an eight-week clinical placement at Birmingham Children's Hospital's specialist live award. As today's 13-hour shift begins, he has a new patient to settle in, five-year-old Caleb.
"Hey guys, my name is TK. I want to do the next..." "Oh yeah, yeah." "My first year was a little bit like a mouse. You'd stand back in the background and you wait for people to introduce you to them. Um, this year I was trying to introduce myself. That's a new thing. I like my second year. When you show an interest and I open up to people, they do the same back to you. Right, pirate, I've come to check your heartbeat. Have you got a heart in there?"
Checking the vital signs of such young patients requires a light touch. "Where's your finger?" "God, it's gone." "Right, are you ready? So something's going to squeeze your arm. I'm telling you." Muscles. It's the bread and butter of nursing. It's, it's one of the crucial parts that you spend a lot of time doing. It does put some ominous on me as a student, um, just thinking I'm responsible in terms of his hearing. Yeah, he's quite deaf. He's had grommets and things, and he's being assessed for hearing aids. The simplest thing is gonna mean the most to these children. And I always say, my, my nursing kit isn't about just the medical stuff. When you see a smiling child's face, for me, that's a bit of a symptom of being well."
"Rules, you're not allowed around here. What are you doing?" "You said yeah, but I say no, no."
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"I love this part. You get rid of your childhood again." Caleb has a liver condition that requires an exploratory operation to check for internal bleeding. His parents aren't allowed in theatre, so to reassure them, TK has volunteered to be at his side. "I feel for the parents because I can empathize as a parent. It can be quite difficult, but, um, I think if a parent can enjoy it as a professional, I should expect myself to do a lot more than that."
"Hi, hello." TK wants to make the most of this rare chance to be in the operating theater. "It is an awkward place and a new place. You don't know where to put yourself. You sort of think, I hope I'm not asking a silly or stupid question, a very obvious question. So, is it that redness that we're talking about? When you actually see a camera that can show you the real life internal organs of someone in this, look exactly like that in the book? Because of that, I really remember because I remember it as Caleb's esophagus, Caleb's stomach, Caleb's, that, and the other. So it really sticks."
The exploratory op gives Caleb the all clear, but coming round from the anesthetic tests TK's new bond with his patient.
[Music]
"But that's because he doesn't want to be helped. There comes a point where you have to step away in order to be able to step back in. And I just wonder when, when his mother comes in, will she be able to do anything different to what we do?" "Okay, Dad." TK must come to terms with the fact that sometimes only mum will do. "It's just a lesson that sometimes there'll be things that I can't do. It's actually quite difficult. I need enough cried. I have no idea where I'm going. I hope you know that I don't have a clue."
In Birmingham's Good Hope Hospital, second year Amy is about to start work on the stroke unit. "Before you walk onto the ward, you do kind of think, oh God, I haven't been to the ward before, so I am looking forward to it. It's probably why I'm a little bit more nervous. I'll be all right." Keen to make a good impression, Amy's not arriving empty-handed. "I did actually make some cookies, so who knows, my mentor, she might actually be really go easy on me today, but hopefully they taste as good as they look."
"So neat biscuit break. We'll have to wait today." And for the next two months, Amy will work 12-hour shifts under the watchful eye of her mentor, Ward Sister Liz. "Let's have a look at you. That's better. That's right. You could just sleep, couldn't you? And there's me poking and prodding." "I do remember what it was like to be a student nurse, feeling very alone and left to get on by myself. I do remember bad experiences, and I remember the good ones, and I've always taken those with me."
Whenever a student comes onto the ward, many patients on the stroke unit are elderly and have complex conditions. 82-year-old Sheila is particularly challenging. "Unfortunately, she has got a swallowing difficulty at the moment, so she's nil by mouth. Should we give that mouth some moisture? It can be quite difficult. You can find it quite hard because sometimes they do pull on your heartstrings, and it is quite uncomfortable."
For Amy, treating stroke patients is especially poignant. Two and a half years ago, her grandfather had a stroke, and she moved in to help. One night, when her grandmother was out, his condition rapidly worsened. "Instinctively, I did all that I could. Call the paramedics, but before they got there, he passed away. CPR didn't work, and by the time they got there, he was gone. By thought, if I can do it for him, there's a good chance that I can do it for somebody else. I know that by doing that, I'll make him proud, and I know that I can do it. Just unfortunately, I didn't manage to save his life, but I know that I couldn't do it with other people."
"Just try and relax, my darling. You'll be all right, okay?" Sheila has dementia, which complicates the treatment of her suspected stroke. "At the moment, we're just waiting on what the doctor says because you were coughing quite a lot. Unfortunately, she's quite hungry, and she doesn't fully understand due to her dementia why she can't have anything to eat. This lady is desperate for food." If she doesn't improve anything and continues to have swallowing difficulties, then she may need a nasogastric feeding tube through the nose. Keen to help Sheila, Amy volunteers to perform the procedure. "I spoke with my mentor, and she's said if that is the case, then obviously that would be something that I could do."
Inserting a feeding tube is a delicate operation, even for the most experienced nurse, let alone a student. At the University of Salford, the first year's clinical placements have just been announced. After eight weeks of theory, they're about to face real patients for the very first time. At 29, Kelly is amongst the older of the new students and is keen to catch up. "I've messed up. I've been married, I've been divorced. I could be a nurse 10 years ago, whereas now I'm driven. I'm taking all these steps and doing all this work and following me dreams, really."
"This is the list that's been posted, so I'll just go into it. So, clinical placement, Salford Royal Hospital, Dermatology. Oh, that should be good. We don't know and stuff from blisters to boils. Dermatology could test Kelly's nerve." "I can be very, very squeamish. I hate snot. I hate bogeys and snot. It makes me want to vomit." For the next two weeks, Kelly will be forced to brave her fears or risk falling at the first hurdle. "I have been nervous about blood and puss and stuff like that, and I'll just have to wait and see what it's like when you get on there, really."
Like all student nurses, Kelly has a mentor on each ward. Here, it's Martin. "And don't be afraid to ask questions, no matter how silly it is." "No, no. Oh, no. I won't be afraid to ask questions." "You do long days all the time, then?" "Mostly, yeah." "So, has Charlie got a lot of tablets this evening?" "No, he's just got one tablet at the moment." "If it was an open wing, do you put maggots in it?" "In this ward? Is this world? Yes, we do. Yes." "I do not want to see that." "But is there an internal messaging system?" "You have no." "You never get tired?" "Yes." "I'll probably really get on people's nerves, but I think you, you're only going to learn that way, and they'll be, they'll be thinking after two weeks, oh my god, she's gone. She has so many questions."
"We've got to do our medications. We've got one more treatment to finish off. Yeah, we've got to get that male patient that's on another ward, get him admitted. Yeah." "As it's my first day, I feel like I'm a bit of a pain. I feel like I'm in the way, and you just feel a bit uncomfortable, don't you? But it's all part of the learning." "I need to give him an injection, which I'll come back and sort out in just a moment. I've seen skin and stuff like flaky skin on beds and stuff, and I thought, oh, now we're going to go and give somebody an injection. I don't know where he's going to put it. When I'm going white and passing out, just, just let me know."
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"I'm just gonna dry inside this hand because I've given those nails quite a good scrub." In Birmingham, second year student nurse Amy is helping care for 82-year-old Sheila, who has a suspected stroke. She also has dementia, and Amy's keen to help her understand what's going on. "Because you can't swallow because you've been coughing and choking, what we're going to do shortly after they've finished the meals, we're going to pop a little tube. It goes in through your nose and down into your stomach and give you something to eat that way." Mentor Liz is letting Amy insert the feeding tube Sheila requires. "It's a blind procedure, so there are risks, as you know. I mean, it can go down the wrong way. It can go into the trickier, but there are normally signs of that, like coughing and just respiratory distress. We're going to try."
"That's Amy in front of you here. She is. Yes, she's very good as well." "So, do you know where you're measuring from?" "Is it just so from here to like around here and then to about there?" "I'm always going to go in with an open mind. There is always the opportunity and always the window for mistakes." "Yeah, that's great. Seven two." "I'm just gonna have to take your oxygen mask off, and then what we're gonna do is pop this tube into your nose, right? You'll just feel this going into your nose now, okay? It'll tickle. Can you give another swallow, Sheila? Try and swallow for me." "It's definitely just stopping at 55 every time. I'm wondering if it's coiled, obviously." "Yeah, that's what could happen sometimes. Something like that can give you quite a bit of doubt, and you think, oh, did I do it wrong, or did I measure it wrong, or? But having somebody like Liz, it's extremely reassuring."
"Well done, beautiful. That's brilliant. Well done. She's absolutely beautiful. Right, you just feel it pushing down now. Oh, we have something that might be when we protected some of the stomach content. It was in the right place, so I'm feeling quite proud of myself doing it." "Right, well done. Nice done, Amy. We'll leave you to have a little rest now." "She did it really well, actually. Some people are hold back a little bit and they're quite happy to let their mentor just show them a little bit too much without without going ahead and doing it. The only way to learn, really, as long as it's safe. So, yeah, I was really pleased with her."
With their patients successfully fed, there's a chance for Liz to try Amy's homemade cookies. "The hideous. A beautiful. Thank you. I'm going to eat them all."
In Birmingham Children's Hospital, TK has spent most of his day caring for five-year-old Caleb. "Imagine if I dropped it, that would be messy, wouldn't it?" The handover of patients between shifts is one of the most important tasks nurses have. "Just gonna be a stage fright, thinking I have to try and tell a qualified nurse, um, or the care details of about a patient I've been looking after for the very first time." TK has been trusted with the responsibility. "I'm gonna, um, get you to hand over to Esther. Our two patients because you'll be working with her on the lathe. You're right with handing over?" "Yeah, okay. It'll be the first time, but definitely this, um, first time for everything. I'm really enjoying listening."
"Oh, yes." [Laughter] "So, um, Caleb's in today for, um, a gas gastrointestinal, uh, endoscopy. For the first sort of five seconds, the drug names weren't blurry, and then you, you skip across to when was it given, and because it's like small handwriting, you're squinting and thinking, oh god. We're trying to make life a bit easier for me, just so I could see it. He's been this morning, and there was need, there was no need for banding. So he's there. There were some viruses, but they're quite mild and grade one to be precise."
"Doing the sand over was quite, um, a milestone. It really felt like I was stepping up to the plate. It's added responsibility, but I did get the feeling of, am I doing this right? You have, you'll have a feed overnight. Act just open up." [Applause] "I'll meet you in the middle." [Music]
As Caleb's parents leave for the night, TK wants to reassure them that their son is in good hands. "So I thought I'd come over and say good night to mummy and daddy, and I promise to look after this pirate." "When parents leave the ward and they leave us down with the children, it's a huge responsibility. But in the case of Caleb, was really fantastic because he was able to trust me." "See you later." "He's off." "Oh, I'm going to act." [Applause]
"Charlie into bed number 14 and just do a swap, okay? All right, okay." Squeamish first year Kelly has had an arduous introduction to the dermatology award. From all of it so far today, she's done more furniture handling than hand holding. "We're just changing the rooms around because there's more people going into the end ward, and then, and then we're bringing a lady into this ward. Just pop a dirt in front of Kelly. Is that about? Just leaving it there now." "Oh, sorry. Today, wacky, then the first time I've drawn the bed. It's a bit stiff. This is it. Just the moment the brakes is on. All right."
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"That's better. What a breeze. This is my first day of driving bedroom furniture, so I'm a bit new at it." As the shift nears its end, she's about to face her greatest challenge so far. "So obviously, this is the injection. This is the first time I'll have seen an injection. Yeah, nervous. The thought of it turns my stomach. Hopefully, there won't be too much blood." To be a good nurse, Kelly knows she has to toughen up. "Somebody like me, who's as squeamish as I am, has done this because you can always overcome those faiths. It's about the interaction with patients and then hoping to make a bit of a difference, and that's what I'm here for."
"And make sure you have your bevel going the right way. Can you see the bit of the difference? Can you see that?" "Yeah, yeah. It makes it easier for the patient." "Okay, just relax yourself. Pat. Okay. Sharp scratch." "Okay, I didn't expect people to put them in so like, you know, forceful in a way. I just thought it was a more smoother, calmer sort of way. But to be fair, most of the time I'm like this." "Does that feel okay?" "Yeah, no problems." "And that's it. It's a big step forward to some things that you do like or you don't like a nurse, and that you're not 100% comfortable with, but you learn to over overcome it. I feel like I will get used to it, like, and I'm sure with things like wounds and stuff, maybe when I do come to it, I find it fascinating. Like, I just found that fascinating."
A newfound courage is not Kelly's only discovery today. "Busy into it. You don't stop. I've not seen you stop all day. You just have days like that where you have your good days, you have your bad days, and some days you're just catching up all day, and other days it can be quite nice and everything is going to plan. But today has just been one of those days where we're playing catch up." "Right, well, majority nurses intend to stay a little bit later than they needed." "Yeah, they do. Because of the job." "Yeah. Because you enjoy." "You, yeah, yeah."
Over the next three years, Kelly will spend more than 65 weeks on the wards. She's now one day nearer to becoming a nurse. "It's been a good experience. An introduction. What we've got to remember is on your first placement, and it's our first award, so it takes a lot to get used to. She's done very well considering it's her first day." "I don't know how nurses do it all the time. My feet are absolutely aching, my back is killing because you stood up all day. My legs are like jelly, and you just, you know when you're just ready to go home with a BT." "When they say long days, they're not joking either. They have long days."
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In Birmingham, TK has been at work for 13 hours, but before he heads home, there's one last thing he wants to do. "Caleb, I thought I could say good night. You're gonna go to sleep? Do I get a high five?" "High five!" "I love five!"
"When you say goodbye to Luke, when you've built a bond with you, just think, I hope I've made a positive impact. It's a real privilege that within the short time we see, I see patients, I'm able to gain that level of trust, and it's, it's an absolute milestone." "In the times, the fun, the laughter, they just make your days work worth it." "I left my house at seven, and I'll be here again in the morning. Tomorrow shaft. My legs are absolutely shattered. I have an appointment with my bed."
"Next time, sirens. There is a time limit. This is urgent. This is real. Setbacks. You can't see a feeling and shocks. What do you know about the heart?"