In my final year I undertook a management placement on an infectious disease and HIV unit, working there gave me valuable experience in infection control and communication skills. On qualifying I was able to continue my connection with this unit by working on a part-time basis when the unit was sort of staff.

As one of a small team of qualified nurses working on the unit my responsibilities included supervising unqualified staff and mentoring newly appointed staff and students. I was also responsible for holding the unit bleep on occasions. This required dealing with any unexpected eventualities which arrived when the unit Sister was not on duty.

Working in care of the elderly requires both unique skills and a broad knowledge base. Each individual client will have different needs, which reflect their rich experience of life. Sometimes this required working with the individual to achieve an acceptable solution to their problem and on other occasions leasing with field experts. The specialist areas within elderly care include reminiscence therapy, working closely with occupational therapists and physiotherapists. It is always important to remember in care of the elderly that we are working in the clients home, not a ward or institution. With this in mind I undertook fund raising activities to improve the physical environment of the unit. This also had the added benefit of enhancing staff moral. A very rewarding activity I participated in was working with clients to arrange visits and trips to maintain their contact with life outside the unit.
 

Within the unit I had responsibility for tissue viability and discharge planning. This involved assisting with the development and implementation of a new hospital discharge plan, liasing with other departments and ensuring hospital procedures in these two areas were followed.

Whilst working on this unit I undertook three training courses, the Harefield transplant course, the English national board teaching and assessing course and a documentation study day. I believe documentation to be a very important area within nurs ing, to enhance patient care, improve efficiency levels and increase nurse’s professional status.

The major injuries unit saw acutely ill patients generally requiring admission to hospital. Due to the location of the hospital patients would present for varied reasons including road traffic accidents, agricultural accidents, boating accidents and acute exacerbation of chronic illnesses. Due to the close proximity of a major motorway, an airport, a major shopping centre and large accommodation complexes all of us working on the department were trained to implement a major incident plan. Resuscitation was often carried out on this side and I was involved in resuscitation and major trauma incidents.

When working on GP referral unit I worked with patients referred to the unit by their family doctor. This was the only unit in the department where we would know in advance the patients we were expecting. Many of the patients seen on this ward were long term sufferers of chronic illnesses, a large proportion required surgical assessment and preparation. At times of chronic shortages of staff or beds around the rest of the hospital it was this unit that nursed extra ITU patients. The majority of individuals who had suffered a CVA were admitted to hospital via this unit.

The area that I found very interesting to work was the suicide unit. The unit housed ten to twelve patients who had deliberately undertaken acts of self-harm. Oxford had an unusually high incident of paracetamol overdose cases, therefore I became well versed with administering parvolex. As well as overdoses of medication we saw attempted hangings, individuals who had jumped from a great height and self-mutilation. The purpose of this unit was to deliver medical care whilst assessing the risk of repeated self-harm. When medically fit people were transferred or followed up by the mental health team as the individually required.

All patients that present in an accident and emergency department arrive unprepared for hospital treatment. Therefore much of the nursing care involved making arrangements for someone to look after the patients home, arrange for transport home, but mainly listening to individuals concerns about their condition. This was often complicated as individuals were under the influence of drugs or alcohol. Language difficulties and cultural differences were an important concern as Oxford has a multicultural community and sees many international travellers.

Whilst working here I undertook an extended skills course in suturing, venopuncture, canulation, plastering and triage.

Working in a variety of settings enabled me to observe and work with many different management styles and record systems, this has given me many different ideas of useful techniques. I have also developed a flexibility to work within different organisational structures.

On arriving in Sri Lanka I undertook a six week training programme with VSO (Voluntary Service Overseas), this involved cultural and language training. During this time we explored the cultural differences between England and Sri Lanka and began to learn spoken Sinhala. The course involved lectures and visits to cultural sites here in Sri Lanka. This area is a field of interest that I have continued to develop during my time here.

Documentation is an area of work that I am also particularly enthusiastic about. Whilst working in care of the elderly I was fortunate to be involved in piloting computerised care plans. Though generally I have used written documentation. Nurses undertake a great deal of work that goes unrecognised as they do not document it effectively, at best this reduces the professional image of nursing, and at worst reduces the quality of care. My interest lies in using documentation to enhance quality of care, promote the image of nursing, and save time.

Another area of interest related to both documentation and stress is communication. I am interested in this field because of its massive potential. It can be used to reduce pain, elevate anxiety and share information and much more.