WARD 10
NINEWELLS HOSPITAL
INFORMATION PACK FOR
STUDENT NURSES
AUTHOR OF STUDENT INFORMATION PACK WARD 10
Wendy Norrie
SSN Ward 10/HDU
CONTRIBUTORS:
Linda Dodds
Gillian Hirst
Donna Byrne
Pam Hodge
Marie Williamson
CN Ward 10/HDU
SSN Ward 10/HDU
CN Ward 10/HDU
SN Ward 10/HDU
SSN Ward 10/HDU
CRITICAL REVIEWERS:
Sandra Larkin
John Hammerton
Brian Gordon
Senior Nurse Ward10/HDU, Ninewells Hospital
Practice Education Facilitator, Ninewells Hospital
Personal & Professional Development Advisor, University of
Dundee, School of Nursing and Midwifery
DEVELOPED SEPTEMBER 2006
REVIEW DATE JULY 2010
RESPONSIBLE PERSONS: SCN/STUDENT NURSE EDUCATION GROUP WARD 10
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STUDENT NURSE INFORMATION PACK
WARD 9
NINEWELLS HOSPITAL
STUDENT NURSE INFORMATION PACK
WARD 10
NINEWELLS HOSPITAL
This pack has been designed to provide information regarding your placement in ward10.
CONTENTS PAGE:
1. INTRODUCTION TO WARD 10 AND YOUR FIRST DAY
PAGE: 4
2. LEARNING CONTRACT
PAGE: 5
3. OFF DUTY
PAGE: 6
4. LEARNING OBJECTIVES AND OPPORTUNITIES
PAGE: 7
5. REASONS FOR ADMISSION TO WARD 10, ADMISSION ROUTES
PAGE: 8
AND COMMON INVESTIGATIONS
6. ORIGINS OF ABDOMINAL PAIN
PAGE: 9
7. ACUTE SURGICAL ADMISSIONS
PAGE: 10
8. USEFUL TEXTS/JOURNAL ARTICLES
PAGE: 11
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STUDENT NURSE INFORMATION PACK
WARD 9
NINEWELLS HOSPITAL
WELCOME TO WARD 10
Ward 10 is a 24 bedded surgical emergency receiving area. Referrals are received from
Accident and Emergency, wards within and out with the hospital and General Practitioners. A
ten bedded High Dependency Unit is part of Ward 10 and an observational visit can be arranged
through your mentor. The workload is very unpredictable with an average of 12-15 patients
admitted every day. 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.
An early shifts start at 07:30 until 15:30 and a late shift commences at 13:00 through until
21:00 hours. 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. Your mentor
will be responsible for your assessment, co-ordination of learning and personal support.
A safety briefing is given to all the nursing team followed by an individual handover on
your patient caseload. The shift co-ordinator will orientate you to the area and introduce you to
members of the nursing team. We aim for you to work with your mentors (usually 2) as much as
possible, if neither are on shift you will be allocated another member of the nursing team to
‘buddy up’ with.
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STUDENT NURSE INFORMATION PACK
WARD 10 NINEWELLS HOSPITAL
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.learningthroughwork.org/
Lowry M (1997) Using Learning Contracts in Clinical Practice Professional Nurse Vol.12 No.4 pp280283
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
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STUDENT NURSE INFORMATION PACK
WARD 10 NINEWELLS HOSPITAL
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
REQUESTS CAN BE MADE
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STUDENT NURSE INFORMATION PACK
WARD 10 NINEWELLS HOSPITAL
LEARNING OBJECTIVES AND OPPORTUNITIES
The following are examples of learning objectives which can be worked towards on ward 10
You will have the opportunity to have time with your mentor to discuss what your learning
objectives are and how you can meet them. Throughout your placement you can aim to become
more independent in working towards meeting your objectives with continued support and
appropriate supervision from your mentor and the nursing team.
1. Participate and become familiarised with the admission procedure, transfers and
discharges.
2. Contribute to the nursing assessment of patients and take supervised participation in their
care management.
3. Undertake supervised practice of clinical skills: catheterisation
drain management
drug administration
fluid balance
intravenous infusions
nasogastric tube management
oxygen therapy
patient observation
SEWS (Scottish Early Warning System)
stoma Care
4. Increase knowledge and nursing skills in pain assessment and management.
5. Develop nursing skills and knowledge on the pre and post-operative patient.
Nursing staff on ward 10 work closely with other patient services including:
Acute pain team
Palliative care team
Diabetic specialist nurses
Pharmacists
Dietician
Physiotherapists
District nursing services
Stoma nurse specialists
You will have the opportunity to meet with these teams to understand and appreciate the holistic
approach to nursing care within the ward. There will be opportunities to visit Endoscopy, HDU,
Radiology and Theatres which can be arranged through your mentor.
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STUDENT NURSE INFORMATION PACK
WARD 10 NINEWELLS HOSPITAL
ADMISSION TO WARD 10 AND COMMON INVESTIGATIONS
Patients are admitted to ward 10 with problems requiring surgical investigation and intervention.
Common conditions are listed in Table 1. Patients are referred through GPs, Accident and
Emergency, wards within Ninewells and from neighbouring Hospitals e.g. Queen Margaret’s
Hospital in Fife.
Table 1: Common admitting conditions
CONDITIONS
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
Patients will undergo investigations from ward 10 and there will be opportunities to
observe these procedures. This can be arranged through your mentor. Common investigations
are listed in Table 2.
Table 2: Common Investigations
INVESTIGATIONS
ABDOMINAL ULTRA SOUND SCAN
ABDOMINAL/CHEST X-RAY
ARTERIAL BLOOD GASES
BARIUM ENEMA
BARIUM SWALLOW
ENDOSCOPIC RETROGRADE
CHOLANGIOPANCREATOGRAPHY (ERCP)
FLEXI SIGMOIDOSCOPY
COMPUTED TOMOGRAPHY (CT SCAN)
LAPAROSCOPY
LAPAROTOMY
MAGNETIC RESONANCE IMAGING (MRI SCAN)
UPPER GI ENDOSCOPY
THEATRE
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STUDENT NURSE INFORMATION PACK
WARD 10 NINEWELLS HOSPITAL
ORIGINS OF ABDOMINAL PAIN
Knowledge of the origins of abdominal pain enables medical and nursing staff to determine the
appropriate investigations, treatment plan and nursing care. Explanation and rationale for their
care can be given to patients and their families.
Epigastric
RUQ
Central
abdo
RIF
LUQ
LIF
1.
Epigastric: Including oesophagitis, peptic disease, pancreatitis.
2.
Right Upper Quadrant (RUQ): Including bilary colic, cholecystitis, hepatic origin, renal
origin.
3.
Left Upper Quadrant (LUQ): Including splenic origin, renal origin, pancreatitis.
4.
Left Iliac Fossa (LIF): Including diverticulitis, gynae origin, urinary tract infection.
5.
Right Iliac Fossa (RIF): 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
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STUDENT NURSE INFORMATION PACK
WARD 10 NINEWELLS HOSPITAL
ACUTE SURGICAL ADMISSION
When a patient is admitted to ward 10 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.
OBSERVATIONS
BP/P/HR/
T/SPO2/BM/
URINALYSIS
ANALGESIA
ANTI-EMETIC
O2 THERAPY
NBM
IV FLUIDS
ELECTROLYTE
ACUTE
SURGICAL
ADMISSION
CORRECTION
COMMUNICATION:
PATIENT
FAMILY
CO-MORBIDITY E.G:
DIABETES
COPD
CCF
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STUDENT NURSE INFORMATION PACK
WARD 10 NINEWELLS HOSPITAL
DOCUMENTATION:
PATIENT DETAILS
NEXT OF KIN
PLAN OF TREATMENT
MEDICAL CLERK IN
BLOODS/ABGS
X-RAYS
URGENT SCANS
USEFUL TEXTS/JOURNAL ARTICLES
Burch J (2005) Pre and Postoperative nursing care for patients with a stoma. British Journal of Nursing.
14, 6, 310-318
Elliot D (2002) The treatment of peptic ulcers. Nursing Standard. 16, 22, 37-42
Sergeant S (2006). Pathophysiology, diagnosis and management of acute pancreatitis. Gastrointestinal
Nursing 15, 18, 999-1005
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
Hall A (2007). Diagnosis and current management of Crohn’s disease. Gastrointestinal Nurse 5, 2, 11-20
NHS Education for Scotland, The Development of Quality Standards for Practice Placements Edinburgh
NHS Scotland (www.nes.scot.nhs.uk)
Oshodi T (2004) Clinical Skills: an evidence-based approach to Pre-operative fasting. British Journal of
Nursing. 13, 16,33-37
PATIENT SAFETY. HTTP://WWW.PATIENTSAFETYALLIANCE.SCOT.NHS.UK/
GUIDANCE FOR STUDENTS.
http://www.nmc-uk.org/Students/
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STUDENT NURSE INFORMATION PACK
WARD 10 NINEWELLS HOSPITAL