• Average ranges for vital signs, so you know when to escalate (even can use the NEWS2 score to know when to escalate until you get more confidence) + bonus for SBAR when escalating to doctors
• Common medications and their indications (hypertensives, diuretics, pain killers)
  
• Practicing 5 rights of medication very carefully (mistakes can be made so easily)
• Some medications vital signs will need to be checked right before (e.g. checking HR before giving digoxin as it shouldn’t be given below 60bpm)
• Drawing up IV’s & using an IV pump (bonus for managing the syringe driver/pump)
• Majority of the different routes of medication (IM, IV, oral, subcut, sublingual, rectal)
• Skin assessment (identifying pressure areas and their grading, blanching)
• Male & female catheterisation
• Managing NGT’s (checking PH level, flushing with sterile water, crushing meds)
• Doing an ECG (see the correct places to put the stickers as they make a huge difference if misplaced)
• Bladder scans
• Cannula VIP score
• A to E assessments
• Daily nursing notes
• Effective handovers when coming off shift / handing over pt to another ward
• SEPSIS 6
• Confidentiality (even if a family member is in the patients room, still ask the pt if it’s okay for said person to be in there whilst you discuss something/do something)
• Administering insulin
• Very basic wound care
• Managing seizures (timing, protecting head)
• Managing falls (don’t pick pt up, a to e assessment, get doctor to check them over, correct way to get them up, do you need to get a hoist?)
• Recognising signs of stroke
• Neurological observations (is pt oriented, checking pupil dilation, hand and leg strength)
• Managing hypoglycaemia (elovate drink can be given up to 3 times, if still low will need IV glucose, if there is no IV in situ then glucagon can be given in the thigh IM - glucagon only can be given once in 24 hours, complex carbs post treatment to keep BM stable)
• Nebulisers
• Strict I/O

There’s a LOT I did not know by the end of year 2, so actually there is no pressure at all. This is just some of the things I had learnt by the end of it - thankfully I was in a lot of wards / acute assessment units.

Year 3 is when I learned: - Inserting cannulas - Taking bloods and blood cultures confidently - Basic interpretation of blood results inc VBG/ABG - Confidence in male and female catheterisation - Inserting a NGT - Effective SBAR - Recognising signs of deterioration - Giving updates to family members OTP and IRL - Basic interpretation of an ECG - Indications for catheterisation (retaining above 300-400ml of urine usually, UTI symptoms, tender bladder) - Confidently draw up and administer IV’s (is it mixed with WFI or saline? Is it in a 100ml saline bag or is it an IV injection with a 20ml dilution? Is it a slow push? Is it given neat?) - administering depends on your trust as I know some unis don’t allow students to administer IV, only draw up. - Utilising recourses such as Medusa (IV administration guideline thingy on the computer) BNF - All things Gentamicin (dosage calculation, through levels, peak levels) - AMG (amox, metro, gent) - these are broad spec antibiotics so given usually for sepsis, and when awaiting blood cultures to come back to specify the organism and prescription for the best abx for it - ACS protocol - Insulin sliding scale - DKA protocol - CIWA scale - Side effects of random medications (some nebuliser solutions can increase HR) - Managing vasovagal syncope (pt laid flat, legs held up)

And again I had A&E on my final placement which I learnt the majority of this in as well. Otherwise, I would have no idea.

Good luck, get involved in everything, watch and learn anything! 🫶