Kate Horne – Student Nurse, UPDATE

Two years ago, I told you I’d jumped into a new career and was studying to become a nurse. It seems incredible, but I'm now already at the end of my second year and about to start my final year of training. Here's another check-in to give you a glimpse of my new world...

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I’m walking out of the Intensive Care Unit after the second 12.5 hour night shift in 2 days, with alarm bells ringing in my ears. The bells were telling me that the oxygen circulating in my patient’s blood was low, and that we’d probably need to increase the amount of oxygen being delivered to her through a face mask. Another alarm told me when her blood pressure had dropped and she needed an infusion of noradrenalin to support it. Yet another alarm lets us know then the drugs and fluids being used to keep her stable and support her recovery are about to run out, reminding us to go and draw up a new set to be administered through a pump. A different sounding alarm in the bay next to my patient comes from a filter machine – which filters the blood of a critically ill patient. On top of all the many skills I’ve been learning in the past two years, in this placement I’m desperately trying to get to grips with a myriad of electronic and mechanical machines – and their noisy alarms which ring through my sleep after a long shift.

Driving home I reflect on how amazing the nurses are in this team, and the almost overwhelming amount of knowledge they need to do the job. They also need good dexterity to draw drugs into syringes from tiny glass vials, and apply awkward dressings to agitated patients, as well as bags of compassion, humour and above all patience – especially when teaching me!

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Talking of dexterity – I was lucky enough to observe open heart surgery last year, and watch surgeons effectively join together the ends of a vein taken from the patient’s leg with a coronary artery. It looked as tricky as sewing together the ends of two tubes the size and consistency of cooked spaghetti. I had a placement in orthopaedic surgery and saw hip and knee replacements – which can appear less delicate than heart surgery, but equally skilful. It was impressive to see patients up and walking on their new joints within 24 hours with less pain and discomfort than on arrival into hospital. One of the big pluses of surgery is being able to wear comfy scrubs….

I enjoyed visiting people in their homes during my community placement and became just a little bit adept at bandaging feet and legs, and applying innovative new dressings containing silver and honey to encourage clean wound healing.

I also got to fulfil a longstanding ambition and do a shift with paramedics in Brighton. It was moving to see their skilful and rapid response to critically ill patients, and also their attentiveness and kindness to those who were not a medical emergency but were worried and lonely and had nowhere else to turn.

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I’ve managed in my final placement to spend a few days in A and E, which has confirmed the hunch that initiated my career change – this is probably where I want to work once qualified. When I reflected on my previous career, the period that most stood out for me as fulfilling was my time leading humanitarian teams for OXFAM responding to crises in Africa in the 1990’s. Being at the front line, working with a fantastic team of colleagues doing something of immediate value for others: acting quickly in the moment really does it for me!

Back to Uni...

In between the amazing experiences on placement, I have to go back to university to study, which is the least favourite part of the training for me. The clinical skills and pathophysiology modules are mostly well taught and I was both thrilled and relieved to pass my exam in acute medicine last year. However the more academic and theoretical parts of the course are in my view time-consuming and off-putting for many great healthcare staff considering training to be a nurse. Having worked for so many years as a facilitator of learning, I know there are more practical, effective and enjoyable ways to learn and assess the competencies nurses need rather than sitting through power-point lectures and writing academic essays.

Keeping a foot in both worlds

It’s been great for me to continue doing some freelance coaching and development, which I’ve really enjoyed and has been essential for subsidising my studies.

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I’m a proud member of the “Extraordinary League of Coaches” - working for an amazing company called LUDIC. We’ve been working with Novartis over the last 3 years, running a worldwide online leadership programme for business partners. The programme included webinars, a fabulous online portal of materials, and coaching sessions. I’ve coached about 25 people, all on the phone, including people in Russia, China, Brazil, USA, Switzerland, Senegal and many other countries. I coached some of them in French and Portuguese. It’s been a very satisfying piece of work, and was very well received by the clients.

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Through LUDIC I came across PCS – Performance Climate System: - It’s a new team tool for assessing team performance which draws on a couple of my favourite team models – Bruce Tuckman’s stages of team development: forming, storming, norming and performing; and Thomas Kilman’s conflict resolution model. It’s a refreshingly uncomplicated and helpful tool – if you’re interested in knowing more or using it to develop your team, please get in touch with me.

I also still facilitate an Action Learning group of fabulous charity chief executives – the group has been running for 7 years now, and despite some members leaving and new people joining continues to be a powerful group for reflection and action.

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Last year, a friend and colleague introduced me to Concern Worldwide, an Irish NGO who sent me to Niger and to Haiti to train their programme management teams in leadership - in French. I LOVED working with these teams on such a brilliant programme. I hope there will be more of that in the future.


I’ll be busy in my final year of training with 3 more placements, one of which is a management placement, managing patient care and members of the team on the ward. I’ll have a dissertation to write and a viva to test my knowledge of medicines and their safe administration. On top of all that, there will be observed simulations to test my advanced patient assessment skills and how I’d respond to deterioration in an acutely ill patient.

Nursing training has been tougher for me than I thought it would be. Many qualified nursing roles are way more complex than I’d imagined, low staffing levels make jobs stressful and low pay does not help retain good nurses. I hope that will change, I’ve come too far now to give up..

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Meanwhile, www.khlearningcompany.com is still open for business, so please get in touch if I can help you with coaching and facilitation to develop your leaders and teams.

Have a healthy and successful year in 2018!