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It’s difficult to believe that just over a year ago I was one of the first student nurses to gain a free delegates place at the 23rd Society for Orthopaedic and Trauma Nursing at Llandudno, Wales in the United Kingdom. Time has moved on and I have now come to a time of transition – things are about to change. Three years of nurse training is almost complete and I’m about to venture into a profession that demands a very high standard of its staff and I wonder if I will be able to meet them.

I’ve always taken an active role as a student. Firstly being my cohort representative then taking myself off to conferences, I valued the how these roles and activities enabled me to keep up to date and network. This said, at times it seems that even this is not enough to meet the challenge of change. Since starting my training back in 2006 one area of enormous transition has been my own pre-registration course. An all degree programme is set to take over from the diploma in nursing and all that entails with regards to attracting the right students onto the course. Another transition is the government’s move to incorporate basic skills training through ‘The Essential Skills Clusters’ (Nursing and Midwifery Council, 2008) which are now embedded in the pre-registration training as practical skill levels on completion of training are questioned by both care providers and service users. Writing about the practical skills aspect reminded me of an event I witness only a few weeks ago and shows how change creeps up on us, how it can masquerade itself as all embracing whilst occasionally discounting previous experiences. When a doctor requested Hamilton Russell traction on a patient none of the trained nurses knew how to apply it. It was left to a fifty four year old auxiliary nurse to organise this as she was the only one who had seen it and remembered how to attach it. She could have done anything and the nursing staff were unlikely to have known if it was correct or not but we were assured after checking the traction manual (Royal Collage of Nursing, 2002) that it was aptly tethered! Another thing my orthopaedic experience has taught me is to think of the patient more holistically. This was evident during a third year placement whilst working with a junior nurse and caring for a patient with a recent total hip replacement. The patient complained of calf pain which the junior nurse initially dismissed as a possible deep vein thrombosis (DVT) but my previous experience from SOTN conference presentations on total hip replacement and its complications helped me educate and convince the nurse that DVT was a possibility. This later unfortunately proved to be the case.

As a newly qualified nurse the expectations of the Nursing and Midwifery Council (UK) are that, with immediate effect, I will be seen as a first level nurse with mentoring responsibilities. Therefore I will be the one that needs to be on the ball, up to date and engaged in lifelong learning. I worry about my knowledge level, how many staff will be available on shift, the impact of wider events like the global recession and how it will affect me and my patients. The public’s expectations are so high and as demonstrated in ‘The Patients Association’ report in August 2009 some basic communication needs are still not being met by care staff – let alone the practical skills! I hope that I won’t be the one that lets my patients down and I hope I will think across the range of my experiences resisting the temptation to focus too early in my career on just one aspect of caring.

This is my transitional year, a year where I consolidate what has past and look forward to a future where I can develop and grow. The Journal of Orthopaedic Nursing has also come to a transitional phase as it builds on the legacy of its previous editor Peter Davis and evolves into the International Journal of Orthopaedic and Trauma Nursing. I expect over the ten years that it has been produced many changes in orthopaedic care have been recorded, researched and revealed. I believe that lifelong learning is an important aspect of professional nursing so Journals like this one play a vital role in informing and supporting both new and established care professionals so that such learning can take place. Maybe one challenge I would put to the editors and the international advisory board of the new International Journal of Orthopaedic and Trauma Nursing is – how are you going to engage those professionals, both new and established in orthopaedics to ensure their lifelong learning is relevant?

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References 

1. The Patients Association, 2009. Patients not numbers, people not statistics. www.patients-association.org.uk (accessed October 2009).
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2. The Nursing and Midwifery Council, 2008. Essential skills clusters <http://www.nmc-uk.org/aArticle.aspx?ArticleID=2914> (accesses October 2009).
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3. Royal College of Nursing . A Traction Manual. London: Royal College of Nursing; 2002;
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