Manchester & Northampton

Tuesday 21st November

Lewis and I left Ollie's place with all our bags and headed to central Thame to catch the bus into Haddenham and Thame Parkway which is where we could catch our train to Oxford and then onto Manchester. Thankfully it wasn't raining as we dragged our bags along the cobblestone streets for 15 minutes. As we arrived on the main street our bus was already there and we we upped the pace to make sure we could get on it. The train station was only about 5 stops on the bus but it was much too far for us to walk with all our baggage and also its a road without a sidewalk for most of the way. We were very early to the train station and there wasn't much around at all other than a small ticket office. I rung my recruiter from Continental Travel Nurse Fran to discuss me starting work on Monday 27th as a nursing assistant until my registration come through and also when I will be told about housing since we are supposed to move in this Saturday 25th. She told me that I wasn't starting work then and there was never plans for this from her end and she reassured me that the housing women would contact us in the next day or so and not to stress over that. I was super annoyed because I originally had a recruiter called Amy who was absolutely lovely and I dealt with her for a year during my registration process and even met her when we first arrived into London. It was Amy who had actually suggested I start as a nursing assistance so that Lewis and I could move into their subsidised housing as you have to be working otherwise they charge you the market rate of £240 ($465.60 NZD) instead of £150 ($290.90 NZD) per week.  I was super frustrated but was still really hopeful that I could pass this Part 2 NMC (Nursing Midwifery Council) OSCE exam first go and could start work the end of the following week anyway. She then also mentioned that I would have to complete a mandatory training course that I would have to fund myself costing another £70 ($135.70 NZD) and I may also require additional blood tests for HIV since she couldnt see this in my blood results I had sent earlier in the year. Although Amy had said I didnt need further blood tests which I was over the moon about when I heard back in September. This blood work would cost me an additional £39 and another £20 since it’s my first appointments ($113.26 NZD) but I havnt heard back from my recruiter about it yet anyway. I got off the phone pretty annoyed thinking I was going to be working for an excellent agency when I contacted them back in NZ. I had heard about my colleagues back at Middlemore who moved over to Australia to work and the agency paid them a relocation amount and gave them heaps of bonuses which I thought I might get as well, its not as if the NHS doesn't need any extra pairs of hands it can get right? So our train arrived and this first one was taking us into Oxford and was only a short 10 minute ride. We then had to switch platforms and catch out train to Manchester which would take just under three hours. We were in a cramped small train that was rather filthy but at least they had enough room for our luggage. Since we were back in the UK we were able to use our phones to watch Netflix since the plan we signed up for allows unlimited Netflix use without it coming out of your data! Mega bonus! This made time go a lot faster and at about 3.30pm we arrived into Manchester. In order to get to our Airbnb we had to take a bus and then a train  and do a fair amount of walking. Since it was pouring down outside we skipped that idea and booked an Uber. On the way out I had to draw £290 ($562 NZD) out from my NZ account to pay for this 2 day nursing course I was attending to help me pass this Part 2 exam since this was easier than trying to set up an international bank transfer. Believe it or not the exam costs me £992 ($1921 NZD) and all of this that I have listed above isnt even the total amount I have had to pay to get this stupid registration. The Uber dropped us off outside a block of houses in Salford and a man waved at us from the top floor which was our host Julio and we ran across the road in the rain where he let us in at the front door. Once again it was a place with three stories and the apartment was on the top floor with no lift. Julio was kind enough to carry my suitcase and food bag which meant I was able to carry the large bag up with Lew. The place was excellent and as much as we appreciated staying with friends for the past 6 days we were pleased to have a place to ourselves again. It was clean, dry, warm and had a kitchen and washing machine also. After unpacking Julio had said there was a supermarket down the road where we could buy some supplies for dinner. It was a short 10 minutes away but that was all it took for us to realise we were in a bit of a nothing neighbourhood but it was close enough for me to walk to my course every morning. I had been craving a stir fry for a while now so we brought fresh veggies, chicken and microwave rice with a black bean sauce for dinner with some snacks for me to take the next two days. Dinner was yummy and I even had a leftover meal to take the next day. We settled in early - well before midnight which was a nice change, although Lewis the night owl still came to bed late.

Wednesday 22nd & Thursday 23rD November

I spent basically most of my waking moments at the course for the next couple of days although Wednesday morning I did manage to wake up early and call home since there was a typical large family dinner occurring when my Uncle is down from Auckland and buys everyone Indian takeaway for dinner! Literally everyone except Lewis and I were there including both of my brothers girlfriends, one of which I got to meet for the first time - I was really wishing I had showered at that point but I was worried Nannie would go home before I got the chance to see her. Then at 9am Lewis and I walked to where my course was being held which was a very small conference room that our instructor Gilbert managed to fit 6 of us into. For those of you who are interested this OSCE (hands on) exam it is a very basic test but marked very difficultly. You have an assessment station where in 15 minutes you are expected to meet an actor for the first time and complete an assessment, vital signs, and activities of daily living. I know that sounds easy but there are also traps in the room that you fail for such as having a cigarettes in the room and you have to address them - explain the hospital is non smoking, give some brief cessation advice and remove them from the patient or a cup of water and the patient is nil by mouth or lollies and they are diabetic etc. Still sounds easy I know. Then there is the planning stage for 15 minutes where you have to write a care plan for you patient. Now this is something we absolutely don't do in ED, who has time anyways? It's more of a ward nurse thing to write these in my eyes so it is something I am a bit out of practice with and I have been told that people fail in this area also if they don't write it in the correct format that the University of Northampton likes. Then there is the Implementation stage for another 15 minutes where you have to administer medications to the patient but the drug chart they use it super confusing and the patient is a dummy so the assessor speaks to you instead. It's a strange feeling really and they try and trip you up by having a patient that is allergic to penicillin but then they prescribe Amoxicillin which is a penicillin based antibiotic. The final step is the evaluation stage where you have to document a hand over to another nurse using all the information you have and adding in potential education point for the patient plus a load of other things. Basically a very very very long summary of what the next nurse needs to do, very specifically. Those 4 stations are called APIE (Assessment, planning, implementation and evaluation) and from there you also have to complete two out of three possible skills. The skills are basic life support, an intramuscular injection and a wound dressing using aseptic non touch technique. When I write all this down it sounds easy and how can someone not pass this, but the the way they mark it is insane and there are a huge amount of critical fail elements that could be just the smallest error and probably the one that shocked me the most is that if your in the basic life support station and you do 122 beats per minute (recommended 100-120bpm by the UK Resuscitation Council) for your compression rate you FAIL! They also have a strange way of completing their wound dressings here where you have to wash trolleys with soap and water, wear aprons and use the plastic bag inside the sterile dressing pack as a glove to take the old dressing off. All this craziness is reflected in the pass rate on their website which is 46% of candidates pass this OSCE on the first attempt. Plus the NMC states that they are testing candidates against current UK pre-registration standards. During the course Gilbert our instructor stated that 100% of pre-registration nurses wouldn't be able to pass this exam and it is being examined well above pre-registration level. Enough of a rant from me, one positive is that you no longer have to sit the day long english language exam (IELTS) which I had to take last December as the first step to this registration process knocking $385 NZD off the process. The nurses I was on the course with were from many different countries. There was two from America, two from the Philippines and one from Nigeria and me of course from NZ. They were all sitting the three day course but I had only opted for the two day. With all these different nationalities it was funny some of the language differences that came out. I was practicing my wound dressing technique and I asked whether I could roll up the patient (another candidate) pants and the filipino nurse that had been living in London for 8 years started laughing at me, I had no idea what was going on until she explained to me that they are called trousers and “pants” are someone’s underwear in the UK! This is something that I probably wouldn’t get used to and no doubt this will cause me some embarrassing moments within the hospital! So whilst I was spending my time at this course Lew stayed at the Airbnb catching up on some work for Smartspace and preparation for his interview on Tuesday with Thinking Works in London. I had told him he was in charge of dinner tonight and the only place he could find a butcher was in town in Manchester so he took a bus in to get some Mexican flavoured beef skewers before catching the bus back to me for 5.30pm so we could walk home together in the dark. I was absolutely exhausted and crashed on the bed watching TV for the next few hours whilst getting up every so often to deal with the washing I had hanging off a spare bed head over a heater in the bathroom. Lew made a superb job of dinner and the meat skewers were an excellent find. I spent the night wide awake with everything I learnt during the day circling around my head which meant I ended up on the couch getting about 2 hours of sleep. The next day was a lot more stressful and we still hadn't heard back from the housing women so potentially we had no where to live come Saturday - 2 days away. We had to check out of the Airbnb at midday so I walked by myself to the course with some of our stuff whilst Lew slept in and then at midday when we had to check out Lew brought the rest of the gear to my course and we stored it at reception. He got stuck in the pouring rain of course so when I came out for lunch he looked like a drowned rat! He then went off into town to find an engineering museum Paul had recommended before busing back to collect me at 5.30pm. We were catching a train to Northampton tonight at 7.15pm and had to walk 15 minutes to the metro in the pitch black with lots of damp leaves that got caught in the wheel of the suitcases. For some reason the bolt on the wheel on our osprey back came out and we had to stop for Lew to get his flathead out to screw it back in. The metro took us right to Manchester Piccadilly where our next train was leaving from. We were confused as it wasn’t on the board (Manchester to Milton Keys to Northampton) and we had to ask at the info desk despite me being very concerned that we were about to get on a train for a couple of hours and I currently had no food! Turns out that it was going right through to London so that was the train we were getting onto labelled under London Euston on the board, but at least we knew what platform we were leaving from now. We were limited for time and Lew had eaten a burger for a late lunch so he wasn’t so stressed about getting food but I was absolutely starving. He stayed back next to the entrance to the platform whilst I ran upstairs and found a salad for £3 ($5.80 NZD), a wrap for £2.60 ($5 NZD) and some fruit to tide us over. Everyone had pretty much got on the train already by the time I got back and because we had to find a spot for our large back we walked up and down the carriages looking for space on the luggage rack before choosing one to get onto. We didn’t think we had allocated seats for this journey so we found a spot and loaded all our gear above us and sat down. Lew went off to check if there was somewhere else to put this poor Jewish boys large suitcase since he was walking up and down the isles looks very concerned and during that time a women came up and said we were in her seats. Re looking at the tickets sure enough we did have allocated seats in the next carriage down and it was on the next train from Milton Keys to Northampton we didn't have allocated seats. We had to leave the bag where it was and cart all our shit through the isles to our new seats. We ended up sitting opposite a women who is a figure skater practicing for some big show coming up and we had a laugh that we were ice hockey players. We were really squished with a table in between us but since it was a 2 hour train ride I was able to get my notes out and do some study. We had found out that we had to get off at Milton Keys and then train back up to Northampton in another train for 10 minutes. Our train was going to get in late to Milton Keys and the booking system has only given us 6 minutes to swap trains which had gone from 4 minutes and then to 1 as we got later and later. We were going to have to swap platforms in a train station we had never been to very quickly so as we were approaching the station we gathered everything up and were standing in front of two different doors to make our quick escape. Lew checked the schedule again and our train was going to be late leaving Milton Keys to Northampton so we had gained an extra two minutes leaving us with three minutes to get to the platform! As soon as the green button lit up on the doors we were out of it and amongst everyone else funnelling up the stairs. There was no time for an elevator so Lew was hauling the bag up in the crowd. Man will we be pleased to have a break from this! We were quick and got to the platform over just as the train was approaching. That was all thanks to Lew seeing as he had already looked at what platform the train will be at and had studied the layout of the station, I just followed him like a wee duckling! There wasn’t any luggage room on this train and it was pretty full so we decided to stand since it was only 10 minutes. Shortly after at about 9.30pm we got into Northampton station and routed ourselves to walk to the Ibis Hotel. We came across some stairs to go outside but went back down the escalator instead to where the large carpark was. Little did we know that we should have gone down the stairs as the way we walked was 12 minutes since we had to walk around a large brick wall instead of three minutes going straight out down the stairs. Last time I had been in an Ibis it was with the Ice Fernz when we stayed the night in London before flying back to NZ and it was awfully small and dated so I was surprised when I opened the door and the room was actually bearable. There was lots of space for our stuff and a desk where Lew could get some more work done. I immediately showered and continued some study until Lew reminded me that it was 11pm at night and perhaps some sleep may be a good idea. I was on the countdown to my exam now and I knew I was not going to sleep tonight so I had made sure I saved some phenergan to knock me out. Don’t worry people it’s just an antihistamine with drowsiness as one of it's side effects that works quite well to get me to sleep. It used to keep me sane when I was made to jump from day shifts to night shifts to 11am-11pm shifts at Middlemore ED. 

Friday 24th November

Well today is the day I have been dreading for a long time! My stomach was already churning at the thought of the exam I would be in soon. I had already prepared the original documents required by the NMC to complete my documents check which involved me dragging my actual degree in its frame across the world along with my original NZ nursing registration certificate, my NZ police check and my birth certificate. I practiced writing another care plan since I would be incredibly upset if that was what I failed on and then dragged Lew out of bed. I decided that I wanted a good breakfast since I had to be at the testing center by 10am where they would check my documents and then my exam was between 11.45-3.45pm so I was going to be hungry. I felt sick but I was going to force some food into myself to make it through. We decided to pay for breakfast at the hotel which cost us £8.95 ($17.40 NZD) per person but the spread was disappointing and I only managed to get some cereal and fruit down so it wasn’t really worth the money at all. Whilst Lew was getting breakfast I started panicking and felt like I wasn’t going to pass out or throw up....or both. I don’t remember ever being this nervous before anything. My last huge exam would have been my state final examination which was the final step before I became a Registered Nurse in NZ but I remember being super calm knowing I could ace it, plus I think I was well and truely over studying for it. I guess I did do another OSCE exam during my post grad course at Auckland University but I still wasn’t this nervous. I managed to keep my breakfast down but time was ticking away fast and I racing back upstairs to put my scrubs on. I had ordered these a couple of days before as I couldn’t find any in a dress up store and I wanted to feel a bit more like a nurse than a normal person, trying to get myself in the zone if you know what I mean. I had sent them to the Ibis hotel and picked them up last night which worked out beautifully. I had time to iron out the creases so they didn’t look like they were brand new but that was about it as I forced Lew out the door. I received lots of hugs as we went downstairs in the elevator but they didn’t relieve any of the nervousness I was feeling. The place where the exam was being held was a short 5 minute walk and Lew had to say goodbye as we got to the door as it said in bold writing "Candidates only" on the door. They signed me in and took my photo for my name badge before letting me sit and wait for my identity check. Every other nurse in there was in uniform with black leather shoes on. I had been also advised to buy some but seeing as I’m unemployed and will never wear them for my work in ED I decided not to. But now I was trying my hardest to fold my feet under the chair so no one could see and stop me sitting my exam. I was called in and my documents all checked with no issues. The women had laughed at me having to lug my degree across the world but that’s their requirements not mine! I then had to sit in a chair and wait. I had a few nervous toilet stops but they called me and another girl in early at 10.30 which meant I also finished early at 1.30pm. I was given BLS & IM injection as my skills and my patient had a subdural haemorrhage. I laughed a little as I realised these were what I would have to do as Gilbert had told me he had a feeling those exact things were what I was going to get. The actor was about the same age as me so it was difficult to imagine she was a 77 year old lady as I went through the assessment stage. My hands were rather sweaty and the constant hand sanitising I was doing wasn't helping but I was too scared to be failed on something so simple as not completing hand hygiene when I was supposed to. The invigilators and examiners were incredibly lovely and despite being so nervous they always took their time to show me around the room and triple checked I was ready before they started the timer. There was a few times where I had to sit on a row of seats outside the doors of the examination rooms waiting for another candidate to finish in there before I was taken through which didn't help with the nervousness. In fact I was often trying to hide the fact that I was shaking like a leaf and drank multiple cups of water to distract myself for a brief moment. I saw other candidates finish and the invigilator congratulated them and then showed them out. My turn to leave and be done with all this couldn't come fast enough but when I signed out and left I really wasn’t convinced at how I went. I was so exhausted I just wanted to cry and didn’t want to even think about having to do all that again. After all it cost me $2k and on the way out I asked the receptionist how long I would have to wait before re-sitting if I did have to. She said if I was sitting the partial exam re-sit meaning I passed one of either the skills or the APIE (assessment, planning, implementation and evaluation) they are full until January so it’s not like I can sit it straight away anyways 🙄. I’m crossing my fingers and toes that it’s a full pass otherwise it will cost me another $1k to sit it again and I don’t know what I’m going to do in the meantime. Since I finished earlier than expected Lew was still working and we stayed at the hotel for a couple of hours whilst I went through my notes checking I hadn’t made any mistake. I did the IM injection and BLS perfectly according to the print out that Gilbert gave us but I couldn’t find any information in regards to codes to put on the drug chart. I emailed Gilbert hoping for an answer but I didn’t get one, just that he was crossing his fingers also. In the afternoon we went to town to check out what Northampton had to offer.... and it wasn’t much at all, in fact everyone in town seemed like drug addicts and I had to remind Lew to wipe the judgemental look off his face!! Haha he wouldn’t make a good nurse. We did find a place for dinner despite it only being 4pm it was getting dark and neither of us had lunch anyway meaning we were beyond starving. We chose a place called The Smoke Pit which was open and did some burgers and other interesting stuff, plus it looked warm as it was surprisingly cold outside. We struggled to find something on the menu as we wanted it to be a lot cheaper than it was and we ended up having to turn a blind eye to it saying it was our lunch and dinner combined and that we were celebrating the fact that I had survived the OSCE! Lew got a burger and you could upgrade it to a platter which came with pulled pork, chicken wings, gherkins and also an extra side of market greens. I just got a burger and a side of sweet potatoes fries. It ended up being a lot of food and it wasn’t half bad. We were however annoyed that once again we were given bottled water and charged for it grrr!! Adding an extra £2.30 ($4.50 NZD) onto our meal. Overall it cost us £35.70 ($69.50 NZD) and we headed via Marks and Spencers on the way back and found so many cheap healthy looking pre made meals that would have been a lot cheaper for dinner if we had a microwave. The best surprise of the day was that they did dairy free ice creams!!! Legit ones with ice cream on the inside and dark chocolate on the outside, totally made my day that’s for sure! We walked back to the hotel and shared the three ice creams which Lew agreed tasted just as good as the real thing. We watched some TV, searched for bedding sales which we would have to go to in London tomorrow and called it a night. Tomorrow morning we are taking the train back to London and are moving into our flat in Canada Water.