Florence Nightingale's Museum

I recommend that if you like your history / nursing / history of nursing you need to go to the Florence Nightingale museum.
It has an amazing amount of information on her life and the work she did. There is also an exhibit on Mary Seacole (who is also a total idol of mine!).
We couldn't take photos inside sadly and as I look back over the contents of my digital camera most of the photos really aren't worth cluttering the blog up.

On a similar note the keyring in the photo from the post before is Nurse Bean (it's from a collection). I have a larger one too but I thought since I couldn't be in the photos my keyring could be. That actually turned out better than I thought.

So nothing much more to report. My visa was granted so I shall go to the States!
Only 2 weeks to go!

The Nursing Meme

1. How long have you been a nurse?
I have been a nursing student for 3 years and 3 months.
2. What Dept/area will you never work in?
Outpatients - when the first thing you get told is 'this is where they put the old nurses out to pasture', it really doesn't endear you to the place.
3. What Dept /area would you like to eventually like to try?
ITU and maybe Paeds (but I'd have to retrain for that)
4. What Dept/area are you in?
Surgical urology
5. What is the grosses thing you have encountered?
Nothing really grosses me out. Did once come across a wound I could put my fist into though.
6. What is the weirdest thing you have seen as a nurse?
Glass eyes always strike me as weird, necessary but weird
7. What one piece of advice would you pass on to new nurses?
Take advice that's offered. Ask questions. Don't act like you know stuff when you don't. (sorry that was 3)
8. How would you help retain nurses?
By NEVER saying 'Why are you doing nursing?' to the students
9. Do you have days you wondered why you ever became a nurse?
Yep whole weeks...
10. If you hadn’t become a nurse what would you be doing?
I would probably be a physics teacher

Oh and new blog rec from where this is been lifted - LivingDeadNurse

Pecking Order

We have quite a few students now. More than 2 and, say, less then 10. We're a big, immensely busy, ward we can take it.
And so the pecking order has developed. You know it had to at some point. Limited chances at the advanced clinical skills makes it first come first served at time. So it's an event that would make Animal Planet or National Geographic happy. We are essentially animals.

And I'm fighting to be alpha female. We have other students doing care management and they only just have their foot in the door. I've been there for 7 weeks now and I have a previous 16 weeks before that, I'm not going to roll over easily. Course that means whoever makes alpha will essentially be the best.

The year 1's and 2's have been on a bit of a steep learning curve, for some this is their first hospital placement. I've been teaching one or two of them a few skills I can do with my eyes shut. Like measuring pre-op patients for TED stockings. Sexy aren't they?
Who wouldn't fancy you in a pair of those!

I hope the claws don't come out too far. Much as the pecking order will fall into place, we need to remember to play nice while we do it. There were 2 drains to be pulled today and 2 management students. One each huh? Nope only one was there quick enough and the other was removed by the staff nurse. It may get dangerous.

Better go get my riot gear on.

I've Found the Love AGAIN!

For those who are eagle-eyed, sharp of brain and generally better at picking up on problems you might have noticed that when things go badly I don't post. (If you didn't, don't feel too bad. I can never see when my friends get haircuts. That's worse!) You really don't need to hear me go on and I don't want to type it as it happens like a bad copy of Nursing Big Brother.
I haven't posted since the first of the month.... It's now the 14th.
I'll leave you to your own conclusions.

Anyway... I'm back and I've found the love I had for nursing way back in the beginning. Which leaves me wondering if I had a period of burnout back there. Personally I think anyone would consider tossing in the towel after 16 weeks leading to failed placement, to be followed by an episode of 'why the fuk am I still doing this' and hitting the wall of 'too exhausted to function' last week.

Weeeeeee I'm gonna be a nurse!! I will be a nurse! I will no longer have to sign 'Student Nurse' after my name!

I'm back baby!

Pond Crossing Differences

I'm looking for a little input here.
The last post showed that nursing in UK isn't really the same as nursing in the USA, although it's the same job. The training isn't.

So to clarify a couple of things....
In the UK we don't sit a board exam at the end of the course (like the NCLEX) before we are placed on the register.

We do have to renew our registration every year to continue being a registered nurse and able to work.

I can be in charge of as many as 12 patients (in this current placement) (with a nurse shadowing me) per shift. These are general surgical patients (or even the rehab patients from my last placement) and not those requiring high levels of care (2 patients to 1 nurse) or ITU care (1 patient to 1 nurse).

Our courses are specific to the area we will be employed in. Cellar Door will be a mental health nurse and is on the mental health branch training (you don't mind being an example do you?). I will (someday) be an adult / general nurse and am on the adult branch. There are also separate branches for paediatrics and learning disability nursing. Midwifery is a separate course altogether.

The majority of nurses in the country are employed by the NHS. Only 25 to 30% are employed by the private sector.

Anyone see any more differences?

The Stethoscope Tag

I was tagged by both Little D, S.N. and Undergrad RN for this one.

Here are the rules:

1) Post a picture of your stethoscope

2) Tell what you love about it
3) Tell what you hate about it
4) Tell me what your dream stethoscope would be
5) Does it have a name?
6) Tag all your nursing friends (Including the one that tagged you) and don't forget to leave a comment on their blog telling them that you tagged them!

So they are both about to have a WTF moment.

We don't have stethoscopes as nurses or student nurses over here. Actually that's a little inaccurate. We do HAVE them. We just don't use them so prolifically.

From what I can tell Student Nurses / RNs across the pond (like we do just not as often) use them for measuring BPs and listening to lung sounds and heart rates. We don't commonly take manual Blood Pressure measurements. For some patients we have to but mostly we use digital machines like Dinamaps. OK mine doesn't have a thermometer on the side but it's just the same thing.

I have done manual BPs but not in a long time. When you have say 12 patients under your care and you need obs on all of them it's not really enough time to do manual BPs.

As for listening to hearts? I've done that. I've heard the sounds of mechanical heart valves. But again we don't do any of this routinely.

Lung sounds? Only in my ITU placement so far and really only then because of the risk of Ventilator Acquired Pneumonia. So there you were checking for air entry into the lungs at the top and bottom and any other noises like crepitus.

If you're looking for a stethoscope on the average ward around here you better start by finding the crash trolley. There'll usually be one hanging off of that.

I remember working the neonatal clinic in an outpatient's department as agency one day when I walked into the consulting room and the docs stethoscope was lying on the desk. He caught me staring at it and I said "That's a tiny stethoscope."
"It's for tiny patients." He replied. See because I'm working with adults most of the day it's easy to forget that we start of as little human beings, who need equally little equipment.

Sorry guys I don't have my own stethoscope. I have a pen torch for doing neuro obs and measuring tape for sizing TED stockings if they count as specialist equipment.

I have no-one to tag I guess. Unless of course Cellar Door has a stethoscope moment she would like to contribute?

Confessions of a Nurse

Anyone in the UK catch the Dispatches documentary - Confessions of a Nurse?
Please tell me you did. Much of it is true, least from what I heard from around the web and throughout my course.
Disturbing.

Patient care

• 42 per cent of nurses and midwives interviewed say they have either been in or witnessed situations where patients have been put in unnecessary danger
• Over half (57 per cent) of the A&E nurses interviewed say they have witnessed situations where patents lives have been put in unnecessary danger
• Almost half (53 per cent) say they have seen colleagues perform medical tasks that they are not qualified to do
• 44 per cent of the nurses and midwives we polled say they don’t always stick to the rules
• Over a third (37 per cent) think that patient care in the NHS has become worse in the past five years

Impact of understaffing and long hours

• Half (51 per cent) of all the nurses and midwives interviewed say that they are exhausted most of the time
• 29 per cent say long hours and exhaustion prevent them from doing their jobs properly
• 83 per cent of the midwives surveyed say they have been in situations where they have had too many patients to look after properly
• 70 per cent say understaffing prevents them from doing their jobs properly
• One third (33 per cent) say they would leave nursing and midwifery if they could

Behaviour of nurses

• 43 per cent say they have seen other nurses shout at patients (13 per cent admit they have themselves shouted at patients)
• 44 per cent of nurses and midwives interviewed admit to calling in sick when not really ill
• 40 per cent admit to browsing the internet when they should be working
• 36 per cent admit to coming to work with a hangover and unable to concentrate on the job properly

We can't care properly for our patients if we are under staffed. There are no great revelations to be had there. Not for those in the NHS anyway.
Bet you the patients will be scared now.
Go watch it on 4od if you can....

Doing Something Right....

I think I must be doing something right. I got stopped by the deputy sister. She was wondering where my obs were..... Ah well you see....
Bugger.
I had a huge pile of things to do (it seemed that way anyhow). Halfway through an admission I stepped out to check the medical notes and one of my other patient's happened to be sick. Well the nurse I was working with was busy. So hmm what do I do? Drop the part done admission and find a sick bowl? Yep that would be it. My patient was OK, in case you were wondering.
So then I get caught with a missing set of obs. I was going to do them, honest. Right after the sick patient was seen to. So she asked me what I had to do (you know communication, team working, etc.) but when I listed everything it was actually rather short. Which I didn't understand. But I had loads to do? No, apparently not. Weird.

I'm going to have to start writing to do lists at work. Well it worked for the SHO on the last ward. I started the day with 7 patients..... I ended the day with 2..... In total 8 different people.





NO! HALT! I didn't hurt any of them! Promise! They were discharged home. Every last one.

Wonder how tomorrow's going to pan out?

Being Green / Being Mean (the toilet talk)

This is an odd balance...
I can be really stingy. Have to be; my money's running out and with this supposed placement over my head I'm not taking as many agency shifts as I could because I really don't know what I'm doing next week. (Honest he's not given me a placement yet and agency needs at least some advance warning.)
This brought me to an interesting thought do you have to compromise on being green so you can be mean instead? There's a toilet paper advert running that states for every tree they use, they will plant three new ones. We don't use this brand in the flat. We use the cheep as chips, supermarket value brand. This costs about £1 for 12 rolls. The brand planting all the trees costs £2 for 4 rolls. Does a cheep roll wipe less asses than the expensive one? I'm not going to test that sorry. But lets make the scientific assumption that the expensive one is slightly longer and more absorbent. You seem at least to get far more for your money with the cheaper rolls.
(I promise you I'm not obsessed with toilet rolls. Bin bags and washing up liquid are far more obsessional.)
I think I'm starting to see where their money for saplings might be coming from.
So back to the question do we have to choose being green over being mean? I'm sure you are aware that greener / fairtrade / healthy products cost more. They do fairtrade coffee has always cost far more than even Gold Blend (and that's not cheap either). People wonder why the west of Scotland has a crappy health record (our 3 biggest killers are heart disease, stroke and cancer). All unhealthy food is cheaper in the supermarkets than the healthy stuff!

Another point I'll make before leaving. How much waste does your hospital produce in a day? The average (read small-ish) operation produced at least 3 large bags of clinical waste. That's 1 small operation. There could be 10 of those per day per theatre. The wards aren't short of stuffed bin bags either. The least green industry in the UK has to be healthcare. A lecturer once said that 'I'm here to do my job. Not save the NHS money.' She meant that if we had to use expensive dressings, or open 15 packets of something to make sure it was right then we did it. But look at the waste we generate. Sterile packages for surgery are double wrapped and 90% of patient contact materials are all disposable. I'm not for a minute suggesting that we abandon disposable gloves, aprons, sterile packaging and our beloved paper-pulp products. Abandoning these would send infection control into meltdown! There is little or no way to cut down the waste created by the healthcare industry. We have to toe the best policy guidelines and it is never in the patient's best interests to cut corners. So other suggestions? Recycling? Er lets not go there shall we?

So is it a valid choice? Yes lets all save the planet but not when I'm on a budget. People should do what they can. We need to recycle more. We need to cut down on packaging (although maybe not in healthcare). Maybe that's where I could be better since I cannot afford the 'green' bog roll to do it for me.

Stand Back I Saw This on Casualty!

Imagine the scene....
You're walking through the local shopping centre when a middle aged man in true theatrical fashion clutches at his chest and falls to the ground. His skin is pale and clammy. His lips are turning blue. All fingers are pointing to something delightful involving his heart. His wife is screaming and bystanders are throwing their 2 cents into the ring when someone comes forward...

At this point I'd be thinking thank goodness someone in that crowd as done CPR at some point. Er no... this helpful person is going to be helping this poor ill man on the basis of knowledge acquired from medical dramas.
Sorry I've done more CPR courses than I care to count and I would still be hesitant (slightly) in rushing in to help. But apparently 1 in 5 would have a go even if they are not trained. 77% aren't.
"First aid is easy if you know what to do" Well thanks St Johns Ambulance. They think you should at least try even if you haven't a scooby. Now if this was another country I could mention that bystander could get sued for not knowing what they're doing. Heck it's happening here too. It's a false confidence that could actually put someone's life at greater risk.

"Stand back I was this on Holby City / Casualty / ER / M*A*S*H / House / Crossing Jordan / Gray's Anatomy / other medical drama!" Ain't really gonna cut the mustard. Keep your precordial thumps to yourself. Assuming you know what that is...

A Student's Guide to Consultants

Consultants generally come in 3 flavours...

• Pain in the ass - Common - comes as standard with the return of the Mr. prefix
  
• Funny (or trying to be) - Rare but worrying comment often ensue
  
• Up themselves - Becoming rarer through time
  

I would consider avoiding all of them but you will have to talk to them at some point in your training and working life. So you can easily see which of these you would rather tangle with (get your mind out of the gutter!) but to be honest even the funny ones are dangerous.

Maybe it's a basic fear but to be honest I'd rather go be an idiot in front of the ward's SHO (she's so sweet and maybe I have a tiny bit of a crush there). Of course placement thinks that I should be planted in front of consultants as often as possible as some sort of bizarre immersion therapy. Those poor sods having to suffer me. OK it boils down to this... I wasn't in for 2 days and then they ask (read tell) me to be on the ward rounds for both of our consultants. I'll admit this now, I do not know everything about our 20-something patients. I do know a lot about the 10 patients I spent last week working with and I have a handover. Let's go wing it!

Actually it didn't go too badly. Thank goodness. It could have been so much worse....

Most important lesson about consultants? Avoid or at least be polite.... then run and hide.

Quote from today... (finished talking to patient who's ears are stuffed with olive oil drops)
Doc - Olive oil embolism?
Me - I'll refer him to Gordon Ramsay then.

Student Learning Curve

The little first-ies arrived yesterday while I was propping up the dentist's chair. Only difference is I don't have to do that again for the next 6 months. Neither of them has been on a ward before so this will be such a baptism of fire for the poor little things. Oh and then I had 6 patients of my own today to look after and while I almost got everything done (there was this mix-up about dressings). Things just went slower and were more difficult. Not anyone in particular's fault... unless it was mine that is. They have no practice with obs... yet, I'll get them proficient by the end of the week.

It's going to be a steep learning curve for them to bring them up to the performance of our auxiliaries. Not all that far away from mine. The one that is bringing me up to the level of our staff nurses.

Truth is they have shown me in less than 8 hours how bl**dy far I've come. I was looking at their outcomes (the basics they need for this placement) and though I'd been working, what, 3 hours and I had used all of these and a whole load of skills they are yet to learn.

Dentists, or the Last Will and Testament of WardBunny

Still trying to psyc myself up for my root treatment tomorrow. So I spent all day sitting on my backside, watching TV and worrying about it.
I am up to date on Holby, Casualty and Special Victims Unit. I've still not seen the 2 part conclusion of season 4 of House so if I could not die before I've seen that.... Or for that matter before I've finished placement and told our ward's SHO that I think she's smoking hot. (She's like Jessica Alba playing a doctor who loves little old ladies while really well dressed)

Oh and I would love to have a go at winding up the new students that are meant to be arriving some time this week. I don't really mean that. OK maybe slightly, I will be kind and helpful but if one of them thinks they know more than me, then I will be slapping them back down.

I get all the joys of working this weekend to make up for taking tomorrow and Friday off. As much as a hate working weekends I would also like to see this one.

I give my goldfish to my parents, my clothes to Oxfam, my laptop to whoever cracks my passswords (that is not an invite to start now by the way!) and my blog to the greater good (or for the NMC to use as an example of what not to do).

I declare that I am of sound mind *coughs* and that these are my wishes.

Quotes and News

If a patient is cold,
if a patient is feverish,
if a patient is faint,
if he is sick after taking food,
if he has a bed-sore,
it is generally the fault not of the disease,
but of the nursing.

See old Florence talked sense occasionally. In fact she was at least 100 years before her time with this...

Bad sanitary, bad architectural, and bad administrative arrangements often make it impossible to nurse.

I don't think she'd notice any difference! Of course I think she might have been talking about little rooms and oddly shaped wards. Preferring those long wards with 2 rows of beds, to the more modern 4/6/8 bedded rooms and single side rooms. But hey the perennial problem of bad management seems to prevail like a crop of bad weeds.

Anyway, my last post was no good but it was true. I've had to cancel one of the shifts this week to make way for a dentist appointment. Since one of my few remaining lower molars is aching. So I get the joy of going to the dentist and I lose out on a shift! They won't let me do a back shift or anything. Poo.

I was going to comment on a news story I found but I'm tired and really it's not the most. interesting thing so I offer quotes and a little comment... and a toothache grumble.

Textbooks

See this is how it goes..... Back in first year I bought a whole load of textbooks. At the moment it works about to around 1 per essay. Then you go and get told that what I was using (which was fine for first year and are still accepted by the college fore written work [or so I thought]) are not in fact of any use. Well granted since I bought most of them they are now out of date. Some of them went out of date only 6 months after I bought them. Massive waste of money, though I still used them just referenced the newer edition (and double checked to make sure they said the same things).
Mostly the only bits to go out of date are the resus / acute care stuff (like I started the course and it was 15 compressions to 2 breaths, now it's 30 compressions to 2 breaths for adults) or blood norms or procedure protocols (which are governed by evidence based practice and seem to change on a day to day basis). Recently I've replaced 2 of my textbooks with the new editions (yes I DO realise I only have 3 months of study to go).
So what textbooks are the best? Meh it seems to be a personal choice to be honest, because if you find one to be easy to understand then go for it but the college / uni might be recomending something else.
Right books I really love...

Your starter for 10... I think everyone should at least read this. I bought it at the begining and it has been faithful ever since. The second edition only came out a couple of months ago to match the new NMC code (there's a copy of the code in it) and it's not one of the ones I replacing.
The Student Nurse Handbook (1st and 2nd year) and The Newly Qualified Nurse's Handbook (3rd year and post qualifing) by Bethann Siviter are fantastic.
Oh and she does the drawings herself!


Right everyone needs a dictionary. I've managed to aquire several over the years but this one at least fits into my bag.






Finally a core text... This one is prescribed but I never took to the 2nd edition. The 3rd edition came out...oh about a year ago and I resented the thought of getting a new one especially at £30 a go.
I just couldn't read the werid colour of text in the 2nd edition (and the writing style left me with a headache). I went out and got the 3rd edition today and they seem to have at least fixed the colours and put in a few diagrams. Warning this one weighs in at about 6kg but we've never had to carry it in.




Other text books.....
Research - consider getting a basic book on research if you're going down the degree route.
Area specific - I know people that loved one area so much the have books on specific areas (e.g. acute, older adult, cardiac, etc). Not essential but can be helpful especially if you enjoy those areas.
Calculations - if you struggle with the maths a good drug calculations text might help... or you know find a helpful math geek (*ahem* that would be me in our class) to help you out.
Nursing model specific - I own a text specifically applying the Roper, Logan and Tierny model (it's out of date now but I got it for a nursing models essay at the time). These can be really good especially when filling out placement paperwork and the like (endless source of references for the likes of communication and dying).
Clinical Skills - there are manuals all over the shop outlining the different skills, how to do them and what you need to do them. Some are more basic than others. I own a basic one but will ned to go out later this week and get a more advanced one for placement references. I'm considering the Royal Marsden Manual for this. I've picked it up a few times and it seems to be what I'm looking for. I'll update on that later.

So yea that's that I'll be doing on my week off!
P.S. I don't work for Waterstones (I just buy a lot of textbooks there) but I wouldn't be upset of they wanted to send me an ebook reader as a token of thanks!
P.P.S. Kidding..... slightly.

Warm Fuzzy Feelings

And those are few and far between these days...
I love learning and the whole nursing course but some days you just feel like chucking it all in. I'm trying to remember the good times so that I don't lose sight of where I'm going.
So where am I going? Going to get a job hopefully. I would of course like to pass this final placement and get out the other side. See part of finishing the course means that you are fit to practice. The MNC talk about 'Good Health and Good Character'.... Well I have my moments of Good Health and mostly that isn't a problem.

Good character is important as nurses and midwives must be honest and trustworthy. Your good character is based on your conduct, behaviour and attitude. It covers examples such as someone who knowingly practises as a nurse or midwife before they are on the register, or someone who signs a student off from an educational programme while being aware of poor behaviour.

Now I'd never want to be signed off if I was incapable (also because it would bite the ass of the nurse that did so) and I am scared wit-less of being incapable. Yea OK it's safe to say I have no confidence left and reading the Committee Reports of nurse conduct is not helping me any more. Not that it was helping in the first place (the whole lot scaring the cack out of me!).
I'm not ready yet. I'm like a part baked cookie... I taste all right but there's something wrong (also soft with no hard outer shell to protect me).
Warm fuzzy feelings? Bah! More like cold hard surfaces... clinical surfaces. I'm going to go rock under the table and hope tomorrow is a better day. Oh and maybe the staff nurse I get on really well with might just be working the same shift......

Your Job, My Job

Cellar Door said something in one of her comments that reminded me about the adult nurse / mental health nurse divide.

I have friends on the mental health branch of the course (mostly from when we all started together in first year) before the 'iron curtain' fell and the 'them and us' mentality was installed.

It's almost natural to think that your job is the best job. Round up a bunch of nurses and, unless you've just caught them coming off the 'shift from hell', most will tell you that they quite like their job. I mean if you hate your job the why the heck are you still working there?

Why do we seem to think that other people, who are also nurses (for talking's sake), have an easier / harder job than ours? You are good at your speciality (even if you 'fell' in to it) and they are good at theirs. Lets put it this way I can't talk down your agitated suicidal patient and you probably can't read the arterial blood gas results and alter the ventilator settings accordingly (OK, I did that once under supervision but I totally get the science).

All our jobs are complicated and technical, but if it came down to it I couldn't do yours and maybe you couldn't do mine (well not without a bit of study or something).

A Naptime Clarification

What I meant by running IVs...

• Running fluids through giving sets
• Making up (under supervision) IV antibiotics
• Stopping / recording finishing time / taking down sets and disposal (with permission, dependant on nurse and placement area)
• Connecting and starting (under some supervision)

Things entirely dependant on place and staff...

• Disconnecting fluids (not drugs / syringe drivers) so patient can go to bathroom
• Silencing Baxter pumps and correcting blockages
  
• Removal / disconnection / disposal (without permission because the fluids are finished)
• The prep of the next bag (without prompting)

I'm quite good with Baxter pumps most of the time, including the ITU's 3 line editions. I know it is medications we are dealing with (just because it's not a pill doesn't mean I can be any less careful). Until you do the IV drug course you cannot flush or inject into venflons (and that is the first post qualifying course I'll be signing up for!).

Right I'm off for a nap..... I got 1 hour of sleep last night. I do have something to post later too honest!

Learning To Change

There's this odd jump I've apparently not made yet from student nurse to real nurse and this is what has caused the problems over the last couple of weeks.

2nd Year Students....

• Do everything while being watched, e.g. dressings, running IVs, paperwork, etc.
• Do all the work of a CSW / auxiliary nurse

Students at the end of the course....

• Can do dressings / paperwork / referrals / ward rounds without being watched
• Can do drug rounds with minimal supervision (we still need the signatures and observation till qualified)
  
• Can work on their own without constant prompting / suggestions / support
• Are essentially mini nurses
  

I'm stuck somewhere between these two places. It's the working on my own, I think, that's the problem.

Things I can do....

• Dressings / running IVs / direct patient care
• Some of the day-to-day paperwork / some of the admit/discharge paperwork (and I can't do it fast enough)
• Finding things to be done and doing them if I can
  
• Finding things that don't seem to be right but apparently are
• Dragging doctors to patients when they need them
  

People say I'm missing the confidence to fill in the gaps between these things I can do. Hmm, right. So what do I do now?

More to follow....... when I find some answers.

Mercury Thermometer

When I was a kid I went into hospital for an op and I had my temperature taken by a thermometer under my arm. That was the last time I saw a mercury thermometer.

Till of course today. See I'm used to tympanic thermometers. Put on a cover, jab into ear, push button and bang result. I don't even know if they are sill considered good practice what with mercury being poisonous and all. NHS direct doesn't think so.

Mercury thermometers are now being phased out, because they are dangerous if they get broken. Mercury is poisonous if swallowed, or if it comes into contact with the skin.

Only adults should use mercury thermometers because children are more likely to bite it and break the glass. You should shake a mercury thermometer before you use it. This is so that the mercury goes back into the bulb of the thermometer, which will allow you to take an accurate reading To take a person's temperature, you can place a mercury thermometer either in their mouth, or under their armpit.

So another one for the lecturers. And that shaking the mercury down? Still haven't managed it yet!