Placement is around the corner.
The uniform is ironed, the fob watch is gleaming and you can see your reflection in your highly polished (thanks Dad!) and ridiculously comfy shoes. And I bet you’re also planning to put your social life in a little box and lock it away. I mean, no one can possibly manage to have a social life whilst on placement, right?! You can’t go out to the pub or the cinema, because you’re doing a twelve-hour shift. There is no way that you pop to your friend’s house for a cup of tea because you’ve got to get up early. And you absolutely can’t stay up to watch trashy television with your non-nursing housemates because you have far too much to do. Have you ever felt yourself thinking anything along these lines? If so, you could well be a placement martyr.
Think about it - there are 168 hours in a week, and we spend about 37.5 of those on placement. Add in some travelling time and that leaves us with roughly 125.5 hours. Then, say you want to get a good 8 hours of sleep a night and we’re down to 69.5 hours. Add in meal times, showering and doing a bit of housekeeping and I reckon you’re down to about 54 hours. And of course, we have horrible assignments and researching and general reading to get on with, which I would say brings our total down to 40 hours. Because really, who does that much work whilst on placement?
So what are you doing with those 40 hours? If you’re a placement martyr then chances are you’re moaning about not having the time for a social life and you’re preaching to your humanities studying friends about the tiring workload of nursing that they couldn’t possibly understand.
And it drives me bonkers.
Placement isn’t an excuse to neglect your friends and moan. If anything, placement makes me want to be around the people I care about more, because nursing is hard and sometimes quite horrible. Sometimes you think the world is quite a cruel place, and that bad things happen to good people (cliché, I know).
And there is nothing I need more than a cup of tea, or a trip to the cinema, or even quite a ‘merry’ night out. And crazily enough I manage to fit these in! I need a life outside of nursing, or else I think I would go quite insane.
It’s frustrating how student nurses think that they can’t have a life. What about qualified members of staff with spouses and children? Do you think that they just go to the hospital and home, and nowhere else in-between?
Yes, you’re studying to be a nurse. It’s a role of great responsibility, and it can be emotionally and physically exhausting. But it doesn’t need to take over your whole life. And if you are a placement martyr, and you disagree with everything I said, then that’s fine. But can you please stop moaning about it?
How to Make the Most of Placement
I absolutely love being on placement. I spend the long weeks in university tapping my pen and counting down to the moment I get back onto the ward. I’ve been lucky to have lovely mentors and to work with teams who have been nothing but supportive, friendly and more than willing to help. But I also used a few tips and tricks to get the most out of my placements, and to learn that little bit more.
Obviously, you want to get your competencies signed, a good review, and to get prepared to be a staff nurse. Those are the key aims. However, in my first year I went to multidisciplinary team meetings, spent night shifts with the clinical nurse practitioners and visited (and joined in!) with a pulmonary rehab session.
I got to see procedures such as the insertion of chest drains, bronchoscopies, and even heart surgery! And how? I just asked!
You are on placement to learn. I was able to concisely explain to a confused patient exactly what an ERCP was, and what it entailed, because I had watched one. I understood what asthma clinic was because I had been there. I love being on the ward and working with patients, but as a student nurse we have opportunities that qualified members of staff don’t. My mentor on my acute respiratory ward admitted that she had never been to a bronchoscopy, whereas in one afternoon I watched 5, and the consultant performing the procedure was more than happy to have me join her and explain what was happening at each and every step of the procedure. I found that everyone, from doctors to radiographers to physiotherapists was eager to share their knowledge, and appreciated having someone who wanted to learn along with them. It was by shadowing the physiotherapists and the occupational therapists that I gained some insight into the role of other members of the team. But by far the most valuable days spent away from the ward were with the Clinical Nurse Specialists. I have a particular interest in wound care, so spending the day with the tissue viability nurse was a particular highlight. These nurses know so much about their speciality, and are a valuable learning resource. Many of them had resource packs for me, and actually enjoyed having a student along with them. And the COPD nurse specialist even looked at my essay on respiratory diseases for me!
No-one organised these visits for me. The Rapid Response Team didn’t ring and ask me if I wanted to join them - I asked them. No one will hand you these visits. Politely ringing, or approaching a specialist whilst their visiting their ward will do wonders. I’ve only been told ‘no’ by the palliative care team, and what was only because they only took third year students with them, but even then I was given a pretty hefty information pack. The worst that can happen is the word ‘no’. The best is a fantastic experience that you will love and will never forget.
Your First Day on Placement
I think, by now, I’ve got my placement preparation routine down pat. I know what I’m going to say on the phone, what I’m going to take for my lunch, and what to say when I step onto the ward. So here are my tips for what to do when you start placement:
- The Phone Call
This is the bit I absolutely hate. I’m normally confident and calm, and I can natter away for hours. But when it comes to the pre-placement phone call, I suddenly turn into a gibbering wreck, and I have no idea why! But by practicing what I’m going to say, I can cope a little bit better.
The first thing is to not ring too early, and to not ring too late. I normally ring about a week and half before placement. Nurses and wards are busy, and they may just forget that you’re coming! However, too late will not make the right first impression. Also consider the time of day. I usually look up the visiting times for the ward beforehand, and ring then. This is normally the time that nurses are at the station, as the patients are too busy! Then there’s the call itself. Introduce yourself as a student nurse starting placement and asked to either speak to the ward manager or the nurse in charge. Ask for the shift pattern, the first few shifts they would like you to work and if there is anything in particular you can read beforehand. And that’s it! That’s all you need to do! Easy peasy.
- The Kit
There are a few things that I would never step onto the ward without.
Obviously my uniform is pretty important, and will make an impression on staff. I’m a messy person, but the one thing I always wash and iron is my uniform. I’ve heard patients and staff bemoan a sloppy uniform, and trust me, people will notice stains and creases. Also, make sure the trouser legs are the right length! I would always rather they be a bit short, as opposed to long, dirty and fraying. The shoes are pretty darn important too. When looking for work shoes I think ‘Can I wipe this clean? Would I like walking about for 12 and half hours in these? Do they look smart?’ If the answer to all of these is ‘yes’ then you will be fine. A fob watch is a must, and by the end of placement whenever someone asks you for the time you will automatically look at your chest instead of your wrist. You’ll also want to collect an obscene amount of pens, and a small notebook to jot things down.
Don’t rely on the canteen for food. Normal meal times are some of the busiest times for the ward, and quite often, by the time you have a break, you’ll find they’ve stopped serving lunch and they’ve finished serving dinner. Take a cold meal on the first day, just in case the microwave is working, and eat something really filling. Trust me, this one is important.
- Saying hello
When you get on the ward, don’t be scared. Just be calm, friendly and introduce yourself to everyone. Act confident, even if you don’t feel it.
Your first handover can be very confusing. It’s hard to know what to scribble down, and what information you need. I always make sure I note the current diagnosis and any important medical history such as diabetes or epilepsy; you don’t need to note that they had a broken arm when they were 12. Allergies are important, as are resuscitation status, mobility, level of care required, frequency of observations and if they have any dietary requirements are the key things I try and get - anything else is a bonus! Make a note of any acronyms and terms you don’t understand and look them up when you have a chance. Handover gets easier the more you do it, and don’t stress on your first one!
Hopefully this will help you get through the first day, and trust me, you’ll pick the rest up as you go along.