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What to do when you're feeling like a spare part

Think you have little do while on placement? Think again …

One of the biggest concerns students have on their placement is being at a loose end.

“I feel like a spare part”, “I don’t know what to do,”, “I am standing around with my hands in my pockets” and “I don’t want to look like I haven’t any work” are some of the many anxieties we hear from students about placements.

So what do you do when you haven’t got a specific task or duty to perform? Mark Hillier, lecturer in nursing at Leeds Metropolitan University, says that’s easy – talk to patients.

“Student nurses often seem to think that unless they are physically doing a test or a task, they are not doing anything. But talking to patients is a hugely important part of therapy and will help patient recovery,” he says.

Leeds Metropolitan University’s Head of school of health and community studies Sue Sherwin agrees. “If there are patients, there’s work to be done,” she says. “Students shouldn’t underestimate how important it is for patients to talk about their hobbies, their families and their lives. Talking about their lives outside of their mental illness or long-term condition can really be a valuable part of wellbeing and promote hope. They can feel a person away from the diabetes or asthma. Students should not underestimate the importance of chatting to patients about things other than their condition or illness.”

Mr Hillier agrees. “When they are on placement, students have a rare opportunity to chat to patients, who can teach them a lot. A lot of qualified nurses would love to be able to have more time for that,” he says. “Work on your art of conversation skills and hone your talents at talking to patients and finding out about them.”

You should learn how to ask open questions – those that begin with who, what, where, when, how and why – which will be an important lifeskill as well as helping you construct dialogue with patients that is useful throughout your career. Note what works and what doesn’t with patients – what makes them feel more open to you and how your tone and body language affects their responsiveness.

Ms Sherwin says you can learn a lot from this aspect of the placement. “I hear this recurrent theme of students coming back and saying they have nothing to do. I say to them: ‘How many patients were on the ward or did you meet today?’. There’s always work to do while you have patients.”

Even without patients, Mr Hillier says you can fill your time by thinking laterally. “If you’re on an orthopaedic ward, do some reading around hip replacements. You can always find something that is relevant and meaningful to do on placement.”

Readers' comments (19)

  • Little One

    Having been told off for 'chatting' to a patient by the ward sister and my mentor, I have to say that from personal experience, chatting to patients has been viewed as 'doing nothing' as much as standing with your hands in your pockets. I was told I would learn 'nothing' from standing about chatting and that I would be better to go and clean the sluice rather than sit and talk to little Doris about her life.

    I think it is very important to speak to patients but I now feel guilty if I do so.

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  • I believe the nurses and hca uses the students as their spare hands.Most student dont really learn the nursing job becos,the nurses dont really work on the floor but paper work. they always want u to do the hca work.My first weeks in placement i was literally feeding patients and laying beds.I feel am not there to learn that, while my mentor was busy on the computer.Anyway, i had to step up and realise if i continue this way i wont learn anything.It is important for the students to know exactly why they are want to derive from their placement.Angel

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  • Little One

    Angel, I have found that really great Nurses do get stuck in with hands on care and provide the basics, helping to wash and dress, taking patients to the toilet and feeding etc, these are very important tasks that we should undertake every day whilst working as a nurse.

    The paperwork is important too but especially during the first weeks of placement I find that it is more important to get to grips with the basics and the general running of the ward than it is to sit at the nurses station doing referrals and writing in patient notes.

    What is wrong with spending the first few weeks washing and dressing, feeding and making beds? You will be required to do so when you are qualified? You can learn from every experience, especially regarding basic patient care, feeding patients is incredibly important, taking into consideration the reports that have recently been released about patients leaving hospital malnourished and schemes such as the red tray system and protected meal times, I hope you know that!

    It is important to know that you want to learn from placement and it is important that within your three years you learn about time management and paperwork, but every placement will require the same core basic skills, and a lot of patients will need some form of help with washing, feeding, toileting, changing positions etc. With an aging population it is becoming more and more important that Nurses have these core skills as more people will require help and assistance with their ADLs.

    Sorry for the little essay!

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  • George Kuchanny

    About to comment, I desisted after reading Little One - all said already.

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  • Made me quite sad to read Anon's comment, it makes me wonder what their concept of nursing is and why do they want to be a nurse?

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  • I am dismayed to read Anon's thoughtless, worrying, illiterate comments - thank goodness those are not the thoughts of the vast majority of nursing students. I think it would be more appropriate for Anon to spend her time productively whilst off duty to consider her rationale to nurse, rather than question the actual tasks she has been given.

    Scandalous.

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  • Gordon McGhee

    Dear Scandalous,
    Give the person a break. Perhaps their experience has only been as being left to feel they are a pair of hands. Perhaps they have not had the support of explanations about why learning these "basic" but vitally important skills are necessary.
    Not all mentors will be as supportive as you must be.
    I would suggest the fact they have posted something on NT would suggest they have an insight into learning and should definetely not be written off.

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  • Student to student, I'd advice you that if you have been assigned a task and you do not understand the benefit of carrying it out, ASK. There is nothing wrong in seeking understanding. This is why we go on placements to have an opportunity to learn and understand the reason behind the theory. I used to think that doing personal care all day is mundane but I realized that if I do not have the opportunity to do that, how am I going to know the integrity of that patient's skin?

    Its the same with feeding, I can make a difference to someone by taking my time to feed them as I do not have any pressing work to do. In doing this I could discover that the reason the patient was not eating before is because they are being made to eat in a rush therefore I have discovered another way to impact on the care of the patient whilst improving on their nutrition which to me makes a good reason why we are in nursing.

    If you do not have people to ask, carry out further reading around your area of location and you will always find additional literature to explain why we do what we do on the wards. I hope you find this useful.

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  • So far on placement I really do feel like a spare part. EVERY morning (which at the moment is all I'm working!) we have 4 staff nurses and 3 HCAs to deal with 17 beds. The 3 HCAs team up into a 1 and a 2 and charge off to make the beds and wash the patients super fast, then they do the obs, tea and coffee rounds and answer all the bells before I can even get there! In the meantime the nurses give out drugs and change dressings but as each nurse only has 4 patients this takes them about 20 mins. I can't follow more than one nurse as they all do everything at the same time, or there's other students on the ward too. People say talk to the patients but if I do that I get told I should be doing something more important!!

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  • Some people seem very ungrateful as why they are on the nursing course! As a HCA for 5 years before my training I felt it was beneficial to 'muck in' everywhere whenever needed. yes, now I'm there in a different context as a student nurse but patients need looking after no matter how qualified you are. Feeding, washing, bed making are the basics of your training. The best wards I have worked on is where everybody mucks in together and works as team. I have been on some wards where the nurses thought it was the HCA job to do all the dirty work and it's just not pleasant. Enjoy your training and make the most of it. You should be treating each placement as a potential job interview as this is where you could be working. If you think it's 'boring' washing patients and doing everyday tasks with them ... why train to be a nurse??

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  • talking to patients on a ward is seen as idling as much as one wishes to learn more about them, to build up therapeutic relationships and trust, and as much as one feels it will benefit the patient. sticking your nose into a book to get vital information is seen in the same light and both of these circumstances you will always be found some menial and non urgent task such as clearning bedpans or cupboards, etc. which could easily wait and which in no way enhances learning like any human encounter or information seeking.

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  • Excellent and common sense though Mr Hillier's suggestions are purely theoretically and he is clearly very out of touch with the reality of working on a hospital ward! This is why the remarks in the above article were probably made by the students in the first place - any more helpful tips as what to do on the ward when at a loose end except to be seen working hard clearning or doing some other menial task? It can be quite difficult trying to make yourself look busy, and is mentally very trying, when you really do feel, or are made to feel like a spare part and in the waym by those who may suffer from an over-inflated sense of self importance!

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  • Little One

    I must say though, just to put across a positive side after so many students (including myself) commenting on how talking to patients is viewed as idling, which in many cases it is, whilst on placement in a community hospital I started talking to a wonderful lady called 'Maggie'. Maggie had recently had a hip replacement and was struggling to get motivated and mobilise, as coupled with her arthritis, she was finding it painful and difficult.

    After spending time with her she showed me pictures of her little dog Beau. Beau was a gorgeous little old dog with a few scars of his own and Maggie had not been anywhere without him for years, she had never been in hospital overnight before her hip replacement and missed him and her husband terribly. I was able to arrange for Maggie's husband to bring Beau to the hospital, and into the day room so she could see him and spend some time with him. I arranged with her husband that Beau would come to visit every day with him and within two weeks I had her outside, walking across the little patch of grass with her husband and her Beau. It was a wonderful thing to see and I think that her progress and rehabilitation would have been a lot slower were it not for the information that I was able to gain from speaking to her and spending the time encouraging her. It was a wonderful thing and I'm glad that something so small as talking to my patient made such a difference. On a selfish note, it was wonderful to have such a lovely connection with my patient, she was clever, funny and intelligent, and it was enjoyable getting to know her. She always gave me a hug at the end of the shift and made me feel like I was doing a good job.

    I had so many good experiences within my community hospital, especially with Maggie and the two other ladies in her bay. I deliberately asked to care for them every day when I was working to provide them with continuity but also so that I could build a relationship and talk to them.

    Another instance included Maud, a lovely 96 year old lady in the bed next to Maggie, also recovering from a hip replacement. She had her own clothes that she was able to wear and put on without assistance in her wardrobe by the door to the bay, but no one had bothered to listen to her, or check whether she had any, so subjected her to wearing a hospital nightie every day for a week. It had been handed over that Maud needed a pad and net pants as she was incontinent. After speaking to Maud it turned out that she wasn't fully incontinent, she was just so embarrassed of walking across the bay to the toilet using her walker because she couldn't hold her nightie closed. Needless to say that within 10 minutes not only was Maud wearing her own tracksuit (that she put on herself with no assistance from me) but I had also rustled up a pair of socks and found her trainers so that she could walk unassisted to and from the bathroom without having to worry. It's lovely to see what big changes can come about from talking to your patients.

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  • Little One | 10-Jan-2012 11:09 pm

    we need far more nurses with this attitude and those who understand and can care for the elderly.

    all the very best of luck with finding a job, you seem to well deserve one.

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  • Little One

    Anonymous | 10-Jan-2012 11:28 pm

    Thank you so much, if there were still specialist Geriatric wards it would be where I wanted to work when I was qualified but unfortunately our hospital no longer has any. Hopefully when I qualify I can take all my good experiences and carry on wherever I end up working.

    Only 5 months until starting to apply for jobs, fingers and toes crossed!

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  • As a nursing student on her last placement. I have to say I have learnt the most from mucking in with the hca assistants and helping with cleaning etc, it has made me seem keen and feel involved in the team meaning the nurses got good feedback about me from the hca. This meant they knew I was keen to learn and meant I got on well with the nurses too which means I could then approach them if I had questions or something I wanted to get involved in. One bit of advice I got early on was to always look busy or ask what needs to be done.
    One placement I got I didn't have a permenant mentor and was left to my own devices but if I saw a opportunity to do something I asked and made sure the nurses on that day knew there was something I wanted to do.
    I want to be hands on with patients as much as I can when I qualify and without doing these things on placement I'd never have the confidence and assessment skills that I have developed. One day while washing a patient I noticed she had a swollen leg , I informed the dr and turns out she had a Dvt, without what I had learnt about assessing patients I may never have noticed this or had the confidence to report to a dr.
    If not busy I see nothing wrong with saying to a nurse that you are going to talk to patients say you need to develop communication skills which is part of the nmc requirements. The nurse will probably be happy enough if there is nothing else to do.
    Enjoy being a student and grasp every learning opportunity

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  • Hi I am currently doing my last management placement on a medical ward and absolutely love it. I agree with some of the messages by other students; that sometimes you feel like a spare part. I have worked for 15 years in the community as a support worker and one of my greatest strengths is chatting to my clients, I also listened ALWAYS!! I totally agree with the lovely story about the patient spoke of above Maggie and her dog Beau, I found the story really touching. And do agree that the information you gain from communicating is VITAL. I never get bored of chatting to patients I learn from them all the time, they are valuable to me as a student, if it wasn't for all the lovely patients that I have cared for on the ward I very much doubt I would of lasted. As the mentoring is not all that it should be, this I have found on many placements.

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  • I am about to start adult nursing degree on Monday. As far as I am concerned, how on earth can you be a good nurse, without knowing the basics? I am more than happy to wash pans, change beds, sweep floors hell, I'll even polish the sisters shoes if it means getting the correct knowledge to do the job I've dreamed of for years. I am 41 yrs old, this is a life change for me. Bring the soggy bedsheets on, I say, I'll have them whipped off and changed in no time :)

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  • Johnathan Crane

    Starting in year one of Mental Health nursing this month, I couldn't be more delighted! Having worked as an HCA for 11 years, talking to patients when nothing else needs doing just seems like common sense to me. It's the fastest and best way to make a good impression on the ward, in my opinion.
    Sadly, this opinion has not always been shared by my colleagues. I have often spent time chatting to an aphasic patient who is capable of expressing themself through nods and headshakes, only to be told that they 'couldn't understand anything' and that any choices or opinions I got from them were 'nonsense' - this to me seems like the very opposite of person-centred care.
    I've worked hard to get to Uni, and consider my communication skills to be a part of my success. Doing as suggested by this article would come naturally to me. I'm not looking forward to having to say that on a placement, but say it I will. Clean sluices are important, but they are much less important than happy patients.

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