The exacting standards of the Marie Curie Hospice in Newcastle impressed the judging panel at the Student Nursing Times Awards. “If you were a student, the nurses here would be excellent role models,” said one.
They were also in awe of the excellent opportunities that the hospice’s 22-bedded specialist palliative care inpatient facility offered those studying nursing.
The unit offers placements to 3rd year management students, 2nd year specialist placement students and 2nd or 3rd year students on community placements. “We don’t take first years because we feel they need basic grounding in nursing skills, while our placement requires more complex nursing skills,” says Helen Forrow, ward manager and acting hospice manager.
“For us, offering the highest level of support to students is paramount,” says Ms Forrow. “In order to do that, we take one management placement for each intake and then a maximum of two other students at a time. The trained nurse to student ratio is a minimum of 2:1.”
The hospice has two dedicated senior nurses who lead on student placements and support.
The students are offered a named mentor and can also access the hospice’s practice educator for practical and educational support. The team has a supportive ethos and the students are offered regular de-briefing sessions from experienced mentors especially following emotional or distressing situations. The team regularly reviews critical incidents and student nurses are encouraged to attend for their own learning needs. “We also encourage them to sit in admissions meeting so they can see the whole of the patient care pathway, and we also show them patients that do get better and leave and are well, so they see all sides of cancer. Students tell us they feel very well supported in terms of dealing with death and dying.”
It may be a huge effort to maintain that degree of involvement, mentorship and emotional support, but Ms Forrow says “the more students get out of it, the more we get out of it”.
And it pays dividends. “The key development we see in many students is their ability to communicate effectively with patients and carers.
This is through experiential learning in a safe environment and by observation of skilled staff,” says Ms Forrow.
This environment nurtures student nurses so they are able to hone their skills and emotional understanding, building their confidence as they are developed into skilled practitioners. “The level of direct clinical and emotional patient care provided by the student is second to none and mirrors the care given by our registered nurses,” says Ms Forrow.
She describes the unit as a “uniquely caring environment” which compared with an acute setting gives nurses “the time and space to fully appreciate what high quality care looks and feels like while developing many key practical skills”.
As the hospice is self-contained the range of experiences available are often unique and completely different to other NHS placements.
The student also has the option to explore other providers of specialist palliative care while remaining within a supportive hospice environment.
Students are able to observe and then implement a variety of skills in this highly specialised environment.
On a practical level, students develop skills in pain assessment, documentation, medication administration, sub-cutaneous and intravenous administration, spinal anaesthesia, bowel and urinary management as well as basic nursing care, catheter, stoma management and oral care.
While the environment may be special, it is the nurses’ ability to prioritise the learning needs of the students and tailor the experiences offered to them to accommodate those needs that impressed the judges at the Student Nursing Times Awards.
So although all student nurses are given a named mentor prior to commencing placement and then remain within a specific nursing team for the duration of their placement, they are introduced to the whole multi-disciplinary team on their first day and have the option of working with any member of the team if they wish to and will gain a valuable insight into another role.
Students are always classed as being supernumerary and are given priority for accessing learning resources within the hospice. The hospice has an in-depth file of relevant, up to date articles and information, which is of interest to student nurses. The hospice has its own in-house library and librarian service. Little wonder that they consistently receive excellent feedback from students on our own evaluation forms and also through university evaluations.
One of the hospice’s students has started work at the organisation after graduation. “We would not have been confident in taking her on if she hadn’t been to our hospice for her placement,” says Ms Forrow. “But she’s been fantastic. Some people think a hospice can be quite quiet and come with a different perception, but this is not the case if they’ve worked here.
“It takes a special kind of nurse to be a palliative care nurse,” she says. “But even if they don’t go down that route, what they learn here will be useful in any setting. We teach them about how to ensure a patient has a good death, and that is relevant in ITU, acute, community or other settings. That’s what we are educating the next generation of nursing workforce about.”
Tips for providing a great placement
- Offer a mentor to student ratio that leaves you able to provide emotional and practical support
- Encourage the student to pick and choose what aspects of learning they need to see
- Make sure they see a broad range of basic and complex nursing skills
- Provide a booklet that tells them what they’ll encounter with you - for example what palliative care is and isn’t, what drugs they will see, introduce them to members of the multi-disciplinary team and health and safety procedures
- Introduce them to the wider multi-disciplinary team
- Offer a reference library for students to refer to and time and space to use it