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Why are so many student nurses experiencing “bad” placements?

  • Comments (16)

Last week, I received an email from a student nurse wanting to ask the Student Nursing Times community for some advice.

We host a regular feature on Student NT for our readers to discuss problems and offer advice, so this email was nothing new. But its content struck a chord with me.

Victoria started her email by saying that the nurses on her placement “weren’t very nice”. She was told to “get on with it” and “find your own learning opportunities”, she felt ignored and it sounded like your classic too-busy-for-students ward.

But her main concern wasn’t for herself, but for the patients the ward was meant to be looking after. As an outsider looking at the ward culture from a fresh perspective, Victoria saw how patients were ignored and she noted “there seems to be a massive lack of compassion and respect for patients”.

We know that there are wards out there run by individuals who are burnt out or so overwhelmed with paperwork and stress that they can’t see the wood for the trees. But every person who responded to Victoria seemed to have experienced the same:

“Sorry to hear that you are experiencing this. I too had a similar problem at one of my placements”

“I can really empathise with your situation as I have been there too”

“Had a similar experience myself in my mental health placement”

“I too had this, so I can completely understand where you’re coming from”

“What you describe is not unique to where you are. Indeed, I have experienced the same scenario both as a student and as a qualified nurse”

“Victoria, this sounds very much like my first MH placement in first year…and looking back on it I recognise it was something of a baptism of fire.”

Thankfully, many of the commenters suggested Victoria raise her concerns and I hope those who could empathise with her had already raised theirs. But with so many student nurses reporting similar experiences, I had to wonder, do student nurses feel able to take their concerns further? And when they do, is something done about them?

Raising concerns doesn’t need to mean getting staff into trouble. But it does mean management are made aware that the culture on that ward, for whatever reason, isn’t working.

Are you surprised to hear student nurses reporting these experiences?

Read Victoria’s email and the responses she received here

  • Comments (16)

Readers' comments (16)

  • I have always thought that having students in the workplace is beneficial for many reasons. They are a fresh pair of eyes. Even though they are inexperienced, they are still able to notice when things do not seem 'quite right', or wonder why a particular thing is done the way it is. Their ideas may not always be helpful, but they should always be listened too, as questioning innovative nurses are what they are aspiring to be. However having said that, there are channels to be adhered to, and criticising nursing staff on the ward, while they are working, especially in front of patients, is not the way. All students should have a mentor they can talk to, and ideally a feedback questionnaire at the end of the placement. What about the link tutors? They can do an excellent job as a bridge between the university and the hospital, and foster understanding of the difference between clinical situations in the classroom and that on the ward. I would never condone lack of compassion or respect for anyone, patient or staff, and if a student truly believes someone is being abused, then she should report her concerns to the sister in charge of the ward, or the directorate until someone listens.

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  • Anonymous

    rather than students just raising their concerns and feeling they are not being heeded, this problem is so widespread there needs to be an investigation to see why this is happening and address the root causes. It is not right in a caring environment such care and respect cannot be extended to students and all members of staff as it ultimately impacts on how patients are treated and the quality of care they receive. there needs to be open dialogue between everybody involved in life on the wards and beyond and nobody should feel intimidated or threatened to speak out. when this is the case learning and improving care at all levels and any innovations due to fresh input is totally stifled and creates a very tense and toxic working environment where there is a lack of trust and confidence in others and in the self.

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  • Ellen Watters

    It's such a shame that any student should experience this and can potentially taint future opportunities for them.

    What about mentors? They have some responsibility here surely or should be flagging it as a concern to their managers.

    A comprehensive plan at the start of the placement with regular meetings throughout should pick up any concerns., And even if the mentor says that there may be times when this all goes pear shaped for whatever reason, at least the student is aware and as long as it's not a regular or longstanding occurrence it may be possible to get back on track..

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  • I think the most recent plans for a University to go completely electronic with their assessment procedures is brilliant, as it will streamline the whole student placement experience and I hope it rolls out nationally. Real time feedback will be great for communication and this student could feedback her concerns electronically perhaps, which might be a little easier and it's documented. I always feel there should be much structure to student placement experiences. For example a signed contract between placement and mentor that must be filled in prior and with a clear meeting before the placement starts, outlining expectations and responsibilities that are clear to all. I also don't think anyone should be forced to be a mentor as not everyone should be. I think there should be more rigorous procedures in place for mentors to be of a good quality. A quality standard, if you will. Teachers are graded by OFSTED and I think clinical mentors should have their own. The mentors for me, can make or break an experience.

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  • Anonymous

    Victoria, I empathise with you. I had similar experiences during my training, and wondered if it was me or them. I was ignored as were patients, and I was once reprimanded for daring to talk to a group of patients on a ward and set up a therapeutic music activity! However, despite the setbacks, I got through it and now have a very demanding but fulfilling job as a Community Mental Health nurse. Some of the nursing staff were so bitchy, they refused to help me and work with me. My mentor was not at all helpful, and I was afraid of "rocking the boat". There is a distinct lack of care in the medical profession, and I guess it is largely linked to the poor pay and working conditions, which are being eroded on a daily basis. It is a shameful situation! At least you care and you deserve to succeed. I suspect you may be too good for the profession, but hang on in there, get your qualification, and then look at upgrading to something better in the healthcare sector. Best of luck.

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  • Negative student evaluations should be taken seriously and investigated. All Local Education and Training Boards are concerned about negative student experiences and with the introduction of student tariffs money can be withheld from Trusts or placements that fail to support students. Victoria makes a very valid point about patient care, if students are not welcome other problems are likely to be prsent as well, such as high infection rates and high staff sickness and abscence rates. Do not be passive Victoria take your concerns to the highest level of both your HEI and the Trust. The CQC takes student concerns very serriously.

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  • I think the most recent plans for a University to go completely electronic with their assessment procedures is brilliant, as it will streamline the whole student placement experience and I hope it rolls out nationally. Real time feedback will be great for communication and this student could feedback her concerns electronically perhaps, which might be a little easier and it's documented. I always feel there should be much structure to student placement experiences. For example a signed contract between placement and mentor that must be filled in prior and with a clear meeting before the placement starts, outlining expectations and responsibilities that are clear to all. I also don't think anyone should be forced to be a mentor as not everyone should be. I think there should be more rigorous procedures in place for mentors to be of a good quality. A quality standard, if you will. Teachers are graded by OFSTED and I think clinical mentors should have their own. The mentors for me, can make or break an experience.

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  • Anonymous

    Yes we all experience these placements, that's why there yards have such trouble recruiting, karma or what!

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  • Anonymous

    I am Victoria the student nurse who sent the original email. I wish to say thank you to everyone who offered me advice and support, it really did help me. I have 5 weeks left now and I have decided just to get my head down and get through it and use it as a bit of a learning curve. A sort of, "well this is the sort of nurse I don't want to be" lesson. It is sad, but I feel unable to address the issues I have now through the appropriate channels as I don't want to be "the awful bloody student who reported us all". However, I am listing everything down as it happens and I will be completely, utterly and brutally honest on my evaluation. I have spent the last week doing a spoke placement and it has restored my faith that there are truly wonderful caring people within the NHS. I have been supported and encouraged and treated as important and valued the entire time. I am committed to doing whatever I can to improve the situation for students experiencing bad placements, even if it is as little as being supportive towards them when I qualify.

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  • Anonymous

    I think Student nurses would experience better placements, if mentors were actually bothered to teach students. Understandably ward environments are busy of course, but that is no excuse to treat student nurses with contempt. I remember as a student having a mentor that didn't speak to me the whole six weeks I was on the ward, and was quite happy for me to just be an extra pair of hands, of course I said needed to learn but still didn't care. Nothing wrong with personal care, I love it when I get the time!, it's all our duty, but I really should have been doing the same stuff she was doing, but alas didn't care, and there are many mentors out there like that, and students don't report because they are so scared, 9/10 times if anyone reported a bad placement they were kept on it, and treated even worse, the universities don't really care either, you have tutors ponificating how to be a good nurse, but the majority haven't nursed patients in years, you learn rubbish about research methods that I can honestly say have never come in handy to the practicality of my job, only for when I'm on a CDP course etc then I know how to write an assignment. I honestly think students don't have great experiences because they are not respected. For example you never have a name, it's always (The Student), or used to escort patients because permanent staff cant be bothered, I always remember 'Oh the student will go', when of course you aren't insured as you aren't in the numbers, but really you are when the ward gets short. But I also had wonderful placements, and the nice staff were always the ones, who I aspired to be like. The only benefit of a few bad placements for me was that, it showed what a good nurse and mentor I wanted to be for future student nurses. Really practice education faciliatators, and even university tutuors need to be coming to the placement areas more often, and checking on the welfare of the students. It amazes me still how they don't understand why there is such a high drop out rate within nursing. But not everywhere is the same, but there is always somewhere that has a back biting and bitchy culture. The only advice I can give students is, if you are in an area where there is a clicky culture, don't get involved, and always remember you are learners as a student nurse, so ask to do skills, and the majority of the time trained staff will say yes, so do try and take responsibilty for your learning. Just remember you are on your way to be nurses, so you be the nurse that you'd want looking after your family, and you will go far and enjoy your career.

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