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

  • Comments (19)

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 (19)

Readers' comments (19)

  • 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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  • Anonymous

    Unfortunately I have just come out of a 10 week placement with a fail. This placement had a severe lack of staff, with the ward manager, ward clerk and several staff nurses have left within my 10 weeks. Every second day for my last month, if not every day there was a new faced agency nurse to help guide to where things were kept. My mentor was who sister in charge was determined from the word go to help me meet my learning objectives however this soon completely changed and I was given a nurse to shadow for the day after handover and soon just taking over the role of the HCA. I very rarely shadowed my mentor but she signed my book at the end as if i did get my minimum 40% time with her. I was constantly running around to please the HCAs and staff nurses, not learning anything to a point where I was often made a show of by my mentor for not knowing certain things which she never explained to me. She was a very rude person who had problems with many staff on the ward and was moved from two wards due to complaints. The fact that I was acting as a HCA staff member for absolutely nothing,no money nor learning broke me to a point where I stopped going in unfortunately I didn't obey by the 2hour policy rule of calling in before placement to say I wouldnt be attending so that is something which is completely my fault. But another reason for my failure was not being of 2nd year standard - a problem I faced in none of my other 2 placements. This is something I feel is unfair due to the lack of support or learning I received from my mentor. I was completely afraid of her. I discussed this with other members of staff who I felt safe in talking with as I knew they didn't respect her, however not the ward manager or my co-mentor as they had a clear bond and I was afraid of it getting back to her. Or even having to work on the same ward with her under a new mentor. Other staff nurses can understand my fear which makes me feel a little bit better with regards to keeping quiet however this led to 10 weeks of sweat and tears to my mentor failing me on my 2nd last day. This now even means taking 6 months out to redo my 10 week placement. So I have an unbelievable amount of regret on my shoulders.

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  • Anonymous

    I'm so deflated by all my nursing placements. I am on an accelerated programme as we all have degrees and hence every placement is so crucial to our learning as we don't have as many as undergraduates. Nurses have treated us with contempt for being on an accelerated programme, I feel my learning is minimal, i'm on my community placement and i'm not even allowed to give an injection. How are we EVER going to learn? the sister district nurse said to me ' you will learn to give them when you qualify and justified that if I was to cause harm to any patient there could be an inquiry and believe me you don't want that as i've had one which was not nice' agreed i'm sure its horrible, but thats what a mentor is for- to supervise, learn, so i know how to give an injection properly we've had training at uni. This is not trust policy this is there own policy. Where is the trust? I know there is a red tape in nursing but they have invented their own. I spoke with uni and even they were shocked. I just feel so dissapointed I went into this with such passion motivation to learn and become the best nurse I could, but now i feel like every time i try and take a learning opportunity i get a slap in the face. :(

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  • Anonymous

    In my situation, my mentor feels threatened by my prior clinical knowledge and experience and she does not understand that I need stuff signed off. She only works 22 hours a week and she feels that she cannot trust me to do things alone even tho the other staff who spend more time with me trust me.
    She is barring me from any sort of learning opportunities and she wants me to stand there next to her and watch her do things.
    I do not feel respected, cared for or even supported by her and the ward sister who apparently is also my mentor yet has never really worked with me. They are always very critical of me and never recognise the amount of hard work and determination. They say that I am too keep and eager.
    I don't know how to deal with this and it makes me feel very anxious. I worry that because of them not "having the time" to sign my paperwork and not allowing me to take advantage of the many opportunities that present on the ward I would not become the nurse I would want to become.
    This is a day surgery ward so the work is pretty straight forward, book patient in for surgery, they go in surgery, come back and they are monitored for a couple of hours with obs and they are given food and drinks and if they are ok they are sent home.
    The work is very repetitive and I can't say I've learned anything new but there are plenty of opportunities to go into theatre, pre-Ams, endoscopy, cardioversion, theatres where I can shadow the recovery and scrub nurses, biopsy clinics etc. The other students on the ward who have other mentors get to see all of these but I am not allowed to because I need to "get used to the ward". They hate it that I have so much knowledge (4 years of medical degree) and they feel threatened. They twist my words because when I said I would like to go and shadow the scrub nurse she said " oh so the nursing assistants' work is not important to you? You know their work is important!"
    I don't know what to do.

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  • Anonymous

    I have found similar experiences in my placement. There is this bad habit of 'bitching' about colleagues and having no respect for each other as staff nurses. I receive no help and is given menial tasks because they don't trust me. I show my enthusiasm and they use this to make me go to every patient as they ignore them and carry on with the paperwork. Once I tried to do paperwork but they didn't want me to sit around cos they needed someone on their feet to basically boss around. Some staff nurses even ignore each other and give me different ''orders'' but then shout at me when I don't do them in the same second. Its quite ridiculous. My mentor she is lovely but I feel targeted when she isn't around. Everyone's attitude changes and they become more bossy and rude towards me. I've been scolded only when my mentor isn't around which is very coincidental. One nurse even rudely said that 'student nurses shouldn't even be doing obs'. There is this lack of trust and respect on my ward for student nurses and frankly I'm not even surprised as they don't normally receive students. Some staff nurses are reluctant to give me breaks and when I ask they are like 'you can go later'. I have had that same problem with when the ward is short-staffed they use me as a support worker. They ask me to do things I've only seen once and get mad when I do it properly...well you could've spared two minutes to teach me properly instead of embarrassing me in front of the patient. The only option for me is to just avoid the days these staff nurses work.

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  • One of my co mentors is not teaching me, ignoring me and when I try to seek other avenues of learning, she is blocking me from learning clinical skills, using me as a pair of hands and offering me to others as well as gossiping about me twice in one day. I feel ganged up on as she uses her seniority to manipulate my learning and this extreme stress is causing a return of my panic attacks. The educators and PDN are not interested to help change this attitude. I'm being accused of not wanting to do as I'm told. When I don't achieve my objectives the educator is called in and action plan is set. If I were given the opportunity to learn I won't have to go through this. I'm fed up and I am seriously thinking of quitting as this harrassment continues.

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  • Anonymous

    I'm at the point were I should be applying for jobs but havnt as im questioning if I want to do this anymore. It's not the job that's puts me off or the patients, I love them both, but it's my bad run of placements, poor teaching, and experiences of staff on the wards. The placement I have just finished had me in tears on the last day because I hadn't had any meetings about progress, a back to work meeting after time off due to surgery, My hours were not signed off and half of my paper work was not filled in. I was told if I wanted it filled then I would have to come back onto the ward after my university dead line and work the weekend for them (I suspect they did this on purpose as they are massively understaffed) . 1 I was not insured to do so after this day as my placement was finished. 2 I had already worked over 40 hours this week and I was still recovering from surgery as one of my surgical incisions was infected and I was on antibiotics. 3 it's not fair that I should suffer due to poor management and support. Honestly you couldn't write it. I did not do one medication round whilst at this placement despite asking and offering as I could counter sign for them. Most days there was only 1 trained on and another staff would be taken from another ward to help. I would be given 20 jobs to do in 5 minutes and before those 5 minutes were up I would have another 20 jobs to do with no support. My experience was the exact same as all the other students from different universities on this placement at the same time. It's unfair and not a good learning environment and quite frankly it does not set us up well for when we are qualified. The quality of nurses coming through is dwindling because we are not getting a good standard of placements which in turn directly effects patient care, stress levels, and the efficiency of wards themselves in the long run. I love to learn and nursing is a commitment to continue to learn throughout your career as research and methods develop new strategies of care. So why are there so many people failing us students? I know staffing levels are horrendous and quite frankly it's scary but that's not going to get better if our experiences remain the same. I'm looking at my situation now like this.... I'm not far off qualified, 5 months to go and I feel like I'm going to be walking into a nightmare. I don't feel like I know enough, I know I havnt had the support or teaching I should have had so I feel at a disadvantage dispite my enthusiasm to learn. I'm walking into a work force that is massively under staffed and the situation is only going to get worse. I've had to stop reading the comments from other nurses ect on the NMC media posts as they are putting massive doubts into my head as they all want to leave. I don't know what to do anymore. I am getting in debt to do this course, the very least I should receive is a high level of support and education. The only reason I did not walk out from my placement early on that last day is because I know the patients would of suffered due to their being 1 less person there when there wasn't any where near enough to begin with. I'm really praying that on my last placement i will meet the nurse that wants to share their years of wisdom with me and show off their skills and help me to develop and perfect mine. I know he or she is out there, hopefully I meet them in time!

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  • Anonymous

    I can consider myself a very lucky graduate: All 6 placements were interesting and varied, the staff was friendly (enough), work was hard, usual free-HCA theme.. On the two boring placements, I was just making sure all the jobs were done, occasionally delegating some simple jobs to remaining HCAs and I was reading the BNF, collecting medication leaflets, talking with patients, trying to memorise the trust policy on handwashing. I am sorry to hear, that so many people suffer on placements, I promise that my students (in the distant future) will have appropriate mental stimulation and interesting time.

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  • I'm hoping CLIPP will catch on and there will be a culture of life long learning and mentorship on the wards again.
    Senior members of ward teams are always chased for results, but not always supported in delivering those results.

    Encouraging imaginative leadership and devolved teaching plans might put wards back on track.

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  • Anonymous

    It is gutting that students are experiencing this but it is largely reflective of life across the NHS with staff unreplaced, undervalued and with even GPs going to food banks it is no wonder staff are unable to support students adequately.

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