On my first day of my very first placement, everything seemed unfamiliar. I couldn’t remember the names of any medications. I was slightly terrified of actually speaking to a real patient. I couldn’t even put on a blood pressure cuff properly.
I was too embarrassed to admit when I didn’t know something, so when my mentor showed me the sluice room during my induction, I said, “Ah yes, where you keep all the… sluice.”
I remember thinking I wanted to fast-forward to my final placement, where I pictured myself breezing in and out of patients rooms, reeling off the names of various medications, feeling full of knowledge and ready to take it out into the real world.
Well, here I am, my first week of my sign-off placement. I have to ask myself: do I feel any different?
During my third placement, there was a sign-off student on the same ward. She seemed confident, knowledgeable, and she’d managed to find ward-appropriate shoes that didn’t hurt her feet – three things I hadn’t achieved yet.
She helped me out with things like medicine calculations and showed me how to properly fill out a fluid balance chart. She seemed to know everything, so I had to ask her: do you feel ready to be qualified?
Then she told me the truth. “I’ve talked about this with some of the people on my course”, she said, “and we all feel the same way. None of us feel ready.”
She explained that you could do a million placements as a student and feel as confident as ever, but as a student, you’ve always got that safety net. You always have a mentor looking over your shoulder, and if you make a big mistake, it’s your mentor, not you, who is held accountable.
As students, no amount of practise will teach us how to manage that level of responsibility. “The things that still scare me are the things I can only learn when I’m qualified”, she told me. “So if you wait until you feel truly ready, that’s never going to happen.”
The sign-off placement comes with a whole new set of expectations. Up until now, if I hadn’t mastered a skill yet, I could just say, “ah, well, plenty of time to learn it on the next placement”. But that time is up. We have 12 weeks to become competent at everything we can’t do yet, and sometimes, it feels like a race to that point. And your mentors are feeling their own kind of pressure.
Mine explained to me, “When we sign you off at the end of this placement, we’re signing a piece of paper that says you are a competent nurse, that you are capable of being a band 5 registered nurse. We have to be sure of that”.
Gone are the days when my mentor signs off a skill saying, “you’ve pretty much got that one down”, or, “you need more practise but I think you’ve got it”. Now it’s, “you’re going to be qualified in 12 weeks, you need to get this”. Now, when I tell my mentor asks me to do something and I tell her I have never done it before, she looks horrified.
This is a lot of pressure for us to deal with. Suddenly, we’re expected to know everything, to do everything, to be good at everything. To be ready. But we have to ignore this pressure. When my mentor expresses shock that I haven’t done something before, I try to tune out the parade of panicked thoughts that starts in my head.
Instead, I listen to her instructions, ask questions, and read up on the subject as much as I can. You do your best, and you work hard to mentally cross things off the big list of “stuff I need to be good at in order to qualify”.
After all, all we can do is our best, because if you’re waiting until you feel truly ready to take the next step, for the rest of your life, you’ll find yourself whining, “are we there yet?”