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'I'm struggling to be authoritative on placement'


Can you advise this student nurse?

“I am currently on my first placement of third year and I seem to be having a slight power struggle with the HCAs on my ward.

“I am getting to that stage of my training where I need to start learning to delegate, polishing my clinical skills and learning about the managerial side of nursing - so obviously to do this I need to hand work over to HCAs as a qualified nurse would do.

“This has been really difficult because I’m only three weeks in and some of the HCAs have been there for over six years! They really do not like the idea of me giving them jobs to do and haven’t been responding well to me when I try to talk to them.

“I have found these three weeks really difficult so far because I’m struggling to decide whether I should be ignoring my frustrations and working hard to get as much as I can to get the most out of this placement before qualifying or laying low to keep off the bad books of other staff members and not irritate anyone.”

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Readers' comments (4)

  • It's not a case of you Being a student nurse and telling them their job after 6 years, it's about team working for the best patient outcome! If you ask "could I please get you to do..." and they aren't responding the way you would hope speak to your mentor, don't let it dampen your confidence and lay low you are working towards your future you can't let other people dictate how that should pan out!

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  • Speak to your mentor and other nurses about how they would best approach this. Also you can also ask HCA in a different way "would you mind doing x, I really need to do y". Sometimes the response we get is a result of the way we ask. Remember managing conflict is part of you demonstrating your ability to lead as a nurse.

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  • Hmm reading the above responses, the implication is the student nurse was in the wrong. I have been qualified many years and sadly I still come across HCA's who think they are running the ward.

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  • As someone who has very recently qualified, I had the exact same thing happened to me on my sign off placement. The least cooperative HCA had actually been on the same ward for 27 years (longer than I had been alive!) and actively told off other HCA's from doing anything to help me, even something as simple as a set of observations when they were doing the rounds anyway. Because she was such a long standing member of staff she was 'untouchable' and I could not make a single member of staff listen to me and my attitude was brought into question for thinking I was 'above' her and told me that I was supposed to do the 'exact same job as her, we were no different' (my learning objectives made me disagree)
    At the end of the day we have no status as students, no "rights" so to speak. It goes without saying that you catch more flies with honey and so you should try to appeal to their better nature to get them to help you but I'm sure you've been doing that already. Don't allow them to source this experience for you. You need to get everything ounce of actual 'nursing' (and yes I do think it is different from caring, you wouldn't have reached third year if you didn't care) you can before you qualify because you'll be thrown straight into it with no safety net of being a student once you're a staff nurse.
    Its cane to light during my experience that if I didn't make them for excellent about themselves and their ability to do their job i was seen as unfit to do mine. Some serious nastiness went on and Staff Nurses started refusing to sign my skills that I had demonstrated and my hours off. I was told that I was not deemed fit to practice and had to transfer and extend my final placement (and act as a straight up martyr on the new ward) in order to have my sign off completed and qualify on time.
    Do NOT suffer in silence like I did! Get your mentor on your side ASAP if you can, keep a contemporaneous log after every incident of the HCA's refusing to cooperate with you (use their exact language and keep it professional- no emotive language or else you will be penalised for that) and get uni staff on-side too in case you need them.
    At least this isn't your last placement so if the problems are not resolved by the time you leave you can at least talk to your next mentor regarding this and they will hopefully be more understanding.

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