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Levelling hierarchies and sharing power as a student nurse

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As a student nurse, I often feel powerless. I have no control over where my placements will be, I can’t make the NHS Business Services Authority reimburse my travel expenses any more quickly, and I have no ability to shift an essay deadline if I fancy a lazy weekend.

Recently, though, I’ve begun to realise how much power we actually have as students, and that a lot of perceived hierarchies exist only as long as we reinforce them.

I’m sure everyone reading this will be familiar with the powerlessness of the first day of placement, all sweaty palms and stammering. At those times, it can be hard to remember the distant voices telling you that you are an agent of change.

But from the hardest situations on placement can grow the greatest moments of power and leadership. My love of research is no secret, and when nurses on my placements ask where I wish to go after qualifying, I tell them this.

“You’ll lose your PIN”, they tell me, “because that’s not nursing.”

“Your place on this nursing training could have gone to someone who actually wants to be a nurse”, said one. 

Do you know what I hear when they say this? Fear. It’s fear of the unknown, of change, of innovation, of being outmoded. These same nurses who recognise the value of evidence-based practice scorn those creating the evidence base – and I think it’s because of the power imbalance.

“Why should this upstart student tell me what to do?”

“What does she know?” 

”This is not the way the power is supposed to lie.”

Intelligent, innovative students threaten the status quo every day, by speaking up and sharing ideas, and not just in research.

Explaining to a fellow nurse that she doesn’t need to wear gloves for a procedure, for instance, knocks the expected hierarchy off-kilter, and that makes people nervous.

“Experience is invaluable but must not be the only factor to consider in relationships in nursing”

I’m not suggesting anybody make a rod for their own back by telling colleagues how wrong or outdated they are, but we are the future of nursing and we must speak up.

Experience is invaluable but must not be the only factor to consider in relationships in nursing. After all, why teach us the most up-to-date clinical skills if we revert to old habits as soon as we reach the ward?

Sharing ideas in a compassionate way, and having the emotional intelligence to recognise when something you say might cause fear or nerves, are skills that will see you well in nursing and in life. 

A great place to learn to share ideas in an open and collaborative way is social media – especially Twitter. I can’t imagine walking into the office of Joanne Bosanquet, deputy chief nurse at Public Health England, and giving her a piece of my mind, but I regularly tweet @MrsBosanquet and hear her thoughts in return.

It’s a forum made to level hierarchies, and we all stand to benefit. If you’re not using it, you’re missing out.

“Approach someone senior, someone in power, someone experienced”

But more than getting to grips with Twitter to share some power and level some hierarchies, I have a challenge for all student nurses. We’re familiar with mentoring, a traditional relationship in which the experienced teach the inexperienced, but what about reverse mentoring?

Approach someone senior, someone in power, someone experienced, and offer to reverse mentor them. Maybe they don’t know how to make the most of Twitter. Maybe they think that nurses who do research aren’t really nurses. Whatever suits you both best.

Transforming Perceptions of Nursing and Midwifery comprises twelve 30-day challenges, and the challenge for December is ‘Mentor a junior colleague or student or reverse-mentor a senior nurse or midwife’.

I know I’m a bit early, but I’m giving you time to prepare. I know I need it. Those hierarchies aren’t going to get levelled overnight.

Please join the ‘Transformation through mentorship’ tweet chat on 20 December, a collaboration between Phi Mu Chapter @PhiMuChapter and the Student Nurse Project @StNurseProject using the hashtag #pmtc to discuss your thoughts around December’s 30-day challenge.

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Readers' comments (1)

  • Graham  Coates

    A really interesting post and one I can definitely agree with. The thought of speaking up in the future during a placement, if a nurse isn't doing something necessary, daunts me. But you are completely right, we are the future of nursing, and if we are learning the most up to date skills and information we need to break old habits. I'm starting my first placement in March and I'm both excited and nervous. Good luck to anyone else who will be starting soon!

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