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'The first day of placement is never easy'


Student nurse Claire Aubrey is feeling the strain of her first placement in a cardiology unit

The first day of placement is never easy, no matter how many times I go through it and, although I was really out to impress from the off this time, I still felt a riot of nerves from the moment I stepped on the ward.

Although I have been sent to a cardiology ward in the past, I was a little bit naughty and spent the entirety of my six weeks there in the most fabulous nursing position I can think of, the Coronary Care Unit. Therefore, I think it is safe to say that this new placement is technically my first medical placement. The patients are quite a mixed bag but there is a certain number of chemotherapy patients amongst others, so I am relishing the new challenges this will bring me.

Along with the general fears of fitting in and making a good impression, I had the added worry of a repeat situation of last time, where a mentor was so hard on me and I felt so out of my depth that I actually questioned becoming a nurse at all.

So I went in full of smiles, note-taking and questions. I performed my duties and took some initiative, much to the pleasure of my new mentor. Things were running quite smoothly until the afternoon; it could well have been down to a combination of the pressure, a bad night’s sleep and a twelve and a-half hour shift but by the late afternoon I was feeling pretty stupid and started to worry about my competence.

Firstly, I forgot to report a BM - not a problematic one, I might add - then was corrected for nearly giving only half a prescribed dose of a medication and finally, the kicker came when I fell full-pelt over a free-standing, height measurement scale. The more things seemed to go wrong, the more stupid and embarrassed I felt, which, in turn, led me to pull away from my mentor. I did not want this to happen because I already work in a very solitary way and it is my aim to liaise better with my mentor both for patient safety and my own self-improvement. Paradoxically, the more nervous I became and the more help I needed, the more independent I became.

Perhaps I was hoping my mentor would not see how idiotic I had become over the day; at the end of the day, this is the person who has the responsibility of saying whether you are competent and will make a good nurse in the future or not.

I must admit that while on placement, I feel the presence of that giant blue signing-off book in my bag all the time.

The thought of missing any opportunity to fill its blank, white pages is horrifying and I wondered yesterday whether the staff ever see the real me. The importance of an outward appearance of confidence and knowledge is so vital to the report at the end and it seems so easy to become caught up in its significance.

Is this the way to train and become qualified, not quite paid staff, not quite free to wander and learn? How can students feel free to get to real grips with the on goings of their placement and patients if there is constantly another agenda behind the scenes?

I am sure that the outcomes are met just by working hard and using common sense, and so the book does really have the foreboding power that it appears to wield. However, it would be naive to think that it does not play a part on an everyday basis and influence the way in which we behave, in that it is slightly unnatural and guarded.

I see by my own withdrawal from my mentor in times of panic that there is a certain danger to that and it is my self-awareness and reflection that I hope will enable me to avoid this situation and become a calmer and more controlled nurse in the future.



Readers' comments (2)

  • Adam Roxby

    A brilliant and heartfelt account of what student nursing can be like. Many thanks to Clare for writing this.

    I also share your fear about the practice document. I wonder whether i'm striking the right balance between being proactive in getting it signed, or just being a pestering nuisance.

    It would be great for others to share their experiences as it is an important part of supporting your fellow students.

    Thanks once again

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  • My first piece, and possibly best piece of advice to students (and I still remember very clearly what it was like, it wasn't THAT long ago that I was one myself) is not to worry so much. Of course it is nerve racking, but remember that we understand that, or at least most of us do! Don't go on there with the attitude to impress, go on with the attitude of trying to learn as much as possible, and remember, that not every area is suitable for you, some people love A&E, or respiratory for example, others don't and prefer other areas, it is fine. We are all individual. No one is expecting you to come on to the ward and love every part of it. If you do, great. If you don't, well maybe the next placement will suit you better? Regardless, there will be something you can learn.

    I feel for the writer in this article, I have had similar days myself where everything went wrong and quite frankly I felt like a complete arse. But hey, we all make mistakes. That doesn't magically stop once you qualify. The important aspect of that is realising that no one is expecting you to be perfect, and that you do have people around to support you.

    As for that all important skills book and documents, well if your mentor isn't available and you perform a task with another Staff Nurse, ask them to sign it? You can learn from many other people on the ward other than your mentor. The most important thing to do is ASK. You are never a pestering nuisance. ASK to be shown things, ASK to do them in front of your mentor to get signed off. If for example, there are no patients on the ward who require a PEG feed (for example) but you need signing off, ask someone to take you through the procedure or offer to give a quick teaching session on it if you feel confident to show your knowledge and skill, which will help when it comes to getting signed off.

    I know some wards have a tendency to use students as unpaid HCAs, and I can speak for the majority when I say few of us minded mucking in, but don't let that deter you from telling a HCA to do certain jobs when necessary and getting in the middle of a learning opportunity when they present themselves. You are there supernumerary remember, to LEARN. The HCAs can make up a bed or whatever anytime, you may only get this one chance for this learning opportunity on this placement, take it! And if you do miss a learning opportunity, don't worry, another one will present itself. You aren't going to be expected to do everything at once!

    Also remember that the skills book is quite comprehensive, and not all of you will get the opportunity to get on placements to be able to do some of them, especially with the placement process being so random and quite frankly, crap some of the time. There are a few students who are put at a disadvantage the way things work. You can still go to your university and ask to perform some skills in a lab at uni, and get signed off by your lecturers?

    There are other opportunities open to you, and if you are willing to learn and ask questions and ask for help, there are a lot of people willing to help you.

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