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What to do when you're feeling like a spare part

  • 19 Comments

Think you have little do while on placement? Think again …

One of the biggest concerns students have on their placement is being at a loose end.

“I feel like a spare part”, “I don’t know what to do,”, “I am standing around with my hands in my pockets” and “I don’t want to look like I haven’t any work” are some of the many anxieties we hear from students about placements.

So what do you do when you haven’t got a specific task or duty to perform? Mark Hillier, lecturer in nursing at Leeds Metropolitan University, says that’s easy – talk to patients.

“Student nurses often seem to think that unless they are physically doing a test or a task, they are not doing anything. But talking to patients is a hugely important part of therapy and will help patient recovery,” he says.

Leeds Metropolitan University’s Head of school of health and community studies Sue Sherwin agrees. “If there are patients, there’s work to be done,” she says. “Students shouldn’t underestimate how important it is for patients to talk about their hobbies, their families and their lives. Talking about their lives outside of their mental illness or long-term condition can really be a valuable part of wellbeing and promote hope. They can feel a person away from the diabetes or asthma. Students should not underestimate the importance of chatting to patients about things other than their condition or illness.”

Mr Hillier agrees. “When they are on placement, students have a rare opportunity to chat to patients, who can teach them a lot. A lot of qualified nurses would love to be able to have more time for that,” he says. “Work on your art of conversation skills and hone your talents at talking to patients and finding out about them.”

You should learn how to ask open questions – those that begin with who, what, where, when, how and why – which will be an important lifeskill as well as helping you construct dialogue with patients that is useful throughout your career. Note what works and what doesn’t with patients – what makes them feel more open to you and how your tone and body language affects their responsiveness.

Ms Sherwin says you can learn a lot from this aspect of the placement. “I hear this recurrent theme of students coming back and saying they have nothing to do. I say to them: ‘How many patients were on the ward or did you meet today?’. There’s always work to do while you have patients.”

Even without patients, Mr Hillier says you can fill your time by thinking laterally. “If you’re on an orthopaedic ward, do some reading around hip replacements. You can always find something that is relevant and meaningful to do on placement.”

  • 19 Comments

Readers' comments (19)

  • talking to patients on a ward is seen as idling as much as one wishes to learn more about them, to build up therapeutic relationships and trust, and as much as one feels it will benefit the patient. sticking your nose into a book to get vital information is seen in the same light and both of these circumstances you will always be found some menial and non urgent task such as clearning bedpans or cupboards, etc. which could easily wait and which in no way enhances learning like any human encounter or information seeking.

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  • Excellent and common sense though Mr Hillier's suggestions are purely theoretically and he is clearly very out of touch with the reality of working on a hospital ward! This is why the remarks in the above article were probably made by the students in the first place - any more helpful tips as what to do on the ward when at a loose end except to be seen working hard clearning or doing some other menial task? It can be quite difficult trying to make yourself look busy, and is mentally very trying, when you really do feel, or are made to feel like a spare part and in the waym by those who may suffer from an over-inflated sense of self importance!

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  • Little One

    I must say though, just to put across a positive side after so many students (including myself) commenting on how talking to patients is viewed as idling, which in many cases it is, whilst on placement in a community hospital I started talking to a wonderful lady called 'Maggie'. Maggie had recently had a hip replacement and was struggling to get motivated and mobilise, as coupled with her arthritis, she was finding it painful and difficult.

    After spending time with her she showed me pictures of her little dog Beau. Beau was a gorgeous little old dog with a few scars of his own and Maggie had not been anywhere without him for years, she had never been in hospital overnight before her hip replacement and missed him and her husband terribly. I was able to arrange for Maggie's husband to bring Beau to the hospital, and into the day room so she could see him and spend some time with him. I arranged with her husband that Beau would come to visit every day with him and within two weeks I had her outside, walking across the little patch of grass with her husband and her Beau. It was a wonderful thing to see and I think that her progress and rehabilitation would have been a lot slower were it not for the information that I was able to gain from speaking to her and spending the time encouraging her. It was a wonderful thing and I'm glad that something so small as talking to my patient made such a difference. On a selfish note, it was wonderful to have such a lovely connection with my patient, she was clever, funny and intelligent, and it was enjoyable getting to know her. She always gave me a hug at the end of the shift and made me feel like I was doing a good job.

    I had so many good experiences within my community hospital, especially with Maggie and the two other ladies in her bay. I deliberately asked to care for them every day when I was working to provide them with continuity but also so that I could build a relationship and talk to them.

    Another instance included Maud, a lovely 96 year old lady in the bed next to Maggie, also recovering from a hip replacement. She had her own clothes that she was able to wear and put on without assistance in her wardrobe by the door to the bay, but no one had bothered to listen to her, or check whether she had any, so subjected her to wearing a hospital nightie every day for a week. It had been handed over that Maud needed a pad and net pants as she was incontinent. After speaking to Maud it turned out that she wasn't fully incontinent, she was just so embarrassed of walking across the bay to the toilet using her walker because she couldn't hold her nightie closed. Needless to say that within 10 minutes not only was Maud wearing her own tracksuit (that she put on herself with no assistance from me) but I had also rustled up a pair of socks and found her trainers so that she could walk unassisted to and from the bathroom without having to worry. It's lovely to see what big changes can come about from talking to your patients.

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  • Little One | 10-Jan-2012 11:09 pm

    we need far more nurses with this attitude and those who understand and can care for the elderly.

    all the very best of luck with finding a job, you seem to well deserve one.

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  • Little One

    Anonymous | 10-Jan-2012 11:28 pm

    Thank you so much, if there were still specialist Geriatric wards it would be where I wanted to work when I was qualified but unfortunately our hospital no longer has any. Hopefully when I qualify I can take all my good experiences and carry on wherever I end up working.

    Only 5 months until starting to apply for jobs, fingers and toes crossed!

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  • As a nursing student on her last placement. I have to say I have learnt the most from mucking in with the hca assistants and helping with cleaning etc, it has made me seem keen and feel involved in the team meaning the nurses got good feedback about me from the hca. This meant they knew I was keen to learn and meant I got on well with the nurses too which means I could then approach them if I had questions or something I wanted to get involved in. One bit of advice I got early on was to always look busy or ask what needs to be done.
    One placement I got I didn't have a permenant mentor and was left to my own devices but if I saw a opportunity to do something I asked and made sure the nurses on that day knew there was something I wanted to do.
    I want to be hands on with patients as much as I can when I qualify and without doing these things on placement I'd never have the confidence and assessment skills that I have developed. One day while washing a patient I noticed she had a swollen leg , I informed the dr and turns out she had a Dvt, without what I had learnt about assessing patients I may never have noticed this or had the confidence to report to a dr.
    If not busy I see nothing wrong with saying to a nurse that you are going to talk to patients say you need to develop communication skills which is part of the nmc requirements. The nurse will probably be happy enough if there is nothing else to do.
    Enjoy being a student and grasp every learning opportunity

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  • Hi I am currently doing my last management placement on a medical ward and absolutely love it. I agree with some of the messages by other students; that sometimes you feel like a spare part. I have worked for 15 years in the community as a support worker and one of my greatest strengths is chatting to my clients, I also listened ALWAYS!! I totally agree with the lovely story about the patient spoke of above Maggie and her dog Beau, I found the story really touching. And do agree that the information you gain from communicating is VITAL. I never get bored of chatting to patients I learn from them all the time, they are valuable to me as a student, if it wasn't for all the lovely patients that I have cared for on the ward I very much doubt I would of lasted. As the mentoring is not all that it should be, this I have found on many placements.

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  • I am about to start adult nursing degree on Monday. As far as I am concerned, how on earth can you be a good nurse, without knowing the basics? I am more than happy to wash pans, change beds, sweep floors hell, I'll even polish the sisters shoes if it means getting the correct knowledge to do the job I've dreamed of for years. I am 41 yrs old, this is a life change for me. Bring the soggy bedsheets on, I say, I'll have them whipped off and changed in no time :)

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  • Johnathan Crane

    Starting in year one of Mental Health nursing this month, I couldn't be more delighted! Having worked as an HCA for 11 years, talking to patients when nothing else needs doing just seems like common sense to me. It's the fastest and best way to make a good impression on the ward, in my opinion.
    Sadly, this opinion has not always been shared by my colleagues. I have often spent time chatting to an aphasic patient who is capable of expressing themself through nods and headshakes, only to be told that they 'couldn't understand anything' and that any choices or opinions I got from them were 'nonsense' - this to me seems like the very opposite of person-centred care.
    I've worked hard to get to Uni, and consider my communication skills to be a part of my success. Doing as suggested by this article would come naturally to me. I'm not looking forward to having to say that on a placement, but say it I will. Clean sluices are important, but they are much less important than happy patients.

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