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PLACEMENT EXPERIENCES

When a placement takes you by surprise: my first community nursing experience

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Before I started my community placement I was not excited. My placement was with a city team, covering seven GP surgeries and I was expecting a slow paced day spent mainly dealing with leg ulcers.

Callum Metcalfe_SNT

Callum Metcalfe is a second year student nurse studying Adult nursing at University of East Anglia

But I was pleasantly surprised by how many procedures the team undertook every day and the amount of clinical knowledge I gained in a short space of time.

The team’s enthusiasm to work with students made it clear how much knowledge underpinned their practice and I felt appreciated and comfortable from the very start.

After just one day of community visits, I knew this was an area of nursing I would be passionate about.

Recently, emphasis has been placed on integrating primary care into undergraduate nursing programmes. This is not just because of the learning opportunities available, such as wound dressings and clinical decision making, but also to help students learn about this area so they can ensure smooth discharge when handing over care to the community team.

The concept of independent practice can be daunting for student nurses. But over the weeks of community placements I found this constantly changing and developing area of nursing fascinating and soon forgot my initial anxieties.

Over the weeks, I felt my confidence rising, especially in regards to wound care. With the NMC placing basic wound care on the essential skills cluster, I was keen to develop my clinical knowledge.

Leg ulcer treatment and management was particularly fascinating and I can see this being a part of my future career, as getting this area of care right can have huge social and psychological implications on patients’ health and wellbeing.

I started the placement using my mentor for support on all aspects of clinical knowledge. But, before long, my mentor allowed me to develop my confidence by enlisting me with own small caseload. By the end of the placement I found I was using my own clinical decision making skills to help patients.

The trust and belief instilled into me by my mentor and the team will always be remembered.

During the placement, I developed a tool to help student nurses assess wounds.

 

Callum Metcalfe is a second year student nurse studying Adult nursing at University of East Anglia

 

W - What, where and when

What type of wound is it? Is it a skin tear, pressure ulcer, venous or arterial ulcer? Where is the wound located? How long has the wound been present? How did it occur?

O - Observation

What is the length, width, depth, colour and odour of the wound? Is there any exudate? If so, how much is there? If a skin tear, is there much bleeding present? If pressure ulcer, what grade/type? If a leg ulcer, is there any leaking present?

U - Underlying pathology

Is there any underlying disease that could affect the healing of the wound, such as diabetes, hypertension, peripheral vascular disease, smoking etc?

N - Nursing perspective

Have you undertaken a holistic assessment, including nutrition, mobility, psychological health? Do you need to make any referrals to specialist services such as diabetes specialist, podiatry, leg ulcer clinic?

D - Dressing

What dressing is needed for the wound? Has the care plan been updated? Are there enough dressings for the next visit? 

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