Many students arrive at The Psychology and Challenging Needs Services, a specialist assessment and intervention service working with adults with learning disabilities and challenging behaviour in Surrey, with a sense of apprehension.
“It can be the first time many of them have encountered challenging behaviour – particularly those students who are not in learning disability but from the other fields of nursing,” says Padraic Costello, lead nurse at the New Malden-based service.
“The first thing we do is reassure them that they will be safe and secure, and they will not be placed in a dangerous situation. We start by inviting prospective placements into the environment before they start to meet all of the team – nurses and other healthcare professionals - and tell them that we will do everything to keep them safe and make them feel included. That is one of the key things we emphasise while they are in our environment. We like to give them some idea of what they will get in 4, 8 or 17 weeks and set the scene of what they can expect,” he says.
Despite the perceptions, the environment is such an excellent one for learning that it has transformed students’ views of learning disability nursing.
“One adult field student described her experience as ‘an eye opener’, and is now considering moving to learning disability nursing,” says Mr Costello.
He says this gives him a massive sense of pride, able to champion learning disability nursing as well as the success of the four-strong nursing team at The Psychology and Challenging Needs Service which is a service within Your Healthcare, the NHS community provider for Kingston upon Thames and for people with learning disabilities in Richmond.
“We used to only take learning disability students but now we take other disciplinary students because we want to encourage them to think about how people with learning disabilities have strengths rather than deficits,” says Mr Costello. “And we teach them that a lot of skills they will learn here are transferable. True, you will see more A&P in acute nursing placements, but we have more emphasis on sociology, psychology and other core skills.”
The team has hosted students for 10 years, and has consistently received positive feedback.
“I think that’s because we try to make them feel welcome, and like they won’t be isolated while they are here,” says Mr Costello. “We all remember what it was like to be a student, and we don’t want them to feel isolated.”
Avoiding this feeling is about preparation, according to the Your Healthcare team.
The team has prepared a 40-item welcome pack, which details 16 learning opportunities students can see “at a glance”.
They don’t just wait until the student arrives to discuss the pack - they constantly strive to improve it, and even since the judging in April, they have added four more items in four months.
“We constantly review it to see if we need to take things out and put things in,” says Mr Costello.
This sense of organisation and intense preparation before the student arrives makes the student feel valued.
The team works collaboratively with service users, families and other professionals involved in the care of the individuals and gives students many opportunities to contribute to their learning and witness the promotion of good practice.
One student who provided a testimonial about her placement at The Psychology and Challenging Needs Service for the Student Nursing Times Awards judging panel said that she felt valued by the team and able to contribute. “Throughout this placement I feel I excelled more so than any other placement and this was due to the support and constant encouragement I received,” she said.
This feeling of inclusiveness starts by giving students control of their own electronic diaries, with mentors setting up draft outreach visits, appointment and meetings so students can start participating in, assessing and co-ordinating health action plans for the service user as soon as they start, as well as being involved in multi-disciplinary team meetings.
“We try not to confine them to their immediate locality but try and expose them to other settings, such as the organisations clinical governance and medicines management meetings,” says Mr Costello.
Weekly supervision is structured, so the student receives sufficient time with their mentors. The placement practises co-mentorship to ensure the student always has objective feedback and plenty of pastoral support. “Having two identified mentors enables us to get double confirmation of how the student is performing and on how to help their development,” says Mr Costello.
At the start of the placement the mentors discuss with the student any previous experience, any specialist interests and any specific areas for development so they can tailor the approach and programme to best suit the student.
“We also share our careers and experience with them because we think it is important to tell the student what we have done and think contributing our experience helps to develop the relationship,” says Mr Costello.
And he sees it as a two-way street. “We give them positive continuous assessment and we always seek feedback from all students to help us develop as mentors.”
He says the team takes pride from their annual education audit, and the fact that they have all taught at the faculty. “How we’ve performed as mentors is important to us,” says Mr Costello.
“We never lose sight of the fact that we were students once, and treat them how we would want to be treated.”
Tips for providing a great placement
- Create a welcome pack and constantly review it with students’ feedback
- Give students their own diary and set up draft appointments before they start to make them feel instantly included
- Tailor the learning experience to suit the student’s strengths and areas they need to develop
- Give students their own space and in-tray so they feel like part of the team
- Set up co-mentorship so that you get a double confirmation and objective view of their performance
- Speak to students about your own career and experience to help deepen the relationship and build trust