It’s Week Nine of Year Three and we are finally back on campus for the first time since our OSCE exams in April! (If any current students are reading this…you will know that I personally have been on campus an awful lot – working Open Days, training Buddies, assisting with Nursing Selection Days…but probably unbeknown to you I haven’t actually had an academic reason to be here for some time!)
It’s been only three days and over the next few months I’m going to have plenty of campus based study to write about so for this blog I’m going to focus instead on everything you’ve ever dreamt of knowing about Clinical Placements which make up a whopping 50% of our course! (Please note all information stated in this blog is correct as experienced in the September 2016 cohort entry to the Child Nursing Programme and may be subject to change). Below you’ll find three sections – a breakdown of placement experiences, answers to frequently asked questions about placements and a short summary of my most recent placement experience on Neonatal Intensive Care. Read as little or as much as is useful or interesting to you!
BSc Child Nursing Placement Experiences
Throughout the three years – BSc Child Nursing students undertake 10 placement blocks. In Year One you are offered two six week placements – half spent Health Visiting or in Nurseries and the other half spent on a general children’s ward.
Year Two brings more variety and complexity with five placement blocks:
- Ward – Another general Children’s Ward placement – similar to first year but allocations will try to vary your experience with the types of Ward you are allocated
- Acute – One from either Accident & Emergency/Theatres/Paediatric Intensive Care Unit (PICU) or Neonatal Intensive Care Unit (NICU)
- Specialist – Can include Mental Health settings, Nurse Specialists, Research Nursing, Children’s Community Nursing Teams or even Private settings
- Schools – Either School Nursing or a placement within a Special Educational Needs (SEN) School
- Elective – is completely down to you! Either a full four weeks or two weeks topped up by a University based project – you plan and undertake your own placement OUTSIDE of the Universities partner Trusts. Some undertake Electives abroad through approved charities – others find Trusts elsewhere in London or the UK, often seeking a speciality of interest to them. Some students even choose to spend time with other professionals e.g. paramedics or social workers.
Year Three kick starts with two four week placements – one on the Ward and one further Acute and finishes with one massive thirteen week block; your final management placement.
Answers to Frequently Asked Questions (Placements)
What will you need for placement? Three sets of uniform (tunics and trousers) were supplied to us by the University at the start of the course. Helpfully they have a Uniform Fitting session which means you know you are taking away the right size. Further uniform is also available for purchase through the suppliers. Shoes you have to sort yourself but it is better to wait until you are on the course for two key reasons. One, Universities and Trusts have differing Uniform policies – what one University deems suitable footwear may not be appropriate elsewhere – so you should always first consult the Uniform Policy. Two, once you are a Registered Student you benefit from lots of rather handy Student Discounts that may make this shopping trip less costly! You will also require a fob watch – as Nurses we have to work “bare below the elbow” to ensure good hand hygiene so you won’t be able to wear your watch. Fob watches are cheap but also are often included in goodie bags when you sign up to the Royal College of Nursing/Unison.
How are placements allocated?
The Placement Allocations team arrange all our placement experiences aside from your aforementioned Elective. As Child Nursing Students we move between Trusts and Boroughs experiencing a wide range of services. The team take into account your London Term Time address and travel routes to the available areas and always try to keep travel time within 1 hour 30 minutes each way where possible. They also aim to offer a wide range of placement experiences to ensure you are afforded good opportunities to cover the full assessed skill set across the year. We are able to put forward preferences where there is a particular area of interest to us and final management placement is allocated from four area preferences and a small comments section made available at the start of third year. Generally the team aim to upload our placement allocation four weeks before the start of a placement – from there it’s up to us to make contact, obtain our rota and prepare ourselves for our new allocation.
How are students supported on placements?
We have a variety of support available to us during Clinical Placements. Every Placement area has an Academic Staff Member allocated as a contact – known as a “Link Lecturer” they will often visit or provide drop-in sessions during the placement blocks to check in with you. Most teaching hospitals additionally have a “Practice Education Facilitator” – a Nurse in charge of Pre-Registration Education on site who will make themselves known to you. Whilst on placement the area will assign you a Nurse Mentor who will co-ordinate your learning but to get the best out of a placement area you can also enjoy time working with other clinical staff members (only 40% of your placement time needs to be undertaken with your allocated mentor).
How do students learn on placement?
As well as working under supervision of Nurses to achieve assessed skills and gain feedback on your clinical practice, you can also arrange time with other professionals and in other related link areas. For example, on my Health Visiting Placement I spent time with the GP, Practice Nurse, Community Midwife, Community Pharmacist, Dietician, and Social Prescriber. I even took time out to attend a Breastfeeding Workshop and the Diabetes Education Service to broaden my community experience and learning. I was then afforded the opportunity to feedback my learning to my Health Visiting mentor which helped update her own breastfeeding advice to the current protocol.
Whilst you have defined skills to achieve each year, there is also space to input personal learning objectives. As a student you are “supernumerary” which means you don’t count in the staff numbers – make the most of this freedom and explore opportunities across the Multi-Disciplinary team.
How do you prepare for a placement?
With four weeks ahead of a placement it’s wise to put in a little pre-reading ahead of your placement. When I make contact with a placement area for the first time, I always make sure to confirm Uniform Policy (where we are not required to wear the City Uniform) and ask if there is any reading they can recommend. Lots of placement areas now provide Student Induction Packs which are made available to us online or can be sent across by e-mail. These often include common conditions, procedures and medications we might expect to come across – enabling us to read ahead and attend placement well versed in the basics.
Can I work alongside the course?
A very common question that often occurs when I talk about placements is whether we can undertake paid work alongside the course. Our placement experiences are expected to cover a full 24/7 picture of care (including weekends and nights!) Hours vary from 12.5 hour rotational shifts 3 or 4 days a week to 8 hour weekdays.
The University asks that you undertake no more than 48 hours of work in any seven day period (including placement and any paid/unpaid work hours). So 12.5 x 4 = no paid work that week!
Plenty of students, myself included manage to upkeep paid work alongside their course! In London there are plenty of opportunities to work ad-hoc either for the University or for Hospitality events and other agencies – where you simply sign up to work only the events you are available for.
If you have no prior HCA (Health Care Assistant) experience you can also join the Staff Bank after successful completion of First Year. This is often good pay and also helps contribute to building your clinical skills. Many students come to the course with prior HCA experience which they upkeep on the Bank or transfer to a local Trust Bank.
Life on Placement: Neonatal Intensive Care Unit (Acute)
I have just completed a four week Acute Placement on a busy Level Three Neonatal Intensive Care Unit – Level Three means they take some of the smallest and critically unwell babies in London (and often from settings outside of London too!)
Neonatal Intensive Care Nurses undertake further Postgraduate Training – attending University Part Time to work in this specialist environment which meant that in comparison to the Wards I had to work under closer supervision than I had maybe grown used to – taking my own caseload of patients in Year Two.
I was provided with a question booklet that included researching common conditions of prematurity that I might see on the unit, developing a care plan for a term baby and drug calculation practice. In Neonatal medicine, drug dosages are often astonishingly small in comparison – so it is important to refine your calculation skills and learn how to convert between milligrams, micrograms and nanograms.
I received teaching from the Doctors through Clinical Simulation sessions and from the Breastfeeding Specialist Nurse – I can now confidently teach a new mum to breastfeed!
The Trust also ran scheduled teaching sessions available for all Student Nurses to attend through their dedicated Education Centre – I was on shift and attended a Chaplain led session on managing bereavement.
I was able to develop my clinical skills – performing heel prick tests for blood spots and capillary gas/glucose testing. I passed Nasogastric feeding tubes and fed via bottle and Nasogastric tube. I learnt how to suction an endotracheal tube and how to understand ventilator settings. I also learnt the checking process for blood products for transfusion and the extra observations needed during transfusion therapy.
In Year Two our pathophysiology module teaches us the basics of Neonatology – covering common conditions of both the term and preterm neonate – Jaundice, Necrotising Enterocolitis, Respiratory Distress Syndrome and Patent Ductus Arteriosus. I was able to observe and assist care for babies with these conditions first hand.
I saw new admissions straight from Obstetric Theatres and Delivery Suite through to long term patients finally discharged home with Mum and Dad. I reassured, helped take family photos, explained procedures and helped new parents out.
I was able to undertake my annual assessed “Episode of Care” on this placement – leading the care of two HDU (High Dependency Unit) babies across a shift. I had to liaise with Doctors, Pharmacists, Speech and Language Therapists. I was communicating changes and delegating task to my Mentor throughout the shift and had to deliver both written notes and a verbal handover to the Night Shift Nurse at the end of my shift. I had to write up my own reflections on this experience before receiving written feedback on my performance from my mentor.
Importantly, I was dreading this placement. I did not feel confident, I was concerned about the complexity of the care offered in this environment and having predominantly worked with older children and teenagers prior to the course I have never really considered myself a baby fan. This placement turned all of that around (much to the concern of my boyfriend who prefers his grand ideas of road tripping the USA and selecting a cute Labrador to me deciding babies are my thing). I enjoyed the autonomy with which Intensive Care Nurses work – and experiencing the varied roles available for career progression within the unit. I enjoyed experiencing the varied levels of care and working with a huge range of professionals. I experienced exceptional family centred care from teaching and supporting new parents to supplying cute little memory boxes containing knitted gifts from kind donors in the community. I was also excited to see the amount of research that was active within the department. As a former A Level Science nerd, research is something I am keen to explore throughout my nursing career and the relatively new and exciting specialism of Neonates affords a great deal of opportunity to become research active.
And that’s me for October! I’m off to spend a little me time trying to teach myself to knit on YouTube so that one day I might knit teeny, tiny bobble hats for preemies! Too cute!