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On placement during a period of extreme strain for the NHS it pays to be adaptable and take your chances to learn
The first placement of the second year of my nursing degree was on a children’s day care unit at my local hospital, which cares for children and young people coming in for surgical procedures or medical investigations.
Nursing Standard. 36, 9, 43-44. doi: 10.7748/ns.36.9.43.s19
Published: 01 September 2021
This was also the first clinical placement of my training so far, so I was slightly apprehensive. Second-year students are expected to participate in care-giving rather than just observing, and my lack of experience in the clinical setting made me nervous.
However, I couldn’t wait to finally put some of the theory I had learned into practice. Even the best constructed case scenarios or simulations are no match for what happens in clinical settings and you cannot become a nurse without seeing real patients.
My placement was allocated last December but, by the time Christmas was over, the COVID-19 pandemic had taken a turn for the worse and infection rates and deaths were increasing at an alarming pace.
The new variant was spreading rapidly in our region. Hospitals were struggling with the huge increase in the number of patients with COVID-19 and intensive care units were becoming overwhelmed.
With services suspended, theatres turning into critical care units and staff being redeployed, students were moved from one place to another in search of a suitable placement.
Placements for my cohort kept changing from COVID green zones to red zones but luckily the vaccine was being rolled out at this time and was offered to students as we are front-line healthcare workers.
Despite some initial hesitancy about the vaccine, our worries about infecting loved ones and vulnerable patients with a deadly virus meant that many of us were ready and willing to be jabbed.
‘This placement was ideal because it taught me about the fundamentals of patient care, which I can now build on and take to my next placement’
I received the two doses of the vaccination before I started my placement, which made me feel much safer and protected – not just for myself but for everybody around me.
Due to the rising pressures on the adult side, most routine paediatric surgeries had been cancelled. Theatre staff were moved to critical care areas and only urgent procedures were being carried out.
On the day I started my placement in January, staff on the children’s day care unit were told that they would have to move out of their area temporarily and operate from other departments in the hospital.
Some staff on the unit had to be redeployed to other settings, including my practice supervisors, but I was allowed to stay on the unit with the nurses allocated to deliver a skeleton service.
Being on a children’s day care unit when patients with COVID-19 were filling up adult intensive care units was like being in a different world; the unit is normally full but the service was significantly reduced during my nine-week placement.
Respiratory viruses, which are common in the paediatric population in winter months, did not materialise to their full extent due to social distancing, extra hygiene measures and the closure of childcare facilities.
As a result, the unit was not as hectic as it would have been in a typical winter season, so I had to grab every available chance to learn. But the team I was working with was welcoming and supportive, and I learned a lot from their extensive knowledge and experience.
When I started my placement, I had zero confidence. I did not know how to approach patients, take observations or fill in the perioperative care pathway. By the time my placement ended, I could do all of this with a degree of confidence.
Be motivated and proactive in your learning Look out for opportunities and be ready to take on new challenges – but be mindful of not overstepping your competencies. Nobody is going to push you into doing things you are not confident with but they will be impressed if you embrace new challenges within your limits
Have confidence in your own decision-making abilities However, always escalate concerns and double-check anything you are unsure of with senior colleagues
Keep a reflective diary I make an entry after every shift, writing about what I did and how it went. This helps me to reflect on my experiences and prompts me to look up any conditions or procedures I am unfamiliar with. It also helps prepare me for when I need to revalidate in the future
Take your breaks You are only human and do not have to be a hero, so make sure you eat, stay hydrated and look after yourself – no one wants you fainting on a patient because you have not had anything to eat or drink all day. Taking care of yourself will also strengthen your emotional and physical resilience, which is so important in this job
Note your feelings Are you looking forward to your placement? Are you enjoying yourself when on shift? You might be in an area which is not totally your cup of tea but it is important to get the most out of every placement and enjoy caring for patients
Prepare to be flexible Not all placement areas will be able to accommodate your personal commitments, such as childcare needs, so try and be as flexible as possible. This will be appreciated by staff, especially if they have quite a few students to fit into rotas and match up with practice supervisors and assessors
This placement was ideal because it taught me about the fundamentals of patient care, which I can now build on and take to my next placement.
It also showed me that I have chosen the right career; I loved looking after patients and their families and making their journey with us as pleasant and welcoming as possible.
Any doubts I had about becoming a children’s nurse have completely dissipated.
My passion for children’s nursing was mirrored by all the nurses around me and I have yet to meet a children’s nurse who does not love their job.
It is a privilege and an honour to deliver person-centred care to children, young people and their families. I will be so happy when I finally get to do this as a registered children’s nurse.
First placement: it can be daunting, but a rich learning experience too rcni.com/first-placement