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Student Reflections on Placement

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Student Day in the Life – Paediatric Burns assessment unit and day-case trauma/plastics/burns surgery

Amy – 3rd Year – Nursing (Child)

6.45: Arrive at hospital and park up, walk into the ward, get changed into uniform.

7.00: Meet for handover, check in with my supervisor, and plan for the day.

7.30: Elective day case patients arrive, I have a 14-year-old dental patient to admit. I take their height and weight as well as complete a set of baseline observations. With the patient and their parent, I complete the relevant paperwork, get them situated on the ward, and answer any questions they have. Once I have finished an anesthetist and surgeon arrive to complete their paperwork and I observe these interactions. I check in with the play lead about any support they can provide.

9.00: Trauma and burns patients arrive following a negative COVID-19 swab and I help to admit another patient.

10.30: Coffee break in the staff room

11.00: I help take patients to theatres, providing a distraction to the child as they are cannulated as well as support to parents afterward and heading back to the ward. Once patients have been taken to recovery, I help take parents to them and then assist with bringing patients back to the ward when needed. Once patients have returned to the ward, I complete a set of observations, offer suitable food, and drink and complete any relevant paperwork. Once a patient has been discharged, I help to clear their bed space and prepare it for the next patient.

14.00: Lunchtime.

15.00: I am spending the afternoon in the pediatric assessment unit as there are a lot of appointments and no afternoon patients on the ward. I check in with the nurses working here and assist with the clinical holding of a burns patient who has returned for re-dressing.

16.00: Assist with a burn assessment in the pediatric assessment unit. A 3rd old child has a hot tea burn to their shoulder and arm from pulling down a cup of tea in the kitchen. I help to remove the dressing applied at A&E, clean the wound, and apply suitable dressing. Give burns care advice and book in for a follow-up. Once patient and parent have left, help clean down the room, re-stock supplies and write up notes.

18.30: I check in with the ward staff and hand over anything that needs to be included for the night staff. I also check in with my supervisor to ensure that everything has been double signed off in my paperwork and discuss how my day has been.

19.30: It’s the end of the shift.

 

Student Reflections – Adult Nursing – Cardiology Placement

Charlotte – 3rd Year – Nursing (Adult)

I am based on a medical cardiology ward, treating patients with a variety of cardiac conditions from heart failure exacerbation to ACS. A day starts at 07:30 with a comprehensive handover from the night team, highlighting any patients that have high NEWS, are awaiting procedures, or are going home. Then, the day can take any number of turns from there!

The team is incredible, supporting me through learning an absolute multitude of abbreviations and medical jargon – Tavis, and STEMIs, and AS, and BAVs – and carefully explaining procedures and conditions to me. The first couple of weeks involved shadowing my practice supervisor, getting used to the medications and what they were used for, and trying to figure out what the squiggles on the cardiac monitor meant. My practice supervisor had just done a master’s module in ECG interpretation, and at the beginning of every shift we reviewed one of our patient’s ECGs to understand if there had been any changes, and so I could begin to get an insight into how you decipher them! Then, when I felt comfortable, I was given my ‘own’ patients to look after – starting with one, and working up to a whole bay, with my practice supervisor acting as HCA, and generally making sure I was doing the right things. It gave me incredible confidence in my own abilities, and I often left for the day knowing that I had made a difference to patient care, and also massively advanced my learning.

Some days involved discharges and admissions, while some days involved supporting patients arriving back from procedures called Angiograms. Agios can be diagnostic, or what’s known as a +/- – where stents can be placed in occluded coronary arteries – and involves a catheter being threaded through the radial artery to the heart, with a contrast dye injected to look for blockages. One of the spokes for this placement area is the Cath labs, where these procedures are carried out, and you’re able to see the procedure, have it fully explained to you, and follow the patient journey. You then follow your patient back to the ward for recovery care.

We also had days of unpredictability, with patients deteriorating, high NEWS scores, and MET calls. It is an acute area, with patients that can be unstable, or need transferring to higher dependency areas, or even having unrelated conditions develop. One shift, one of our patients developed sepsis and deteriorated very quickly. As this patient was elderly, they didn’t display the classic high temperature, and if the respiration rate had not been counted correctly, and escalated, it could have been easily missed, or mistaken for something else. For me, this highlighted how well nursing teams know their patients, and know something is wrong. We realised they were not themselves, and escalated to the appropriate teams, creating a chain reaction that got our patients the treatment they needed very quickly.

It is impossible to put into words how much I learned on this placement, and how much is transferrable to other clinical areas. I have become more confident in escalating my concerns, in applying pathophysiology, in meds management, and in myself as a nearly third-year student nurse. My advice to you, if you get any cardiac placement, or with any placement at all, is to get involved as much as you can, soak it in, and make it known that you want to learn everything and anything – don’t be afraid to ask things, you deserve to be there. Oh, and maybe take a notebook.

 

Student Reflections – Mental Health Nursing – CAMHS Placement

Steph – 3rd Year – Nursing (Mental Health)

I’m writing this as a year 3 mental health nursing student two months from qualifying, reflecting on first placement of my second year.

Before I came to CAMHS I had many preconceptions, mainly from news articles and social media posts on their lacking compassion and care. I was nervous to start because I had (and still have) so much passion for child mental health services (CAMHS) and I didn’t want to become one of these “uncaring CAMHS professionals” (which there are none of, and I explain this later on in the blog).

Everything I had learned so far in the 2 years of my mental health nursing degree revolved around adult nursing. From blood pressure and other vital normal ranges to symptoms of mental health conditions, were only relevant when concerning adults. After a lengthy induction and getting to know the team, I assisted with the ADHD clinic. I was asked to use the automatic blood pressure machine in the clinic room and seeing the measurement of 95/55 felt alarming, but I was reassured that this was healthy for a child of this age. From the first clinic, I realised how lacking I was in knowledge of this age group and how it isn’t always discussed on the course.

As a student the biggest part of our role (especially in the first and start of second year) is to observe, and in this placement, I manage to observe so many positive aspects from this team, I was privileged to watch children recover from some mental conditions, witnessing families become more functional and even became a part of others recovery.

Reflecting back, the reason I’m deciding to pursue a career with children is the constant technique changes to keep a child engaging. It’s looking after families holistically rather than one person as a patient. I found that there was a lot of anger in the media and from the public towards CAMHS as a service due to the increase of children’s poor mental health and lack of resources. Working from the inside I watched specialised nurses burn out from putting their all into their work, I witnessed their dedication and passion to helping every child overcome their mental health issues, but there was no reward in the media for this, no excitement for every child they managed to keep safe, no acknowledgment for the times they stayed past 5 to talk with a family, or even a round of applause for the workload that toppled over into their personal time and family lives.

I did wonder for a while why nurses went into the service when most of the feedback in the public eye was and still mostly is negative until I met a young girl, she had suffered massively with her mental health without going into details, after months of visits and treatment alongside family therapy this girl who never smiled, began to do just that. She would laugh in sessions and talk about future plans; she became full of life again. That feeling you get when you’ve put time into a person and you see the glimpse of hope and recovery, nothing compares to it. That’s why these nurses continue on through the negativity because seeing a child and their family go from helpless to enjoying life is worth everything else that comes along with the job title.

This is not to say the frustration and anger from the public are not just, but I believe the energy is being poured into the wrong place, these nurses, psychologists, psychiatrists, and carers all care deeply for children’s mental health, but when there is lacking of resources, lacking teams and lacking capacity it all stems down to the funding, and that is where the energy should be placed, to gain more funding to make the services fitter for practice without every nurse burning out.

I’ve now in my final placement, worked with every age group, from children to the elderly, and although in every placement I put my all and every team has been welcoming and just as caring as the last. Nurses in all domains are doing amazing jobs, and the passion that shines through I’m always in awe of, but I’ve never felt more at home and more thriving than when I was working in CAMHS.

 

Student Reflections – Adult Nursing – Surgery Placement

Rebecca – 2nd Year – Nursing (Adult)

Walking into a hospital for the first time is one of the most overwhelming yet amazing experiences of being a nursing student. That feeling doesn’t change even on my second placement of the second year. As a student, you will have gained so much knowledge during your first 2 years that you know how to approach each new placement with confidence. It always takes some time to adjust but once you do, everything is familiar, and you feel as though you are a part of the team.

I am currently on a placement at a private surgery placement. The shifts are 12 hours and the day starts off with handover, which is one of the most important parts of the day. Handover provides all the relevant information for patients who have stayed overnight and information about the patients having surgeries that day. Throughout the day you are assigned with a nurse, and about 4 patients.

The day consists of medication management specifically towards post-operative care: pain, nausea management, washing, and any relevant personal care, taking observations, and other monitoring. For example, if a patient has an epidural, they have regular checks, as well as wound care/dressing changes and documentation.

Each day is different and you are faced with a wide variety of patients, personalities, and problems. Having the same patients gives a lot of time to get to know them, something they don’t tell you is by the end of the second year you will have mastered small talk.

As a student on a surgical placement, you have the opportunity to not only spend time with patients and the nurse, but to watch surgeries, small procedures, and scans. This has been fascinating and a completely new experience, seeing someone having a knee replacement is something you will never forget.

The most rewarding part is going home knowing you made a difference to a patient’s day, even if it’s only small, those days are the best.

Finally, your placements will be part of the nursing course that will prepare you the most for working while also being the biggest step forward in building your confidence, expanding your knowledge, and giving you the experience you need for practice.

Good luck!

 

Student Reflections – Mental Health Nursing – CAMHS Placement

Elisa – 3rd Year – Nursing (Mental Health)

My current management placement is at a CAMHS (Child and adolescent mental health) in-patient unit. The struggles and diagnoses our patients currently present with are psychosis, self-harm, anxiety, neurodivergence, eating disorders, and depression.

It’s hard to describe a day as it varies so much as we journey through the highs and lows with our patients. However, from a nursing point of view, the day starts with allocating the shift, dispensing medication, and discussing with the wider MDT patient needs. Working in CAMHS you are in close contact with social workers, education, parents, and carers. The range of patient struggles alongside normal teenage hormonal changes can be an intricate process to discern and decide what needs treatment and more importantly how the young person can be supported through normal teenage concerns.

I’ve learned so much here- around emotional boundaries and resilience, however compassionate care has remained in the front of my mind. When I reflected with a nurse around compassion fatigue, they reminded me that when you are with a patient who is struggling and it feels like they aren’t responding to your support, it can feel disheartening, however, every kind of act each person gives builds upon each other so that the young person can feel able to respond to the care. For example, if I’m with a young person who is self-harming and I try to de-escalate them out of it, but they don’t respond to me, yet when another staff comes along they are able to de-escalate, it can quickly feel overwhelming, and that I am not a good enough nurse. In such an instance I must remember that all compassion is remembered and received, it can just take people time to accept it and bring them out of the sadness they are in. This reflection has encouraged me in remembering that recovery and healing take time, and it takes a whole team; no individual staff can be the answer for everyone and that is ok!

Teamwork, time, hard work, and patience are what paves the road towards healing and hope.

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