Nursing can be a very demanding profession. It can also be incredibly rewarding. These conclusions cannot be taught, though, they have to be experienced. Which is why placement opportunities are an integral part of our nursing courses. 

Students complete 2300 hours on placement, and spend 50% of their time in practice education, providing students with considerable experience, developing their ability to form positive in-work relationships, and familiarising them with vital equipment such as the percutaneous endoscopic gastrostomy tube (inserted into the stomach through the abdominal wall, in case you wondering), and, er, video game consoles.

Student Learning Disability Nurses Rachel Gittons (above, on graduation after receiving a prestigious Chancellor’s scholarship) and Mihaela Avram have both enjoyed placements in the Dewi Jones Unit, an in-patient mental health facility designed to help children and young people aged 5 to 13, and part of the Alder Hey NHS Foundation Trust. It has, they readily admit, been tough, but both are looking forward more than ever to starting their nursing careers.

So, what did they learn?

No day is the same.

Rachel: 

“I was slightly apprehensive but very excited, as I’ve trained on Child and Adolescent Mental Health Service (CAMHS) units before. I had a variety of tasks every day, from allocating notes to checking the daily planner to 1:1 support for the young people on the ward. My knowledge and skillset have grown, in medication management, leadership, delegation, and group presentations and discussions.”

On a placement you can find yourself in unexpected situations.

Mihaela: “I spent time supporting the kids in school. I learnt so much about how to interact with children with mental health conditions, such as Tourette’s, anxiety or Asperger Syndrome. The teacher utilises the principles of Positive Behaviour Support, which in practice means the kids being offered ‘positive points’ each day, even if it’s just for showing up in class, which the children can then trade for rewards during their free time. She was just really kind and honest with the kids, which I think they appreciate.”

Games can play a vital role in mental health.

Mihaela: 

“There were many video game consoles on the unit, and staff, children and students often compete at games such as Mario Cart. While it’s a lot of fun, it also teaches the children how to play as part of a team, how to accept loss, and not to get too upset when they come in last. Which didn’t happen once I joined in, as that place was quickly taken…by me!”

But the job can be very tough, for staff and children.

Mihaela: “There were also some hard times. Some of the children had moments when they couldn’t control their emotions and needed supportive holding, or they needed to be go to the seclusion room, and at those times students needed to leave the room, for the child’s dignity and for our own safety. These moments can be challenging, as there is screaming, kicking, or potential self-harming. At those times, I tended to step back, but stayed close enough to observe what the nurses and support workers said to the children, how they de-escalated rising tensions, or soothed the children when they were going through a hard time.”

Students are entrusted with responsibility from the start.

Rachel: “I was required to present prompt sheets - an overview of patients’ status - to the core team, which could be quite daunting. The biggest challenge was realising that I was now responsible for a daily shift, and therefore all these young people, with the authority to make changes. Even though I’ve done countless shadow shifts, following different nurses each with different management styles, being the responsible adult, that first point of call, was nerve-racking, and it will continue to be even after I’ve qualified.”

Mihaela: “I wrote and presented weekly reports about in-patients in meetings with other professionals working in the hospital. I also attended the core meeting, where I discussed with my team how best to help each child. This was such a privilege, and being a fly-on-the-wall helped me learn so much. I also wrote notes about the children’s day, participated in planning the care they received, and observed the nurses during medication rounds.”

Learning opportunities can occur at any time.

Mihaela: “I think my most important lesson occurred one afternoon. A group of us - children, nurses and support workers - were chatting in the lounge. Two of the children asked to chat with one of the nurses, and returned after a few minutes. Curious, I asked one of the children what it was about. They told me that it was private. A little frustrated, I asked the nurse. Her response was, ‘if they said it’s private, it’s private’. That cured my nosiness. Relationships take time, and you can’t cut corners by trying to find out information they’re not ready to share with you.”

When you begin your career, placements will help you hit the ground running.

Rachel: “This placement provided a brilliant transition from student nurse to Registered Nurse Learning Disability (RNLD). The best moment was being praised for my effort and enthusiasm during shifts. Following my shifts in charge my appraisals were always positive, with suggestions for only minor improvements, which has been a big boost to my confidence.”

Learning to work effectively with other people is a vital aspect of any job.

Mihaela: “My previous placements were in adult services, and relationships between adults can be quite different. The staff-members at the Unit all have lovely relationships with the children, they’re all kind, patient, funny, and very interactive. This was so refreshing to observe.”

And these are just a handful of observations from Mihaela and Rachel’s placements. Imagine what you’ll have learnt by the end of their work experience.

They say that it takes 10,000 hours of practice to become expert in a skill. By this measure, by the time you start your nursing career you’ll be almost a quarter of the way to becoming an acknowledged expert.

edgehill.ac.uk/courses/nursing-learning-disabilities/

http://www.alderhey.nhs.uk/departments/dewi-jones-unit-childrens-mental-health-services/