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Competency 'shifts' - responsibilities as a student HCP and after?
I was left 
this morning due to an interesting incident where someone from the community nursing team (not sure if they were actually a nurse) turned up to change my PEG button without having seen one done before. On arrival they felt this was fine as they'd done suprapubic cath changes (!), but luckily decided for themself that this was:
I. a different procedure
II. they weren't competent.
However, this reminded me quite forcibly of some of the situations that I found myself in as a student AHP (commonest being being asked to lone work in settings that may not be appropriate or ideal), or being asked to delegate tasks to people that you didn't know were competent or not (e.g. transfer Ax to new assistant).
So:
Has anyone else had 'incidents' where they felt they had to step out and say 'thanks, but I don't feel I'm competent?/this needs 2 staff...' etc?
What about delegation? (Something we were warned against as students if unsure as it might still be counted as our responsibility).
this morning due to an interesting incident where someone from the community nursing team (not sure if they were actually a nurse) turned up to change my PEG button without having seen one done before. On arrival they felt this was fine as they'd done suprapubic cath changes (!), but luckily decided for themself that this was:I. a different procedure
II. they weren't competent.
However, this reminded me quite forcibly of some of the situations that I found myself in as a student AHP (commonest being being asked to lone work in settings that may not be appropriate or ideal), or being asked to delegate tasks to people that you didn't know were competent or not (e.g. transfer Ax to new assistant).
So:
Has anyone else had 'incidents' where they felt they had to step out and say 'thanks, but I don't feel I'm competent?/this needs 2 staff...' etc?
What about delegation? (Something we were warned against as students if unsure as it might still be counted as our responsibility).
swiftuk
Has anyone else had 'incidents' where they felt they had to step out and say 'thanks, but I don't feel I'm competent?/this needs 2 staff...' etc?
It's hard sometimes to be brave and admit that you don't know or aren't confident. It's easy as a student, relatively easy as a junior in whatever job but as you become more senior, I would suggest, that it gets a lot harder and you're forced out of your comfort zone more often.
Delegation as in what? People passing their jobs or responsibilities onto you?
Thank you for the considered response Renal - fortunately I managed to handle all the situations I had with relative tact (presumably, as I'm registered now).
It's also something that I think varies a lot between placements. The only examples I can think of particularly are OT/PT based due to the introduction of role-emerging placements and placements with long-arm supervision; my final placement was long-arm supervision in that I got supervision from an OT once a week - the rest of the time I was expected to do group and individual work with long-term MH patients either alone, or with a student nurse if I was lucky (oh, and the trusted pull alarm on my belt).
This included things such as doing individual risk assessments (and documenting) prior to group sessions, to say whether I felt that person X's current signs/symptoms/presentation were compatible with attending safely (for themself/other patients/staff).
I also took the 'discuss with supervisor/uni asap' approach, but still felt that I was being asked to exercise a lot of judgement at times (although obviously I would consult with the nursing team and all handover notes/documentation as well, sometimes the pts key nurse simply hadn't seen them that morning).
The addition of 1st year student nurses as a 2nd 'staff' member in group was in some ways good, but in other ways I had their mentors suggesting that I was responsible for them as well (and did end up debriefing). I still have mixed feelings around that, and am not sure how appropriate it was (medicine were only called in as needed on the unit generally, ditto psychologists).
On other placements I was asked to decide (for example) which transfer assessments I could safely delegate to an assistant technician, and which not. That is a lot simpler, particularly if you discuss a red flag list with your supervisor...but I still think it raises 'when, what, why?' questions in terms of preparation and feeling comfortable enough with your supervisor to be able to say no. (This para is prompted by the thread I was just reading re: mentorship on this board, which saddens me...although I know that some of my colleagues had similar experiences on placement).
When I referred to delegation, I was thinking of a number of scenarios (which I'm comfortable to discuss in open forum as it's 2 years since I was a pre-reg student).
The main one was delegating tasks to an assistant/technician, or leading a group with one. On one of my placements there was some feeling that a third year degree student was the responsible one if something went wrong in group, as opposed to the Band 3/4 member of staff due to professional training. Whilst I could understand some of their arguments to a degree, I can't say I was totally happy with it. Other placements felt that culpability would be down to the student, their supervisor and the 'untrained' (hate that description) staff member.
The same applied to work with other students, and was not a problem when working with peers, but as I think I said above, I had some placements where I was expected to be responsible for 1st year nursing student(s), and their decisions to some degree (at which point I put my foot down and said I was only having one at a time, if at all).
It's also something that I think varies a lot between placements. The only examples I can think of particularly are OT/PT based due to the introduction of role-emerging placements and placements with long-arm supervision; my final placement was long-arm supervision in that I got supervision from an OT once a week - the rest of the time I was expected to do group and individual work with long-term MH patients either alone, or with a student nurse if I was lucky (oh, and the trusted pull alarm on my belt).
This included things such as doing individual risk assessments (and documenting) prior to group sessions, to say whether I felt that person X's current signs/symptoms/presentation were compatible with attending safely (for themself/other patients/staff).
I also took the 'discuss with supervisor/uni asap' approach, but still felt that I was being asked to exercise a lot of judgement at times (although obviously I would consult with the nursing team and all handover notes/documentation as well, sometimes the pts key nurse simply hadn't seen them that morning).
The addition of 1st year student nurses as a 2nd 'staff' member in group was in some ways good, but in other ways I had their mentors suggesting that I was responsible for them as well (and did end up debriefing). I still have mixed feelings around that, and am not sure how appropriate it was (medicine were only called in as needed on the unit generally, ditto psychologists).
On other placements I was asked to decide (for example) which transfer assessments I could safely delegate to an assistant technician, and which not. That is a lot simpler, particularly if you discuss a red flag list with your supervisor...but I still think it raises 'when, what, why?' questions in terms of preparation and feeling comfortable enough with your supervisor to be able to say no. (This para is prompted by the thread I was just reading re: mentorship on this board, which saddens me...although I know that some of my colleagues had similar experiences on placement).
When I referred to delegation, I was thinking of a number of scenarios (which I'm comfortable to discuss in open forum as it's 2 years since I was a pre-reg student).
The main one was delegating tasks to an assistant/technician, or leading a group with one. On one of my placements there was some feeling that a third year degree student was the responsible one if something went wrong in group, as opposed to the Band 3/4 member of staff due to professional training. Whilst I could understand some of their arguments to a degree, I can't say I was totally happy with it. Other placements felt that culpability would be down to the student, their supervisor and the 'untrained' (hate that description) staff member.
The same applied to work with other students, and was not a problem when working with peers, but as I think I said above, I had some placements where I was expected to be responsible for 1st year nursing student(s), and their decisions to some degree (at which point I put my foot down and said I was only having one at a time, if at all).
swiftuk
I was left this morning due to an interesting incident where someone from the community nursing team (not sure if they were actually a nurse) turned up to change my PEG button without having seen one done before. On arrival they felt this was fine as they'd done suprapubic cath changes (!), but luckily decided for themself that this was:
I. a different procedure
II. they weren't competent.
However, this reminded me quite forcibly of some of the situations that I found myself in as a student AHP (commonest being being asked to lone work in settings that may not be appropriate or ideal), or being asked to delegate tasks to people that you didn't know were competent or not (e.g. transfer Ax to new assistant).
So:
Has anyone else had 'incidents' where they felt they had to step out and say 'thanks, but I don't feel I'm competent?/this needs 2 staff...' etc?
What about delegation? (Something we were warned against as students if unsure as it might still be counted as our responsibility).
this morning due to an interesting incident where someone from the community nursing team (not sure if they were actually a nurse) turned up to change my PEG button without having seen one done before. On arrival they felt this was fine as they'd done suprapubic cath changes (!), but luckily decided for themself that this was:I. a different procedure
II. they weren't competent.
However, this reminded me quite forcibly of some of the situations that I found myself in as a student AHP (commonest being being asked to lone work in settings that may not be appropriate or ideal), or being asked to delegate tasks to people that you didn't know were competent or not (e.g. transfer Ax to new assistant).
So:
Has anyone else had 'incidents' where they felt they had to step out and say 'thanks, but I don't feel I'm competent?/this needs 2 staff...' etc?
What about delegation? (Something we were warned against as students if unsure as it might still be counted as our responsibility).
Yeah course i have, i was asked to once change a leg dressing by myself when i'd only observed and assisted, i did it as i felt pressured and wanted to be 'nice' but i asked for supervision and they got all huffy with me, plus i had another incident where a patient deteriorated and there were no members of staff near by to help me
Related discussions
- University of Edinburgh MBChB for HCP 2022
- Placements and children
- Jobs whilst training in radiography
- Clearing
- HCP-med 2024
- I hate placement
- Help!!!! Mature student - nursing
- Is air traffic control a good career?
- Midwifrey student placement hours.
- HCP Med at Edinburgh Uni: query about studying as a parent of a small child
- 1st year midwifery student
- HM Passport Office (Grade 1/Grade 3?)
- Thoughts on Medical Degree Apprenticeship
- No band 5 roles
- Edinburgh MBChB for HCP 2023 Entry Applicant and Offer Holder thread
- How do I prepare for my nursing degree interview
- Organising Shifts for a Nursing Placement
- not being supported by the practice assessor on my placement
- Magnesium melting point
- UK Border Force
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