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    I've been given an elderly medical ward (I knew what to expect but I was kinda looking forward to it anyway just to experience it). I walked in and was told to instantly wash a bed.....2 seconds later I was told to 1-1. Anyway long story short I 1-1 majority of the shift and I wasn't even shown around, no handover, absolutely nothing. I was basically a bank hca all shift. I don't even think I can cope with this for 9'weeks. I've spoken to my university and they said I've to "stick it out" and if there's further problems with me being 1-1 they will come in and tell them it should not happen....but then how awkward will it be for me?! I got home last night and I literally cried. And I've never ever cried over work. If I was a student nurse with zero care experience I would of quit
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    The job isn't easy and you do have to stick it out to learn and get experience but equally if there are things you're doing but shouldn't be you need to let someone and your uni know and don't be embarrassed about it. Charlotte49
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    (Original post by wbnurse)
    I've been given an elderly medical ward (I knew what to expect but I was kinda looking forward to it anyway just to experience it). I walked in and was told to instantly wash a bed.....2 seconds later I was told to 1-1. Anyway long story short I 1-1 majority of the shift and I wasn't even shown around, no handover, absolutely nothing. I was basically a bank hca all shift. I don't even think I can cope with this for 9'weeks. I've spoken to my university and they said I've to "stick it out" and if there's further problems with me being 1-1 they will come in and tell them it should not happen....but then how awkward will it be for me?! I got home last night and I literally cried. And I've never ever cried over work. If I was a student nurse with zero care experience I would of quit
    Lots of placements will treat you this way for you to get a feel for the ward before taking on nursing responsibility. Even lots of qualified nurse roles will have you work as an HCA during your preceptorship to get a feel for the ward. You do need to give them at least a week or two to start involving you in the nursing tasks too. This really is not unusual, and it is done to help you.

    Washing a bed, for example, is not a HCA task. All nurses have responsibility for all aspects of care. No one wants to work with a nurse who thinks that they are above washing a bed, sitting with a patient, taking someone to the toilet, showering a patient etc. This is true of all nursing areas and especially in elderly wards where the workload needs to be shared across all staff.

    With regards to providing 1-1 supervision, this is not something outwith your role. Having an understanding of the rationale and principles behind this are important. Should you be doing this all of the time? Of course not. But one or two shifts doing this is fine as you are learning. When you are qualified and need to ask your HCAs or bank staff to do this, you will be better for having had experience so you will know the sort of support and assistance you can give them.

    If you have concerns, speak to your placement mentor. When you are a qualified nurse you will not have a university to fight your battles and it would be a good idea to ask your mentor if you could have a tour of the ward etc. Lots of mentors will expect you to take initiative and ask if there is something you want to see or be involved in, rather than offering things to you. As you progress you are expected to manage your own learning.
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    (Original post by Charlotte49)
    Lots of placements will treat you this way for you to get a feel for the ward before taking on nursing responsibility. Even lots of qualified nurse roles will have you work as an HCA during your preceptorship to get a feel for the ward. You do need to give them at least a week or two to start involving you in the nursing tasks too. This really is not unusual, and it is done to help you.

    Washing a bed, for example, is not a HCA task. All nurses have responsibility for all aspects of care. No one wants to work with a nurse who thinks that they are above washing a bed, sitting with a patient, taking someone to the toilet, showering a patient etc. This is true of all nursing areas and especially in elderly wards where the workload needs to be shared across all staff.

    With regards to providing 1-1 supervision, this is not something outwith your role. Having an understanding of the rationale and principles behind this are important. Should you be doing this all of the time? Of course not. But one or two shifts doing this is fine as you are learning. When you are qualified and need to ask your HCAs or bank staff to do this, you will be better for having had experience so you will know the sort of support and assistance you can give them.

    If you have concerns, speak to your placement mentor. When you are a qualified nurse you will not have a university to fight your battles and it would be a good idea to ask your mentor if you could have a tour of the ward etc. Lots of mentors will expect you to take initiative and ask if there is something you want to see or be involved in, rather than offering things to you. As you progress you are expected to manage your own learning.
    Thankyou for your reply. Can I just clarify that I am not in the slightest annoyed I am being used as a hca....this is not something that would ever bother me unless it was for the entire placement. I knew I was going to be with the hcas. Now what I do have a problem with is that I walk on not even an intro or being shown around, no handover about my patients, no fire safety (which HAS to be carried out) instead I was told I had to Learn to wash a bed. I said no I don't need to learn that I've been a hca for many years I'm more than happy to wash the beds myself so staff aren't having to show me things I know. I was barely spoken to all shift I was like a lost dog. I was 1-1 for over 3 hours.....completely disagree that students should be left in 1-1 for that long when they are not suppose to be in the numbers. I also disagree with me having to use my initiative and ask for things to do....I'm a first year student. I'm not confident enough to be confronting people like that. They had no idea what placement number I was on or even if I knew what day it was....they should be giving me tasks to aid my learning not for me to follow them round and hound them. Not all students will even understand and I feel sorry for any new student who has zero ward experience to experience what I did yesterday because I'd of been in the verge of quitting. Luckily I know some placements are just like this. I've spoken to my uni and they agree the way the shift went was not what is meant to happen and they are keeping an eye on the rest of my placement. I am going to stick it out....just going to be a very long 9 weeks. I actually cannot wait for the future and i get mentor students....il always make sure they don't get left to wander a ward for hours on end and feel like they are not wanted
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    (Original post by wbnurse)
    Thankyou for your reply. Can I just clarify that I am not in the slightest annoyed I am being used as a hca....this is not something that would ever bother me unless it was for the entire placement. I knew I was going to be with the hcas. Now what I do have a problem with is that I walk on not even an intro or being shown around, no handover about my patients, no fire safety (which HAS to be carried out) instead I was told I had to Learn to wash a bed. I said no I don't need to learn that I've been a hca for many years I'm more than happy to wash the beds myself so staff aren't having to show me things I know. I was barely spoken to all shift I was like a lost dog. I was 1-1 for over 3 hours.....completely disagree that students should be left in 1-1 for that long when they are not suppose to be in the numbers. I also disagree with me having to use my initiative and ask for things to do....I'm a first year student. I'm not confident enough to be confronting people like that. They had no idea what placement number I was on or even if I knew what day it was....they should be giving me tasks to aid my learning not for me to follow them round and hound them. Not all students will even understand and I feel sorry for any new student who has zero ward experience to experience what I did yesterday because I'd of been in the verge of quitting. Luckily I know some placements are just like this. I've spoken to my uni and they agree the way the shift went was not what is meant to happen and they are keeping an eye on the rest of my placement. I am going to stick it out....just going to be a very long 9 weeks. I actually cannot wait for the future and i get mentor students....il always make sure they don't get left to wander a ward for hours on end and feel like they are not wanted
    Ok, so firstly, staff are encouraging you to learn basic care skills. You are in first year so will spend a good proportion of your time doing 'HCA skills', whether you have worked as a HCA previously or not. They probably don't know this and are trying to help you. Spending three hours 1-1 with a patient is not unusual. Some shifts, a bank HCA will be brought in to spend a whole shift doing 1-1. Arguably it is not really what they expect to do during a shift either, but the patient needs that level of care and it must be provided. It is normal for all staff and students on a ward to take turns doing this if it is not possible for an extra HCA to sit all day with the patient at that time. Although you are supernumerary, you are expected to help out when needed and to participate. 3 hours is not a long time in the grand scheme of things. This is definitely a learning experience because you need to know how to provide that sort of care.

    Secondly, I agree that you should have at least had a tour of the ward and mandatory induction (fire safety, absence reporting, uniform etc.) chats. You need to bring this up with your mentor and get this done. This does happen on busy wards, and mentors sometimes forget how important this is. You arguably should not be on the ward without this training. Anyone in uniform is looked at as an authority figure by patients and visitors - they don't know whether you are in 1st year or nearly qualified, and in the event of an emergency you need to know how to protect them and yourself.

    You are doing a degree and self-directed learning is a huge proportion of this. You are not going to be constantly given tasks to do to keep you busy all day. Even from first year, it is expected that you use initiative and ask for learning experiences. If you see something interesting happening, ask if you can sit in and watch. If you want to know something, ask. If you ask questions and seem interested in what is going on, people will involve you (e.g. I'd really like to have a go at doing some dressings, would you mind letting me know when you do one so I can watch?'). This is the adult world, you are not at school, and learning will not simply be spoon fed to you. I apologise if this comes across harshly, but nursing is very much a sink or swim degree and the sooner you learn these skills, the better.

    I am sorry that you feel that asking for things and speaking up is not something you can do and really do not know what to suggest if you don't feel like you can do that at all. I would really urge you to try and approach your next few shifts with a bit of positivity otherwise you are certainly going to have a miserable time. It's easy to get worked up after a disappointing shift or two and convince yourself you are going to hate the whole placement. Yes - this may be a bad placement, but it is still within your power to make it into a good learning experience, but you cannot do that without being a bit more confident. Give them the benefit of the doubt, ask for things, be a little firmer with staff if they are unhelpful, and if things don't improve, go back to the uni.
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    I have to agree with Charlotte here.
    Yes you may be a first year and lack the confidence and the skills to approach them and ask for what you need.
    However, this is part of learning how to be a nurse.
    They will be assessing you from the moment you walk through the doors.
    All first years need to be treated the same, as they don't know your prior experience. As well as this, you're a student nurse. Not a hca. You will approach and do tasks differently, regardless of what they are and who may usually do them.
    I've had prior experience (a good few years) but as a student nurse - even if I'm carrying out what some would see as a hca task - I'm doing it differently as I'm aware of the responsibility and legality of the paperwork. I'm more aware of the evidence base behind the task and why it needs time be completed a certain way.
    You can only do so much as a first year, but almost writing it off and going back with a negative attitude will be evident.
    Wards are busy places and if you become a nurse, you will understand this.
    You will also realise that some people just have bad days and unfortunately a new student or someone wanting to shadow for a day may have to take a back seat as the patients are the priority. And their needs and what needs to be done on the ward comes before you and your needs that day.
    A lot of your nurse training as you go through it will show you that you need to see a really big wide picture wherever you go.
    No action is done without a reason. Nothing is written without a reason.
    But you may not always be aware. This is where you will also learn to become an effective and safe manager. By understanding that people may have issues that they don't want to discuss etc.
    Do your self directed learning. Make a note of getting to know where the fire equipment is. Ask someone to show you the emergency trolley etc.
    You have a voice. Use it.


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    I'm going to play devils advocate a bit here.
    I understand the point about learning the basic fundamentals of care. I always pushed my students to do it.
    But I have also been on a ward where I was made to feel very unwelcome.
    I think what OP objects to is the way in which they were asked. Turning up for your first day and just being told to "oh go do this" and left to it, is incredibly intimidating. It shows a lack of interest in their wellbeing and can be a sign of things to come.

    Perhaps if the staff had taken the time to introduce themselves and give a mini tour (or at least an I owe you a tour as soon as I'm free). Or said I'm caught up with this but you get started with these beds and when I'm done we'll catch up and get you settled in properly. Then the student won't feel abandoned.

    We can all remember how scary it can be to turn up to a new placement. You don't know the staff. All the paperwork and equipment are in different places. Staff have slightly different ways of doing things.

    It's all an issue of empathy. Take all that into account and help someone settle in. Students need to learn the basics but they also don't deserve to be treated as commodities, just there for a few weeks to prop up the numbers.

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    Hi wbnurse!

    Congratulations on starting your training! I am really sorry to hear that your first day of placement didn't go well. My background and speciality is medicine for the elderly so I am always sad to hear about people's bad experiences working in this field. Were you allocated a mentor or associate mentor on your first shift? I know on my ward we have had students start placement but aren't on shift with either mentor. If you end up with a junior member of staff or a nurse who is not a mentor it may be the case of they don't really know what they need to be doing with the student. I know it doesn't take much common sense or a qualification in mentoring to show someone around the ward and give them a handover, but if the RN doesn't have a lot of experience of students and are very busy, they can sometimes forget about the student. I'm not saying it's right, but it happens from time to time and hopefully this can be rectified when you manage to work with your mentor. If you were with your mentor, then they have no excuse. I would say that it's a bit quick to say you hate your placement because of a bad first shift. There may have been factors going on that you weren't aware of. Please give it a chance because there is potential to learn so much. If your mentor and members of staff get a hint that you are disinterested then they may give you a hard over it because they may think "why bother?" as they may see it as a waste of time if you're not really bothered if you are there or not. I'm not saying that this is the case for you, but try not to come across as annoyed or disinterested because of one bad shift. I have mentored a lot of students. Most of them have been fabulous and are moving on to great things but there is nothing more frustrating than trying your hardest with a student and they are just not bothered.

    Why don't you try turning the negatives into positives as I see that from 2 basic tasks that there is a lot you can learn from it and write excellent pieces of evidence for your portfolio. I will give you a couple of examples of what I mean.

    1) Cleaning a bed
    -What is the protocol for cleaning beds in your area? What does current literature say is the best approach?
    -What are the benefits and drawbacks in infection control policy? (A benefit could be that it reduces the spread of hospital acquired infections such as c diff and MRSA. A negative could be that it's time consuming, therefore staff rush and do not complete the task properly due to high turnover of patients)
    -See if there is anything hot in the news regarding infection control. I don't think this went public but our trust had an outbreak of a certain strain of c diff. It was found in certain pockets of nearly every ward. We suspect it was because of beds not being cleaned properly in between patients due to high turnover. There may be other stories similar.
    - Incentives. Does your trust have any incentives for ward staff to maintain good infection control? Ours has an accreditation for wards that consistently maintain standards during audies.
    -Spend time with infection control and see what they do.

    2)1:1 with a patient
    - What is the rationale for the patient to require 1:1 nursing? Is it because they are confused, wandering, aggressive, pulling at medical devices, high risk of falls etc.
    -Has the patient got mental capacity? If not why not? Has it been formally assessed? What does the law say about capacity? (Mental capacity act etc.)
    -Have protocols been followed? Our trust has increased supervision bundles for patients who require supervision or 1:1. If patient is strictly 1:1 and lacks capacity has DOLS been completed?
    -What nursing interventions could help the patient? What does current literature say?
    -Has the patient been referred to mental health liaison or psychiatry for assistance in managing the patients behaviour?
    -Spend time with mental health liaison, dementia specialist nurse, Parkinson's specialist nurse etc.
    -Research delirium, dementia etc.

    I don't agree with any member of staff being left to 1:1 a patient for 3 hours, let alone a student. Unfortunately things happen and staff get tied up and are unable to relieve you. I am guilty of this myself and I have also been in this position. If I was the only trained I often sat in the supervised bay whilst I wrote my care plans, wrote in communication cardexs, plan discharges and complete admissions. This is hard if the patients are constantly disruptive but it can be done. I have had shifts where even as a band 6 I spent most of the day 1:1. Also when we supervise bays we do the hourly rounds, fluid charts, food charts, toileting for all the patients in the bay, not just the patient/s you are watching. It sounds difficult but it can be done. You really have to learn to multi task when you work in care of the elderly, lol.

    I hope this helps to reassure you that care of the elderly isn't so bad and gives you a few hints and tips. I try my best to look at the good in a bad situation. I think it just goes to show that you are a better person if your placement is bad but you continue to use your initiative and learn. It shouldn't be this way but sadly it happens. I really hope that this was just a one off and the placement improves for you.
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    Thankyou everyone. Really value all advice I do! Forestcat has just nailed exactly what I mean....I just couldn't think of what I was annoyed about! (I know that sounds odd). If I'd of walked on and someone would of simply come over and said "hiya, we are so busy right now and are you ok if I give you a quick tour after you've helped out with this bed I'd really appreciate it".....I wouldn't of even batted an eyelid. I'd of said yeah course I understand. It's all first impressions and I was mega apprehensive as it is. I've only ever worked on one ward and I loved that ward dearly. It was like a well oiled machine. We was an amazing team and I miss all my old colleges ALOT. We always welcomed students and made them feel comfortable and i just could not help but compare....which is something I wanted to avoid. I felt, as forestcat said perfectly, intimidated. And that's why I couldn't speak up. It was like I was shut up before I even spoke. Kindness is absolute massive. Show me some and il blossom. I know they are busy and half the mentors never chose to be mentors I know how it works. I'm not expecting anyone to wipe my ass or spoon feed me anything. I just want to learn something new. That's it. Il work with the hcas all day but aslong as I feel like I'm developing and I don't feel I am. Past few shifts I have spoken up, I've learned a few new things. They are majoring understaffed so I know it's hard. I question why students are even being sent there. I also miss my beautiful children terribly. This does not help at all. Going to a place I can say I dread and also not being paid and leaving my children at home (I know this is expected blah blah) but I can't help feeling like that can I.

    ButterflyRN Thankyou for your reply also. I love your posts you are full of wisdom and tons of useful info. I've taken in board everything and even jotted a few things down in my little notebook

    Again thanks guys. I am trying my best. It is so hard.
 
 
 
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