Qaali123
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Background. I am currently a second year nursing student at Kings College. I love nursing but my biggest passion is public health nursing. Kings offers a community centred placement programme for nurses who want to work within community. I felt that this would be best for me but quickly I was discouraged by student nurses in the upper years as they felt like I would get more clinical experience within wards. Although I feel this is true, I am currently on my 4th placement in a ward and I regret not choosing the community circuit route as I know for sure that I want to work either as Health Visitor or School nurse both centred around the community.
My question is are there any nurses who’ve been lucky to have both community and ward placements. How is your experience in both? Which one do you prefer and why? Do you think I should ask my university to centre my placement more around the community?
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Emily_B
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Personally, I didn't like community placements - a mix of feeling uncomfortable working in people's homes and struggling to find an interest in community nursing (not through lack of trying!). I've always preferred hospital work, hence having taken a NQN post on a hospital ward.
There were people in my cohort who were the opposite to me, and were loads happier working in the community.
Community and hospital experiences are very different - it's about having different skills rather than lacking in skills.
I'd suggest discussing your community/ward concerns with the uni - where they send you on placement is really down to what the placement areas can accommodate, but it won't hurt to ask.
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moonkatt
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Community nursing wasn’t for me, but to suggest you won’t gain as many clinical skills is rubbish, particularly with some of the acute teams there are that are around for admission avoidance. You should get a placement in the community at some point in your course, speak to your uni to make sure, but I’m pretty sure a primary care placement is a mandatory component of the course.
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paub
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i cant think of anything that is done in a hospital that cant be done in the community.apart from testing and some infusions. community is much more than what most people think. if your aiming for a community role be it school or health visiting then get community experience. a lot of community nurses have had a lot of other experience.
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Emily_B
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(Original post by paub)
i cant think of anything that is done in a hospital that cant be done in the community.apart from testing and some infusions.

Community services may be brilliant, however have you seen any of these done in the community?
Operations, especially major abdominal surgery
Immediate postoperative care
ICU treatment
Heart monitoring for MIs and really, really unstable AF
Thrombolysis

There's loads healthcare wise that can be done in the community, however there is a limit - and this list is just a start to the limitations.
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paub
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(Original post by Emily_B)
Community services may be brilliant, however have you seen any of these done in the community?
Operations, especially major abdominal surgery
Immediate postoperative care
ICU treatment
Heart monitoring for MIs and really, really unstable AF
Thrombolysis

There's loads healthcare wise that can be done in the community, however there is a limit - and this list is just a start to the limitations.
well lets see
1 Operations, especially major abdominal surgery is a medical not nursing.
2. obviously immediate post op recovery is a hospial job. but we are getting major orthopedic at 3 days as well as most other surgeries so yes we do.
3 depends what you deem icu . we do central lines picc, non invasive ventilation, oxygen therapy transfusions. iv antibiotics and lots more.obviously we dont do icu.
4. heart monitoring. yes we do.unstable AF you should have seen our last one last week. IT was so bad they should have been dead. they spent 12 hours in hospital discharged home to die. they are still going. our gps start twitching when we call them over ecg's
5. Thrombolysis obviously not stroke related but we do treat dvts ect so yes we do. obviously we monitor and administer anti Thrombolytic treatments
you forget we deal a lot with the frail elderly that are deemed not fit for treatment. we do what treatments that can reverse reversable conditions but recognizing that there underlying conditions are terminal and supporting them to have the best life they can.
oh yes
we also do deal with kidney failure, heart failure and other related conditions. liver lung and most other conditions. end of life. cancer support, rehab long term conditions. dementia, learning disabilities. mental health. and of course we are experts on wound dressings and the causes of chronic wounds. yes there are acute things we cant do. but we really are not as unskilled as you seem to think we are. most of us are independent prescribes able to diagnose. most of us have masters and have extended skills.
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Emily_B
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(Original post by paub)
well lets see
1 Operations, especially major abdominal surgery is a medical not nursing.
2. obviously immediate post op recovery is a hospial job. but we are getting major orthopedic at 3 days as well as most other surgeries so yes we do.
3 depends what you deem icu . we do central lines picc, non invasive ventilation, oxygen therapy transfusions. iv antibiotics and lots more.obviously we dont do icu.
4. heart monitoring. yes we do.unstable AF you should have seen our last one last week. IT was so bad they should have been dead. they spent 12 hours in hospital discharged home to die. they are still going. our gps start twitching when we call them over ecg's
5. Thrombolysis obviously not stroke related but we do treat dvts ect so yes we do. obviously we monitor and administer anti Thrombolytic treatments
you forget we deal a lot with the frail elderly that are deemed not fit for treatment. we do what treatments that can reverse reversable conditions but recognizing that there underlying conditions are terminal and supporting them to have the best life they can.
oh yes
we also do deal with kidney failure, heart failure and other related conditions. liver lung and most other conditions. end of life. cancer support, rehab long term conditions. dementia, learning disabilities. mental health. and of course we are experts on wound dressings and the causes of chronic wounds. yes there are acute things we cant do. but we really are not as unskilled as you seem to think we are. most of us are independent prescribes able to diagnose. most of us have masters and have extended skills.
Woah. I NEVER called you unskilled.
- surgery requires nursing. Scrub nursing and recovery nursing are required. It may not be traditional nursing, but the patient is always in hospital when that happens.
- I know. I routinely discharge such appropriate people home at 3 days and less post op, but that's a few days after.
- complex and ICU aren't the same thing. I never said you don't deal with the things you mentioned. But the ICU where I work is full of people who can't be dealt with in the community.
- so, you don't deal with all thrombolysis then.

My point was:
Despite everything that can be done in the community), there's stuff that plain and simple can't.
I never called you unskilled. I never said you don't deal with a lot. Just get off your high horse and stop pretending that there are a lot of hospital services which aren't required.
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Tracey1995
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(Original post by Emily_B)
Woah. I NEVER called you unskilled.
- surgery requires nursing. Scrub nursing and recovery nursing are required. It may not be traditional nursing, but the patient is always in hospital when that happens.
- I know. I routinely discharge such appropriate people home at 3 days and less post op, but that's a few days after.
- complex and ICU aren't the same thing. I never said you don't deal with the things you mentioned. But the ICU where I work is full of people who can't be dealt with in the community.
- so, you don't deal with all thrombolysis then.

My point was:
Despite everything that can be done in the community), there's stuff that plain and simple can't.
I never called you unskilled. I never said you don't deal with a lot. Just get off your high horse and stop pretending that there are a lot of hospital services which aren't required.
I agree with you Emily on that nurses are the ones who does all the aftercare of operations regardless of in hospitals or at home in community.
The doctors comes along in the morning rounds and then its upto nurses to look after the patients after that.
There's are things like you said you can't be done in the community as those require hospital care .
You get people Emily thinking they know better than us nurses regardless of which field we work in but they only there for few seconds a day like doctors & surgeons and thereafter its on the nurses heads to look after the patients till they go home . help them with bathing,perhaps have to feed them , hand out medications & clean beds and mess up .
Wouldn't worry to much on somebody who think they know more than us nurses ok.
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paub
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(Original post by Tracey1995)
I agree with you Emily on that nurses are the ones who does all the aftercare of operations regardless of in hospitals or at home in community.
The doctors comes along in the morning rounds and then its upto nurses to look after the patients after that.
There's are things like you said you can't be done in the community as those require hospital care .
You get people Emily thinking they know better than us nurses regardless of which field we work in but they only there for few seconds a day like doctors & surgeons and thereafter its on the nurses heads to look after the patients till they go home . help them with bathing,perhaps have to feed them , hand out medications & clean beds and mess up .
Wouldn't worry to much on somebody who think they know more than us nurses ok.
i have been since i did project 2000 in in the 1990s.
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