Final placement

As a 3 year student on my last placement I am assigned on a ward that I don't feel I'm doing anything. I don't feel proactive and as a proactive student it feels terrible. My placement area is badly organised my initial assessors they passing me to other assessors like been a tennis ball. My main assessor has issues with her training certification. I'm struggling 2 weeks now to find how's gonna be me practice assessor and supervisor. Every time I work with a nurse they keep asking me where I worked before so they can see if I have gained any experience but at the end as a post op ward I don't do anything. Or mostly likely feels that way. In a usual day I do medication rounds with one of the nurses, documentations, fluid balance and food charts and preparing antibiotics in the afternoon. Discharges on the system are done from the sisters. I'll be allowed to use the pump under supervision and maybe do the ng feedings. Some times when is very busy I'll be asked to do the obs and help with cares. Most of the times tho from 12-6 there's nothing to do and it's so boring. Whenever I ask the nurses if I can help them with something that is related t antt or catheter ngs wounds they'll say you have to have an additional training which I agree, but I never asked them to do them by myself. All I ask is to assist. I'm on my third week and I don't have a group or bay of patients to handover. And when I ask the sister- assessor to do one she told me that I can handover only the NEWS and the BG. On my previous placement on AMU I had a full bay of patients to look after, do everything for them and handing them over. And it feels terrible that I don't do that anymore, it feels like a waste of time. That's the only time that I can make out everything that I want/can while I student. Also another thing is that despite I am supposed to finish at 19:30, they want me staying till they finish handover which sometimes takes them till 19:45, but I am supernumerary and also takes me an hour with public transport to get home considering most of the time I am supposed to be on placement the day after. I'll ask from my tutor and practice educators to change the ward but if it doesn't happened what do I do?

Reply 1

iL1L

Volunteer Team

Hi
I just wanted to let you know that you posted twice. Which thread do you want to keep? :smile:

Reply 2

Emily_B

I'm sorry to read that you're having a tough time.
I'm a senior band 5 nurse on a surgical ("post op") ward and an experienced practice assessor. There's a fair few things in here that I'm going to try to break down into sections to advise on.

Original post by KX7.

The training for practice assessors has been in-house training for the last 4 years. Your main assessor needs to get this sorted... but that bit is her issue to sort (having said that, not being a practice assessor won't affect her pin, just your education and paperwork being signed off).

I really hope you've been pestering the ward about this, and if you have, you'll need to escalate it to the practice education team at the hospital.

Original post by KX7.

Every time I work with a nurse they keep asking me where I worked before so they can see if I have gained any experience but at the end as a post op ward I don't do anything. Or mostly likely feels that way. In a usual day I do medication rounds with one of the nurses, documentations, fluid balance and food charts and preparing antibiotics in the afternoon.

Medication rounds = doing something
Documentation = doing something
Filling in fluid balance charts and fluid balance charts = doing something
Helping with antibiotics = doing something

Original post by KX7.

Discharges on the system are done from the sisters.

Maybe you can ask them to show you the process?
There's also loads more to discharging patients than sending them off the ward and taking them off the system. How are they getting home? Do they have anyone at home (or do they need someone at home)? Do they need to go to practice nurses, or a district nurse referral for anything? Do they need dressings changed? Do they need a package of care (and has this been organised)? Have they got a supply of medications to go home with?

Original post by KX7.

I'll be allowed to use the pump under supervision and maybe do the ng feedings. Some times when is very busy I'll be asked to do the obs and help with cares.

Obs and care duties are part of a nurse's job as well as the "nurse-y", "fun" stuff.

Original post by KX7.

Most of the times tho from 12-6 there's nothing to do and it's so boring.

I genuinely don't believe that.
- It's impossible for lunchtime medication rounds to be completed by midday, unless morning medications were given at 530am.
- It's impossible for all documentation to be done purely between the hours of 7-12 and 6-730.
- If you're completing fluid balance charts, then why aren't you completing them between midday and 6pm? People drink and wee between those hours, including on a post op ward.
- I don't believe that no patients ever come back from theatre between 12 and 6pm. In fact, 1pm-8pm is the busiest time for patients returning from theatre. That means there's post op care to be done 12-6pm.

Original post by KX7.

Whenever I ask the nurses if I can help them with something that is related t antt or catheter ngs wounds they'll say you have to have an additional training which I agree, but I never asked them to do them by myself. All I ask is to assist.

Have you done the additional training? (Yes it exists for students too!) If yes, great, do it under supervision. If no... you not supposed to be doing it at all, not even under supervision.

Original post by KX7.

I'm on my third week and I don't have a group or bay of patients to handover. And when I ask the sister- assessor to do one she told me that I can handover only the NEWS and the BG. On my previous placement on AMU I had a full bay of patients to look after, do everything for them and handing them over. And it feels terrible that I don't do that anymore, it feels like a waste of time. That's the only time that I can make out everything that I want/can while I student.

You need to be pushing this with the ward, that you need a cohort of patients to take charge of. Explain that you don't feel that you're getting much learning done without being allowed the (supervised) responsibility you were given elsewhere. Get the practice education team involved if needs be.

Original post by KX7.

Also another thing is that despite I am supposed to finish at 19:30, they want me staying till they finish handover which sometimes takes them till 19:45, but I am supernumerary and also takes me an hour with public transport to get home considering most of the time I am supposed to be on placement the day after. I'll ask from my tutor and practice educators to change the ward but if it doesn't happened what do I do?

Attempting to change wards, without addressing the things you've mentioned (and I've given advice on) isn't going to be very helpful.
Yes, the ward hasn't given you the best start. However, you're saying that it's "boring" and there's "nothing to do" on TSR... you may (accidentally, unintentionally) be giving off the impression that you're bored, don't want to be there and don't want to learn even when that's not the case (and I've had students do that without realising!)

Reply 3

KX7.

Hey Emily. Thank you for your response. In regards my assessors training she told me to get in contact with practice education instead of her.Today I was assigned another new assessor. I end up doing most of the FB and FC when I escalated to the sister that they are not properly done. I do all documentation and other nursing things I mentioned earlier but I'm not doing as much as I would to. I keep asking the nurses if there's else I can do but personally I don't feel I'm doing enough. I'm doing few referrals but most patients don't need POC or referrals. From my perspective there's nothing to do with the hours of 12-6. They might be few patients coming back, however hca because they don't have something to do they look after patients by doing their obs and assisting them. Most of the patients come back around 6 tho. In regards the training I uphold most of the skills from back home as a band 5 and as a current hca/stn. I don't mind looking after a patient by cleaning them doing the obs or even as feeding them. I might sound weird but nursing comparing to back home is different, and probably I'm harsh on myself because I want to do more help more because when I qualify in few months I'll left alone doing everything. So that makes me wanting to learn everything. Don't get me wrong when I say "I'm asked to do obs and help with cares" I know that they are important because without them we wouldn't be able to escalate patients who score high to doctors, but I feel they are so much more to do nursing wise which I don't feel confident doing by myself and want to practice more. So that's why from a personal perspective I'm saying I feel bored because they aren't so many things to do.