Clinical placements provide nursing and midwifery students with the opportunity to transfer theory into practice and build critical hands-on skills.
The journey from classroom to workplace challenges knowledge and provides the real-world experience required to prepare the next generation of nurses and midwives for their future careers.
Melissa Rogers is a Bachelor of Nursing (Graduate entry) nursing student at Flinders University in South Australia.
The 37-year-old mother of three spent the past decade working for South Australia Police, primarily as a crime scene investigator, before embarking on a career change to pursue nursing for lifestyle and personal reasons.
Melissa is currently in her second and final year of the two-year registered nurse course.
Like all university students across the country, Melissa faced hurdles navigating her studies amid the global COVID-19 pandemic, with online learning becoming the norm and clinical placements being put on hold or cancelled altogether.
“It was hard for me because most of the course went to online learning,” she says.
“We were having collaborative sessions online where we used our cameras to see our tutors and speak to them. I have three children so it was hard for me to do all that learning at times when I had the kids. I had to juggle all of that online learning, but I also found it difficult to ask questions at times with intermittent internet issues at my end. I find it easier to learn in a hands-on environment than I do from listening or reading.”
Melissa only undertook one clinical placement last year, a two-week stint at a rural aged care facility in October.
She spent the first half working on a dementia ward and the remainder working with residents in the general ward.
“I was very nervous,” she recalls of her first clinical placement.
“I think I’ll be nervous at every placement I undertake because I want to make a really good impression. I hope that I have the skills that I require and that I’m where I should be at my level of education.”
Working in aged care was challenging and emotional at times, but ultimately rewarding, Melissa says.
“I found the experience extremely rewarding and both an honour and a privilege to be able to help provide physical, emotional and mental support to residents in improving their lives and wellbeing for the better,” she says.
Melissa undertook her second clinical placement at the Royal Adelaide Hospital in February this year on the general medical/surgical ward.
Due to the interruptions caused by COVID-19 last year, in 2021 she will undertake months of clinical placement on top of full-time study.
Melissa, who one day aspires to become a critical care nurse in an intensive care unit (ICU), shared the 10 things she learned on her first clinical placement in aged care with the ANMJ.
On the first day of clinical placement, I learnt very quickly the value of carrying a notepad at all times, enabling me to record common chronic medical conditions and medications that I was able to research to increase my knowledge and understanding of the pathophysiology of medical conditions and associated medications.
It also encouraged me to write down pending questions associated with procedures or policies that I was unable to ask due to time constraints, confidentiality, etc. which I was able to seek clarification on at a more appropriate time.
Scope of practice
Ensure that you are familiar with the scope of practice specific for your level of study as this will enable both the mentors and yourself to have a firm and common understanding of your clinical knowledge, clinical skill level and capabilities for the clinical placement. The scope of practice outlines what duties you can and cannot legally perform.
Wear your student identification badge at all times whilst on placement. Not only does it assist staff and mentors in getting to know you, it also helps patients/residents in getting to learn new faces and names and, is particularly helpful for patients that have memory difficulties.
Be honest and open with mentors and patients about your knowledge base and limitations and seek guidance or assistance where required. Patients are understanding that as students we are learning and performing clinical skills such as showering, taking vital signs such as blood pressures and carrying out wound dressings may take us longer than other staff.
Explain to patients if you do not have the knowledge base to answer specific questions that may be posed but, seek out answers from mentors where required, ensuring that patients receive the answers they need.
Taking the time to listen, talk and spend time with patients enables you to gain a greater understanding of their capabilities and healthcare needs whilst building a rapport with them and aiding in providing appropriate patient-centred care.
Tackling challenging situations
Clinical placement can expose you to situations that are mentally or physically challenging, such as working with patients who have mental health issues such as delirium and dementia, where confusion and aggression may be present.
This can be particularly challenging if you have not had previous exposure to or experience in working with patients living with these health conditions.
I learnt the importance and value in seeking guidance from experienced mentors and reading patient body behaviour for maintaining safety with aggressive and violent patients where certain behaviours may be caused by miscommunication, pain, toileting or hunger or thirst.
The importance of interdisciplinary healthcare teams
Take every opportunity to speak with other allied health professionals that are working with patients whom you are caring for such as physiotherapists, occupational therapists, general practitioners and pharmacists. Familiarising myself with the differing roles and functions of allied health staff increased my understanding of how allied health teams work in collaboration with one another in the coordination and care of the residents.
Getting feedback from mentors is vital for understanding where you are at in your learning and development as a nursing student.
Seeking feedback on clinical knowledge and skills has enabled me to identify aspects of nursing that I am doing well and areas that require improvement. Asking questions and seeking clarification guided me in ways to address these areas for improvement and increase my areas of strengths.
By asking questions I’ve learnt that students are not expected to know everything, we are learning. If you don’t know, just ask. Receiving both positive and constructive criticism has enabled me to increase my clinical skills and knowledge base so that I can improve on my delivery of patient care, leading to better patient care outcomes.
Supporting one another
As a nursing student, I aim to apply my knowledge and clinical skills to provide patient-centred care to patients and their families whilst learning from my mentors and fellow staff members.
I think it’s important to remember that you are not the only student on clinical placement at your designated facility and if you see another student lacking confidence, overwhelmed or stressed, offer help and support to them wherever you can, regardless of what institution they are from or what area of health they are undertaking such as care worker, enrolled nurse or registered nurse studies.
We are all on clinical placement for the same reason, to work towards a qualification in an industry where we may help people in a period where they are at their most vulnerable and to make a positive difference in people’s lives.
Treating people with dignity
One of the main lessons I learnt from clinical placement was the importance of delivering patient-centred care, to communicate with respect and to treat people with dignity and kindness, the same way I would treat one of my family members and the way that I would like to be treated if it were myself being cared for in a residential aged care facility.
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