An engaging chapter in a new book for nursing students, ‘Becoming Practice Ready’, provides practical advice for nursing students about preparing for and making the most of clinical placements.

The chapter, by Federation University Associate Dean of Teaching Quality and Student Retention and Senior Lecturer in Nursing, Dr Karen Missen, arms students with knowledge of key challenges and how to address them.

Nursing students are expected to take on a range of shifts, including evening, overnight and weekends. Managing this time pressure can be challenging for mature students with family responsibilities. They face financial pressures because it’s not advisable and often impossible to continue with other paid work while on placement.

Dr Missen frankly addresses ethical and emotional challenges students can face in clinical settings.

On the ward nursing students, may witness poor nursing practice, including physical or emotional abuse of patients, breaches of patient safety, privacy and dignity, the provision of substandard or outdated care, and clinical errors.

When they try to raise concerns about their observations, they may encounter hostility or resistance. In worst-case scenarios, students experience bullying and incivility.

“A study by Budden et al. (2017) revealed that 50% of nursing student respondents experienced bullying and harassment behaviours while undertaking clinical placements and that the main perpetrators were registered nurses.”

Exciting opportunities

Despite all the possible challenges, Dr Missen writes that clinical placements can be incredibly rewarding and pivotal for final year students: “One of the most exciting things about the final stages of nursing study is that you will get the opportunity to be more actively and independently involved in patients’ care.”

Another bonus is the opportunity to develop professional relationships and networks with potential postgraduation employers and co-workers: “The clinical placement environment provides students with the opportunity to foster relationships with nurses who may be potential referees for graduate year applications.”

Dr Missen’s key points of advice for graduating student nurses:

• Be professional and maintain safety: Dress according to the specified uniform. Be punctual – arrive at least 15 minutes before shifts.
• Maintain standards and scope of practice: Follow appropriate clinical procedures and protocols under the supervision of a registered nurse and work only to the level of practice commensurate with your nursing program.
• Be self-directed: Meet with your preceptor on your first day of placement and go through your learning objectives. Identify your strengths and limitations and set goals each week.
• Acknowledge limitations: Intellectual honesty is critical to safe practice. Acknowledge when you do not know something. Ask questions, seek help and support.
• Seek regular feedback: Actively request feedback from staff you are working with. Be aware that feedback can be formal or informal, so be sure to monitor verbal and nonverbal communications.
• Access resources: Read local policies, procedures and guidelines. These might include infection prevention and control, dress code, manual handling, equality and diversity, electronic devices, and social media use. Organise resources specifically designed for quick access to medication information, calculation formulas and other essential reference material pertinent to your learning.
• Engage proactively in learning and developing: Seek and engage in diverse experiences to meet your learning goals and develop your capability as a registered nurse.
• Learn about diagnoses and procedures pertinent to your patients.
• Practice procedures even if you have done them before.
• Reflect on what you have learnt at the end of each shift to reinforce learning. Keep a de-identified record of these reflections for your portfolio.

From the chapter ‘Becoming Practice Ready’ by Dr Karen Missen in Transition to Nursing Practice from student to professional published by Oxford University Press

About Oxford University Press:Oxford University Press (OUP) is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. OUP shares the University’s uncompromising standards, defining qualities and belief in the transformative power of education to inspire progress and realise human potential. As a not-for-profit organisation, OUP generates revenue to publish and support the University’s wider educational mission.

Author:
Dr Karen Missen is Associate Dean – Teaching Quality and Senior Lecturer in Nursing at the School of Health at Federation University Australia