Final nursing placement: looking after my own patients

Final-year nursing student Abbi has been on placement on a children's ward, treating her own patients under supervision. She reflects on all that she has learnt.

At the start of my final year studying Child Nursing, I was lucky enough to be able to go back to the children’s ward that I had my first placement on as a student nurse. I found this very exciting as it meant that I would be able to see how I have developed since my first year.

Back on the children's ward

This time around, I was able to start working towards looking after my own workload of patients with my mentor’s support.

On my first day back on placement I was very nervous, however my mentor reassured me and we set out my goals for the placement. These included looking after a workload of up to four patients.

How the children's ward works

A day on the children's ward starts at 7.30am and all staff have a 'safety huddle' which tells us if there is anything we need to know about. We are then assigned to our areas. On this ward there is the paediatric assessment unit (PAU) in which children are observed and assessed to see if they need to be admitted to the ward. There is also the ward which is split into two sides known as Side 1 and Side 2. Allocations often vary which meant I got the chance to learn how to assess patients and their needs as well as looking after them on the ward.

My first shift

After getting used to the ward again and any changes, I decided it was time to start looking after my own patients (with my mentor supervising me at all times). I started with two patients.

Patient A (confidentiality means I cannot disclose their personal information) was a baby who had bronchiolitis. This is a common lower respiratory tract infection that affects babies under two years old.

Patient B had just had a tonsillectomy (their tonsils removed). I felt these patients would be a good start and would help me develop some prioritisation skills too. I found managing two patients was fine, therefore I decided on my next shift I would push myself and look after three patients.

Second shift: managing three patients

I took three patients my next shift.

Patient A was a child with blood in her stools and vomiting; patient B was a child with meningitis having daily antibiotics; and Patient C was a child who had had a 6cm growth removed from the throat.

Having three patients was very tough so I decided to plan the day. I wrote down exactly when I needed to give the children medications and exactly when they needed their observations such as heart rate and temperature completed.

I gave myself time to document, too. Documenting exactly what happens throughout the day and any changes to patients' care plans is very important, so that other nurses and professionals are aware of what is happening with their care.

I also had to do medications. Policies state that student nurses are not allowed to give patients medications autonomously, therefore I worked with my mentor to ensure they were given on time and correctly. This meant I had to make sure that I knew what my mentor was doing so I was giving her enough notice when medications needed to be given.

What I learnt from my final placement

When taking your my own patients:

• plan out the day so that you do not forget to do vital things such as giving medications
• make sure there’s time to document and do it throughout the day not at the end to prevent forgetting vital information
• always ask for help when it is needed.

What I liked about looking after my own patients as a student nurse:

• I was supervised which meant that if I needed lots of support, I could ask my mentor
• I was learning whilst working with a real-life patient which helped my knowledge of the body
• I got to practice my medication management skills with my mentor.

What I found challenging:

• my mentor had her own patients meaning we had to balance both patient loads and ensure we were prioritising their needs
• sometimes I didn't know the answers to questions that parents asked; however, this was also a positive as it helped me learn.

Looking after my own patients has made me even more excited about qualifying as a nurse and I cannot wait to be able to do this autonomously.

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