What's it like on a nursing placement?

Caroline Buttress

Faculty: Health, Education, Medicine and Social Care
School: School of Nursing and Midwifery
Course: BSc Adult Nursing
Category: Nursing and midwifery

2 November 2018

This is usually the question that dominates conversation when talking to new or prospective students. The answer is not straightforward because no placement is the same.

I am now approaching my final year (scary stuff!) and have had a variety of differing but equally interesting placements.

Year 1

Hospital ward specialising in elderly care dementia and delirium
The placement was eight weeks long in total, broken up into four weeks before Christmas and four weeks after. This was not only my first ever placement but, as I do not have a healthcare background, my first ever experience of real hands-on patient care.

During this placement I was very much learning the ropes and my mentor (a senior staff nurse with ten years' experience) was an excellent support. Day-to-day tasks included personal care for patients, medication administration, writing individualised care plans and supporting and assisting patients confused by dementia or delirium. I had the opportunity to spend the day with the dementia specialist nurse, who gave me some fantastic advice on how to assist patients with dementia without taking away their independence. 

The team was made up of diverse professionals including physiotherapists, occupational therapists, pharmacists, doctors, healthcare assistants and obviously nurses. I was encouraged to work alongside everyone to enhance patient experience and eventual discharge.

Hospital ward specialising in caring for orthopaedic patients both pre and post operatively
Again this placement was over a duration of eight weeks with a two-week break for exams and essay submission in the middle. 

Most patients on the ward were admitted for elective surgery and in the main, hips and knees replacement dominated the workload. Patients arrived early on the day of surgery and I would begin by writing a full admission booklet and completing a pre-operative checklist. The admission booklet is a good way of getting to know your patient and gaining insight to their home life and any social needs they may need post-surgery and upon discharge. 

Patients were sent down for surgery and, on a number of occasions, I was lucky enough to join the specialist orthopaedic nurse and the surgical team in theatre and witness the surgery. 

After surgery, patients spent a short time in recovery before returning to the ward. My roles post-surgery included checking patients vital signs, writing care plans, liaising concerns to senior staff, changing wound dressings and removing drains from operation sites.

The staff on the ward were hugely supportive and willing to facilitate my learning wherever possible. I was very sad to leave.

Emergency department psychiatric liaison team
Although I am not training to be a psychiatric nurse, I have come across many acutely ill patients with varying levels of mental health problems, therefore I feel this placement was hugely valuable for my future practice. 

Based in Casualty, this team of psychiatric doctors and nurses tend to every patient that presents in A&E with mental health problems. The caseloads varied massively from acute illness exacerbated by anorexia, to unsuccessful suicide attempts. Whatever they were presented with, the psychiatric team did their best to give relevant support there and then, and offer additional support when they were discharged. My role was very much observational but the experience has definitely enhanced my practice.

Year 2

Hospital ward specialising in haematology and oncology
Because cancer is so non-discriminate, this placement was probably the most emotionally challenging for me. 

Unlike previous wards I had worked on, many of the patients were closer to my own age and were also parents of young children. Despite the emotional challenges of this placement I didn’t let my feelings deter me but instead used the emotions to drive my quality of care. Tasks varied widely but included personal care, care of the dying, offering comfort to family, administering medication and organising home care for patients who wish to be at home.

The team on this ward work very closely in order to give excellent patient care and make a difficult time as easy and uncomplicated as possible.

Critical care unit
This is my current placement area and again, it's very different from any other setting. Unlike any other acute award where a nurse may be allocated around eight patients, critical care nurses are allocated a maximum of two patients depending on the level of care required. 

During this placement I have cared for a number of heavily sedated patients that are mechanically ventilated for a variety of reasons. Other patients come to critical care due to severe infection and require therapy such as haemodialysis to rest their kidneys and filter their blood. They are lucky enough to have their own clinical educator, who is very keen that students get the most out of this practice area; she even ran an education day to help with our exam. 

I have also spent some time with the Critical Outreach team assisting with assessments and advising ward-based staff on appropriate care.

Looking to the future

So there you have it, my placements so far. As I said before: all different, but all interesting in their own right. 

I still have a number of short two-week placements to complete this academic year with the health visitors, at a doctor's surgery, in an outpatients department and finally within a community team. 

I have been very lucky to have enjoyed all of my placements, but it makes the decision of where I eventually want to practice a tricky one...!


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