Your training and career rest upon one final placement, it is the most important of them all, you must demonstrate to your ‘Sign-off Mentor’ that you are ready to qualify.
This post contains the advice I wish someone had told me prior to my management placement. While I encourage you to read the whole article, I’ll put the important bits in BOLD.
The first thing you need to understand is that being a sign-off mentor is a big responsibility and as a Student Nurse you can’t just assume you will pass simply because you have made it through 3 years of training, a lot of people do and will carry on failing at the last hurdle. The next few months of your life will be a test, of sorts, the Registered Nurse you are assigned to will be looking at you, in great detail, to make sure you’re ready for life of a Nurse.
Now, every mentor is different, this isn’t going to be a guaranteed guide to passing your management placement, I am simply drawing from my own experiences as a sign-off mentor and the criteria I like my students to fulfill.
First and foremost do a little research, take control of your education, you aren’t going to be spoon fed anymore – after all you won’t be as a Nurse. You need to have an idea about the speciality you have been assigned to before you arrive. For example, If your going to a respiratory ward make sure you know the basics about the conditions they treat (asthma, COPD, CF etc) and the difference between type 1 and type 2 respiratory failure. I can firmly recommend the Nursing Survival Guides by Ann Richards to assist you in this, they are fantastic! Small and pocketable you can take them to placements easily.
If you have been given an induction booklet, read it carefully.
Make sure you’re on-time, flexible and organised. This is something I can’t stress enough, in a few months when you’re a Registered Nurse you will need to be on time otherwise who will look after your patients? Demonstrate you can do this and your mentor is likely to be understanding when you need to swap a shift or have study time. We also understand you need a social life but don’t try to take us for idiots, be honest – we respect that.
The Universities change the paperwork mentors need to complete on a near daily basis make sure you know what needs signing and when.
Next you MUST have the right attitude when you’re at work, we understand that being a Student Nurse is hard, we’ve all been there, but you’ve got to demonstrate how much it means to you to have the title ‘Registered Nurse’.
We will want you to have good medications knowledge – in a few months you’ll be doing a drugs round by yourself. Make sure you have a good foundation and basic knowledge of; pain relief, antihypertensives, antiarrhythmics, diuretics, antibiotics and drugs that are specific to the area you’ll be working in. Invest in the ‘Drugs in use’ Survival Guide and carry it with you on medication rounds, if you don’t know a drug look it up quickly.
You will need to know your limitations and development needs. Know when to stop and ask for help, don’t just put on a front – ask questions!
Don’t overstep the mark, admit that sometimes it’s best for you to take a step back and let the people with experience take over, speaking to irate families and dealing with delicate situations is something that comes with experience.
Make sure you take every learning opportunity during your placement, in a few months when you’re in numbers you won’t have the time to have an insight visit with a specialist nurse – do it while you still can.
Try and integrate into the team and demonstrate you are a team player, this will have a big effect on how you’re perceived on the ward and ultimately your reference. More than anything don’t be ‘too posh to wash’ – it will be something you’ll miss once you qualify.
Learn how to talk to patients, after all they are human beings too and need reassurance and comfort. I thoroughly enjoy having students who have great communication skills, as this is something that’s very hard to teach and therefore learn.
You need to respect the nursing assistants, sometimes they feel overstepped by over-zealous student nurses. If you respect them, they will respect and help you when you need it the most, remember effective delegation is an outcome!
Make sure you’re able to manage your time and a patient load, start off small 1 or 2 patients who you know everything about and increase this number as you go through your placement. Take a look at our Shift Planner for help planning your day and care.
These things combined will contribute to you having a smooth and effective management placement although all being said and done, it all falls down to if you can demonstrate to your mentor that you are safe and fit to practice.
Do you have any advice you could share with your fellow student nurses? Post it in the comments section!
Preparing For Your Placement
Preparation is key.
Preparation for your placements will give you confidence before you start and can put you ahead of the game.
You should try and visit your placement area before you start. Wards and units can vary greatly. Visit the area you have been assigned to before you start and ask if there is anything you should be aware of prior to starting.
Identify your learning needs and outcomes as early as possible. Identify these early and be aware of the skills you want to develop or learn – this will help you get the most from your placement.
Know your documentation. Ensure you have clarified with your university which parts of your training documentation need to be completed by your mentor. It can be hard to complete these at a later date.
We have created several useful guides on preparing for placement in specialist areas, you can find those here:
- Preparing for your placement in clinical heamatology.
- Preparing for your placement in accident and emergency.
- Preparing for your placement on a respiratory ward.
- Preparing for your placement in critical care or intensive care.
You may also find out guide on how to survive your management placement useful. The most important piece of advice I can give you is to ask questions, get involved and tell somebody if your unsure.
Preparing for Your Placement in Clinical Haematology
Clinical haematology can encompass a range of sub-specialities.
Clinical haematology wards are busy places, full of very sick patients – understanding the basics will put you ahead of the game.
Clinical haematology can encompass a range of sub-specialities such as; bone marrow transplant units, general haematology wards, haematology clinics, genetic mapping centres, obstetric haematology and day case units.
Throughout your placement you will be exposed to a multitude of haematological conditions and it will be a unique opportunity to develop skills, knowledge and gain confidence in dealing with these.
Patients in these areas, generally, have very poor immune systems – so you’ll be advised to stay away or wear a mask if you arrive at placement unwell.
What to Expect from your Placement
The ward or unit routine will differ from trust to trust, but this is something you will pick up quickly – so get as involved as you can.
You will see the day-to-day management of conditions such as; leukemias, lymphoma, myeloma, sickle-cell and various clotting disorders. Over-time these patients become very knowledgeable about their conditions – so use them as a resource to learn.
Most units actively participates in clinical trials governed by the National Cancer Research Network (NCRN). This will involve patients trialling potential new treatments for heamatological conditions.
You should get plenty of experience managing a septic patient. You should familiarise yourself with ‘Sepsis 6‘ and clinical escalation within your trust; Doctors, CCOT, Emergency Medical Teams, Hospital at Night etc.
Preparing for your Placement
There are a few things you can do to prepare for your placement within clinical haematology;
Try and visit your placement before you start. Wards and units can vary greatly. Visit the area you have been assigned to before you start and ask if there is anything you should be aware of prior to starting.
Identify your learning needs and outcomes. Identify these early and be aware of the skills you want to develop or learn – this will help you get the most from your placement.
Brush up on your anatomy and physiology. Familiarise yourself with the mechanisms of bone barrow and the haematopoietic stem cell cycle.
Read up on the basics. You should read up on the basics of haematology – familiarising yourself with the different types of leukemias, lymphomas and myelomas. The MacMillian, NHS Choices, Cancer Research and Bloodwise websites are fantastic recourses to help get to grip with the basics.
Understand the social impact on patients. A cancer diagnosis can be devastating to both an individual and a family, with individuals remaining inpatients for months at a time. Consider the impact this would have on a family; emotionally, financially, spiritual, sexual, professional etc.
Learn about neutropenic sepsis. Neutropenic sepsis is a life threatening complication of anticancer treatment and a genuine medical emergency. haematology patients have a tendency to deteriorate quickly so be sure to escalate to your mentor if you discover an unwell patient.
Research area-specific medications. You should read about commonly used anti-virals, anti-fungals and antibiotics. You could also invest in the Drugs in Use (Nursing and Health Survival Guides).
Understand the risks and complications of blood transfusions. You will see patients being frequently transfused with red blood cells or platelets. Understanding the complications and reasoning behind these transfusions will put you ahead of the game.
Look at ABCDE assessments and their importance. This systematic approach is used for the assessment and treatment of patients ABCDE model.
Chemotherapy will be administered in these areas. Although it will be interesting to watch you will be limited in your involvement due to the enhanced training required to administer.
Getting the most from your placement
Haematology wards and units are usually very busy places, although you are supernumerary their will be jobs you’ll be asked to undertake independently once deemed able. There will be the chance to easily obtain learning outcomes and measures of practice.
You should use this placement to gain experience managing a patient load, managing a septic patient, clinical decision-making and, if possible, arranging insight visits with specialist areas.
The final and most important piece of advice I can give you is to ask questions and get involved.
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