Day in The Life of a Student Nurse on Placement
Preparation
Shifts on placement are long and busy. It is really important that you prepare properly! Shifts are normally either 7.5 hours or 12.5 - 13 hours long. Bringing enough food to fuel you for the day is important. I often try to batch-cook for the week - you can’t go wrong with a cottage pie or pasta bake! I also try to make sure I have something nice to get me through the day and, of course, something healthy to keep energy levels up. Along with food prep, when I start a new placement I check out the route, how long it will take me and if there is any parking or public transport available. It is worth bearing in mind that hospital parking often comes with a charge and can be very busy. Speaking to your placement can be a useful way of finding out any tips and tricks for travelling. Sometimes you may be able to carpool with another student, or one of your colleagues on placement might give you a lift to the train station - although there’s no guarantee of this! Placements are very understanding about the travelling involved, so discuss this with them if it worries you.
When you are allocated a new placement you need to get into contact with them to ask about shifts and anything you need to do to prepare. It can also be a useful opportunity to ask for a tour of the ward, to help you get your bearings and meet some of the team. There is always a lot to learn when you are on placement, so it can be a great idea to do some research into conditions you are likely to encounter, or the medications often administered in that environment. For example, I am currently on placement on a respiratory ward, so I need to know about COVID-19, COPD, pleural effusions and asthma among many others. You don’t need to be an expert before you begin placement and the nurses teach you whilst you’re there, but having a foundation of understanding can help you look after patients and understand care plans. The theory from uni will be a really useful source of information for this. Revising some anatomy and physiology helps when you see that theory brought into life in practice. This is also true of clinical skills you would have learnt at uni - in person at Sam Fox House and online on clinicalskills.net. If you have some idea of how to do basic skills you can build on these in practice and get some proficiencies ticked off! Being able to help out by using your clinical skills is also a great way to feel useful on placement. There will definitely be moments where you feel like a loose part, but remember that everyone was a student once. Often if you offer to help someone with a task or to observe you can find some great learning opportunities.
What Does a Day of Placement Look Like?
Different hospitals, wards and community placements have different shift patterns, but here is a general idea of what most placements look like (based on a long day shift on a hospital ward):
- 7:00am Arrive at placement, get changed into uniform and pop your food in the fridge
- 7:15am Start of the shift
You are assigned to a team of patients, this could be anything from one patient to ten depending on the level of care given (e.g. ICU) and on staffing levels. A handover is given by the night shift about each patient, who they are, why they are in hospital, past medical history, the plan for their care and how they have been overnight. You also get a handover sheet to use for reference throughout the day.
- 7:45am Night Shift leave and everyone starts waking up
As a first and second year, you will often spend time with the healthcare assistants and nursing auxiliaries in the morning, helping to get people up, washed, dressed and the bedding changed, ready for breakfast. As a second and third year you are more likely to do the morning medication round with the registered nurse that you are working with. This is normally the biggest drug round of the day so can be overwhelming at first!
- 9:00am Ward Round (Meeting with the Doctors)
A handover from the nursing staff to the medical team. The medical team then reports back later in the day to update each team on the plan for each patient.
- 9:30-11:30am 15min Morning break! (And many other tasks listed below)
- 12:00 Lunchtime
The patients have lunch and you do the lunchtime medication with the nurse. This can include oral, topical, inhaled, injections, suppositories/enemas. In 2nd and 3rd year you can also manage IV infusions (once you have learnt this at clinical skills), although you cannot connect IVs to the patient as a student.
- 12:30-17:00 30min Afternoon Break! (And many other tasks listed below)
- 17:00 Teatime medication round with the nurse, similar to lunchtime
- 19:45 Handover
You give a handover to the night staff about your patients. You develop this skill over three years, by the end of 2nd year it is likely you will manage some of your own patients so you will lead the handover of these.
- 20:15 Finished for the day
Other tasks throughout the day
- Fluid balances and bedside charts
- Assisting with eating and drinking
- Helping patients mobilise or go to the toilet
- Answer questions from patients and families
- Taking samples for testing e.g. COVID swabs, blood tests (as a second or third year)
- Managing bed moves, admissions and discharges
- Chasing up scans and results
- Last offices (when a patient passes away)
- Observations of vital signs for a NEWS score (every 15 minutes to every few hours)
- Checking pressure areas and doing wound care and dressings
- Documentation including care plans, these are something you will do increasingly
- Being ready for anything that comes up!
How you are assessed
You complete reflections based on the work you have been carrying out. Collecting testimonies from patients, families and other staff members are all ways of building up evidence that you are competent at a skill. You also complete a medication round and episode of care with your practice assessor, during which you will be asked questions then write up a reflection afterwards.
Top tips
- Ask lots of questions, even if they feel silly
- Look after yourself - prioritise a work/life balance
- Don’t be afraid to challenge other people (politely) if they do something different to how you were taught
- Make the most of every learning opportunity
- Don’t feel guilty for being a student. Everyone was one once! It can be easy to feel like you’re in the way, but you are there to learn and with the right support, nursing students can be really useful! (Especially when there's a staff shortage!)
- Remember that it’s normal to get overwhelmed or struggle with studying alongside placement. Be proud of yourself for getting where you are, be honest if you need a break or more support.