So...you are about to go on placement: A guide to placements for students by students
Guide to placements
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Introduction Section 1: Pre-placement allocation Section 2: When you’re on placement Section 3: Post-placement A day in the life of health and social care students on placement: Student midwife Adult student nurse Paediatric student nurse Learning disability student nurse Mental health student nurse Operating department practice (ODP) student Paramedic student Student diagnostic radiographer Student radiotherapy radiographer Social work student Social work student (statutory placement) Speech and language therapy student, (adult placement) Speech and language therapy student, (paediatric placement)
Introduction
Introduction This booklet is the result of students from a variety of health and social care professions reflecting on their placement experience. Having met on a number of occasions the students were surprised to learn from each other, even within similar disciplines. However, irrespective of background there was a great deal of common understandings that shaped their placement experience. As a result students sought to offer advice in order to assist other students, to enable them to make their own placement experience as successful as possible.
The booklet is divided into three sections Pre-placement, Placement and Post-placement. In addition there are brief accounts of students from different disciplines offering an insight into a day-in-the life of a student on placement. There are some very useful hard earned nuggets to be found within the booklet, I’m sure you’ll agree! Dr Phil Shelton Senior Lecturer
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Pre-placement
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Pre-placement
Pre-placement
Things you can be doing before the placement is allocated Be prepared!
Be proactive!
• Invest in comfortable shoes! Many courses will have to wear these in some pre-placement mandatory sessions such as Basic Life Support. Either way, your placement shoes are going to be your best friend so get something durable and comfortable and your feet will thank you. • Familiarise yourself with the relevant course material and there may also be skills sessions offered including using particular techniques, assessment tools and even equipment such as hoists and the radiotherapy VERT suite. • Sometimes you may have to fill in sections of your placement documents beforehand so go through the booklet to have an idea of what is expected of you in terms of skills and existing knowledge. • Have an idea of expected dress code and make sure that your uniform fits properly as you need time to sort this out, if this is applicable to your course. • Meet your personal tutor. For courses such as nursing and radiography, you will have the same personal tutor for the whole three years but for others such as Speech and Language Therapy you will have a placement tutor that you can contact. Often they can give you advice on what work to do beforehand and contact details of who to speak to in university if you might want extra support. • Familiarise yourself with professional codes and policies. • Make sure you know how many placements you will have to undertake, how long they will be and when they will be. In your course plan, there may be periods in the year where you can take an extra placement if you do not pass first time. If you are unsure of these, talk to your tutor. This varies a lot between courses so it’s important to check! • Be aware there are diverse placements within your discipline and your experience can vary a lot. • Be aware of the financial implications of going to placement including petrol money or cost of public transport. You may be eligible for financial assistance and your costs may be reimbursed but you will still need to pay upfront. • Read through your course handbook before so you understand that in some courses, such as nursing, from your first placement you are expected to work over a full 24 hour/7 day period and you will not be able to book regular shifts either on placement or as a part time job. • Get to know key pieces of legislation and Policy. Get up to date with current affairs. Keep an eye on the 'community care' website. 5
Pre-placement
• You may also have to complete mandatory training sessions such as Basic Life Support and Manual Handling before being allowed to go onto placement. Chase these up if you have not completed them. • Also make sure to attend all Occupational Health appointments and complete your DBS application. There are staff at university that can help you with these if you are having problems. • Your professionalism starts before you begin placement, so really think about how much information you share on social media. You may also want to think about how easy it is for staff and patients/ service users to find you through search engines and what they can see if they do.
Take every opportunity
You have been allocated a placement – hurray!! • Talk to your tutors about how long before starting you should make contact with your placement. This may be via email or call. • It is important to understand what hours this placement covers as this will have implications for any childcare you have to arrange. Get this done as early as possible! • Research the placement before making contact, for instance look them up on google and find out where they are based. Try and find up-to-date contact details if these have not been supplied on your allocation. Sometimes this can be tricky but stick at it! Contact the Placement Allocations team if you are struggling. There is a useful space to write down their email at the back of this booklet so keep it handy for future placements.
Don’t be afraid to ask
You made contact!!! Questions you might want to ask • What would the placement expect you to wear: will it be uniform or would it be smart casual? Will you have a minimum sleeve length? What about shoes? What about hair? What jewellery is allowed? What cultural dress is appropriate and might you be restricted on colour and style? • Find out about the patient or service user group you will be working with, this way you can start doing background research on the conditions they might experience and any relevant anatomy and physiology. • What time are you expected to arrive on your first day? Some hospitals operate shift patterns and you may be expected to arrive
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Pre-placement
• •
Be valued and respected
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at 7am. Some placements may give you an ‘off duty’ or rota for the week you start but make sure to be clear on the hours to expect following this and don’t be worried if they have not prepared this in advance. Also, some placements do not expect students to work bank holidays so check this too. Once you know, begin to plan travel. What parking is available? Do you have to pay in advance? If so, talk to staff about arranging a permit if one is available. Are there any facilities on site for lunch or should you bring your own food? Also think about staff kitchen facilities. Sometimes you will have access to a microwave and hot drink facilities but it’s best to never assume. Sometimes there are changing facilities and lockers available for staff. Do you have to arrive in uniform? Can you store your normal clothes in a locker and do you need a pound coin, token or padlock to use them? Have placement staff got any recommended reading before you start or particular terminology that you need to be familiar with? This will vary between clinical areas and even between the same unit in different trusts. Some placements like if you make contact, others do not. Some placements like if you come for a visit beforehand, others do not. Don’t worry! Discuss the supervision process, including what you wish to gain from effective supervision. Discuss your anxieties.
Placement is hard on the first day so expect to be overwhelmed – here are some practical tips! • Always before your first day, have a trial run of the journey, especially at the time you are expected to arrive if you may be in rush hour. It’s always best to allow plenty of time. • Take too much on the first day because you can always whittle it down. That includes snacks! Also, stock up on black pens. • Take a note book and pen that can fit in your pocket so you can always jot things down. Sometimes you may need to take other stationary such as red pens or a short ruler, so speak to staff and other students beforehand so you are prepared. • Get a folder for important documents but make sure to adhere to confidentiality guidelines and information governance. • Ensure the placement has your emergency contact details if you are happy to disclose them. • Find out what to do if your assessor is ill and the procedure if you are. • Purchase a decent diary! 7
On placement
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On placement
On placement
Whilst on placement it is important to: Remember you’re a student and not qualified
Smile it will be worth it
• Introduce yourself as part of team to assimilate. Remember that you are not just or only a student. You have worked hard to get here and all the professionals you are working with will have been students at some point too. • Work with what you’re comfortable with. Never be afraid to ask questions because you are there to learn. No one expects you to know it all! Also, remember that in university you are taught absolutely up-to-date techniques so staff may even be able to learn from you. Don’t be obnoxious, though. • Have someone available to talk to other than your mentor or assessor. This will give you different perspectives and there will always be some people that you find more approachable. • Gain as much multidisciplinary team (MDT) experience as possible. Try shadowing different staff if you don’t get direct experience. • Look at the different approaches different staff have and pick up tips from them. Some people love to carry a spare pair of gloves. Also, remember to put your apron on before your gloves! • Never be afraid to be proactive. Talk to other staff members, spend time with different staff, talk to the patients! Their journeys are important and the point of you being on this course is to care for these people. • Attend any extra talks or workshops you are offered as these can be valuable learning experiences. • Learn to be emotionally resilient. It’s ok to cry! You will learn your own coping techniques to stop yourself from having a meltdown on the ward/unit. • Practice communication skills. Think about how you come across and the way you explain the techniques you are using. How would this come across to your patients and service users? Make sure what you are saying is right rather than using terminology you may not understand or which may be misinterpreted. Try practicing on people outside of the placement: maybe your family and friends. • Understand your boundaries as a student! Think about the course handbook, trust guidelines on students and the code of conduct for your profession. • If you are not sure about doing something, don’t do it! You are working with real people and saying you don’t know will keep them safe, keep you safe and ultimately earn you a lot more respect from the people you work with. • Always make a note of who to contact on placement if you are late or ill. Even if it feels like it will never happen, be prepared! 9
On placement
Take every opportunity that is offered to you
• Always be professional. Some tasks might be strange, difficult or outside your comfort zone but never lose sight of the fact that you are there to learn and your priority is the wellbeing of the people in your care. • Talk to staff and make sure you know who in occupational health to contact should an incident occur. Different teams will have different risks and different processes. • Know who to discuss concerns with if there are professional differences, although this can be a learning opportunity. • A top tip is to try and keep on top of your book or any other progress documents you might have to complete. Try not to leave all your work to the last minute as it may be more difficult to be signed off by your mentor. It also means you realise early if there are clinical skills you cannot do in your immediate placement area and organise pathways with appropriate teams. • Another top tip is to use any opportunities you have to use the toilet as you may not get another for 8 hours! • Finally, placement is likely to be difficult and it may be that you have no previous experience. It is incredibly important to have a good balance between your practical and academic studies and also your home life. Make time to do things you enjoy and see the people you care about. • Engage with all available training opportunites.
What to do if things aren’t going to plan • If you are concerned about anything you have seen in practice, then always talk to someone about it. • Talk to your tutor. The level of involvement of your tutor varies between courses and some may come and see you in practice every couple of weeks whilst others you will need to request a visit from. Your personal tutor is usually your first contact if something goes wrong but you might want to speak to another tutor. The important thing to remember is that there are always people to speak to and support you in university. You are never on your own. • If you need to raise concerns over poor practice, there are Whistleblowing strategies available for each trust. Think of the professional guidance that states it is your duty to raise concerns. It can be very hard but it is important to find the courage and strength to look after the people in your care.
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On placement
It’s ok to cry!
• Sometimes you might have problems with other team members. It may even be that you don’t get on with your mentor. Before escalating this, do your own research on strategies for dealing with adversity either from a patient or within team politics. Sometimes one of the most important things you will learn on placement, is your own resilience. • In severe cases, you may have to escalate this and the placement teams in university do work hard to look after you. • Student funding can also be a huge problem but make sure not to push yourself to take extra shifts in paid work whilst on placement because this is likely to make you ill and cause problems when applying for the bursary after exceeding the designated hours under the European Time Directives. There is support available in university from Student Services. • Student Services also offer confidential support if you are having problems away from the course or difficulty finding a good work-life balance. • Remember that thousands of people graduate from health and social care courses at Birmingham City University every year so it is possible, and the staff here want to help you. You are never alone to deal with problems.
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Post-placement
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Post-placement
Post-placement
Post-placement Some courses have designated reflection sessions with your coursemates. This is an opportunity to share some of the experiences you have had and talk it through with staff. As well as these sessions, you might want to: Always communicate
Value and respect yourself and others
• Create your own MDT. Get to know people on other courses and take time to have a coffee with someone from another discipline to reflect on your placement experiences. This way you have a better understanding of what students in other fields or courses do. It is also interesting to get an external perspective on some of the issues you have dealt with. • Prepare for going back into university by going through any placement books or documents you have and make absolutely sure they are complete and signed. • You may want to write down a reflection on a critical incident, experience or skill you have gained. This practices the process of reflection and allows you to think about the situation from different perspectives. There are many different reflective models and there will be some that you enjoy and benefit from more. It also demonstrates that you are keen to get the most from each placement and want to apply your learning to future practice. • Practice some of the skills you have gained. Students on some courses may want to use the SPACE skills labs to practice some of the clinical skills including life support, wound dressing, injection technique, taking physical observations and many more. It is also important to maintain good communication skills so practice on colleagues, friends and family.
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A day in the life
A day in the life of
health and social care students on placement
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A day in the life
A day in the life of a student midwife on placement Long, exciting, challenging, interesting and exhausting, are just a few words that could be used to describe a day on placement for the student midwife. A word that could never be used is ‘boring’; each day brings the unique stories and circumstances of a diverse group of women and babies. You could be caring for a woman having her fourth baby, uneventful pregnancy, all previous normal deliveries and spontaneous labour, or a woman having her first baby with gestational diabetes who developed high blood pressure and was delivered at 37 weeks via emergency caesarean section. Perhaps you have a booking appointment with a woman that speaks no English or a postnatal home visit to a baby with suspected jaundice. Under supervision, students are involved in every aspect of day to day care and practice profiles outline a number of proficiencies that require a mentor to sign off as competent. Taking manual blood pressure, blood samples and assessment of birth trauma are just a few of the named skills that are to be learnt on placement as a student midwife. The nature of midwifery means that with consent, we get up close and personal with the women in our care. For example, during the antenatal period, it is routine to examine the pregnant abdomen to determine baby’s position and listen to the heart rate using various equipment. On delivery suite you will be required to participate in vaginal examination and the postnatal period will include giving lots of breastfeeding support, checking wounds and emptying catheters. Then there are the babies. Other ways in which student midwives participate in assessing baby’s wellbeing in the antenatal or childbirth period is the use of equipment to obtain a trace of the baby’s heart which can determine any deviations from the norm. Student midwives also accompany women to scans and monitor fetal growth by taking measurements of the mother’s abdomen. Under supervision, students get hands on experience of delivering a baby and undertaking the newborn initial examination which involves a head to toe assessment of baby’s wellbeing soon after birth. This monitoring of wellbeing continues into the postnatal period where student midwives will participate in weighing babies, being vigilant to common deviations such as jaundice and advising new mothers re feeding and other health education ie cord care. During a day on placement, student midwives will participate in the 15
A day in the life
safe preparation and administering of medications to both mother and baby including those given via injection. There are very few limitations to the role but do include controlled drugs and operating pumps used to administer medication through the vein, however, learning can still take place through observation. Once training has been provided, students are also able to monitor the blood sugars of mother and baby which is a common procedure on the postnatal wards. Students are expected to enhance their communications skills during placement and are required to communicate clearly and effectively verbally, electronically and via written documentation. Dialogue within the multidisciplinary team is required on a daily basis whether beeping a porter to collect bloods, taking a plan of care from a doctor following a ward round or neonatologist following review or handing over care to colleagues at change of shift.
A day in the life of an adult student nurse on placement Nursing requires long hours with early starts, some might find the added travel time makes for a very long day but when you’re taking care of your patients, making decisions that have a big impact on their treatment or holding their hand and helping them through a difficult moment, the time seems less significant and you get absorbed in the role of being a nurse. Whether you’re on a ward or in a community based placement your shift will invariably start with handover. This is an opportunity to learn a bit more about the patients under your care: why they’ve come in to hospital and the plan for them in the future. Having a notebook to hand so you can write down any abbreviations or conditions you don’t understand means you can ask your mentor about them and improve your knowledge base. After handover a shift on a ward really comes alive. Whether you’re administering medications with your mentor, assisting serving and feeding breakfast to patients who need a little extra support or starting to help patients with their personal hygiene needs, you’re going to be busy! Each ward varies and each day varies: with admissions and discharges, differing specialities and changes in an individual patient’s condition you can never assume that one shift is going to be the same as the previous. You have to listen to your mentor, use your own skills and knowledge appropriately and work with the team around you to adapt to the changing needs of your group of patients. 16
A day in the life
There are always so many tasks to be done: drawing up intravenous (IV) medications, changing dressings using aseptic non-touch technique, skin inspections, nursing documentation, observations, escalating concerns or requests to the doctors, accompanying patients to imaging department, attending ward rounds or MDT meetings, working with specialist nurses and other members of the MDT on the ward or in clinic. The list is endless and sometimes you can even be surprised by the things you do to support the health, comfort and independence of your patients. As the day progresses you will get opportunities to ask questions, of your mentor and of the patients themselves. With long term conditions the patients or their carers are often best placed to help you learn more about their conditions. Some patients may be upset about being in hospital or due to a recent diagnosis, taking the time to sit with them and listen to what they have to say is richly rewarding for both patient and student. Nurses don’t just work on wards and each different place of work will have their own routine. You may work in a GP surgery or visit patients in their own homes but the principles of the care you offer and the attitude you show should be the same. Each shift as a student nurse is an opportunity to learn something new and to grow and develop into your role.
A day in the life of a paediatric student nurse on placement A shift will typically begin at 7.30am, so you will arrive about 5/10 minutes early especially if its your first shift as you will want to meet your mentor before you go into handover. At 7.30am, handover will begin and the nurse in charge of the previous shift will run through each patient on the ward. After this the nurse in charge of your shift will allocate patients to each nurse (between 2 and 6 patients depending on the dependency of the ward you’re working on) and you may then receive a more detailed handover from the nurse that was looking after these patients. At around 8am, along with your mentor you will introduce yourself to all your patients and do the bed space checks to make sure every patient has working emergency equipment at their bed space. You will also check their folders and make a plan for the shift with your mentor so you know when every patient is due a feed, medication, observations, or any scans or operations they’re having that day etc. 17
A day in the life
8am is also around the time that a ward will start a drug round so it’s important as a student that you try to do as many of these as you can to learn your medication administration skills. At this point if you have any patients for theatre it’s important to make sure their theatre checklists are done and they’re prepped for theatre. After you have made sure all your patients and their parents (most children will have a parent stay overnight with them) are awake and had breakfast you can start the bed baths/baby baths on any immobile patients. If parents are present it is important to negotiate nursing cares, like feeding, washing and giving medicines, with them as part of family centred care. Around 10am doctors will start the ward round, when they get to your patients try and have the 10am observations completed and stay to see what the doctor’s plan is, discharge, continue same treatment or more investigations. After this you will usually sit down with your mentor to discuss your patients and who will do what. As a student you will often be asked to take patients and their parents down to theatre, stay while the child is anesthetised and then bring the parents back to the ward and explain what happens next and comfort them. The rest of the shift consists of observations and reporting back to your mentor, filling in fluid balance charts, answering the phone, helping doctor’s to take blood and cannulate distressed children, passing and setting up nasogastric feeds, bottle feeding babies, changing nappies, admissions, discharge, helping out and observing other members of the multi-disciplinary team such as physiotherapists, occupational therapists and speech and language therapist and practice drawing up medications with your mentor. As a student you can usually take your breaks when you want but most of the time if you go opposite your mentor then there’s always someone looking after your patients who they know. If there is any a point when the patients you are looking after with your mentor are all up to date with their cares then you help out other nurses with their jobs, fill in your placement book, arrange visits to other areas like theatre or outpatient clinics, or go and play with the children that are bored or don’t have any visitors. At the end of the shift your mentor may ask you to write in the patient notes and they can then check and counter sign them. Together you will update the handover sheet for the next shift and your mentor may then ask you to give handover to the next nurse caring for your patients.
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A day in the life
A day in the life of a learning disability student nurse on placement A typical day in the life of a learning disability nursing student doesn’t exist as there is no such thing as a typical day in this field! You work with a variety of people and I have learned something new from every single one. There is an emphasis on person-centred care, on strengths and potential, on meaningful engagement and community involvement. At the beginning of a shift you will receive a handover then reflect and plan for the current shift; nurses coordinate care and diaries are full of activities and appointments. Nurses work inter-professionally with: speech and language therapists, social workers, psychologists, psychiatrists, physiotherapists, community nurses and GPs (to name but a few). As a source of current information you can promote evidence based practice for colleagues within the working environment and many people who work in this area are caring, creative, proactive and passionate. A lot of people with learning disabilities have comorbid health conditions and require physical health interventions. You will administer medication under supervision via a variety of routes: oral tablets, liquids, injections (e.g. insulin), topical ointments and medication and nutrition via percutaneous endoscopic gastronomy (a tube in the stomach) and nasogastric tubes (in the nose). You learn a lot about medication and you have to be vigilant and have a good knowledge of contraindications and side effects as the person you are supporting may not be able to verbally communicate that they are feeling unwell. It is up to learning disability nurses to share knowledge by educating and supporting care staff and communicating concerns to professionals in Multi-disciplinary team meetings. You will learn about capacity, consent and best interests and most importantly you will promote autonomy and include the people you are supporting; ensuring their voice can be heard by using their preferred method of communication. You will assist with personal care which can involve assessment of skin tissue viability and general health as well as determining how much an individual can do independently with the right support. Wearing a uniform is not usually required as most settings are not clinical, they are often in the person’s home and this can seem less personal however you will still have to ensure you are dressed appropriately being mindful of infection control as well as being able to be free to move and get involved in a multitude of activities. You will act as a health facilitator, counsellor, detective, activities 19
A day in the life
coordinator, behaviour analyst, fitness instructor, lifestyle coach and much more. The role of a learning disability nurse is varied and depends on the individual, you can support people in a range of environments: home, respite, school, hospital, prison, employment. You advocate for people and find that it is often the social factors and not the learning disability itself that makes people ‘vulnerable’. As a learning disability student nurse I feel privileged to be able to practice holistically; considering every important dimension of an individual’s needs and feeling like I am able to make a real difference.
A day in the life of a mental health student nurse on placement I think the thing that struck me the most during my placement experiences is just how varied each day and each different placement can be! It may sound like a cliché, but there really are no two days the same in mental health nursing. But really, that is one of the reasons that I love it! A ‘typical’ long day shift on an inpatient placement will start at 7am and you will be on shift until 8pm. This means it involves getting up at an hour that seems like the middle of the night (between 5am and 5.30am for me) to get dressed into your uniform and prepare your bag and pockets with all of the many things that you may need during the day. I usually aim to arrive 15 minutes before the start of shift to allow time to get into the unit and make a cup of coffee and say hi to my mentor and those I will be on shift with. The shift will begin with a handover from the shift before detailing information about all of the service users on the unit and any tasks that need completing for the day. At 7.30am, the night staff leave and you begin the day. As I said, no two days will be the same, but there will almost always be medication rounds to complete and you will work with your mentor to ensure that you have a good understanding of what medication you are administering, the correct dosages and the potential side effects. There may be a multi-disciplinary team meeting where you may be expected to present nursing feedback on some of the service users and to advocate for them in their care plan. You will have to get used to answering and making phone calls and being confident in writing notes and making referrals.
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A day in the life
As a student, I have found that I learnt so much from simply talking to the service users and making myself available to them, whether that be to chat about their medication, the voices that they may be experiencing, or to play a game of pool, table football or scrabble. Time will be spent carrying out therapeutic observations, assessing a person’s risk for their section 17 leave, care planning with a service user or going along on escorts to the local area (although never alone, as a student). Getting your head around all of the legal aspects of mental health nursing can seem massively daunting in the beginning, with terms like section 2, section 3, AMPH, SOAD, IMHA, section 17, section 5(4), section 132 rights, tribunal and many more being encountered daily. The thing to remember is that you will quickly pick information up and your mentor will be there to help you if you aren’t sure… the important thing is to remember that you are there to learn, so ASK questions. Sometimes things can seem quite strange on placement, especially on the inpatient units. I have found that talking about things with my mentor really helps and also actively reflecting on incidents when I get home from placement at the end of the day. Things that happen on placement, initially can seem so strange but quickly become ‘normal’. A long day shift is 13 hours long with a 45 minute break. Some units split this into 2 shorter breaks whilst others give one longer break. I found the idea of this really daunting as I was not used to such a long day but I found that the time really does go quickly as you will be so busy. The most important thing for me has been comfortable shoes as that is what makes the difference between feeling good at the end of the 13 hours or feeling uncomfortable and in pain! It will seem daunting, but soon enough you will be presenting the handover to the oncoming shift with confidence and be leaving a shift feeling excited and prepared for the next one.
A day in the life of an operating department practice (ODP) student on placement The day in the life of an ODP student is exciting, challenging and often very demanding with no two days ever being the same. There 21
A day in the life
are three main aspects of and ODP’s role, which are anaesthetics, surgery and post-anaesthetic care, each being an equally important role to play. If you have never worked in theatres before starting placement can be very daunting, but all the theatre staff you work with are aware of this and don’t expect you to get involved in everything immediately, gently easing you into the role. It is important that you maintain a professional attitude at all times to other members of staff and patients and you should work within your own boundaries. If you are unsure of anything it is vital you ask for support and advice from your personal mentor or another member of the theatre team. Students typically work Monday – Friday with the option to volunteer for weekend shifts depending on your trust, and you get placed with an experience mentor to work with who will guide your learning and support you as you work. Before entering the department you are required to change into your theatre scrubs and clogs which are all provided for you, and you must make sure all jewellery is taken off and your hair is covered. If you are working as an anaesthetic practitioner your day will start by preparing a wide range of specialist equipment and drugs that will be required throughout the day for each patient. As a student you are not allowed to handle or prepare the drugs yourself, but you should observe your mentor to learn how the drugs are safely kept and accounted for. You will then check the anaesthetic machine is working properly and safe for use, and that the environment is clean and ready for the acceptance of a patient. Having excellent communication skills is paramount in this area of an ODP’s role, to ensure the patient is cared for efficiently and safely, and as a student it is important to ask questions and speak up if unsure of anything. Before patients are sent for a team brief is done where all members of the theatre introduce themselves by name and role, then discuss the patients along with any special or specific requirements. When you are on anaesthetics you are often the first person the patient will meet and they can be anxious and nervous, which means it is important to create a good relationship with them and help them to feel comfortable and as relaxed as they can. Once in the anaesthetic room you will apply vital sign monitoring to the patient and assist the anaesthetist with intubation. As you grow in confidence and skills you will start to prejudge what the anaesthetist will need in advance and pre-empt what my happen next, as things can often change very quickly. Once anaesthetised you will help to move and position the patient making sure they are kept warm and safe throughout their procedure, then get the environment and equipment ready for the next patient due in. As a student you will then learn how to fill in patient paperwork correctly, and offer support to the anaesthetist in ensuring the health and safety of the patient. 22
A day in the life
Alternatively, you may be working as a surgical ODP when on placement. This means you will be assisting the surgeon throughout the surgical procedure or offering support to the scrubbed staff at the table. When in this role you will start your day preparing the environment, making sure it is clean and that sets and equipment that will be needed during the operation are readily available. After the morning brief you will do one of two things, either scrub up or circulate for the case. When scrubbing up you wash your hands according to trust protocol and wear a sterile gown, gloves and mask. Your role then involved opening sets up in a sterile manner, making sure they are all correct and safe, and setting up your trolley with the equipment that will be needed for the procedure. It’s helpful to get your own way of doing this early on as a student, as you need to be able to quickly put your hands on an instrument the surgeon asks for without having to rummage around in the set, but your mentor will scrub with you during your first few weeks, or if you are unfamiliar with a case. When working as a scrubbed ODP you will assist the surgeon during the operation, and as a student this can be daunting as it is a very intense time, but the theatre team and your mentor are there to help assist you. During numerous stages of the operation you do counts of swabs and sharps to ensure the safety of the patient. As a circulating ODP you act as a link between the scrubbed staff and other parts of the theatre, passing supplementary items when needed in a safe and sterile manner, along with helping with paperwork and swab counts. Most of the time patients are unconscious during this stage, so it is important you make sure they remain safe throughout. After the procedure you take a patient into recovery and handover the patient to the recovery staff. In recovery you may take charge of the patient's recovery from anaesthesia and provide one-to-one care until they are ready to be transferred to the ward or go home.
A day in the life of a paramedic student on placement Going out on placement can be very daunting. The shifts are long, and can be very challenging. A day shift for me starts at 6am. I arrive on station no later than 15 minutes before the start of shift. This allows me to have a cup of tea, and discuss the day ahead with my mentor. During this time, my mentor and I will discuss a variety of topics. From a job I’ve been to and not understood, to filling out my ongoing achievement record for university. Once shift starts, and providing our vehicle is back from the night shift, we have ten 23
A day in the life
minutes to go through the kit, making sure we have adequate levels of stock. Whilst checking the stock, we’re ensuring the kit is in date and it is not damaged. Once we are happy that the vehicle is in good working order, we let control know that we are on standby and ready for a job. More times than not, we are sent straight out to a call. Depending on the types of jobs we have, we can complete around 7 jobs in a ten hour shift. Not all call-outs mean that the patient has to be transported to A&E. Paramedicine is changing rapidly, and more patients are able to be left at home with a care pathway from other service providers. However, finding alternative pathways, for example contacting a GP, can see you on scene for over an hour. No two shifts are the same, and there is a challenge behind every job. There are times when a job comes through and your mind is racing 100 miles an hour, trying to think back over the training you’ve had, and how it can be applied to the job. A typical shift usually lasts between 10 and 13 hours. As a rule, we normally get a break half way through the shift. However, this is not always appropriate if you’re on a job, so it may be longer than six hours before you have lunch. But there are opportunities throughout the shift to grab a snack if you need to. At the end of shift, my mentor and I have de-brief and discuss anything we feel necessary. If there has been a particular job I was unsure of, or a job that was new to me, I go home and write a reflective account about it. Not only is this part of my university portfolio, but also a good way to learn. For me, putting on my uniform at the start of every shift fills me with pride. Patients are dialling 999 because they need help, and helping people is what we, as a profession, are good at. It’s a challenging career and not all outcomes are successful, which can be very difficult. But with support from colleagues, students, and university staff, we can experience, learn and grow.
A day in the life of a student diagnostic radiographer on placement It’s actually quite a challenge to figure out what a day in the life of a student diagnostic radiographer is like, as every day is so completely different which is one of the things I love about it. As a radiographer, we are expected to work across a range of different modalities such as plain film, CT, MRI, theatres and mobile radiography, ultrasound, fluoroscopy, angiography, nuclear medicine, dental radiography, and mammography. Usually we spend a week in each modality, so that 24
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we have a chance to familiarise ourselves with the different roles and equipment and build our confidence. Key to every area we work in is patient communication. Patients encounter us usually at their most vulnerable moments, whether that be after falling off a ladder and being worried about a spinal injury, about to undergo a pacemaker insertion, looking forward to seeing their unborn baby for the first time, or about to have a scan for cancer staging. Being able to put people at their ease, gain their confidence and trust, and give clear instructions regarding the procedure is of paramount importance. We usually do 7.5 hour shifts, and don’t expect to sit down much during that time! If there are moments when we are not directly involved in patient care there are always things to be done, such as daily checks and stock takes on the crash trolley, restocking and cleaning all rooms and equipment, ensuring the gowns are fully stocked and the linen is changed, or making up the drinks of contrast media to be given to outpatients or taken to the wards prior to scanning. The learning curve is massively steep, and you will go home exhausted – not just from the physical aspect of walking around 12 miles of hospital corridors a day and assisting in patient manual handling or moving heavy equipment, but because your brain will be saturated with new procedures, new experiences, and new technology. The technology we get to use is just mind-blowing, and one of the things I love so much about it is that it is constantly evolving and getting better. Along with learning how each piece of equipment functions, and practicing with it to get an image that is of high diagnostic quality, it’s always important to remember that we are dealing with radiation a lot of the time, so the safety of our patients, ourselves, and those around us should always be put first. We encounter all ages of patients, from pre-natal babies, neonates, and children, to elderly, frail people, so being adaptable is also vital to our role. We often work as part of a team in trauma, theatre, angiography and fluoroscopy cases, so knowing our role and communicating with other members of the team is hugely important. Diagnostic radiography is incredibly exciting, challenging, physical, and precise, and I can honestly say that as a mature student who has had a previous career, I have never felt so fulfilled or excited about my future profession. Enjoy it – it will all be worth the effort!
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A day in the life
A day in the life of a student radiotherapy radiographer on placement A typical day on placement for a student radiotherapy radiographer can be long, emotional, exhausting, challenging and interesting, however no two days are ever the same. Each day brings a new experience whether this be observing treatment of a rare cancer, observing a new technique, learning a new aspect of patient care or recognising when a patient requires medical attention. Under the radiographer’s supervision students are involved in most aspects of a patient’s treatment including first day chats, setting up of patients and filling in treatment sheets. However there are some limitations and it is important that as a student you are aware of these and do not go beyond them and always adhere to radiation safety procedures. One of the most fundamental items for a student radiographer is a decent, comfortable pair of shoes as you will spend a lot of the time running in and out of a treatment room. The distance can equate to several miles over the course of a day and your shoes will become your best friend by the end of a placement block. One of the most important skills you need as a student radiographer is the ability to communicate with both staff and patients. This may sound easy, however some students feel it is the most challenging aspect of the role. One day you may be chatting to a patient whose prognosis is positive and another talking to a patient who has just been told their condition is palliative and they do not have long left. This can be an emotional time for both patients and their families and it is vital that you are able to empathise with their situation and offer support. This can be as simple as sitting and listening to them or making them a cup of tea. As a student you will find yourself on placements that you feel may not be applicable to you or where you cannot participate, this may include chemotherapy, diagnostic imaging or oncology wards. It is important to approach each placement with an open mind and as an opportunity, as the chances are that you will never get the experience again. Always show an interest and find something that you can do, this may be as simple as chatting to a patient about their experience, it is amazing what information you can find out from them. 26
A day in the life
Then there are the naked bodies! The nature of radiotherapy means that you will see a lot of flesh and intimate anatomy and have to manoeuvre patients manually. At first this may be embarrassing but it is important that the patient is made to feel as comfortable as possible and their dignity maintained at all times. It is also important to be aware that at times you may be exposed to vomiting, phlegm, urine and other bodily fluids so a strong stomach is sometimes required. While you might think working with cancer patients can be depressing and sad, this is not always the case and the radiotherapy department can be a happy, jovial place with plenty of tea, chocolate and biscuits.
A day in the life of a social work student on placement To describe it in one sentence; a fast paced, exciting, scary and challenging emotional rollercoaster. No one day is the same. Often you are left to your own devices as you plan your day and attempt to fit in all of your tasks and leave enough time spare to complete the jobs that never do get completed. Get used to that. Time management is a very important skill in this field. Nobody appreciates the work load of the social worker out on the front line. Get used to rushing about. An abundance of home visits, meetings, conferences, core groups for example will fill your diary at a great pace. Take control of this, own it, do not be scared to say no or wait an appropriate time to return a call. Prioritise your work. Emotions get tested, patience gets stretched, you will get caught up in office politics and you will not please everyone. But, you will, as time goes by, realise that this is what it is all about. You have got this far and you are out in the real world putting your skills and knowledge base to the test. There is no other job like this. You will be put in some of the most difficult situations you have ever been in. You will be relied on to make some of the most difficult situations you have ever had to make. You will do this, happy in your decision that whatever choice you do make, is made with your clients best interests at heart; this is a great feeling. I cannot explain the feeling of satisfaction you will get when a family thanks you for the work you have carried out, although this is sadly a rare occasion due to the nature of the role.
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A day in the life
I cannot guarantee that you will agree with the practice that you see out in the field or the policies that in fact drive your own way of working; that is down to you as an individual. However, I can guarantee that regardless of your placement, you are about to be introduced to an amazing learning experience. You are about to learn new skills and gain an understanding of your chosen subject that you cannot get from a text book. Embrace it, engage on a deep and personal level and enjoy the ride. You are about to learn more about yourself than you ever knew.
A day in the life of a social work student on a statutory placement During my practice placement I was placed in a Local Authority within the Children in Care Team. My work within this team has been varied and I provided support to children who were fostered, and their foster carers to meet the variety of their needs. This placement gave me an opportunity to work with Children in Need (CIN), Child Protection (CP), Safeguarding and to familiarise myself with the Common Assessment Framework (CAF) process. I was allocated five cases which I was directly responsible however, throughout my time on placement working with the foster carers and the children who were being fostered, were aware that I was a student social worker and if I had to include any information of them in my university work I had to seek consent which demonstrated my professionalism, and that I followed the Birmingham City University Code of Ethics and HCPC Code of standards. Whilst at my practice placement I had the opportunity to work with a variety of professionals which included Education (Schools), Police, Housing Projects, Health, Youth Group organisations, Court settings and Housing providers and Private Landlords etc. Whilst working with these professionals this enabled me to gain knowledge of different services and the roles they played to help support children and families. I attended school meetings for the children on my caseloads, placed some children under the Local Authority care out of area, and sourcing appropriate accommodation for them. I specifically worked with children in care aged ten years and above who were sexually abused, parental alcohol misuses, housing issues and or neglected by their biological parents. I undertook initial visits with regard to referral to all five cases allocated to me and I also had the opportunity to shadow other qualified social workers from 28
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Safeguarding teams and attended Adoption Panel meetings and reviews. Although I was not directly allocated some safeguarding cases I worked with the children linking them with the required services. Throughout my placement whilst shadowing qualified social workers from other teams I had the opportunity to attend family court proceedings for Safeguarding teams, family contacts appointments, adoption panel and review meetings, Child Protection Conferences. In addition I chaired different children meetings at different schools and also at the Practice Placement taking minutes of these meetings and I was involved in the process of a Section 47 of the Children Act (1989). I applied University theory to practice like legislation such as children Act 1989, Children and Families Act (2014), Looked After Children policy documents, Working Together (2013) Policy, Every Child Matters (2004), Children and Adoption Act 2002, Human Rights Act (1998), Equality Act (2010), Carers and Disabled Children Act (2000) and Carers (Equal Opportunities ) Act 2004 etc. I was able to discuss any issues of concern with my Practice Supervisor and Practice Educator. I had an excellent First Practice Placement and I will apply this great experience and skills acquired in my next Practice Placement and after qualifying as a professional social worker.
A day in the life of a speech and language therapy student on an adult placement I arrive at the hospital at around 8:30 and make my way to the office, it’s taken me a few weeks to find my way without getting lost! My clinician makes me a cup of tea and goes over who is still on the ward since I was last in and who the new referrals are. We discuss the people we are likely to see today, their age, diagnosis and why they’ve been referred and then I am given time to consider what we might do. I try to consider what should be assessed, how and what other information is needed while my clinician answers the messages and fills in the paperwork. Sometimes I take the chance to talk to the other therapists’, the occupational therapists and physiotherapists for the stroke ward also share this office (it’s crammed at lunch). Once my clinician is finished we talk over what I’ve suggested for each client and my clinician helps go over what’s good and what I might want to think more about until we have a plan that we’re happy with. 29
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We then make our way to the ward, we discover that 3 of the 4 people we were supposed to see have been discharged and there are 5 new referrals waiting for us. My clinician notes down all the referrals and decides who should be prioritised and then we look up the information we have on them. We look at medical notes and speak to the staff involved and then discuss this information, what we will do with that client, how much I will do and what is likely to happen. Once I’m happy with what I’m doing I go in to see the client. We have a chat, I carry out assessments, gather information and answer some of their questions. Sometimes sessions don’t go to plan, family are visiting, the client is unwell or agitated or they may ask particularly difficult questions or I may completely mess up an assessment but my clinician is on hand to step in whenever I am struggling. After the session is finished we make our way to a quiet part of the ward and discuss what we’ve found, what observations I’ve made, what the assessment can tell us, what conclusions can be drawn and what the next steps may be. This is also a point where my clinician tells me what I did well and what points I need to work on for next time. I’m a perfectionist so it’s not always easy to hear the parts I haven’t done so well on but it’s always helpful. My clinician then goes to quickly see a client for swallowing while I write in the medical notes. My clinician comes to check the notes before they’re put back in the trolley and we start on the next client! The acute ward is very fast paced but tea breaks are squeezed in wherever they can be! At the end of the day we return to the office to go over what we’ve done that day and I’m given a couple of clients to consider and plan sessions for next time. When I leave the hospital I am exhausted but it’s been the best day, I’ve seen speech, language and swallowing difficulties and the most diverse and wonderful range of people.
A day in the life of a speech and language therapy student on a paediatric placement It’s Monday and I’m in a community clinic consisting of Speech and Language Therapists, Occupational Therapists and Physiotherapists. Most weeks we would have a full day of seeing children with their 30
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parents/carers, either for initial assessments, or for a session of therapy. Before the first client arrives in the morning my clinical educator and I sit down and discuss the work I have been set the previous week, this normally consists of revising a particular assessment ready for a session, making resources, or writing reports. We also look at the notes for the children we are seeing that day, and write down some clinical questions to consider when we meet the child. Unfortunately in community clinic clients can fail to attend their appointments (this is called a DNA (did not attend)), this can be frustrating, especially if you had already prepared resources. However, resources are versatile, and I take advantage of the extra time I gained to write up reports, or do some reflection. Or better still, write down what I would have done with the child in the session, and show it to my clinical educator. During an initial session either I, or my clinical educator take a case history from the parent/carer about their child. Be sure to write down all the relevant information, and don’t risk missing something important by hesitating to ask a client to clarify if you don’t understand. Also, try and explain to the client why you’re asking these questions, especially as some can be quite intrusive, so it’s important they know why you require the information. Between each appointment, I take the time to discuss my thoughts on the child with my clinical educator. This is where you can get marks, by demonstrating that you’ve understood why you’ve carried out the assessment you did, or what the findings mean. Don’t be afraid to say what you found difficult, as your clinical educator is there to help you, and will advise you on how to improve on these skills. However, depending on the busyness of your day, you may not have the time between sessions to discuss clients with your clinical educator, but if possible ask your clinical educator to set aside a few minutes at the end of the day, or at lunch. I found community clinic to be the most exhausting of my placement settings, and always made time to eat and drink at lunch so I was on top form for all the clients I saw. At the end of the day, my clinical educator gave me a brief overview of the following week’s clients and gave me some homework to prepare for the sessions. Although I was tired by the time I arrived home, I found it helpful to do preparation for these clients on the same day I received the information, as this was when it was the clearest in my mind.
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Authors
This booklet was written by Claire Albrighton Marianne Kipling Sharon Masih Hazel Nash
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Ruby Reynolds Lindsay Sparks Tara Sullivan Chloe Wilkes
Notes
Notes
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Notes
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Guide to placements
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Faculty of Health, Education and Life Sciences Birmingham City University City South Campus Westbourne Road Edgbaston Birmingham B15 3TN T: 0121 331 5000 www.bcu.ac.uk/health facebook.com/bcuhealth