Finding your feet in third year: a lesson from A&E

*Disclaimer: this post includes description of a traumatic situation which some may find distressing* 

When I started 3rd year, I was excited! I had a fantastic end to second year, and I truly felt ready to enter my final year of my degree. But with that excitement came the endless worrying about jobs, dissertation, and work for other modules. When placement began, I realised I felt like a complete novice again! Despite only having two months off over summer, I felt like I couldn’t remember how to do anything on placement (clinically speaking). I was even putting on blood pressure cuffs the wrong way. Everyone asked me what year I was in, and saying “I’m in third year, but I don’t know what I’m doing” every time was ruining my confidence.

It wasn’t until my 5th shift when I finally started to feel less on edge. I was working in resus (for the most critically ill patients in a&e), and we had an man with chest pain and fluctuating consciousness. Since he was in a bad way, a few anaesthesiologists from ICU came to set up mechanical ventilation for the patient. It was really fantastic to see everyone working together almost seamlessly, and including me in their decision making. I was given little jobs such as getting supplies or checking the observations but it was all I could really help with at the time. After a very long trip to CT, it was clear our patient was deteriorating. As soon as he was back in resus, our patient went into cardiac arrest. The nurse I was working with asked if I had done CPR before, and if I wanted to get involved. To my own surprise, I agreed. I have been learning CPR for well over 5 years now, so I knew that I could help in some way. Each person did 2 minutes of CPR, whilst keeping an eye on the defib heart monitor. Due to the patient being on a hospital bed, we all had to stand on a stool in order to reach, which I found really bizarre!

I wish I could accurately describe the feeling of trying to save someone’s life, but I can’t. There was so much adrenaline rushing around me, but all I kept thinking about was how I was currently involved in the worst day of someone’s life.

During CPR, the doctors confirmed (through an echo-cardiogram) that there was nothing left we could do. Myself and the nurse went to work on ensuring our patient was at peace, and ready to be seen by his family. They were in shock and declined, which I understand. And our day went on. I had a debrief with the nurse, and a HCA who had also performed CPR for the first time, which was lovely. We spoke about how CPR is so different from how it is often portrayed. I had never thought about the fact that you won’t be able to reach a patient without standing on a stool, or how someone must time each session of CPR.

Despite being a high-pressure and sad situation, it helped me a lot. I did something I had never done, but had extensively prepared for. If you feel like you are back at square one, despite being a third year, I challenge you to think about what you do on placement. I think there is a tendency to see progression as acquiring new skills, but sometimes its about putting our current skills to use in a new situation.

 

 

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Never ‘just’ a student

“I’m sorry, I’m just a student.”

Sound familiar? How many times have you said this while out on placement? Maybe it’s just me, but I’m ashamed to say it’s more often than I can count, especially in the first two years of my training. It possibly stems from a lack of confidence or uncertainty, perhaps a fear that I’d do or say something wrong – something we’re all bound to experience at some point during our training.

But is this lack of confidence a wider issue among qualified nurses, as well as students? Do we sometimes have a tendency, as a profession, to devalue our work and contribution? Do we see ourselves as less important or influential than other health professionals?

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Conference programme

I recently attended the 2017 Nursing and Midwifery Conference held by the newly formed Manchester Foundation Trust at Manchester Royal Infirmary. The keynote speech was given by Dr Eden Charles, a leadership coach and consultant who has been successfully supporting individuals to create cultural change in their organisations, including the NHS, for more than 30 years. He recognised that as nurses and midwives it is in our nature to give, to put others first and to sometimes put our own needs on the back burner. But, he said, with that sometimes comes a tendency to lack confidence in our huge strength and contribution as a profession. He said he often hears nurses refer to themselves as ‘just’ the nurse and is always baffled because of how important the role really is from the perspective of patients.

As student nurses or midwives, we are on the cusp of joining the largest professional body in the health service who are in a unique and privileged role as both care givers and advocates for patients. Although not yet registered, we are still an integral part of the nursing profession and make a difference in many ways to care in the NHS. The more confidently we value our contribution, the better we can speak out for our patients and give a voice to those who otherwise might not be heard.

In his speech, Dr Charles said: “Never say ‘I am just a nurse’. Change that story to ‘I am a professional nurse’. Put yourself into the world boldly and confidently as people who deserve to have a voice.” He challenged us to be ‘nursing rebels’ or ‘rebels for compassion’; to acknowledge our strength and abilities in order to gain greater influence and make changes to practice that really matter. He reminded us that leadership can be found at all levels, not just at the top; we all have a responsibility to bring about the changes we want to see. It’s not always easy or straightforward, but as students we can make positive changes by living the values that brought us to nursing or midwifery in the first place.

So I’m making a promise to myself and I hope you will too; I will never be ‘just the student’ or ‘just a nurse’ ever again.

Thriving, not just surviving: award-winning toolkit supports the mental health of student nurses and midwives in Manchester

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Tracy Claydon, PEF

As we highlighted earlier this week, Tuesday 10 October marked World Mental Health Day, an annual, global event recognising the impact of mental health on the lives of many and the importance of showing compassion to those struggling with mental ill heath, as well as looking after our own mental wellbeing. As student nurses and midwives, we may experience a broad range of mental health issues throughout our training as we adjust to our role; juggle placement, academic work and our personal lives; and because of the distressing experiences we may be exposed to on placement. Thankfully, the wonderful team of practice education facilitators (PEFs) at the newly formed Manchester Foundation Trust  (formerly CMFT) have our backs, creating an award-winning toolkit for mentors to enable them to better look out for and support our mental health in practice. We are delighted to share this Q&A with Tracy Claydon (pictured above), PEF for the Division of Specialist Medicine and the Corporate Division at Manchester Foundation Trust and project co-founder. She gives us an overview of the Mental Health and Wellbeing Toolkit and how it aims to support students and mentors in practice.

Firstly, what is the Mental Health and Wellbeing Toolkit?

We identified that there was no specific practical guidance to help mentors in supporting students who may be in emotional distress and/or be experiencing issues relating to their mental health when on placement; the Royal College of Psychiatrists’ (2011) indicated that as many as 29% of students may experience mental health difficulties at some point during their studies, while the National Union of Students (2015) have this figure as high as 78%. The toolkit was developed to support not only current nurses and mentors but also of course to support students to better manage the emotional demands of the role and feel supported to carry out their job confidently.

It is possible and also likely that a significant proportion of the students presenting in distress will not have a diagnosable mental illness but will be experiencing distress related to ‘life stresses’ and will need support to allow them to cope effectively with these rather than seeking to be prescribed an antidepressant or similar medication (NHS Choices, 2016). The provision of a toolkit that would provide a structure and framework for mentors to better support their students was clearly needed. The toolkit includes:

  • Tips for mentors including advice on how to discuss and identify concerns
  • Algorithms for accessing support
  • ‘Having the Initial Conversation’ guidance for mentors
  • Top Ten Tips for students to look after their own mental wellbeing
  • Agency Directory

The toolkit was launched in November 2016 and re-launched in May 2017 to coincide with World Mental Health Awareness Week which had a theme of ‘thriving or surviving’ which reinforced our message… we don’t just want our students to survive, we want them to thrive!

Where did the idea for the toolkit come from?

Students will often experience quite harrowing situations during one single placement that possibly other members of the public will go through their entire lives without seeing.

We talk often about resilience, but how do we build this? And crucially, what can we do when anxiety becomes more than a transient emotion? From a practical guidance we recognised that there were gaps in our support mechanisms within the organisation and also that we had the underpinning literature to evidence this.

The Nursing & Midwifery Council and the Royal College of Nursing recognise the potential for students to experience difficulties in their mental health and yet surprisingly neither agency has/had provided any guidance for nurses or mentors to support them.

At Manchester Foundation Trust (MFT) we wanted to fill this gap and the toolkit was developed as a resource to address this. Equally, it was also incumbent upon us to acknowledge how anxiety or a sense of isolation when not managed in the early stages can then escalate into something more concerning.

The goal was to support our students at the beginning, end and at all points in between on their placement and learning journey, so that they will recognise and regard MFT as a caring and compassionate organisation that enables students to thrive and not just survive and that they would wish to return as qualified staff.

How did you go about developing the toolkit?

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Ant Southin, Specialist Mental Health Liason Nurse

It came as a result of a real life situation where I as a PEF was supporting a compassionate and kind mentor who was struggling to support a student on placement struggling with mental health issues. Myself and my PEF colleague Sharon Green, began working on the toolkit as a resource however, the toolkit only truly started to develop when we were able to access the knowledge and skills of Specialist Mental Health Liaison Nurse, Ant Southin (based at MRI, pictured right) who was able to provide the expertise that we as registered adult nurses by background lacked. This enabled it to have a real MDT approach and became a wonderful collaboration!

How has the toolkit been used in practice so far?

For some students the situations they observe or are involved in will be the most distressing thing they have experienced. It is important that they have a means of communicating and understanding these feelings and recognising that there is help available. The Toolkit has been used in a number of situations where students were struggling to cope emotionally: including supporting students who were affected by this year’s Manchester Bombing.

What are your plans for the future of the project?

Despite having been awarded the MRI Fellowship Award at the recent Nursing and Midwifery Conference and also having been acknowledged as an example of Best practice by Health Education North West (available as an E-Win) we feel this work is still in its infancy; while it is currently aimed at students, we recognise that the messages are important for all of our staff. We hope that we can develop it to be used to support any member of staff experiencing distress. The Human Resources department have requested a meeting to begin discussions around achieving this within the wider organisation. We will be presenting at the upcoming Midwifery Forum at St. Mary’s Hospital and we have also had heard nationally from other NHS Trusts interested in adopting the toolkit within their own organisations.

The MRI Fellowship Award 2017 included a £1000 monetary prize which will be used to support ward areas to develop their own ‘buddy box / soothe box’ resource which they can then continue to develop to meet the needs of their students and staff.

…and finally, what advice would you give to student nurses and midwives to take care of our mental health while on placement?

Student nurses and midwives need to feel prepared and supported for the career they are about to embark upon. The profession is challenging and demanding but with huge personal and professional rewards. Mental health issues can affect any of us at any time in our careers and should be considered a priority for all of us whatever stage of our career we are at. By making them a priority for students it is hoped that they will continue to see this as a priority as they progress through what we hope will be successful nursing/midwifery careers. Using our dedicated #icareforme approach we will continue to maintain the profile of the huge importance of self-compassion for staff working within such challenging and complex environments. It is vital that mental health has the same parity with physical health and we can only achieve this by making it the priority it deserves and needs to be.

Thank you Tracy!! If you’re interested in learning more about the toolkit, you can find it here – in particular, take a look at the ‘Top Ten Tips for Good Mental Health’ on pages 8-9 for simple ideas that we can all use to look after our mental health.

Remember that if you are struggling with your mental health or feeling anxious, worried or depressed then don’t try and suffer on in silence. If you feel confident to do so, speak to your mentor, PEF or academic advisor (AA) or the University of Manchester has a fantastic confidential Counselling Service. Often speaking with your peers can ease the burden – you may find that others are feeling the same – or if you simply want a kind, listening ear then Nightline is another brilliant option, you can find the contact number on the back of your student card.

World Mental Health Day 2017

World Mental Health Day, founded by the World Federation for Mental Health, takes place each year on 10th October and adopts a different theme each time. The aim is to raise awareness about mental health and encourage people to think about ways to support those who are experiencing mental health conditions. This year the focus is on mental health in the workplace.

imageThe World Health Organisation discussed how depression and anxiety disorders are common and can have an impact upon a person’s work life. Stress is a major factor that contributes towards the development of mental health conditions. With increased demand, funding cuts and staff shortages, there is no doubt that nurses and healthcare services in general are under immense stress. Nurses working in hospitals are said to be twice as likely as the general population to have depression.

For some mental health nursing students, having lived experience of depression and/or anxiety is a big part of what motivated us to choose to study for a degree in this field of nursing. Personally I chose this career because of the platform it can hopefully give me to help improve mental health services that I was involved with when I was an adolescent and to promote awareness of mental health using not just personal experience but professional knowledge too.

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Not many health professionals speak out about their experiences of living with mental health conditions through fear of having their capability to support other people doubted. Mental health conditions affect people in the workplace, and healthcare settings are no exception. To reduce the impacts of stress and workplace pressures on mental health it is important for people be aware of the support services available for employees. The NHS Services Directory is a useful tool for locating local places where psychological therapies can be accessed. Offering support can be as simple as asking a colleague how they’re feeling. If we start conversations, we’re closer to ending the stigma.

Balancing the Bank: Things I’ve learnt as a bank HCA, by Caitlin Mitchell

Joining the bank or an agency as a Healthcare Assistant is probably something you’ve already considered if you, like many of the rest of us student nurses, are a little low on funds! You’ve probably already considered the pros and cons of joining the bank over a non-healthcare part-time job but I wanted to share some of the reasons why I’ve loved banking as a HCA, and what I’ve learnt from it …

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Exposure to other services/areas of the hospital

I am now able to confidently signpost patients to these services. I’ve also been able to use it as an opportunity to make contacts with other professionals and was able to arrange some interesting spoke opportunities from it! It’s great for networking and if you’re considering a job on a particular ward after graduation you can always go and scope them out by booking a few shifts there! Having first hand experience of the ward and a good first impression with future colleagues on shift can also give you an edge over other candidates in the interview!

Providing personal care

I found this quite daunting when I started the course due to not coming from a hospital background but having the chance to work with HCAs whilst banking helped me feel more confident with what I was doing, and also impress the HCAs I later met on placement!

Communication 

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I improved my communication with non-verbal (due to having tracheostomies) and deaf patients. I initially found this challenging but spending large amounts of time with these patients, delivering the bulk of their personal care helped us learn to communicate with each other and we even managed to share a few jokes! I found that patients and relatives were often all too happy to share how they like to communicate and even taught me some sign language!

My best advice if you don’t know sign language is to start by speaking slowly to allow the patient to lip read if they can and build up from there. This may seem like obvious advice but if it’s been a busy shift it can be easy to forget and speak too quickly before rushing off to the next task, remember to wait until you have eye contact with the patient before speaking, if deaf or hard of hearing they may not have heard you enter the room so wait until you have their attention before you begin! I also really recommend following @BritishSignBSL on twitter because they post a new sign each day, you can also download and print the finger spelling alphabet from their website!

Decision-making and autonomy

I felt that, on certain wards, I was trusted more to get on with certain care tasks than I was as a student. Whilst this was a confidence boost, I was also reminded of the importance of asking for help if I didn’t feel confident doing something on my own, and of working within the limits of my job role.

Delegation

I feel that my delegation skills improved through banking as I was reminded of the importance of checking that the person you are delegating to feels confident with the task, and the importance of thanking someone who has helped you with a task!

Time-management

fob watchIt almost goes without saying that balancing a part-time job on top of uni work and placement requires top notch time-management skills. To help with this I would recommend investing in a decent planner if you’re going to be splitting your time between uni, placement, a part-time job, and any other hobbies/socialising in order to know where you need to be and when! This all lends itself beautifully to a colour-coding system!

If you’re struggling around exam/deadline season, the beauty of bank work is that you can book shifts as and when suits you, so if you need to take some time to concentrate on your studies you’re not tied down to committing to certain hours and then you can pick more shifts up outside of term time as it suits you. Being able to balance time effectively is an important nursing skill and I was able to use this as evidence of this skill at my staff nurse interviews!

I hope that some of these points have helped give some of you an insight into the benefits of bank/agency work!

Sexual health healing: my elective placement in a GUM clinic

People coming to sexual health services experience a wide range of emotions; from embarrassment and fear to shame, guilt and anxiety. Sexual health carries with it some serious baggage and stigma that other areas of health don’t, but why is that? We wouldn’t think twice about going to the doctors for other health conditions, yet for some reason feel like we need to sneak in to sexual health clinics cloak and dagger, desperately hoping that we won’t be recognised. Sex is one of the most normal and natural things imaginable and anyone taking proactive steps to look after their sexual health should be celebrated…yet it is an area of health that many still find embarrassing or taboo.

This summer I completed a seven week placement in a sexual health clinic. I was excited to start as I’d always been interested in sexual health, but I must admit I was also a little nervous. Discussing sex openly and frankly can sometimes be just as intimidating for the healthcare professional as the patient – especially for an inexperienced student nurse still finding her feet! I’d be lying if I didn’t say I had the odd awkward moment over the placement – I struggle to hide my emotions and definitely felt my cheeks blush on the odd occasion during my first few solo interviews – but I soon realised that patients took their cues from me and the more relaxed I was, the more at ease they seemed. Before too long I was discussing STIs and sexual preferences as casually as the weather or what they had for tea last night. It was rewarding though, seeing people arrive at the clinic looking nervous, upset or worried and leave, free condoms in-hand, looking relieved and reassured. Along the way I also learnt a thing or two about the broad skills and expertise of sexual health nurses. Here is what I learned:

They can keep a secret

Confidentiality is one of the fundamental principles of sexual medicine. All staff working in sexual health, from consultants to student nurses, must sign a confidentiality agreement on entering the department. Of course this principle applies across all areas of healthcare, but it is particularly precious in sexual medicine where a patient’s right to privacy is central. Patients are not obliged to give their real name or date of birth when accessing sexual health services, nor will you hear a nurse calling people in the waiting room by their full name. Patient notes are also kept completely separate to other systems in the NHS and information will not be passed to services like GPs without consent or unless absolutely necessary. Explaining this to patients at the start of their appointment is often a good basis for gaining their trust and confidence.

They are expert communicators

Specialist sexual health and HIV nurses are incredibly skilled in taking detailed histories, asking the most personal questions imaginable, while remaining non-judgemental. Those questions can seem extremely intrusive and many people wonder why they need to share details of foreign partners, drug-taking or exactly what type of sex they had, so it takes a highly-skilled communicator to gather this information in a matter-of-fact, caring and non-judgmental way. As the interview unfolds, you can sometimes visibly see people recoil at the questions – in the cold light of day, sitting in a clinical room opposite someone in a uniform asking you about some of the most intimate parts of your life can be extremely difficult. Sexual health nurses completely understand that; they want to make the process as painless as possible, so will adopt many different communication strategies to put their patients at ease.

They know their stuff

The majority of sexual health and HIV nurses are specialists, with many years of experience and additional qualifications or training in sexual medicine. While in the past nurses in sexual health clinics would have assisted the doctors, they now work autonomously, often in nurse-led clinics. Nurses are the backbone of gentio-urinary medicine (GUM) clinics, working closely with consultants and experienced healthcare technicians. It’s a highly-skilled role that requires in-depth knowledge of sexual health conditions including their symptoms, methods of diagnosis and the latest evidence-based treatments, some of which they are now able to prescribe themselves under Patient Group Directives (PGDs). They work hand-in-hand with the doctors, undertaking the same assessments and doing the same tests and examinations. They also tend to be the clinicians delivering the treatments, from antibiotics or deep IM injections to wart freezing. They can do the whole lot.

They are un-shockable

Believe me, they have heard and seen it all. They are not there to judge your sexual behaviour and they don’t. They ask such personal questions because they want to make sure they carry out the most relevant tests, ensuring that they pick up any potential sexually transmitted infections (STI) someone could have been exposed to. Knowing whether someone has had foreign sexual parters or taken drugs, for example, can influence whether they decide to add in blood tests for hepatitis B and C. It pays to be as honest and frank as possible because it means that they do the full range of relevant tests.

They care about your physical AND mental health

WHO define sexual health as both absence of disease and healthy attitude towards sex. Sexual health nurses aren’t just concerned with detecting and treating STIs and giving out free condoms; they also play a therapeutic role, helping to ease anxieties and educate individuals about safe sex.  They can play a big part in helping someone overcome a bad sexual experience, often taking on a support and counselling role, especially nurses who choose to be sexual health advisors. Even for patinets who don’t specifically open up about their worries, you can see how a skilled sexual health nurse can make someone feel better just by being kind and matter-of-fact. Conditions like HIV of course sadly come with some of the greatest stigma and potential to impact mental health. HIV specialist nurses therefore are key in helping people come to terms with their diagnosis and cope with the wide range of emotions they may experience. They are often the first port of call for patients, sometimes being the only person that a patient has disclosed their HIV status to and feel comfortable phoning up to discuss worries and fears. As well as managing and monitoring their treatment HIV specialist nurses often become a trusted confidant, helping individuals to regain their confidence and self-worth or access local networks where they can access peer-support.

All-in-all, my placement in a sexual health clinic revealed the nursing role to be fascinating and rewarding. Sexual health nurses are a down-to-earth bunch who come into contact with people from all walks of life and use a broad range of advanced nursing skills to make a positive impact on physical and mental health. There’s a lot more to it than giving out free condoms, that’s for sure!

If you’re interested in sexual health, there are some brilliant websites out there. The British Association for Sexual Health and HIV (BASHH) guidelines for example share evidence-based clinical guidance for diagnosis and treatment of STIs. There are also some fantastic Manchester-based charities and organisations with a focus on improving sexual health such as Manchester Action on Street Health (MASH), a charity supporting women engaged with sex-work in Manchester; George House Trust, a charity supporting people living with HIV; LGBT Foundation, who offer sexual health testing for LGBT communities among many other services; and Sexpression Manchester a student-led organisation that offers informal sex and relationship training for young people.

Do you have an experience or reflection from placement that you would like to share with other student nurses and midwives? We think every student nurse or midwife has a unique and interesting perspective to offer so we are always keen to welcome new student bloggers to our team. If you have a story to share please do get in touch via our Facebook page @UoMPlacementProject or email studentnurseplacementproject@gmail.com. 

Pearls of wisdom from the 2016 graduates!

It was great to meet so many of the third years at today’s employability conference and to the new cohort of first years a very warm welcome! We’ve been asking some of the BNurs 2016 graduates what they’ve been up to since graduation to help give you some inspiration, careers & studying advice and some reassurance that there is light at the end of the tunnel!


 

Gina, Chemotherapy Nurse.

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I work on a nurse led chemotherapy unit, one of the most interesting things about my job is being able to assess patients and use my own clinical judgement in providing holistic care. Rather than task oriented nursing, you’re able to work more autonomously but there’s still a lot of support available from the rest of the team. We see patients from a variety of different disease groups with different chemotherapy and immunotherapy regimes so there’s been a lot to learn over this first year! There’s also exposure to higher acuity patients and oncological emergencies so there’s a variety of clinical skills.

I’d advise current final year students not to underestimate the benefits of a good preceptorship programme! Ask about what support and training trusts can offer you as a newly qualified member of staff and it’s also worth looking at how they score on recent CQC reports. Always have a few questions prepared to ask at the end of an interview to show your interest in the role and it’s well worth organising an informal visit or arranging a phone call with the ward manager to find out more information. They’ll remember you and if offered an interview you’ll have an advantage over other candidates who didn’t show the initiative!

For first years at the start of their nursing journey, make the most of what your placements have to offer and get involved with sports and societies while you’re at uni, sometime it can feel like a struggle to balance everything but it’s important to have variety and these things will help you unwind after a hectic shift! Always show interest on placements and ask lots of questions, make sure to go to your PEF or AA with any issues and they can support you through it and improve the placement for other students in the future.21952670_10155829453445820_863942415_o

One of my proudest achievements so far was presenting a piece of research I did at the RCN Centenary conference, it was quite daunting being a student at an international research conference but I’d definitely recommend applying for things like this, there’s so many amazing opportunities out there! I’m definitely interested in research career options for the future but I also enjoy the clinical side of nursing, I don’t have any set goals for the future as there’s so many fantastic career paths out there but I’m quite interested in becoming a nurse prescriber, I’ll just have to wait and see what pans out!

Chris, Cardiology Nurse.

The most interesting thing about my job is the procedures and interventions carried out on patients. I’m currently working towards mentorship and a link nurse role and in the long term a specialist nurse role. For current third years job hunting; choose an area you find interesting to work in (for myself it was cardiology). Ensure when you prepare to interview you show your passion or interest for that speciality or area. Demonstrate your knowledge!

Some advice for first year students would be, don’t be shy. Ask lots of questions and get stuck in as much as possible when on placement. I wish I had known more abbreviations of medical terms. Advice for final year students, get on top of your dissertation early. I can’t stress this enough!

Emily, RMN on a Psychiatric Intensive Care Unit.

I chose this job because I wanted a fast paced ward and it’s certainly that! It’s really interesting to see people come in very poorly but go back to acute wards much better. I see myself staying on this ward for the next 2 years or so, then hopefully moving into forensic services.

Some advice for third years’ looking for jobs is to go for something you know interests you, you’ll enjoy going to work then. Research the ward and trust before the interview, they’ll most likely ask you for evidence/scenarios to back up your answers.

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Also, take time for yourself!! Although the course is full on you need to make sure you look after yourself, take the time to do it now because you won’t get it when you start work! Take it as it comes, get ahead with your dissertation, DON’T leave it until last minute. You will have enough stress in your final few months. And finally, enjoy your training, don’t let it get on top of you. It will go by quickly!

Liz, Staff Nurse on a General Surgical ward.

Something I wish I’d known when you started the course? I remember everyone complaining (including myself) how we felt like we only did obs for the first placement. This is an important skill the more you do the more efficient you become and the better you get at recognising deteriorating patients early!

Advice for current third years deciding where to work: Go to every interview you get offered they are good practice! And then if you get offered lots of jobs you have more choice.If you feel like it’s impossible or you don’t feel ready. You are ready and you can do this! There will come a time on your final placement when you wish you didn’t have to check the drug round e.t.c with someone every time. That’s when I realised I couldn’t wait to qualify!

I’m enjoying my new role, it’s very diverse and I get to use and perfect every clinical skill I could wish for, in a first job. In the future, I see myself working in the merchant navy and also on the bank in an NHS hospital. Moving from student to staff nurse is the most challenging and fun time. Enjoy it and remember to be nice to the students who, before you know it, will be your mentees!

Natalie, Surgical Triage Nurse.

I chose this area as I love Surgery and wanted to gain experience in Acute illness, emergency surgery and different surgical conditions not just one speciality.

Enjoy student life whilst you can as 2nd and 3rd year are intense. Spoke out as much as you can and make the most of the supernumerary status to learn. Make sure your work/placement/study/social life is well balanced. Seek advice where necessary.

Some interview tips for third years is to learn about policies in your chosen field, memorise the 6C’s,  and look at recent CQC reports to draw on points for why you chose their hospital/department.

Alyssa, Community Staff Nurse.

whitworth hallI am a community staff nurse, nursing patients with long term health conditions. The patients whom I care for can be under my care for years. The care that I deliver enables you to build a very strong therapeutic relationship with patients that you wouldn’t necessarily get in a hospital environment. In the future I see myself working in the community, hopefully as a district nurse.

Some tips for first years would be to follow your passion. Find something that you love and run with It! For me, that was community nursing. If you do what you love, this will show in the excellent care you give to your wonderful patients!

And for third years preparing for interviews; do lots of research about the trust you want to work at e.g. core values of the trust and the person specification for the role which you’re applying for. Phone your prospective ward prior to the interview and ask for an informal visit to get a feel for the ward/department.

Third year is tough. There will be a lot of blood sweat and tears during your final 12 months, but there is a light at the end of the tunnel and if you work hard you’ll soon be wondering where your final year went! Your hard work and pure determination will pay off. Your patients will make you feel so blessed every day and I promise all your stress and worry is 1000% worth It!

Donna, ICU Nurse.

What made you choose this speciality to work in? What’s the most interesting thing about your role? I wanted to work in a dynamic and interesting area, seeing lots of different ailments and issues that people come into hospital with. I love being 1 to 1 with my patients and able to give all patient cares, being 100% involved. I get to be very involved in the patient journey and plans for their care and my opinions are respected and listened too.

Some tips for 1st year students, don’t leave everything til the last minute! 3 years might seem like a long time, but it flies by! In placement, there is something to be learnt in every situation that will develop you as a nurse and make you a safe but above all, caring practitioner.

Final year students, don’t get too wrapped up on knowing everything, no one expects you to know what you are doing when you qualify! You will get training and helped along the way by your peers! Enjoy your last few moments of student life, it’ll be over before you know it! Be proud of yourselves!

Placements aren’t the be all and end all. I did not have a placement in critical care, but still managed to get my dream job. Never let someone tell you that you can’t do it! If I can, anyone can. Whether you’re in the final phase or are just at the beginning of this journey, you have achieved something wonderful to come into this profession, especially at such an unstable time. I wish you all the best with your future endeavours, whatever they may be.

My proudest achievement so far is being able to actively be involved with my patients journey and care plan! When you start out as a fresh eyed newly qualified nurse you feel like a fish out of water, especially in such a highly specialist area as critical care! To be able to see yourself develop and be able to suggest or question a care plan with enough knowledge to back it up is a huge achievement. In the future, I’d like to progress in my role, maybe into a band 6? Who knows. But for now i’m happy to learn my specialisation and will start a level 7 course in critical care next year and begin my mentorship course!

Victoria, Critical Care Nurse in ICU & HDU.

The fast pace and quick thinking, variety of conditions I come across and complexity in illness, continuation of learning and developing new and old skills and knowledge, problem solving and the use of all my nursing skills attracted me to working in this speciality.

Some tips tips for 1st year students are to always ask and never be afraid to ask for help at any time..nurses are more willing yo help than you think, always reflect on your day it will help you throughout your career. If things get a bit too overwhelming stop, make sure you patient is safe and remove yourself from the situation and take a breather.
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I’d advise third years to do what you enjoy because you’ll be passionate in providing great care to your patient. Relax and be yourself…yes, you are being interviewed, but so are your possible employers, so always go armed with questions yourself. Be organised and try to stay on to of your work. Time management is very important.

My proudest achievement so far is getting awarded a first class degree and getting the opportunities to carry on my learning to help others. In the future I’d see myself being an experienced critical care nurse and mentoring and supporting other newly qualified staff in the area to be fantastic nurses.

Enjoy every moment of your university time and career, the hard work will pay off and if you enjoy what you do it will translate in your work and the care you give your patients. Always smile, a smile goes along way and is noticed by all, patients included!

Holly, Staff Nurse in A&E.

Initially I wasn’t sure where to work and A&E provides such a variety of conditions. The most interesting part of my job is providing life saving care in resus. I want to work in A&E for a couple of years to build on my skills and confidence, but I’ve not thought past that yet!

For job hunting in third year, don’t stress about it! If you are a last minute kind of person, like myself, and your friends have all got a job lined up by December of 3rd year don’t let it panic you, I didn’t apply for jobs until the end of summer of 3rd year and still got a job well before graduation! Start the dissertation early, don’t leave it all till the last minute like I did, trust me it’s not worth the stress!

My proudest achievement so far is getting a first class degree, never thought it would happen but hard work definitely pays off. I was a mature student and found the financial side of being a student very difficult, going from working with a full time wage to do 4 years of study (I did the access course & degree) was a difficult decision and I can only imagine how hard it was for my colleagues with children, but it is so worth it. If you’re having a rough time at uni and really struggling, I used to think about my first months wages and think about what I’d treat myself to…only afforded something little after bills were paid but that felt amazing. Keep at it, 3 years seems like a long time but it goes so fast then you have a fulfilling career ahead of you.

Ellie, Mental Health Nurse in Acute CAMHS.

I chose this speciality as I really enjoy working with young people, it’s challenging at times working in an acute environment but really rewarding and enjoyable too.

I’m currently working towards becoming a student mentor as I’m still at a point where I remember how it felt to be a student, and also what it was like to have a bad mentor. I love working with students now. In the future I can see myself training to be a nurse therapist.whitworth hall (2)

Some advice for first years would be that confidence will come in time. Every skill the nurses have they learned somewhere, you can be a great nurse if you stick with it.
For current third years deciding where to work, don’t be disheartened by everyone else saying they have jobs (there’s lots of quiet people who don’t)! I felt like I was one of the last ones to get a job and I ended up getting one in my ideal speciality – it made me glad I got rejected for the ones I wasn’t actually too fussed about!

Do I have any advice for current students on managing their final year? It ends! Joking aside, it really does. You’ve got this guys. Honestly, finishing a nursing course at University of Manchester is one of my proudest achievements so far. It is genuinely one of the most academically rigorous courses out there.

Nina, Paediatric A&E Nurse.

I loved A&E since my third year placement.  The most interesting thing about my job is that I work in a major trauma centre in London and get to see a wide range for illnesses and injuries. In the future I can see myself doing a management role or being an Advanced Nurse Practitioner.

Some advice for new students would be to get stuck in with placement! Take opportunities and involve yourself. For current third years deciding where to work; pick somewhere you have a passion for or want to learn more about!

Julia, Community Dementia Nurse.

grad bannerPersonal experiences made me want to work in elderly and dementia care, I felt I had a basic understanding of what a patients family are going through and help me to support them better.

I’d advise current students to speak up on placement and be questioning… ask why was this or that done a certain way whilst on placement. For third years job hunting, go with something you feel slightly confident with. For managing your final year, stay organised till dissertation is done! Don’t be afraid to start from scratch again if needed.

My proudest achievement so far is making patients smile and getting thank you cards from families I’ve helped. In the future I see myself doing exactly what I’m doing now! Just more knowledgeable at it!

You never stop learning, transition isn’t that bad, but remember you are accountable which is scary but don’t let that stop you from holding hands up if something goes wrong. Support is out there. You learn from your mistakes.


If you graduated from the UoM BNurs cohort in 2016 and want to contribute your experiences of your first year since qualifying to this article please use the contact form below.

Likewise if you’re a current student and want to get involved with the placement peer support project or write a guest post on a particular placement or topic that interests you, please drop us a line! We’d love to hear from you!

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