Top Tips for Your First Placement

 

There is only two weeks until the first year placements start!!! Not only has this made me super nostalgic (and panicky because I’m halfway through my degree now), but it gave me the idea to write down some top tips.

Be YOU. This may sound like the cheesiest advice ever, but it’s true. With every placement, I’ve started this year, I’ve been quiet and not myself at all for the first few weeks because I’m so nervous. But what I’ve (finally) learnt is that once I started acting like me, I felt so much more relaxed. Make jokes, smile, talk to your colleagues. The secret to making it through any shift, even when you’re not having a great day, is with the people you work with! PLUS, the more you act naturally on placement, the easier it will be to feel more and more like a proper nurse, not just some clown in a uniform.

Throw yourself into every opportunity (if you’re comfortable****). I made a habit of not saying no to any task that was handed to me, just so I could experience everything. Sure, I didn’t always want to walk down to the Pharmacy and ask (for the 8th time that day) where our medication was , but it helped! I got to know the hospital, understand the breadth of the role that the pharmacy has, and take a little breather from the business of the ward. Even boring tasks help you learn something, even if all you’ve learnt is I’m not a mad fan of this!

****Sometimes, you aren’t ready. There are times when you will be asked to do something (like giving an injection) and you might not feel ready. That is OKAY! Talk to your mentor, learn the methods and take some baby steps. You get to decide when you’re ready!

Don’t beat yourself up for making mistakes. They happen all the time. We are learning and working! You’ll do things wrong sometimes and that is okay. Whoever is teaching you should walk you through it anyway.

Talk about your day! One of my favorite times of day whilst on placement is going home and getting it all off my chest. Since I live with non-nurses, I often filter out the gory bits (bless them) but it really helps to process the day and reflect.

Get your paperwork sorted out on time! Both of my first-year placements involved me panicking because I didn’t talk to my mentor about paperwork. I thought it would make me look pushy. It doesn’t. 99.99% of the time, your mentor might have just forgotten or they might have a plan of their own. Just talk to them! If issues arise from there, talk to your PEF and AA.

And finally- GOOD LUCK! This journey is hard and can be frustrating, but there will be so many days when it’s so so worth it.

If anyone fancies trying their hand at blogging their experiences with placement, why not give us an email, a Facebook message or a tweet? We’re always on the lookout for more student nurse’s and midwives!

ATTENTION FIRST YEAR STUDENT MIDWIVES… Your PAD, White book and signatures!

I APOLOGISE AS THIS IS LONG…STICK WITH IT….. IT’S IMPORTANT INFORMATION;-)

Ok…you first years are all starting to think about placement right? It’s about a month away for the student midwives so your uniforms will be arriving shortly if you don’t already have them and you will have your documentation staring out of wherever you have hidden it because, if you’re anything like me, the thought of even starting to read that huge PAD document thing on top of all the studying you have to do is so out of the question it’s unbelievable!

Well I am here to hopefully hold your virtual hand through the whole documentation experience and share my many mistakes so you don’t make them!

First of all let’s clarify the difference between your

pad

 

PAD (Practice Assessment Document)……

 

 

 

 

white-book

 

 

……..and your white book (Record of Statutory Clinical Midwifery Experience).

 

 

 

 

 

You may not believe this but it took me a good couple of months to work out who can sign what and how equally important but different these two documents are!

 

So I’ll start with what I think is the easier one-the White Book. This will be held by you for the full 3 years then handed in at the end of your degree. Your AA will look through this during your individual meetings just to make sure you are ‘on track’.

The White book is where you record your statutory skills which every student midwife at every university will have to get signed off before they can qualify. You have the space in here to log your 40 births which seems to be the area of focus for a lot of students but there are A LOT more skills you need to achieve as well as delivering babies. For example, you need to record evidence of  antenatal examinations & care of 100 pregnant women and examinations & care of 100 postnatal women and their newborn babies.

In these midwifery areas any qualified midwife can sign off your evidence. They DO NOT need to be a mentor/sign off mentor. This is important because you will work with a lot of midwives when on placement and you may carry out a beautiful abdominal palpation and listen to the fetal heartbeat with a pinard whilst your mentor is on a break and you are working with another midwife…..WRITE IT IN YOUR WHITE BOOK AND GET IT SIGNED OFF! The white book just needs the woman’s hospital number, the date, what you did and the midwife’s signature. It can be written up in a couple of minutes and signed there and then! Otherwise you will get home, not written down half the hospital numbers for the women you have worked with that day, for the ones you have written down you’ll have forgotten what parity the woman was or the pregnancy gestation and for the ones you can remember you will realize the midwife who you worked with is now on maternity leave and so won’t be around to sign that evidence off (YES…ALL these have happened to me!!!-it’s gutting!).

There’s areas of the white book which can be signed off by qualified Healthcare professionals who work in other areas i.e. neonatal staff  or breastfeeding support  workers but the important thing to get into your heads about the white book is…

ANY QUALIFIED HEALTHCARE PROFESSIONAL CAN SIGN YOUR EVIDENCE FOR THE RELEVANT AREA YOU WERE IN WHEN YOU COMPLETED THE SKILL

AND

GET IT SIGNED THERE & THEN!

 

OKAY…..big, deep, breath…..THE PAD! Unlike the white book your PAD skills and interviews get handed in at the end of each academic year but you keep the folder (mine is already wrecked!). Your PAD skills are handed in through an official process where you are given a deadline (date & time) and you complete a front sheet for each set of skills and hand them into an exams officer (I point this out because this process was much more official than I expected it to be and it unnerved me a bit!). Your AA will probably take your interviews but this does depend  on the AA; I still have my complete set of first year interviews but I know a lot of my cohort have handed theirs in.

Signing stuff- this is a bit trickier than the white book as the people who can sign your skills off are limited. Let’s just talk about the actual documentation as an opener……..

Interviews

Ideally, at the start, mid point and end of each placement you and your mentor need to sit down and do your interviews. These will be read and checked at your AA meetings and are important for all parties involved as they help you assess where you are up to and also help you gather your thoughts on whether you are getting what you need out of the placement and if not how you can be proactive in accessing more opportunities.

During your mid placement interview do not forget to get your mentor to sign the actual interview AND the mid placement interview section on the front sheet of the set of skills you are working on (i.e. in the community this may be ‘Midwifery Care Pregnancy & birth antenatal skills’ section of your PAD. If your mentor has students from different universities they may not be familiar with UoM paperwork as every uni is different so its your responsibility to ensure every thing is completed.

As an aside, I did not realize our skills directly related to the academic units we were doing until about 6 months in…..don’t judge me I was overwhelmed!!!

Also you will have your progression points at week 19 & week 52….these tend to coincide with final placement interviews but not always so stay on top of these dates….get them in your diaries as both your mentor and AA need to write comments and sign these.

Skills

The skills section of your PAD is divided into 4 sections. Familiarise yourself with the sections, notice which sections coincide with your academic units so you can use what you are learning in university to inform your practice and vice versa, then write them up! Sounds obvious but it isn’t always! For example, if you have been learning about abdominal palpation in university and you are out on practice in the community, tell your mentor you have had a session on abdominal palpation and the use of pinards. Let your mentor know that you would really like to practice this in clinical placement. Your mentor will support you in this (if the opportunity arises) then you can write this skill up using all the theoretical knowledge and the practical skills you gained then get your mentor to sign this skill off! This, I recognise, is an ideal world scenario but this is YOUR clinical placement….make it work for you. This is your opportunity to apply what you are learning in theory to your practice; it is NOT your mentors responsibility to work out which skills you need to practice and get signed off!

Mentor/sign off mentor/SIGNATURES

You will be assigned a mentor when you go on placement for every clinical area you will be working in. You need to find out if they are a sign off mentor (they are usually quite forthcoming with this information!). Only sign off mentors can sign your paperwork and assign you a grade. If your mentor is not a sign off mentor ensure you know who the sign off mentors are in that clinical area and try and work at least a couple of shifts with them. Your mentor can sign your skills but the sign off  mentor needs to countersign them. THIS IS NOT THE SAME AS YOUR WHITE BOOK ! So if your mentor signs off that you are amazing at communicating with women the sign off mentor needs to countersign and date this skill as well.

I am going to **star** and bold and italic this next sentence because this caught me out on my placement and meant I spent most of my last shift at my first year trust running around trying to find one member of staff and ringing my AA almost in tears……..

******AS SOON AS ANYONE SIGNS YOUR SKILLS IN YOUR PAD MAKE SURE THEY SIGN THE SAMPLE SIGNATURE SHEET FOR EACH SET OF SKILLS THEY HAVE SIGNED AND WRITES DOWN WHEN THEY LAST HAD A MENTOR UPDATE******

(i.e. if a sign off mentor countersigns a skill in the ‘intrapartum care’ section of your PAD and the ‘tackling health inequalities’ section of your PAD, THEY NEED TO SIGN THE SAMPLE SIGNATURE FOR EACH SET OF SKILLS.

Imagine the scenario….you are finishing a night shift on the midwifery-led birth centre and the midwife you worked with observed you support a couple during a lovely labour & delivery. You had the opportunity to write up the skills you demonstrated during this shift and you got your midwife mentor to sign these skills off and she quickly got the sign off mentor, who’d just come on an early shift to countersign them before both you and your mentor floated off home to sleep…… WITHOUT GETTING THE SAMPLE SIGNATURE SHEET SIGNED BY THE SIGN OFF MENTOR!!! YOU NEED TO GET THE SAMPLE SIGNATURE SHEET SIGNED (yes this is what happened to me!!!) If you don’t, as a first year your PAD will be referred and you will have to return to your old trust to track down the sign off mentor to sign the sample signature sheet and then resubmit the whole skill set. If you do not have all the signatures completed on the sample signature sheet in second and third year YOU WILL FAIL (this makes me feel sick!).

Another starred, bold, italic section coming up……………………….

****YOU NEED TO DATE EVERYTHING YOU SIGN****

A LOT of my cohort got our PAD skills returned to us because we hadn’t dated our signatures on our skills documents! We had ensured our mentors had dated everything but we actually hadn’t! There is no ‘date’ prompt next to the student signature section but you do need to date it! I cannot begin to tell you what a complete pain in the rear it is when you have finally tracked down the sign off mentor to sign your sample signature sheet, hobbled, exhausted and emotional to hand in the PAD documentation hoping you never have to see it again, only to get it ALL handed back as ALL my signatures needed dating! Literally, every single one of the 60 or so skills I needed to go through and date! DATE THEM!!! Believe me you will not want that PAD handed back to you! If you aren’t sure if something needs dating and signing do it anyway! I am very much ‘better to be safe than sorry’ …once bitten and all that!!!

Think that’s all the terrible tales I need to pass on about documentation!! I do wonder how I managed to even get on this degree as reading back over this makes me look a bit lacking but I blame sleep deprivation!

You will be getting your uniforms soon-empty all pockets before you take it off and buy a tub of vanish….white is a TERRIBLE colour! What were they thinking giving nervous, tired students white?!! One night shift my pen had leaked in my pocket and because I was on an antenatal ward and the women were sleeping, all the lights were dimmed ….by the time I realised my pen had leaked I had fingerprints on my uniform, on some lovely white sheets, on a couple of CTG monitors and on my face!

uniform I was very glad I had purchased a tub of vanish big enough to bath a baby in!

Good luck and DATE EVERYTHING!!!!

 

`

 

 

 

‘Trust Talk’

wordle

Trust talk!

So since starting placement I have come across quite a lot of peculiar language. Peculiar to me but to everyone around me it seems the norm!

I find myself intensely nodding ,nodding like one of those Churchill insurance dog things people put in the back of their cars! Nodding profusely to conversations about ‘BM protocols’, ‘customised and population centiles’, ‘TCU”,’voids’ and many other terms.  So I thought I’d put together a mini jargon buster designed to help first year student midwives settle into trust life. That way when you arrive on placement you will have some valuable knowledge to start off with and not end up nodding like an idiot!! e.g, like me, to terms you have no clue about it!

Starting placement is very daunting and the hope is by sharing and comparing different ‘trust talk’ from trusts across the Greater Manchester area, familiarity to medical, maternal and neonatal terminology will make it less daunting through our midwifery journey.  So below is a list of the main terms accumulated from student midwife experiences.student midwife 1985 other

  • BM– Blood monitoring, assessing the blood glucose levels of babies
  • CUSTOMISED CENTILE– A centile constructed from the mothers BMI, height etc.
  • POPULATION CENTILE– Measurements we use in antenatal to measure fetal growth
  • SCBU – Special care baby unit
  • VOID– Measurement of urine
  • TCU – Transitional Care Unit
  • MEOWS– Modified early obstetric warning score – Record of maternal observations
  • BBA – Born before arrival
  • EMCS– Emergency caesarean section
  • ELCS– Elective caesarean section
  • NBFD– Neville Barnes forceps delivery
  • KIWI– A type of  vacuum delivery.
  • BARRIER NURSING– When there is an infection control issue,  gloves and aprons  mandatory when assisting the woman.
  • SROM– Spontaneous rupture of membranes
  • HCA– Health care assistant
  • CARDEX– Drug prescription chart
  • PIH– Pregnancy induced hypertension
  • HYPOTENSION– Low blood pressure
  • PRETERM– Born before 37 weeks
  • NICU– Neonatal intensive care unit
  • TTO– To take home in reference to own medication for home
  • POD– Prescribed on demand Often hear women are “pod’d” with medication.
  • DCAU– Day care assessment unit
  • ANC– Antenatal clinic
  • TWOC– Trial without catheter
  • ENB– Examination of the newborn
  • NIPE- Newborn and infant physical examination
  • NNOBS– Neonatal observations
  • EWS– Early warning score. This is the same as a MEOW
  • SRC– Self retaining catheter
  • LFT– Liver function test
  • ECO– Early consultant opinion
  • NEW– Newborn early warning chart
  • FDIU- Fetal death in utero

 

Learning from the ground up

As a student nurse, especially in first year or on your first placement, it can feel really daunting first stepping onto a ward. I had absolutely no previous experience of working in a hospital and next to no knowledge about what it would really be like when I got there.

What jobs would I be asked to do? Would I be left alone with patients? Would I be administering life support in the first 10 minutes? That sort of thing.

The key thing to keep in mind throughout first Placement, I found, is that this is the first step of the marathon that is your Nursing training. It is true that training goes fast, honestly I can’t believe I’m over halfway through it already! But I wouldn’t be anywhere near as confident in the more complex things I do now, without my basic training in Nursing care.

I completely understand new student nurses’ frustration at the end of a day on placement if you feel you’ve only been doing basic tasks such as bed baths, repositioning or obs all day. It feels like you’re not being taken seriously or even used as free labor, this is not the case.

Nurse_Edith_Cavell_1865-1915;_Brussels_Q70204A new Student Nurse said to me the other day that she relishes these opportunities because this is what the foundation of Nursing is built on.

Yes, you do go one to be carrying out complex, intimate and vital tasks supervised by your mentor or other staff members but you have to be realistic about this. To be honest if student nurses were performing high-risk bedside procedures on their first shift – I would be very concerned! I know I wouldn’t of felt confident or ready to be removing chest drains for example when I’d just got into clinical practice. You need to build up to these things.

2227726759_d1285989d7_o

A well made bed with hospital cornered sheets is a ward’s bread and butter

The basics may seem dull and repetitive but it’s often where you find your stride. When you’re giving a bay of patients their washes, helping them to use the bathroom or commode or just generally being the face they see when they press the
ir call bell, when the time comes for you to change their wound dressing or remove their catheter you are confident in yourself. Getting to know your patient and getting to know yourself and how you act under pressure is key to becoming a more reflective and efficient nurse. And don’t go thinking that this isn’t what nurses do. It is. We do the dirty work because our patients need us to and we care about their well being and I’m very proud of that fact. I’d remake every hospital bed in Manchester if it meant preventing bed sores for our patients!

That said; you shouldn’t be being used as an HCA whilst you’re on placement. Don’t be shy in asking your mentor what learning opportunities there are for you to see that day. Observe as much as you can, be nosey, be bold and ask to go on ward round with the doctors to help you get to know the sorts of conditions that your patients are suffering from. Then, when you or your mentor feel you’re ready. You can step up and know that you can do this; you have the courage and can act in a confident, competent and caring way.

Meeting the 2015 cohort!

The Placement Project team visited this year’s welcome week fair in September to hand out our ‘Placement Survival Packs’ and meet the 2015 entry cohort! We asked some of the new students their thoughts on placement; what they were expecting, worried about, looking forward to and things they hoped to achieve. Towards the second half we interviewed some current students who reflect on their first placements and now the first years are all about to start placement soon they might want to have a look back on this. We hope it meets your expectations and best of luck on your very first placement from all of us!

Here’s the video below…