A collaborative post authored by blog curators and 2^nd and 3^rd year course reps; Beth, Ellie, Tia and Maddie –

Over the last couple of weeks, I’ve had many a panicked message from pals of mine who are in their first year as student paediatric nurses. The first placement is approaching for Year 1 student nurses at Surrey, and quite rightly, people are feeling excited and anxious in equal measure. It’s really difficult, particularly if you’ve never been in a practice environment before, to know what to expect from that first placement and so with that being said, we have collaborated together to give you some information and “top tips” about what you might expect.

What happens on your first day?
This will always depend on where your placement is, both in terms of area and locality. However generally you will be met by a member of Nursing staff who will show you what to do with your belongings and help you settle into handover. Don’t worry if handover seems confusing or there are things discussed that you do not understand, just ask after the handover is finished. Regardless of whether you are working a shift with your mentor or co-mentor, you will always be allocated a member of staff to work alongside on each shift. If you are not, just ask – handover is a busy time and it’s easy for things to be forgotten, so don’t take it personally. You should also be given a tour on your first day of the practice environment, orientated and introduced to the multidisciplinary team – you might even be given some exciting policy folders to read 😉

What am I expected to know/do as a first year student?

This was something I was really worried about, and this anxiety is shared with most student nurses before they commence their first placement. The short answer is – NOTHING. Your mentors will know that you are a first year student and their expectations will be of such. They don’t know your background – they don’t know (or care) whether you’ve just spent ten years as a HCA or you’ve barely left school and never stepped foot in a hospital before. So go into every placement with an open-mind, enthusiasm to learn and a smile on your face and that’s all you need. For the first few shifts on that first ever placement, stick to your mentor or allocated nurse like glue (except following them to the toilet…yep, we’ve all done it!) but you will realise very quickly that as you pick up knowledge and skills over the weeks, you will become more confident and comfortable with working more autonomously.

How on earth do I REMEMBER everything?

You don’t have to! Make it easy for yourself. Get yourself a pocket sized notebook to keep in your tunic pocket. This will become your little bible. Use your notebook to note down medications and their uses, as this will help you to familiarise yourself with them. You start very quickly being able to associate a particular medication to a condition – for example, you’ll learn that IV ceftriaxone is an antibiotic used to cover for/treat sepsis, phenobarbital an anticonvulsant used for seizures, dihydrocodeine an opiate analgesic for post-operative pain, etc.

Also keep note of diagnoses/conditions that you come across that you were unfamiliar with. In the quiet moments, or after your shifts, it’s a good idea to go through these and do some extra reading and research. It’s often much easier to learn and remember things if you can apply theoretical knowledge to a practical scenario.

What if I don’t know how to do something my mentor has asked me to do?

Do not do it, do not wing it, do not make it up as you go along. If you undertake a clinical task which you are unsure of and make a mistake, you will be putting both yourself and your patient at risk. This does not mean you shouldn’t do things you’ve never done before – but explain to your mentor that you’re unsure how to do the task asked of you, and ask for them to show or assist you through the process. Don’t be scared of saying “I don’t know” – learning is part of being a student nurse.

How do I write my Initial Review/SWOT analysis?

You’ll probably have had a bit of practice doing this during your PM1 module. SWOT analysis is a really useful tool at the start of each placement to allow you to explore your strengths, weaknesses, opportunities for learning on each placement, and any threats posed to your development. It can be laid out as you please – bulletpoints or full sentences, whichever you find easiest. It can be personal, you can use “I” and talk about your thoughts and feelings.

How do I write a reflection?

I (Beth) wrote a blog post for The Student Nurse Project with a guide to writing reflections, which you can read here: https://studentnurseproject.co.uk/2019/03/04/how-to-write-a-reflection-and-why-is-it-important/

Over the course of the year, you need to write three service user logs, focussing on one of them to write a detailed critical reflection. You also need to write logs regarding your additional learning experiences (adult, mental health and learning disability) and any short visits during your placement. As this section of your PLP is not graded, how you approach and tackle your reflections is very individualised. It’s more about the process and practice of reflection than the actual written product.

It’s also a good idea to keep a diary throughout the duration of your placements – even a short entry at the end of each shift so you can write down how your day went. This is often useful for when you come to write your reflections, but is also really nice to look back on.

What happens if I’m sick, or I’m going to be late?

Call your placement with the phone number that you have been provided. Do NOT email, as it will not be received in time. Make sure to call in good time before the start of your shift, and please don’t worry – placements understand that things go wrong and students get ill. If you’re absent, also ensure you record it on your PLP and contact SSO at University.

What do I do if I’m worried about practice I’ve seen on placement, or I’m unhappy with the learning experience I’m getting?

There are procedures to follow for Raising Concerns, but the first port of call should be your Practice Liaison Tutor who will guide you and support you.

What do I do if I feel upset by something on placement?

Firstly, know that it is NORMAL to feel this way. Don’t give yourself a hard time – you are only human, and the empathy and compassion that you possess which makes you a good student nurse also means that sometimes you’ll find things on placement upsetting. Don’t keep it bottled up – talk to a staff member on the ward who you feel you can trust. This will often be your mentor, but if there’s another nurse or healthcare assistant you’ve built a rapport with, they will be equally happy to talk it through with you. Furthermore, speak to your practice liaison tutor/personal tutor at University. They don’t disappear when we’re out on placement – but equally they won’t know if anything is wrong until you speak to them. Also remember that at Surrey we have bi-weekly Wellbeing Wednesday sessions where you can go to debrief and destress with other students and a member of the Child Nursing team.

And some extra ‘Top Tips’!

1. You’ve probably heard this from the tutors – but EAT BREAKFAST on your first day. It’s probably the last thing you want to do – you feel sick with nerves, it’s ridiculously early in the morning – but you’ll be surprised just how drained you will feel if you don’t eat properly. Every mentor has a story of a undernourished student fainting on them!
2. Some students also find it useful to carry a few sweets or mints with them in their pocket to keep your sugar levels up, particularly if you don’t take your break until later in the day. Also bring a water bottle onto the ward and ask where it can be kept – keep taking a minute to go and take a drink, because the bright lights and dry air on the ward can lead to dehydration headaches! But remember that if you’re feeling funny, or need a break – just speak up – your mentor is there to make sure you’re okay and should be accommodating of your needs.
3. Be organised! Do not leave filling out your PLP to the last minute. Plan with your mentor dates for completing your initial review, midpoint, final, CGT and Snapshot Assessment. Ensure you get time to sit with your mentor and discuss your progress – this can be challenging if it is a busy environment, but it is the responsibility of both you and your mentor to protect time for you. If you have difficulty collaborating with your mentor to do this, speak to your PLT. And write your reflections and logs as you go along – many of us leave them and then regret it as you get to the final week of a placement and suddenly you have twelve hundred logs to write! 😉
4. If your placement area allows, it is also really helpful to download the BNF app onto your phone. It’s free, and allows you to access the BNFC quickly and easily, and it is always up to date. You will use the BNFC to check dosages for preparing medications, and it’s often much easier to be able to search the app on your phone rather than flicking through the book.
5. Count respiratory rates for a full 60 seconds when taking observations – this is a bit of a random one, but you will observe qualified staff and even other students counting for 30 (or even 15) seconds. Do not pick up bad habits. Babies and young children in particular have irregular respiratory rates and you could be missing something if you don’t count for a full minute. Student nurses notoriously hate taking respiratory rates and children don’t like to stay still, so if you’re struggling to get an accurate reading, try placing your hand on the child’s chest or belly, or pretending to take a radial pulse – or worst case scenario, observe them from a short distance!
6. Make friends with your fellow student nurses – and not just your first year friends, but you will find second and third year students out in practice with you. We aren’t scary, and lots of us love to teach and support more junior students! I still remember how brilliant the final years doing their supervised practice placement were at supporting me during my first ever placement.

There is nothing that anybody says that will completely ease the nerves you are probably feeling prior to the start of your first placement. But we promise, as soon as you get into the first shift, the nerves will ease quickly. You will find your feet, things will click into place and you will realise exactly why you’re studying for the best job in the world – not that we are biased!

GOOD LUCK FROM ALL OF US!

Authors: Beth Phillips (Year 3), Ellie Mee (Year 3), Tia Dolphin (Year 2), Maddie McConnell (Year 2)