NQN · Placement · Pre-Nursing · Reflection · The StN Project

Management Placements

A few of the Student Nurse Project team are currently on their management placements. We thought we’d write a collaborative blog sharing some of our thoughts, worries, and concerns prior to starting and how we’ve combated these. Five of our team shared their experiences, as you will see, we all have similar anxieties, even though we study different branches of nursing. 

  1. What were your main worries before starting?

That I didn’t know enough. My management placement is an acute assessment ward like MAU, but it has CDU & surgical patients too. There’s a lot of high acuity and I felt I didn’t know enough to manage very poorly patients.  

I guess my main worry before starting was would I feel ready to be a registered nurse by the time I had finished the placement. I have the tendency to feel like I need to know everything, slightly irrational, I know, as all nurses continue to learn and develop throughout their careers and there will always be more experienced nurses and members of the MDT there to help.  

As my management placement started, I was most worried about a few things. Firstly, it was in the community, so I was concerned that I wouldn’t be able to do much ‘management’ as such. I also worried about the length of the placement, 14 weeks! 14 weeks is a long time to spend in 1 place if you don’t fit in with the team or feel unwelcome. Finally, my knowledge, I feel this is only natural for us to doubt our knowledge or skills, but I was concerned that I wouldn’t be good enough. 

The idea of the last placement creeps up on you, in first year it’s the ultimate goal. The most exciting prospect which hypes up your motivation – you want to get started, bring on the assignments, give me all the placement details, all of it!! Its what keeps you going through the increased workload of second year. Then suddenly, its here. The last time in purples. I think I saw it as the last chance to learn anything and everything I needed to know for that first day in blues. 

I was incredibly excited, but also incredibly nervous in case I wasn’t ‘ready’. In case other people thought I wasn’t. 

“Before I started, I was so worried about being good enough. Good enough for a final placement student, good enough for my mentor to sign me off, and good enough to meet my own expectations. I was also worried, as I am about every placement, about the team liking me and me being useful to them” 

  1. Did anything you did help alleviate these worries?

I’d been banking as a HCA on the ward since 2015 so knew the environment quite well but I chose to exclusively bank for them and got to know the staff really well. The ward manager was really supportive, and the staff always included me in the nursing side of things and explained what they were doing.  

I’m fortunate that my university operates a hub placement structure, so I had previously been to my management placement in first and second year. Therefore, I already knew the ward, the patient group we work with, and most presenting conditions. I went into the placement making sure I had clear objectives and goals of what I wanted to achieve. I wanted more experience managing complex discharges and liaising with social care and other members of the MDT, as I know these will be things I am responsible for in the very near future.  

In terms of being worried about being in the community for my management placement, I spoke to other students, registered staff and tutors at university who were able to offer me experience which alleviated that worry. Secondly, the worry of not enjoying the placement, I continuously told myself to be positive and look at all the amazing placements I have had in the past. No good thinking negatively about something or worrying over it when it hasn’t even happened yet! Finally, in terms of being concerned about my skills and knowledge, it’s important to be aware of your weaknesses so that you can work on them but it’s also important to reflect on what you do well. Have clear aims of what you want to achieve each week in your management and the skills you need to work on. Having goals helped me break down the work and skills I needed to do into more manageable sizes. 

On my first day, I sat down with my mentor and we went through what I was worried about. I was lucky enough to get my first choice of management placement and my sign off mentor had been my mentor on this same placement last year. So, the pressure of us getting along, and her knowing me and what I wanted and was capable of were taken care of. 

She was fantastic as ever, and told me, very calmly, that if I told her I wasn’t nervous, she’d have been more worried. She told me to think of it like a driving test. Your 100% competent when you pass, but you don’t really learn to drive until youre in your own car and doing it by yourself. 

I went in with a plan of what I wanted to get the hang of while I was here, and she made a plan around it, making sure I got every available opportunity which would benefit me. She organised study days and experiences she said she wished she’d had before she’d qualified. 

“I emailed the matron before I started and went to visit the placement, this definitely helped me feel calmer. I’d definitely say by doing a practice run of how long it takes to get there, where you’re going to park and where the department is located makes it so much easier for that first day! 

I also went through my concerns with my sign-off mentor when I met her and explained what I wanted to get out of the placement, where I felt I might need more experience and everything I was worried about.” 

  1. What advice would you give to someone else prior to starting management placement?

Visit the ward, introduce yourself to the staff and ask their advice. They know their job better than anyone so can give you hints and tips of how to prepare. Every ward is different with different specialities so the advice will always vary.  

If you don’t know the area you are going to or haven’t been there before, do as much research as you can. That way you know what type of patient group you will be working with and what types of conditions they will have. Arrange a visit to the ward or placement area if you can. Have clear objectives and goals which you can share with your mentor when you first meet them and map these to any skills or competencies you need to get signed off.  

– Go in with a positive head, sign off placement can be daunting but go in with your head held high and ready to learn.  

– Take every learning opportunity you can after all this is your final chance to learn and have the protection of a mentor  

– Be organised and plan ahead. It can be only too easy to work your way through a placement, perfect your skills and make great development as a nurse. However, if your mentor hasn’t signed you off for that then you won’t pass your management. Make sure to have goals and targets and get things signed off as you go, even though it’s tough when you’re mega busy. 

– Your sign off mentor is important, make sure you make contact with them early and maintain good communication with them throughout your placement. Be proactive!  

I think my advice would be what my mentor said to me – take every opportunity, if you’re unsure of anything ASK. Everyone there has been in the same position – they get it. 

Think about where you want to start your career as a NQN and have a look at things which you think you want to know before then. 

Ask other nurses for advice on the last placement and as a NQN. What do they wish they’d done or learnt? 

Enjoy it!! 

“My advice would be to take all of the opportunities you get, you won’t get the same experience again, so make the most of the journey. You do need to push yourself and make yourself do things that you know you’ll have to do when you register. There’s no point in hiding behind the student label, as soon as you put on that blue uniform, you’ll be the one who’s got to do it all. Definitely try and enjoy the last few months of your degree, you’ve come so far. This placement will cement everything you’ve learnt and bring it all together!” 

  1. How are you feeling now you’re part way through?

Loving it! I have 1 week left until my final sign off and this week I instantly recognised my patient had been brought around from ED and was triggering for sepsis. I kicked off the sepsis 6 screen and care pathway and by the end I had to take a step back just look at how well I’d managed it. I can’t believe how much I’ve learned in the last 12 months! I finally feel ready to become an NQN. 

I am feeling much more confident than I thought I would and am managing my own caseload of patients under supervision and loving the extra responsibility. I still ask lots of questions and carry around a notepad writing everything and anything I can down; I would suggest everyone do the same. I am also remembering I am still a student and taking advantage of my supernumerary status to gain extra learning experiences I won’t have time to do once I’m a registered nurse. I have been to theatre and next week I am going to the clinic with the Clinical Nurse Specialist and spending a day with the Discharge Coordinator. 

As I write this, I’m currently week 11/14 of my sign off placement and I’m not going to lie, I’m in this weird mixed up period of feeling so many different emotions, I’m exhausted but I don’t want to stop, I’m excited but I’m scared, I still feel like I’ve got forever but I have a matter of weeks, I’m not sure if I’m ready but at the same time I feel so ready! 

I’m now 5 weeks into my management placement, and I’m loving it. Im right where I want to be work wise. 

Its tough, I wont lie. It somehow feels different to other placements, in that I’m not so much an observer this time. Rather I’m being observed doing the job and ironing out any time management / prioritising creases! 

We’re each different and find different methods more or less effective. My mentor has been an incredible support, but from more of a spectator role. Obviously, there’s still things we’re unable to do as students, but knowing when these should be done and the basic process of them and the knowledge behind them is sometimes enough. Letting me finish late because I didn’t prioritise the tasks quite right and was unwilling to hand tasks over which I hadn’t been able to do taught me about effective teamwork; asking me after handover what I thought the days tasks where and which were most important and what help I needed from others taught me about delegation. 

Rather than letting someone else take the lead on what I’m doing, its me taking the lead, just still with a huge safety net! 

“I’m 8 weeks through my 12 week management placement currently. I feel like I’ve learnt so much, so much more than I have on other placements. But, whilst writing this and reflecting, I’ve realised that it’s everything I’ve learnt on other placements that has got me to this point. I now feel like I can actually do this job and I’m so much more confident in myself. I have a big appreciation of how much there still is to learn, I think the more you know the more you realise you don’t know! This is good though, because no one is an expert in everything and we’ve got specialists and field specific nurses for a reason.” 

It’s completely normal to feel worried about this placement, after all, it’s the last one before you register and become a NQN! You are not alone, no one expects you to be perfect, hopefully by reading this you’ll feel reassured that everyone has doubts. Just remember, you wouldn’t have got to this placement if you couldn’t do it! 

Team #StNProject xoxo 

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