Level of study: Part 2
University: University of Hertfordshire
Programme: Adult Nursing Undergraduate BSc
Host Trust: Royal Free London NHS Trust Hospital
As a mature student nurse in my second year, I would like to share my learning experience in a new flexible but powerful placement model. The Expansive Learning in Practice Model that was being trialled across NHS Trusts in North Central London (NCL). This included my Trust which is Royal Free London NHS Trust Hospital where I am studying to be an Adult Nurse. In October 2022 whilst in my first placement of second year, I was fortunate to be invited as part of my peer group in the pilot project of the practice model through the collaboration of my university and Trust. We attended expansive learning experience each week which included virtual sessions.
I learnt about various aspects of patient care and nursing, along with other students across different branches of nursing from different Universities and Trusts. In these sessions, we developed our perception of practice through our beliefs, values, and experience. It was enriching in a way that shaped my idea of health care on a larger scale.
In 2018, my mother suffered from a ruptured aneurysm and had brain surgery (craniotomy with insertion of stent). Delivering her nursing and caring needs during this time shifted my whole paradigm! I developed new belief that I can do this. The rewarding joy and fulfilment of ‘seeing her recovering and gaining back normal life’ inspired me to transition from many years as a health care non-clinical admin member of staff to a Health care assistant (HCA) role and step up to study my second degree as Nursing!
Being a sales and marketing undergraduate, it was a courageous step to move into nursing for me.
Studying a nursing degree is not easy as it transforms a person inside out. I am sure many of you who are going through this journey, will agree with this fact. It is sometimes, like a roller coaster. Our hunger to know, passion, perseverance and enthusiasm shapes us as a good nurse.
It is the encouragement, faith, and belief of my practice educators, practice assessors, practice supervisors and other members of staff that has made me believe in myself and grow. Innovative practice support and coaching like the Expansive Learning in Practice model plays important role in developing students as professionally successful nurse. I am not here to criticize the established method of teaching in university and hospital-based placement. However, this learning practice model has reached 1800+ students of various nursing branches who now have developed better and wider viewpoint about safe and compassionate patient care in their clinical areas.
My professional identity of nursing has been expanding. It has enabled me and my peers to work closely and learn from each other along this journey.
In these sessions, we had plenty of opportunities to ask questions as well as contribute our ideas, opinions, views, and suggestions. We were asked about our needs, our priorities for learning, coached to identify the gaps and reminded consistently of the basic elements of excellent person-centred compassionate and safe care. Through expert guest clinicians, we had interactive learning about various conditions such as Multiple sclerosis and Sickle cell condition. We also participated in clinical scenario -based activities that developed our critical thinking through using patient assessment tools in-depth.
Our understanding of clinical leadership was strengthened as we listened to Matrons who kindly shared their career journey, told us what their busiest day looked like and what is expected from them to be able to lead a department or team. Each week when I reported to my shifts in my clinical area, I noticed that I felt more independent and confident in managing my patient caseload alongside my assessor or supervisor. I understood what was going on with my patients, why treatment decisions were made. I gained my voice to speak up and advocate for my patients. This was because my knowledge and interpersonal team skills had improved.
In my surgical recovery placement, there was a 51year old male patient who had recovered well post operatively from incision and drainage of abscess. He was due for discharge that day. Just before this patient was leaving the ward he started to complain of severe abdominal pain. The Staff Nurse and I reassured him, promptly carrying out an assessment, including checking his vital signs, and called a doctor to examine the patient. The doctor advised that an Electro-cardiograph (ECG) and Venous blood Gas (VBG) should be done. Urethral catheter insertion was also discussed. In this situation, I remembered what I had learnt in a previous placement and my experiences in the expansive learning sessions. I suggested an alternative intervention which was to do a bladder scan to check if the pain might be related to urinary retention. My supervisor and the doctor agreed that a bladder scan was a good investigation to carry out. I found 300mls of urine retained in this patient’s bladder. I offered reassurance to him and encouraged him to use a disposable pot to pass urine. After some time, this patient successfully managed to pass urine. I reassessed him and after a while he was comfortable and ready to go home safely.
Well-being and Life Balance, competing priorities or conflicts in personal life affects both student nurses and qualified nurses. Then this is compounded by the demands of what is expected in delivery of patient care. This can be a lot to juggle and affect wellbeing. Our practice educators always encouraged us to find balance through hobbies and other methods to protect our wellbeing. I practice Anapana and Vipassana (ancient Indian meditation technique) daily to help me feel calmer and more peaceful. If you are interested in checking these techniques, Anapana is available online at https://uk.dhamma.org/more-resources/mini-anapana/. Vipassana is offered face to face via https://uk.dhamma.org/.
Lastly, from my contribution in my expansive learning sessions, I developed my leadership skills and was fortunate to share my story to education stakeholders at a recent regional workshop.