LD Hybrid Placement Experience

Written by Sam Kitchen

Attending placement is one of the best things about life as a student nurse. You get a unique insight into the area of work that you’re based, get to meet lots of different healthcare professionals and of course the wonderful clients and patients. There are so many opportunities for learning, both new skills and about yourself.

However, doing this in a global health pandemic is for many reasons, not ideal. A minor
inconvenience, to say the least. Placements are often associated with hospitals and wards,
but many placement experiences happen outside of these environments. As a learning
disability nursing student, most of my placements would be based in the community.
However, many of the places our clients would attend in the community were closed and
many of them had been encouraged to shield. Because of this, a lot of my most recent
placement took place online.

As is usual protocol, I contacted my placement area 2 weeks before I was due to attend. I
had a phone conversation with one of the nurses, who explained the background of the
team, what they usually do and how they had adapted to the current circumstances. It was explained that my shifts would be 8am-8pm based in the office, though I would also receive a laptop so I could work from home if needed as space in the office was limited due to Covid-19 capacity guidance. I collected the laptop 1 week before my placement started to ensure I could access the relevant systems from home, which fortunately, I could.

On my first day of placement, I attended the office, bringing the laptop I had been provided. I was warmly welcomed by all staff members, introduced to everyone, and given a tour of the building. In previous times, it would have been difficult to find a chair at all on this placement due to how busy it was, but I was allocated an office to myself as the staff member was working from home full time. I logged on, connected my NHS smart card, opened the relevant systems and was ready to go.

While it was fantastic to have so much room to myself, it was sometimes quite a lonely experience. Where previously I would have been able to build relationships and rapport with staff, this was not as easy. As the building comprised of smaller offices that were often only allowed two members of staff in at a time, conversations were had while stood in doorways. In past times, there may have been a time in the afternoon where everyone joined with a cup of tea in one room to have a chat and debrief about the day so far, this was not possible.

However, the team were aware of this and the importance of it. They made a great deal of effort to speak to me and ensure I felt included. I was invited to daily morning meetings which took place via Microsoft Teams, where workload was allocated and delegated between staff in the office and those working from home. There were also afternoon meetings for staff both in the office and working for home to check in.

Visits to clients and patients were only to take place if they were essential, and many
residential settings made it clear they were reluctant to have external visitors. Some visits
were able to take the form of ‘walk and talks’, where we would meet the client outdoors and as the name suggests, go for a walk and talk about how the client is really doing. It also had health benefits for the client as many were fearful of going outside, but the presence of a nurse of healthcare assistant mitigated that. Just because we were not able to visit clients and patients in person did not mean they did not get contact from the service. There were phone calls and meetings on teams with clients who felt comfortable with this, and for those who did not, regular conversations were had with their support workers.

I had the opportunity to attend many multidisciplinary (MDT) meetings that I may not have otherwise had the chance to attend. In previous times, these might have taken place in a large room with a wide range of healthcare professionals in attendance including nurses, GPs, healthcare assistants (HCA), occupational therapists (OTs), physiotherapists, speech and language therapists (SALTs), psychologists and many more. I may have been sat awkwardly in a corner, nervously scribbling notes of things to research. However, attending these online meant I could ‘Google’ definitions as we went along and could happily scribble away.

In past times, we would have had the opportunity to attend spoke days in different areas of practice. However, because of covid-19, this was not possible. Instead, the trust offered a series of webinars on a variety of topics including:

  • The Criminal Justice System
  • Recovery College – an online mental health support platform
  • Psychiatric Intensive Care Unit (PICU)
  • Fluid & Nutrition Management
  • Catheter Care
  • Injection Technique
  • The role of a Domestic Abuse Champion
  • Defensible Documentation
  • Care Planning

Along with this, we were able to attend various conferences that counted towards our
placement hours including the LD Nursing Symposium with NHS England, MH and LD
partnership conference led by Humber and Vale Healthcare Partnership and more.
The placement was an unusual experience, spending a lot of it isolated in a room with a laptop, though staff made a large effort to ensure I had plenty of learning opportunities and was able to attend client visits with them where this was possible. They recognised the value of having a student nurse there who was able to ask questions and provide an opportunity for reflection beyond their usual day to day working. I had some unique opportunities I may not have otherwise had and as so much of my experience was online, I was able to do a lot of invaluable research.

There were benefits to doing this on shift, instead of frantically researching when I got home after a 12-hour shift. There were benefits to experiencing a placement this way, though I do look forward to future placements where hopefully there will be more opportunities for ‘in person’ contact.

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