Reading about placements on the HUNS website, and recognising September 2020 nursing students were heading for their first experience, I felt moved to contribute some personal reflections. On 4th June 2021, it’ll be 42 years since I started a three-year nurse training course at a local long-stay learning disability hospital (terminology of the time being mental subnormality). I was one of a cohort of eight student nurses in the second group that year. Pupil nurses, who completed a two-year training, were also taken on each March and September. Between us, we largely went on to supply the qualified nursing needs of the main hospital and two smaller ones within the district for men and women with learning disabilities. Many of you will be unfamiliar with such services which were a feature of 1970s NHS provision, existing also for people experiencing mental ill health and some older people. Latterly, community located care for many groups has developed to the extent that, regardless of your programme of study or field, you’re now likely to meet and support people with a variety of needs not restricted to your speciality.
I’m also writing this almost three months since retiring from the learning disability nursing team at the University of Hull. In that time, I’ve been busy sifting through the reams of paper I’d saved not only from my pre-Registration nursing course (yes, really!) but also a range of subsequent job roles and accompanying programmes of study. One of the (many) things that struck me whilst reminiscing, reading student and pupil nurse names in cohort lists and from the proceedings of Badge awarding ceremonies in the hospital Recreation Hall (your Graduation equivalent), was how well-integrated – professionally and socially – students of the two qualifications were. It’s great to see that tradition continuing with Nursing Associate students sharing their similar and unique experiences in Nursing Society blog posts.
It’s a universal truth that every professionally qualified individual you encounter on your student journey – whether Practice Supervisor, Practice Assessor, Lecturer, colleague member of the multi-disciplinary team – will once have been a student. I say this to remind you that – however they may appear to you – they could well have felt some of the things you do (and may still do, given a change in circumstance). For example, despite having been a competent Unit manager in bedded services, qualified for seven years, I can still recall the apprehension I felt on Stephen’s* doorstep on my first unaccompanied community nursing visit back in 1989.
I read recently the first page of notes I made during my six-week introductory study block in the hospital School of Nursing back in 1979. It contained this profound, enduring message:
The idea is to see the patient as a person.
Whilst I’d be unlikely today to use the term patient to refer to many individuals with learning disabilities, the practice environment was a hospital, home to as many people as there were days in the year (365), including children and many adults who had lived there since childhood.
Linden ward was my first twelve-week placement, supporting women with a variety of personal needs, including those more common with learning disability. These include physical and sensory disabilities, epilepsy, behaviours of concern and manifestations of mental ill health. Sister terrified and nurtured me in equal measure – I owe to her my continuing ability to apply a spiral bandage! The work was physically tough and the equipment (for example, to move and handle) largely absent but I was taught well, not only by staff but especially by people with learning disabilities.
I was hooked.
During the first year of training, two care studies were completed (adult and child) and I identified Elsie* as my first. I found it recently amongst my emptied office contents and travelled back in time to read the beginnings of learning about – and giving respect to – her as an individual, distinct from the other 27 women with whom she shared her dormitory and two bathrooms.
If we can recognise individuality in those we support, we should embrace it in our profession too. I strenuously believe that there’s more than enough room in nursing for uniqueness – think of the variety of people it equips you to help. You may sometimes feel, for example, you’re the ‘wrong’ age, are too quiet/assertive, that a placement situation’s too far outside your sphere of experience. Remember, one size (approach) could never fit all.
For me, and my contemporaries, each subsequent two-week study block in the School of Nursing ended with a test and at the end of year one, an intermediate exam comprising a written paper and an oral test with two Assessors (generally Ward Managers) related to one of our case studies. No Data Protection or recognition of sensitivities here – all students’ marks were published to all! Following successful intermediate completion, we also undertook four practical assessments across the next two years. Whilst this is not dissimilar to those re-introduced by the Nursing and Midwifery Council (NMC) in the latest pre-Registration Nursing Standards, more senior students will recognise them as naturally occurring ‘rites of passage’ under continuous assessment. So, I led Beryl’s* nursing care on Larches ward; completed a medication round on Poplars; taught what we now refer to as safeguarding on child and adolescent unit Mill Cottage (Non-accidental injury to children; “The battered baby syndrome”); and managed the shift as a senior student on Ivy ward.
Despite the passage of time and a multitude of changes in professional education and care provision I hope my reflections from retirement are of passing interest. Your experience of being students through a pandemic is unprecedented. This, and other more positive memories, will variously stay with you for the rest of your career, shaping the future nurse you become. I wish every one of you all the best in this.
*not their real names