January 26, 2010, by Teaching at Nottingham

Negotiating learning outcomes and opportunities on a practice placement

Video >>
Alison: “If you look at basically nursing, or I suppose any professional group then, you’ve got to identify your clients needs, which is your assessment process. And then you’ve got to put a plan of care, or action in to meet those needs and then, you’ve got to be able to evaluate it, and I think probably for students, seeing that whole process through, especially as these placements are short and sharp, they may not see the whole end point. The patient might be only at the beginning and they might be in the middle, or they may be leaving, but they don’t know how one patient got there.”

Pam: “A lot of students think that nursing is getting – making a patient better and that’s it. My role is to show them, I think, that there is a bit more to that. The person still has a home and still has a life. It’s not the broken leg in the bed, it’s Ada with a husband and a dog at home, and I was trying to – what we – when we spoke about it initially, was I said, “What we were going to try and do was get her to follow a patient all the way through the hospital,” ’cause there is a team like me on B floor that deal with patients who are actually in hospital already that we haven’t been able to get out of A&E, and so she has worked with them a bit, but she’s only followed them to the next stage, the admission ward. She hasn’t gone on to the next ward, which, you know, is something that we’re going to have to try and negotiate.”

Review meeting

Pam: “What do you mean by challenging role, what would you like to do?”
Ochala: “Okay, when a patient comes in, if there’s a patient that needs to get on the – that needs to go on the ward, like the first week we talked about following a patient through.”
Pam: “Right, yeah.”
Ochala: “From the point of entry to when the patient is…”
Pam: “Hopefully discharged.”
Ochala: “…finally discharged from hospital.”
Pam: “Yeah, we did, didn’t we?”
Ochala: “Yeah, so – yeah, but…”
Pam: “And we haven’t done that, have we?”
Ochala: “There was a gentleman that came in on the 24th, yeah, 24th of last month. He came in, he was sent to B53, was it B – no.”
Pam: “57.”
Ochala: “D57, yeah.”
Pam: “D57 or B3.”
Ochala: “D57, and he was sent to D57, and the next day was when I was supposed to work with the IDT Team upstairs. So I went upstairs and saw the patient.”
Pam: “Well that’s fine.”
Ochala: “Yeah, we saw him, but after that, I didn’t know what really, really happened to the patient and he was still there, or he was gone home.”
Pam: “Did you have any input?”
Ochala: “Yeah, I did his initial assessment.”
Pam: “You did the initial assessment?”
Ochala: “In A&E, yeah.”
Pam: “So, what you want me to do – or you want – what you want to do then, is we want to get somebody that we’re going to admit. And then the next day you want to follow them through. And then perhaps even follow them through into whether, are they going home or whether they’re actually going onto one of the healthcare of the elderly wards or other specialities.”
Ochala: “Yeah.”
Pam: “Okay. Right, so we can put that down for the new action plan, so you actually want to follow the patient’s journey, don’t you, from…”
Ochala: “Yeah, from the start to finish.”
Pam: “…admission to discharge.”
Ochala: “Yeah.”
Pam: “Okay, so that’s our – one of our new action plans. Follow patient from Emergency Department to discharge. Okay. Right, so we can put that down for the new action plan, so you actually want to follow the patient’s journey, don’t you, from…”
Ochala: “Yeah, from the start to finish.”
Pam: “…admission to discharge. Okay, so that’s our – one of our new action plans. Follow patient from Emergency Department to discharge.”
Ochala: “What I’ve discussed with Pam is, if the patient comes in, I want to follow it from that point, if a person is admitted onto the ward, follow it up, so it is like you have a clear picture of what really, really goes on. Instead of just seeing 20 people in a day and the 20 people just ends there, so you just take it from that point ’til they get on the ward, then getting discharged from the ward. Where did they get discharged to? Nursing home, their homes, then in that case you get a very clear picture.”

 Alison Clark, Ochala Ojonugwa, Pam Winn (School of Nursing, Midwifery & Physiotherapy)

Extracts from meetings between student nurses, their professional mentors and an academic, and interviews with the participants, produced as part of a CEPPL funded project on placement learning.
This article was originally published as part of PESL’s Teaching at Nottingham collection. Produced January 2010.

Posted in Learning outcomesPlacements and work based learning