Practice makes perfect

first_imgIncludingoccupational health as a practice placement for student nurses as part of theirpre-registration diploma is a process that has also been advantageous to OHteams, by Tammie Daly, Nia Harris & Alison ClarkeOccupationalhealth nurses (OHNs) are in a unique position to assist student nurses to meetthe public’s ever-changing health needs.Thisarticle discusses the setting up, implementation, and benefits of includingoccupational health as a practice placement for student nurses as part of theirpre-registration diploma programme – a process that has also been advantageousto the OH staff involved. Accordingto an article in Nurse Education Today, ‘collaboration between educationalinstitutions, clinical practitioners and managers is necessary in order toreduce ‘reality shock’ and bridge the gap between nursing education and nursingpractice’.1NottinghamOccupational Health (NOH) has always maintained close links with NottinghamUniversity, through lectures, health screening and support.Ithas, in the past, placed Project 2000 students in industry but, due to ashortage of suitable placements, time constraints and, in some cases, theattitudes of the students, the project folded.TheDepartment of Health’s (DoH) Placements in Focus advocated a more innovativeapproach to providing student nurse placements.2In2001, Alison Clarke, from Nottingham School of Nursing, suggested NOH considerincluding OH as a themed placement for adult branch student nurses as part oftheir ‘community experience’.3Therationale behind the initiative was for student nurses to understand theeffects of work and the workplace on health, and the effects of ill health onthe individual’s fitness to work.Thiswould then enable them to provide better advice to patients on managing theirhealth in relation to their working environment, managing chronic health atwork, liaising with appropriate support to continue to work with an existinghealth problem and returning to work after illness.Outlineof projectTotry to involve other OHNs, Clarke spoke to the Nottinghamshire OH Group and theinformation was distributed via their newsletters. Some OHNs thought thestudents would be too inexperienced to work in our speciality, while others feltunable to commit the time. Six nurses, however, did see the potential, and metwith the programme manager and placement co-ordinator to explore the conceptfurther.Twoorganisations, Nottingham Trent University and NOH, agreed to pilot the scheme,while other organisations expressed a willingness to have the students visitfor periods ranging from half a day to two days.Theplacement sites were first audited by the school to help ensure they would meetthe learning needs of the students. The group met to develop a learning packagearound professional practice, care delivery, care management and thedevelopment of self and key skills.4Eachof these domains was explored in relation to OH practice and to ascertain whatpossible insight could be expected from the placement, as well as thedevelopment of practice skills. Thispackage proved a useful guide for OHNs to facilitate, direct and focus learningfor the students on placement. The placements also benefited the OHNs by makingus critically analyse our own practice, especially when reflecting anddiscussing clinical situations with the students.Itcan be difficult for the busy OHN within the daily constraints of clinicalpractice to find time to search for, read, appraise and think about usingresearch. Students ensure we do find the time, especially as they are taught tolook for evidence-based practice, thereby making us initiate, develop andmaintain change. Theproject started in October 2001. NOH, which has three departments and a team ofnurses, was able to place two students, while Nottingham Trent University tookone student, as its nurse worked alone. The placements were structured and aprogramme produced before the students started. These included visits to otherOH departments such as Astra Zenica, Boots, The Fire Service and RHMS bakery.The students also visited other sites and industries with their mentors (seebox, left).GettingstartedOnthe first day, all three students met at the hospital for the induction. Thisallowed the nurse from the university to meet the students to help ensure peersupport would be possible during the placement and, hopefully, reduce theanxiety of the students entering a new environment.Groundrules were negotiated to ensure the students realised that the health, safetyand welfare of the OH client group was the main concern. The induction includedan explanation of the role of OH, confidentiality issues (especially as peerrecords would be stored in the hospital’s OH department), and the learningexperience that would be available within, and allied to, the placement. Italso covered the expected outcomes from the placement.OutcomeThroughoutthe placements (usually six to eight weeks long), the students met about threetimes with the tutor from the school of nursing, to link theory to practice.The mentors also attended these sessions, providing the opportunity forcommunication and consultation between the students, mentors and tutorialsupport. It also helped the mentors ensure that the students met their expectedoutcomes.TheOHNs negotiated the learning experiences, acted as role models and promotedlearning through reflection.5 They facilitated the students in self-directedlearning by allowing time within the placements for the students to exploreareas of interest (for example, offshore medicals and drug screening).Thiswas especially important because during the placement, the students had toexplore a work/health issue and write a 1,000-word report. Subjects tackledincluded reasons for undertaking respiratory surveillance and hepatitis C andthe healthcare worker.Sofar, six groups have had their themed placements in the OH setting, all ofwhich were evaluated by students, mentors and the school of nursing during agroup discussion at the end of each placement period. Nearly all the studentsgave excellent feedback and the placements have proved popular (see box, p20).Theplacements would not have been so successful without the support of other OHdepartments. Organisations such as Astra Zenica, Boots, Nottingham FireBrigade, and RHMS bakery supported the two main organisations, helping to givethe students a good insight into OH.VickyWright, OH nurse for Sainsbury’s in the Midlands, is hoping to join the schemeand take the students for a couple of days next spring. “I am looking forwardto helping student nurses during their training to see how health in the adultsof working age is supported and managed in the workplace,” she says.ProblemsidentifiedItwasn’t all smooth sailing; there have been obstacles. One organisation thatjoined the scheme later had to withdraw due to time constraints. However, thatnurse still wants to take students for shorter periods.Thismight lead to joint placements in the future (two organisations having astudent for a shorter duration or even half a week each for the six weeks).There have been rare incidents of problems with time-keeping and absences, butagain these were dealt with on a personal level.Itmust be recognised that it can be emotionally demanding on the part of the OHN,especially if, like the OHN at the university, you work alone. Also, there canbe conflict between the responsibility to clients and giving the studentsenough quality time.Itcan sometimes be difficult to just let go, stand back and allow the students toundertake procedures, especially if there are time constraints and you wouldnormally be able to do it quicker yourself. This is one factor you must takeinto consideration when supporting students – supervised practice takes time,and teaching takes even longer. This has, however, been offset, and provedinvaluable when the students were able to provide support in delivering clientcare during staff shortages.PositiveeffectBeinginvolved in student nurse training can only have a positive effect for allconcerned. It is through education that the quality of care provided topatients and the general population will be improved.Studentswill be able to link theory to practice, and vice versa. They will be able tolook much more holistically at the patient in relation to work and health, andhopefully provide them with appropriate health education so they can takeresponsibility for their own health at work.Onfuture placements, they can raise awareness of good practice, such as promotingOH services, infection control issues, and action to be taken followingcontamination from blood or body fluids. They will understand that ill healthmay arise from exposure to hazards at work whether physical, chemical,biological, psychological or even from an accident.Thisknowledge will stand the students in good stead when they themselves becomeward managers. It will also enable them to look at what the patient will bedoing on discharge from hospital, and think about any special requirementswhich will assist them in successfully returning to work. It may even encouragethem to enter the speciality in later years.ConclusionTheOHNs learned a lot as well, especially through reflective practice and, for themost part, have found the students enjoyable and interesting.Ithas made us look at our own evidence-based practice and competencies and hasencouraged other team members to take an active part in student training. Ithas also encouraged us to read more literature in relation to our own practice.Itdoes take considerable time, commitment and resources on everybody’s part, andwe certainly would not be able to offer such a wide variety of experienceswithout the assistance of our colleagues in other industries.Byworking collaboratively with the school of nursing, it has strengthened thepartnership between education institutions and OH. OHNs can benefit from theexpertise of the university and the students have insight into research andwriting for publications. One student working at the university assisted inwriting a latex glove policy and, as a result of his involvement, a jointarticle was published in Occupational Health.6OtherOHNs should be encouraged to either contact their local school of nursing orhave a more positive outlook if approached to take part in a scheme, especiallyas the number of pre-registration students is increasing and more placementswill be required. It is beneficial – honestly.TammieDaly, RN, MA(Ed), DPSN(OH), is a nurse consultant at Nottingham OccupationalHealth, Queen’s Medical Centre, University Hospital NHS Trust, Nottingham. NiaHarris, BmedSci (Hons), DipOSH, RGN, is an OH specialist at Nottingham TrentUniversity. Alison Clarke, MSc, BN, RNT, RN, is a health lecturer at theUniversity of Nottingham School of NursingE-mail: [email protected]: [email protected]‘We don’t sing the chorus when the folksinger’s here: the learning society andhealthcare’, Schuller T, 2000, Nurse Education Today, 20,218-2262.Placements in Focus: guidance for education in practice for health careprofessionals, Department of Health, 2001, ENB, London3.Care of Adults in Community and Non Institutional Settings (DN10), NottinghamSchool of Nursing 2000a, University of Nottingham (in-house publication)4.Diploma in Nursing Assessment of Practice Record: Adult Branch, NottinghamSchool of Nursing 2000b, University of Nottingham (in-house publication)5.Journal of Advanced Nursing, Volume 21(5), 1006-1015, Atkins, 19956.Stretching the boundaries with new latex-free policy, Harris, N; Roper J, 2003,Occupational Health, Volume 55, no.1, 19-21ThemedplacementsNottinghamOccupational Health placements include internal visits/sessions with:–Infection control team–Health and safety team–Lectures on manual handling, DSE, first aid, risk assessment etc–Visits to income-generating companies including a bakery and lead factory–University siteNottinghamTrent University placements included internal visits/sessions with:–Health and safety department–Personnel department–Physiotherapy–Lectures on risk assessment, DSE, manual handling etc–Agricultural college and satellite site, which includes life sciences, sportsscience, and labsKatherineHoeglund’s experiencesBeforestarting the placement, I did not even know what OH was or how relevant itwould be. I had attended a few times for my hepatitis B vaccinations and thatwas about it.Iwas a bit worried I would not enjoy it, mainly because I thought it might be abit boring. However, having now completed five weeks on placement, I havethoroughly enjoyed it. More so than on any other placement, the importance ofpolicies and procedures has become evident.Myconfidence in undertaking health screenings has soared and I’ve been able tomake links with theory and practice; in other words, my understanding behindnursing actions.Thevariety of the placement surprised me, with a lot of visits to externalcompanies and other OH departments in different fields – vaccinations,audiology, vitalagraph and vision testing, first aid training, health andsafety risk assessment training, blood-borne virus lectures, back carelectures, and infection control training to name but a few. Theskills I have learned on this placement are highly relevant and transferable tofuture roles. I would highly recommend this placement to other students. Related posts:No related photos. Previous Article Next Article Practice makes perfectOn 1 Oct 2003 in Personnel Today Comments are closed. last_img read more