Clinical placements

COVID-19: why I’m glad I faced my fears and opted for an extended clinical placement anyway

I have learned so much about being a nurse by working in a great ED team during the pandemic

Picture: iStock

As a nursing student in the last six months of my degree, I was looking forward to completing my final clinical placement and handing in my dissertation before going on a much-needed break.

But coronavirus means I am now on an extended placement in the emergency department (ED) of my local hospital, helping front-line NHS staff tackle the pandemic.

I had read about Spanish flu and was in Africa when Ebola ravaged part of the continent, but nothing prepared me for COVID-19; it felt like we went to bed in one world and woke up in another, with daily updates on death rates becoming the norm.

To opt in or to opt out – big decisions for my nursing student cohort

In its response to the pandemic, the Nursing and Midwifery Council said students in the final six months of their programme could opt in by doing a paid, extended clinical placement or opt out and continue their studies online.

‘The number of healthcare workers dying from COVID-19 heightened my anxieties. Many of my cohort are from BAME backgrounds, and the statistics for us were particularly worrying’

Opting in or out may sound like a simple decision, but there were a lot of things to consider, not least the financial implications; like other nursing students, I have been on placement for months without so much as minimum wage and did not want to turn down a paid placement.

Our university tutors did their best to answer our questions and provide us with as much information as possible, but ultimately it was our decision to make. After some careful thought, I chose to opt in, but I was still anxious, as were others in my cohort who had chosen to opt in too.

Would I be more hindrance than help in this high-pressure environment?

We were going into clinical practice early to help and add to the numbers, so would not be supernumerary and this would not be a period for more teaching. As well as being concerned about my learning outcomes, I was worried I would be a burden to the nursing staff – I am still learning the ropes, so would I be more of a hindrance than a help?

On a more positive note, an extended placement meant more practical hours, and I would be learning on the job. It felt like being thrown in at the deep end and asked to swim, but as one of my tutors said, what better way to learn more about nursing than in a global pandemic?

Concerns about how ethnicity and COVID-19 mortality are linked

The number of healthcare workers dying from COVID-19 further heightened my anxieties. Many of my cohort are from black, Asian and minority ethnic (BAME) backgrounds, and the statistics for us were particularly worrying.

‘It is vital we protect our mental health, so if you are struggling, make sure you talk to someone’

An analysis carried out at the end of April found that of the 106 NHS staff who had died, 63% were from a BAME background. Of the 35 nurses and midwives included in the study, 71% were from a BAME background. NHS England data shows that one in five nurse and midwives in England have a BAME background. 

Then a report published in early June by Public Health England, which analysed the deaths of 119 NHS staff, revealed that people from BAME backgrounds were more likely to die from COVID-19, with diagnosis rates highest in black communities.

Frightened, yes… but prepared and supported to do my bit

Am I scared? Yes. I have a family who I want to keep safe, and the thought of passing the virus on to them is an additional burden. But I have been taught how to don and doff my personal protective equipment (PPE) carefully, and I was fit-tested for a suitable mask before I went on placement.

I also have a supportive network, and an advice line has been set up by the university. It is reassuring that our tutors are only a phone call away.

I opted in and want to do my bit, but I am worried about the psychological effects of COVID-19, both now and in the future. It is vital we protect our mental health, so if you are struggling, make sure you talk to someone. 

Cry if you want to, step away if you need to. These are unprecedented times of great stress and we must look after ourselves and each other.

We all have our fears but the team pulls together

Going into clinical practice early was always a gamble, but I have been on placement for just over a month now and am enjoying it.

Working in the ED during a pandemic is daunting, but the team have been supportive. We all have our own fears and worries but are pulling together to support each other.

View our COVID-19 resource centre

We wear full PPE in the ED, and I was given some valuable advice about this at the start of the placement – a colleague told me that no matter how dire the situation is, ensure you are safe before attending to the patient. Like on a plane, put your life jacket and oxygen mask on first before helping others.

A rich learning experience and a rewarding way to start my nursing career

Effective communication and teamwork are key in the ED, and my skills in this area have definitely been enhanced. I also have a list of competencies I have to work towards and am learning so much – every day brings its own surprises, which is what makes working in the ED so exciting.

I have always wanted to work in trauma medicine, and the ED is a great place to start my nursing career. I am staying on after my placement ends, and am really looking forward to working with such a great team.

Ijeoma Okolo is a final-year adult nursing student at the University of Essex