Posted 25 March 2021 - 10:37
Posted 25 March 2021 - 10:37
Clinical placements
Pop-up hospital helps students make up for placements lost to COVID-19
University’s sessions offer practical experience with clinical scenarios role-played by student peers
University’s sessions offer practical experience with clinical scenarios role-played by student peers
Providing opportunities for nursing students to practise hands-on patient care has been challenging during the COVID-19 pandemic, but the University of Northampton has devised a novel solution with its own pop-up hospital.
‘Waterside General’ uses vacant teaching rooms to create simulated inpatient and community settings, with third-year nursing students playing the roles of different patients in scenarios that encompass all four fields of nursing.
Clinical practice in a safe setting
The idea is the brainchild of the university’s senior lecturer in adult nursing Claire Clinker. ‘The students had some clinical placements over the year, but we felt we needed to help them with their understanding of what ward and community life was like,’ she says. ‘We didn’t want them to be disadvantaged.’
While getting others on board was the easy part, developing the different scenarios took time. ‘Each field wrote a couple of different ones, for inpatients and outpatients,’ she says. ‘We now have a bank of scenarios we can use.’
The sessions have taken place over six Saturdays in February and March, each involving between 25 and 45 nursing students. They undertake an eight-hour shift in small mixed teams, working their way around a variety of scenarios that attempt to depict the kinds of nursing experiences they may encounter in practice.
These include caring for a patient with diabetes who has a lower leg wound, a woman on a mental health ward with depression, and an older man in the community with a suspected urinary tract infection.
Each scenario takes an hour to complete, with time afterwards for debriefing. ‘This is really important,’ says Ms Clinker. ‘It’s not just about looking after the patient, but assessing what the student has learned and what else they might have done.’
Mental health nursing: ‘Communication skills are fundamental’
For second-year mental health nursing student Alexandra Ingram, gaining insights from the year above has proved invaluable.
‘When you’re training, hearing feedback from peers is one of the most important things,’ she says. ‘They’ve been in the same situation and they know how we’re feeling. Some of the third-years took time to talk me through their experiences, giving me advice and telling me where I’d done well. I hope that when I’m in year three, I’m able to help students in their first and second years.’
As the only mental health nurse in her group, she was able to practise depression and anxiety assessments on a third-year student who was role-playing a patient with suicidal thoughts. ‘Communication skills are fundamental in mental health nursing,’ says Ms Ingram.
Time to ask questions and learn from peers
Being able to ask lecturers and other students questions along the way was particularly useful, she says. ‘When you’re on a placement, sometimes there just isn’t the time to ask questions or have them answered.’
Focusing on some aspects of physical health has been beneficial, says Ms Ingram. ‘It’s given me a keen interest in learning a lot more. As we know, physical and mental health are so interlinked.’
Experiencing all four fields of nursing was also memorable. ‘It helps with understanding about the multidisciplinary team. We had a flavour of what each of us does and how we can all work together – which is so important when you’re delivering person-centred care.’
Before she took part in the experience, she admits feeling nervous about going back on placement. ‘But I feel much more confident now,’ she says.
A few surprises make the scenarios more realistic
The university has also added some dramatic events, including a patient who collapses with a cardiac arrest, a heated argument, and a fire, necessitating evacuation. ‘It’s about getting the students to think these things could happen,’ she says.
Ms Clinker has been impressed with how resilient the students have been, and how they have coped with studying during the pandemic. ‘I can’t comprehend what they’ve been through over the past year,’ she says. ‘They’ve shown such professionalism in the ways they have managed themselves and the respect they have for each other. They’re like a big family.’
Learning disability nursing: ‘It relit the nursing spark’
Having the opportunity to open others’ eyes about learning disability nursing was key to Helen Morgan’s appreciation of her training session.
‘I enjoyed the learning disability scenario because that’s my field and that’s what I’m proud of,’ says second-year student Ms Morgan. ‘But I also loved the fact that others could experience what we do, learning new skills about service users and how to handle different situations.’
The learning disability scenario focused on a patient with communication difficulties. ‘Not a lot of people know what learning disability nursing is like and I’m hoping this gives people more insight,’ she says. ‘Some people ask whether it is real nursing, which can be frustrating.’
She also enjoyed the chance to learn more about other fields of nursing, including in the community; organisers created a mock living room, complete with sofas, a radio and even a pretend dog.
‘You rang the doorbell and immediately had to adapt to that situation – it felt very real,’ says Ms Morgan. ‘Being more open to other fields is one of the things I will take away with me. We’re all here to do the same job and we shouldn’t be closed off to each other.’
Like many others, she has found studying during the pandemic challenging. ‘Nursing is hands-on and it’s about communicating with patients,’ says Ms Morgan. ‘It’s a personal profession, so not to have that contact, and just a screen to stare at, can really have an effect on how you feel. This has relit that nursing spark.’
Waterside General will stay open after the COVID-19 pandemic
The experiment has been such a success that they plan to continue the sessions even after the pandemic has passed. ‘We’re looking at possibly using it as the first placement for nursing students in their first year,’ says Ms Clinker, ‘so they have that experience of what might happen in a very safe way.’
Among those taking part was second-year adult nursing student Gemma Farr. ‘COVID has led to so many cancellations that I’m only just completing my second placement,’ she says. She missed out on a week in a school, another at a mental health nursing home and a third working with people with learning disabilities.
‘A large part of your first year is gaining this cross-field experience, spending time in different settings,’ says Ms Farr. ‘We had proficiencies we needed to meet in all fields and the university needed to find a way we could do that without being on placement. It made the whole virtual hospital experience more relevant. We were all surprised by how much we learned during the day.’
The community scenario brought home to her the differences in managing someone’s care compared with ward-based nursing. Her group also had to cope with a patient with dementia who absconded from the ward.
‘We had to think about what we would do in that situation,’ says Ms Farr. ‘You assume that staff are keeping track of other patients, but this happened under everyone’s noses.’
A much-needed confidence boost
With limited experience of nursing children, she found the scenario of caring for a sick child especially difficult. ‘I hadn’t realised quite how different the assessment process was for children,’ says Ms Farr.
Not having patient contact for many months had begun to affect her self-assurance, Ms Farr believes. ‘You can overthink things and end up losing your confidence, even with simple tasks like talking to patients,’ she says. ‘But during the day, any anxieties I had melted away and I felt as though I came into my own again.’
Children’s nursing: ‘Building a partnership with the family’
Playing the role of a concerned mother, who has brought in her sick child with abdominal pain, helped third-year children’s nursing student Phoebe Sawyer demonstrate her leadership skills.
‘It was interesting to see what the students did,’ says Ms Sawyer. ‘They needed to think for themselves and decide what they would do. Towards the end, I was able to share what I would have done and suggest ideas for what they could have done differently. I was also able to use some examples from my own practice.’
Among the tips she shared was tackling the paperwork in order, ensuring that nothing was missed.
She was pleased the nursing students picked up on safeguarding issues triggered by the child’s weight loss and a lack of attendance at school. ‘They had an amazing bedside manner, speaking to the mother and child, even though the child was a model,’ she says.
‘As a children’s nurse, it’s not just about concentrating on the child, but building a partnership with the family. You have to work with them and see how the hospital admission is affecting them.’
She found taking part in the experience rewarding and wished it had been available earlier in her own studies. ‘I think it would be especially beneficial for those who’ve not had much hospital experience,’ says Ms Sawyer. ‘For me, the day enabled me to see how far I had come. You do things every day and you don’t realise you’re doing them until you can see how you’ve progressed.’