Clinical placements

Learn to prioritise and let go of the guilt

One of the biggest challenges of studying nursing is having to walk away from someone who needs you because someone else needs you more
Split screen photograph of nurse being pulled in two different directions

One of the biggest challenges of studying nursing is having to walk away from someone who needs you because someone else needs you more

As nurses, there are countless demands on our time, but we simply cannot be everywhere at once. I signed up to help people and coming to terms with the reality of the role can sometimes be difficult.

Not being able to provide the care you want to because of other priorities can evoke feelings of guilt an emotion with a seemingly magnetic quality that makes these occasions stick in my mind.

Building a rapport

It is guilt that makes me wonder if Mrs Smith (not her real name) ever forgave Gary the name she called me every day of my two-month placement on a medical ward.

An older female patient without capacity,

...

One of the biggest challenges of studying nursing is having to walk away from someone who needs you because someone else needs you more


Picture: iStock

As nurses, there are countless demands on our time, but we simply cannot be everywhere at once. I signed up to help people and coming to terms with the reality of the role can sometimes be difficult.

Not being able to provide the care you want to because of other priorities can evoke feelings of guilt – an emotion with a seemingly magnetic quality that makes these occasions stick in my mind.

Building a rapport

It is guilt that makes me wonder if Mrs Smith (not her real name) ever forgave ‘Gary’ – the name she called me every day of my two-month placement on a medical ward.

An older female patient without capacity, Mrs Smith had been in hospital for some time awaiting a package of care and considered me her pal until my very last day.

‘I returned to Mrs Smith but by that point she had decided I was "just like the rest" and wouldn’t speak to me’

She had some behavioural problems and often refused to take her medication on time or let the nursing staff carry out her observations. But as I took the time to sit and talk to her, she would happily relent whenever I’d ask to take her blood pressure or give her an injection.

Short staffed

On this particular shift, the ward was buzzing from the start. I was just about to help a patient go to the toilet when I heard Mrs Smith shouting my name (well, Gary’s name) down the corridor.

I popped into her bay to find her packing up to leave. This wasn’t the first time this had happened, and I knew she could be coaxed into staying if I could spend a bit of time with her.

But time was something I had very little of that day – the ward was short staffed, and I found myself being pulled between the patient who needed the bathroom and the patient in front of me who just needed someone.

‘These decisions are not always easy to make but learning to prioritise and manage your time are core nursing skills’

I had little choice but to leave Mrs Smith and attend to the patient next door. I returned to her as quickly as I could but by that point she had decided I was ‘just like the rest’ and would no longer speak to me.

While most patients understand that nurses are incredibly busy, and are constantly being pulled in different directions, patients with confusion or cognitive impairment are not always able to recognise this.

Had another member of staff been available to help, things might have been different, but I wasn’t there for Mrs Smith when she needed me.

Best possible outcome

However, it is also important to focus on the positives. While care was not of the standard I would have wanted for Mrs Smith, there was a patient in the next bay whose dignity and independence had been maintained by making it to the toilet on time.

I weighed up the options available to me in that moment and chose the one with the best possible outcome. 

These decisions are not always easy to make but learning to prioritise and manage your time are core nursing skills, and a key part of our education.

Safe staffing levels

The biggest barrier I faced was short-staffing, something we are thankfully starting to see action on across the UK. Both the Welsh and Scottish governments have taken steps to enshrine safe staffing in law, offering hope for patients like Mrs Smith in the future.

As nursing students, we can all do our bit to help. Those in Scotland can back the RCN’s #AskforMore campaign, while students from the rest of the UK can lobby politicians to push for change.

If we all pull together to try to make safe staffing a reality, having to choose one patient over another could soon be a thing of the past.

Further information


Grant Byrne is a third-year nursing student at Queen Margaret University, Edinburgh

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