Supporting a nursing student in general practice
General practice nurses take on a new challenge by supporting nursing student Chantelle Atkinson in her training.
The Willis Commission (Willis 2012) recognised a potential shortfall of nurses working in general practice in the near future. General practice nurses are therefore being encouraged to mentor nursing students in an effort to attract them to a career pathway in primary care.
This article reflects on the recent placement of a third year nursing student, whose objective was to develop decision-making skills, to explore the challenges and rewards for the mentor, nursing team and the student.
The mentor – Sue Mantell
The main challenge I encountered was to provide an environment in which, by indirect supervision, the student could safely manage patient consultations.
First, I considered the requirement for the student to observe and work alongside the whole nursing team to demonstrate she had the relevant theoretical and nursing knowledge to manage patient consultations, without compromising patient safety (Nursing and Midwifery Council (NMC) 2008).
Regular reflection with the student was essential and I became aware of her frustration at not being permitted to work without direct supervision after a few weeks in placement, when some of her peers were seemingly undertaking this role at an earlier stage. However, a reflective session enabled us to discuss the processes to ensure her ultimate objective was achieved in a safe and judicious manner.
Students should ideally set their own clinics to manage but this proved logistically difficult. The identification of suitable non-complex patients in advance involved a significant amount of administration time and planning which was impracticable within the placement timeframe. This was overcome by examining the nurses’ appointment diary daily and together identifying patients for the student to manage via indirect supervision.
This allowed the student to develop her own consultation skill set, working in practice guidelines and developing her confidence in the decision making process.
This was the first time I had mentored a third year student. On reflection, each member of the nursing team appeared more acutely aware of their own practice and decision-making skills than with had been the case with previous students.
Assistant practitioner – Lorraine Hicking-Woodison
As an experienced assistant practitioner in general practice I was delighted to have the chance to work with a nursing student. I realised that to support the student’s learning and development effectively I needed to demonstrate best practice. This provided a chance for me to examine and reflect on my own knowledge and skills.
The student spent time observing my clinic, which offered her a sense of working in general practice, and the chance to familiarise herself with the setting. I encouraged the student to introduce herself to the patients and noticed early on that she had a pleasant and caring approach towards them.
I endeavoured to create a positive learning environment by encouraging and valuing the student’s input, as well as reinforcing her progress by giving timely feedback.
Gradually the student was able to take a more active role in the consultations. I supported her in taking the lead in clinics and only intervened when needed. Before long she demonstrated that she had the ability and confidence to undertake all aspects of the clinic. This progressed to the student being given the opportunity to test her ability and initiative by managing her own clinic workload under indirect supervision.
I felt confident that the student was aware of her boundaries and sphere of competence and would seek help and guidance if needed.
It was a rewarding experience to witness the transition from a fairly cautious to confident student but working with the student was a two-way process.
The close working relationship we developed gave me opportunities to enhance my own knowledge from the student’s previous experiences that she was able to share.
It has given me great personal and professional satisfaction to have been able to help in the development and learning of another.
The student – Chantelle Atkinson
My placement in general practice has given me a comprehensive understanding of the nurses’ role in primary care. I have gained knowledge in regards to long-term conditions, for example, diabetes, asthma and hypertension and gained confidence in wound assessment and wound care.
I have acquired knowledge regarding commonly used drugs in primary care in relation to pathology, physiology and pharmacology.
I primarily worked alongside the assistant practitioner. This helped me learn the essential aspects of primary care, and I was able to input my own knowledge from my experiences in other care settings. Her positivity and passion for her role had a positive impact on my experience.
I found the practice very supportive. Each member of staff spent time to explain procedures for which I was very grateful, as few work places allow time for discussion and reflection with nursing students.
Prior to this placement, I felt slightly cautious as this environment is seemingly different to my previous placements. On my first day my mentor and I discussed my learning needs and what she expected from me as a third year student. It was apparent that before I was given my own patient caseload, I needed to prove myself to be competent in the role.
Initially I found this to be challenging, as other placements enable students to work independently, fairly quickly. Following a reflection with my mentor, I was able to understand the importance of demonstrating my knowledge and skills before being given my own clinic to manage.
To develop my decision making skills the whole nursing team was involved in observing my consultations. Once I had gained more confidence in the role, I undertook patient consultations on my own, conferring with senior staff members with any concerns or queries. This method worked well.
I respect my mentor and the other staff members for their efficiency and honest feedback and I am grateful for having the opportunity to work in primary care.
Implications for practice
This has been a positive exercise in sharing experiences, knowledge and skills while embracing the opportunity to participate in the development of the future nursing workforce.
It has empowered the assistant practitioner to reflect and evaluate her role to ensure best practice is achieved, while at the same time supporting and facilitating the student in identifying their needs and managing their expectations during the placement.
The mentorship of nursing students is a rewarding and challenging role. Challenges were effectively overcome by identifying situations that would support and enhance the student’s learning to ensure her objectives were achieved.
This, together with the opportunity to regularly reflect between mentors, peers and the student helped the successful achievement of goals during this placement.
- Nursing and Midwifery Council (2008) Standards to Support Learning and Assessment in Practice. London NMC
- Willis P (2012) Quality with Compassion: the future of nursing education. Report of the Willis Comission on Nursing Education 2012. London, RCN.
About the authors
Lorraine Hicking-Woodison is a healthcare support worker adviser and assistant practictioner in general practice. Sue Mantell is nurse practitioner at The Hawkinge and Elham Valley Practice, Kent. Chantelle Atkinson is a nursing student, Canterbury Christ Church University.
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