Being an effective student: learning in a community setting

13


Being an effective student


learning in a community setting



CHAPTER AIMS



• To use scenarios to highlight experiences that can challenge nursing students in achieving their learning outcomes during community practice learning


• To invite the student to analyse scenarios, to reflect on similar experiences from practice and consider options and potential actions or outcomes


• To guide the student to use the knowledge and skills from previous chapters and further reading


• To encourage students to discuss challenging situations with their mentor or university tutor



Introduction


Most students enjoy a positive and productive learning experience during their community placement. They develop a good rapport with service users and their families, feel part of the multidisciplinary team and benefit from a very wide range of learning opportunities, which enable them to meet their learning outcomes and personal objectives. There can also be times during practice learning when not everything goes to plan. However, working through a problem or challenge may not only help to resolve difficulties but may also involve very important and positive learning that can be applied to similar situations in the future. Some challenges such as dealing with conflicting opinions or difficult interpersonal relationships are not unique to practice learning in the community but others are. The following scenarios give you an opportunity to think through situations that you may have already experienced or may come across during a community practice learning placement. They may also provide the basis for discussion with your mentor, peers or university tutor.



Activity


Read through the following four scenarios and try to put yourself in the position of each student. Use the questions to prompt your thinking about:



There is no single action or solution and your response will depend on how you view the situation. Some suggestions are provided after each scenario but you may come up with alternatives that are equally relevant. Remember the reflective framework referred to in Chapter 4 will assist you to explore a variety of issues within the scenarios. You may find it helpful to make a note of your thoughts and answers to the questions as you read through the scenarios.



Scenario 1



David: Settling in




I really enjoyed my last placement. I was on a surgical ward in the university hospital with three other students from my year and two third year students who I worked with a lot. The ward was very well organised and the ward routine was like clockwork. My mentor told me exactly what to do and when she wasn’t around, there were always other staff to help me. All the students fitted well into the team. I always knew what to do next. As the hospital is next door to the university, it was handy to call in to see my tutor and go to the library. It was easy to meet my learning outcomes and after 6 weeks there, I felt very confident. I was sorry to leave.


I started my community placement this week and I’m not sure if I’m going to enjoy it. I don’t know the area, I’m the only student here and my mentor seems to rush around the whole time and not have much time for me. There are so many different people and services and every patient seems to have a completely different problem. To be honest I don’t really know what’s going on and what I can learn here.




Actions for Scenario 1 – David: Settling in


The questions that David could ask himself in relation to maximising his learning opportunities that are listed above could also be asked of him by his mentor. This could be the basis of a discussion with the potential to raise awareness on both parts of what David could do, supported by his mentor to enhance his learning experience and progress towards achieving his learning outcomes.


David had felt very settled in his previous placement in a hospital ward with its controlled environment and set routine. He liked being in close contact with peers and staff members as well as his mentor and being in familiar surroundings in a hospital he knows. He is now in a very different environment, out of his comfort zone and he is feeling daunted and disoriented.



Activity


Look over any notes you have made, think through what you might do in a similar situation and perhaps discuss any potential actions with your mentor or student colleagues before reading the options we have suggested.


Let’s say that David is approaching the first progression point and must meet the NMC requirements to progress to the next part of the programme. There are a number of skills and professional behaviours that he must demonstrate, for example, ‘demonstrates safe, basic, person-centred care, under supervision, for people who are unable to meet their own physical and emotional needs’ (NMC 2010: 98) and ‘acts in a way that values the roles and responsibilities of others in the team and interacts appropriately’ (NMC 2010: 101). Learning in practice time is very valuable and it is important that students settle in quickly and use the time available to make sure essential skills are not only mastered but demonstrated to their mentor. What could you learn from this scenario that would help you to meet the NMC requirements and standards of competence for moving through the programme progression points and meeting the criteria for registration?



Discussion point 1




Nursing in the community is very different from nursing in a hospital setting. If David hadn’t expected this, then it is no wonder he feels the way he does. It can take experienced practitioners who move from hospital settings to the community some time to grasp the complexities of nursing in the community and David should not expect to do so in the first few days of his placement. The problem is that feeling insecure and lacking confidence in the value of the placement at the outset can stifle motivation to learn and undermine the whole experience. Here are some of the things that a student could do beforehand so that they begin their community placement with realistic expectations of the learning environment and the potential for learning and get off to a good start:



• Prepare for the placement, e.g. access information about the placement, make contact with the mentor, talk to students who have been there before, make arrangements to call into the placement, visit the area to see what it’s like. More detail about preparing for the placement is given in Chapter 4.


• Develop understanding of the community context, e.g. read over university notes that are relevant to nursing in the community. Chapters 1 and 2 provide an overview of health and social care in the community and the practitioners and agencies that deliver services.


• Appreciate some of the differences between nursing in hospital and community settings. Chapter 3 and Table 3.1 identify and discuss some of the unique characteristics of nursing in the community.


• Think about personal objectives and the types of activities that would assist in meeting the learning outcomes for the placement.



Discussion point 2




David’s feelings of insecurity are contributing to an apparently negative approach to learning at this stage in his community placement. He is comparing the beginning of this placement with the end of a previous one where he felt comfortable and confident. Better preparation would have helped him to make a positive start but there are a number of things that he could do now to feel more motivated to learn:



• Accept that early days in a new placement are bound to feel strange and that it is not unusual for students to feel overwhelmed. A positive approach and willingness to get involved and take advantage of the learning opportunities that are available soon enables students to settle into the community environment.


• It is not too late to do the preparatory work and find out about the placement and the community nursing context.


• See the advantages to being the only nursing student, or one of a limited number, in the placement; often one-to-one teaching; undivided attention from specialist staff during observational visits; more choice as there is no competition from other students for learning experiences. Not having peers around to interact with acts as an incentive to get to know the clinical staff, be more involved and feel part of the team.



Discussion point 3




David is feeling neglected by his mentor, unsure of what he should be doing and what’s going on around him. This is in contrast to his previous placement on the surgical ward. Perhaps not enough has been done to recognise David’s needs as an individual and maybe he has not made these clear to his mentor. When people have worked in the community for a long time, they can forget what it is like for someone who is unfamiliar with the set up. The important thing at this stage in the placement is for the student and mentor to communicate effectively, understand each other’s expectations and agree a plan for student during the placement. Here are some examples of what students and mentors can do to enable students to settle into the placement effectively:



Moving to any new placement can be difficult at first; not knowing the staff or where to go and what to do. Some students find the community placement challenging, especially if their previous experience has been in a hospital setting. However, community staff will support students to settle in as quickly as possible, particularly when students communicate any concerns or reservations, see the potential for learning and are positive and proactive learners.

Related posts:

  1. Developing competence for person-centred nursing in the community
  2. Promoting clinical effectiveness and maintaining quality of care
  3. Medicines management in the community
  4. The context of community nursing

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Feb 19, 2017 | Posted by in NURSING | Comments Off on Being an effective student: learning in a community setting

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