Introduction

The reasons why it is important for you to get the most from your learning experience in the community is explored in this chapter. Whether or not you plan to work in the community once you have qualified, the skills and knowledge that you have the opportunity to acquire during a community placement, have the potential to make an important impact on your beliefs and values about nursing and your approach to care in any setting.

Nurse education is becoming more focused on preparing nurses to be proactive, flexible, confident and competent to provide nursing care and support for people of all ages, wherever they use services. For many nursing programmes, this is a move away from more traditional and hospital-oriented preparation for nursing roles and is driven by the revised NMC Standards for pre-registration nursing education introduced in 2010 (NMC 2010). NMC Standard 6 for example, which focuses on the need for placement learning opportunities for students, emphasises the importance of practice learning; expecting nursing students to learn in direct contact with healthy and ill people and communities; experience 24-hour and 7-day care and learn across a range of hospital, community and other settings. The theoretical component and learning outcomes of programmes must reflect this and include more topics that support the development of skills and knowledge required for nursing in the community. These include approaches such as anticipatory care, case management, self-care and enablement, health improvement, public health and safeguarding vulnerable children and adults.

Learning outcomes

The overall aims for each module or component of your nursing programme will be described in your programme guide or handbook as general statements and overarching intentions. However, more specific statements, which describe what you should know, understand and be able to do at the end of each component are usually expressed as learning outcomes. Learning outcomes for nursing programmes differ between universities but all are designed to address the NMC requirements for registration; the achievement of the general and field specific competencies, the Essential Skills Clusters and demonstration of fitness to practice and fitness for an (academic) award. Practice learning gives students the experience and opportunity to demonstrate the skills, knowledge and behaviour which are required to achieve the learning outcomes associated with nursing practice. Universities work very closely with the NHS and other health and social care providers to ensure that the practice learning experience they offer involves a diversity of service users and a wide range of organisations providing services in different settings.

Make sure you are familiar with the learning outcomes for practice learning in the community and that you understand what is expected of you. The learning outcomes direct your learning experience by helping you to determine what is important for you to learn and the types of experience that would give you the opportunity. You will find this particularly helpful in the community, as there are so many learning opportunities to choose from. Of course what makes learning outcomes important, is that they are the basis of the assessment to becoming a nurse and therefore must be achieved for successful completion of specific parts of the programme.

Be prepared for practice learning before you commence your placement experience

As with all of your practice experience, it is important to do some preparation before your community placement commences. Give plenty of time for this as the information you need may not be easily accessible on the last minute. Use a checklist such as the one in Table 4.1 for ensuring that you have prepared yourself for practice.

Information that the university provides

Always check your university practice placement information site for the following information:

Make sure you know where you are going and how to get there

One of the most obvious objectives before going to your community placement is to make sure you know where you are going and have planned how to get there. Within more remote areas, for example some rural areas of Scotland, it may be possible to negotiate with staff regarding your starting and finishing times, but you need to contact staff within your placement some time before commencing practice. You should also find out the cost of travel and how you will be reimbursed for this.

Contacting your mentor

It is important that you make the initial contact with your mentor. This is an opportunity to ensure that they are expecting you and to clarify the arrangements for your first day. You can find out what time you will be expected to arrive and leave, whether you need to wear a uniform and if not what dress code is expected. If necessary you can use this early contact to negotiate any specific requirements regarding off duty. Some areas have developed an induction or ‘Welcome’ pack for students and it is sometimes worthwhile visiting the area beforehand and reading this before you start.

Relevant theory and practice

You may not have completed any specific theory relating to community nursing. However, you will have knowledge and skills which can be transferred to the community setting and it is important that you take time to explore this before commencing your placement. Nursing notes and subjects such as epidemiology, sociology and social policy are all very relevant to the community and it is worth checking reading lists for articles and text books that have been recommended. You may have already developed nursing skills in other practice learning settings or in the simulated clinical skills centre which can be transferred to the community setting. Remember that you should not take on any task that you have not been taught or that you do not feel competent in undertaking.

Personal learning objectives

Before you meet with your mentor, it is useful not only to review the specific university learning outcomes for community practice learning but also to review your personnel aims and objectives. This will help you to feel more confident when you first meet your mentor and help you to plan the learning experience more effectively.

Find out about the area before you start

The more you know about your practice learning area before you start, the more interesting and enjoyable your experience. Having an idea about the health profile of the community will give you some time to think about what you would like to see, do and learn. This will help inform discussions with your mentor when you are planning your learning experience and identify how best to achieve your learning outcomes. Ask your mentor if there is a practice profile or community profile available. Some community teams have developed these themselves and in other areas, they have been developed by the healthcare organisation. Table 4.2 gives an overview of the type of information contained within a community profile. (This is discussed in more detail later in this book.)

Meeting with your mentor

The learning outcomes for community practice learning will provide the focus for your initial discussion with your mentor, and should enable the development of a programme of clinical learning experiences appropriate to your specific learning needs.

Planning your learning experience

The benefits to planning your learning experience include:

Developing a learning contract

Learning contracts or learning agreements have been used extensively in practice learning to enable the student and mentor to negotiate and agree a learning plan. They help to avoid any confusion and clarify expectations on both sides. They identify what you want to achieve personally from your practice experience and the ways in which you can achieve your learning outcomes (Hart 2010).

The following steps which can be used as a template will assist you with this:

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