Social distancing on clinical placement: how to overcome the learning barriers
Infection prevention measures introduced due to COVID-19 can make students feel like an inconvenience. Here are some solutions
When I started my nursing degree apprenticeship with the Open University in January 2019, I could not have imagined the challenges I would face just over a year later when the COVID-19 pandemic arrived in the UK.
I am doing my nurse training while working full-time as a healthcare support worker on a rehabilitation ward at a community health trust.
Block placements and taster days
The trust’s nursing academy arranges block placements, where we are released from our ‘work base’ for the duration. We have four six-week placements a year with additional taster days to enrich the variety of services we can experience.
Since March 2020, my placements have included district nursing, health visiting, a wound clinic and community in-patient rehabilitation wards.
‘It sometimes occurs to us we are the only ‘non-essential’ people present; although experience in clinical practice is essential for our learning, is it essential to the care of the patient at that time?’
As a nursing student on the front-line of COVID-19, I understand the importance of preventing the spread of infection. Efforts have been made in every area to decrease the chances of transmitting the virus, including reducing the number of face-to-face appointments with patients.
Patients may feel wary of our presence as ‘the extra person’
Social distancing has become a reflex during the pandemic; we have all been there – reaching past someone in the supermarket then jumping back when you realise you are too close – but for nursing students, social distancing on clinical placements has become a barrier to our learning.
Under normal circumstances, we would be encouraged to seek out every learning opportunity we can, but we now have to appreciate that patients might not feel comfortable with an extra person in the room.
It sometimes occurs to us as students that we are the only ‘non-essential’ people present; although experience in clinical practice is essential for our learning, is it essential to the care of the patient at that time?
Learning opportunities are being lost
We all want to keep ourselves and each other safe, and the fear and uncertainty surrounding the virus is also evident among staff. While working with a district nurse, I leaned closer to help support her as she applied a dressing and she instinctively jerked away from me. I was so focused on the task, I inadvertently made my colleague feel unsafe, even though we were wearing full personal protective equipment (PPE).
‘We sometimes sense we are an inconvenience, which can leave us feeling like a burden on an already over-stretched nursing workforce’
I also used my own car to follow a district nurse to a patient visit to maintain safe social distancing. It might have been okay to be in the same car as the nurse if we were in full PPE with the windows open, but this was a cold day in January.
Normally, I would be able to chat to the nurse on our way to see the patient and reflect on the care delivered on the way back. Now we can no longer do this, it’s another learning opportunity lost.
Pressures on nursing teams can make students feel excluded
Staff in placement areas have been very welcoming, doing their best to integrate students into their teams. But when nurses are already tired and stressed out, there has been some reluctance to have us tagging along for the morning.
This is understandable given the circumstances, but it can make students feel like we are getting in the way. We sometimes sense we are an inconvenience, which can leave us feeling like a burden on an already over-stretched nursing workforce.
‘There is a constant internal battle between our enthusiasm to jump at every opportunity and the need to take a step back to ensure everybody stays safe’
Social distancing affects every aspect of communication. Face-to-face interaction is kept to a minimum and maintaining a two-metre distance is not conducive to casual catch-ups and informal check-ins. Apart from patient contact, there are few opportunities to strike up a conversation.
When there is more than one student on a placement, we would usually have the opportunity to debrief with each other and reflect on our experiences. But we have to spread out as much as possible during the pandemic to keep each other safe, which means not sitting together and taking lunch alone.
Fellow students are an invaluable support network while on placement and we miss the opportunities we would normally have to share our experiences and concerns, and generally bolster each other.
What to do if you are struggling on placement
- Talk to your practice supervisor or another member of the nursing team – they can offer advice and support on how to get the most out of your placement during this difficult time
- Your university lecturers are also there to support you – if you are having problems with your placement, ask for their help
- Set up a chat group, such as a What’s App group, with the other students on your placement or in your cohort. This will help you stay connected and you can support each other by sharing your experiences and concerns
- Keep a small diary on placement and note down anything you want to discuss with your practice supervisor. You could email any questions or concerns to them so they can look at it at a convenient time
- Join student support networks on social media, such as @westudentnurses on Twitter. As well as offering support and guidance, these are great places to learn what other students are talking about and to join the debate
- If you are struggling with your mental health, seek professional support straight away. The RCN has a free, confidential counselling service for members and you can also contact The Samaritans in confidence
Nursing students’ dilemma: balancing social distancing with our learning needs
As students, we find ourselves facing a dilemma; we know we need to limit non-essential contact with both patients and staff, but we also need to have our learning needs met. There is a constant internal battle between our enthusiasm to jump at every opportunity and the need to take a step back to ensure everybody stays safe.
Acknowledging the impact social distancing is having on the quality of our learning experience makes it easier to find solutions to the problems. Could part of the placement be done virtually? Are there other areas in the placement setting that students can go to? Perhaps we could shadow a specialist nurse or member of the multidisciplinary team – at a safe distance – to learn more about their work.
Presence of students places extra burden on nurses
Being a nursing student during a global pandemic is tough. We understand the pressures nursing staff are under, and that our presence adds an extra layer of responsibility for our practice supervisors and the other members of the nursing team we work with.
But as the next generation of nurses, it is imperative that we are able to continue with our studies to the best of our ability and are not made to feel like a burden. We might not be ‘essential’ to patient care now, but we soon will be.
Resources
Related articles
- Making up for missed clinical placements during the pandemic
- Online learning options during-COVID-19 and-beyond
- Can virtual placements compare to the realities of blended learning during COVID-19?
- CPD article – Improving nursing students’ experience of clinical placements
