A group of student nurses on placement on a ward felt they were not getting the learning and training opportunities they were meant to be receiving.
The students understood the ward where they were working was busy and workers were under pressure. While they were happy to cover gaps and breaks, they too often felt as if they were ‘counted in the numbers’ of workers on the ward. They were spending all their time on patient observations or escorting patients to other appointments or left inappropriately unsupervised. This situation continued over a number of shifts and the students became increasingly concerned that they would not fulfil the requirements of their training. They felt let down that their expectations of the placement were not being met.
The students were unable to raise the issue with their mentors as they were rarely scheduled on the same shift and, when they were, their mentors were also stretched. There was no opportunity to find the time to run through issues or even sign off paperwork. The students felt that their concerns were not taken seriously. They spoke to the academic support office, who in turn talked to the ward manager who promised things would change, but the same issues continued. This left the students feeling disempowered.
With the support of one of the Trust’s Freedom to Speak Up Champions, the students spoke to the Freedom to Speak Up Guardian about their experiences. The guardian contacted the Associate Director of Education and the Head of Nursing, after which the students were invited to talk through the issues directly with the Head of Nursing. They were also encouraged to provide full feedback to their university as part of their placement evaluation process.
Following the meeting, an action plan was put in place by the Head of Nursing to start to tackle the issues raised. The students were pleased that the situation was taken seriously and that actions were being taken to make the ward a better place to work for everyone, not just student nurses.
The action plan includes:
- giving protected time for student induction and orientation
- sharing the names of students, their start dates and shift patterns on a board in the staff room so that all workers know which students to expect and when
- providing students with access to a computer and printer in the staff room for online learning
- assigning students the same shifts as their practice educator where possible.
We recognised that we weren’t doing enough to make sure that our student nurses were consistently welcomed to our wards. Staffing challenges have caused delays for students in meeting their practice educators to discuss learning objectives. We now assign two nurses to each student nurse – one of whom the students work with the majority of the time and a second nurse who has an overview of their performance and can provide constructive feedback.
The action plan addresses a number of the areas for improvement, and we will seek feedback on this from our current student nurses before working with colleagues in the Education team to roll out the same plan across all areas of the Trust.
Head of Nursing
The two mentors idea seems positive – if a student has an issue with one of their mentors it should hopefully give the student some reassurance that there is someone else assigned to them that they can go to for help, support and paperwork. This is a great step in the right direction.
It took courage for the students to speak up about their experiences. This matter shines a spotlight on the wider issue of how managers hear and respond to concerns raised with them. We are continuing to work with managers across the Trust to help improve our culture, so that anyone feels able to speak up when they have a concern, an idea or a suggestion, and knows they will be heard.
The launch of our leadership behaviours, as part of the launch of our new Trust values, along with the roll out of ‘Listen Up’ training for managers should help us on this journey.
Kate Hanlon, Freedom to Speak Up Guardian