Student Nurse Stepping out of My Comfort Zone

I’ve been employed by the trust for 13 years as a Health Care Assistant in the Emergency Department.

The trust advertised the adult nurse degree apprenticeship in 2020, and this was the perfect opportunity for me as a working mum to still have an income and chase my dream of becoming a registered nurse. The educational component is provided by Keele University and the placements by Mid Cheshire Hospitals NHS Foundation Trust was ideal, as I knew many of the policies and protocols and it was building on the knowledge I already had gained with the trust.

The eagerly awaited email arrived with my placement detail, District Nurse, Winsford, within Central Cheshire Integrated Care Partnership (CCICP). I remember taking a deep breath and thinking “OK, it’s 6 weeks. I’ll be fine.” I was very apprehensive. Community nursing is not something that I had ever thought too much about as I have always worked within the acute sector.

The first day of placement arrived and so did the nerves. I arrived at the surgery where the district nurse team are based and made myself known to the reception team. As I did, a voice from behind said, “It’s OK I’ll take her up”. I was instantly welcomed by one of the HCAs from the DN team. Without saying too much, she settled my nerves almost instantly with her friendly demeanour. Every person within the team was friendly and welcoming whilst I was on my placement.

Prior to this placement, if I’d been asked to describe what district nurses did, I would have said they looked after patients with leg ulcers in the community. How naïve I was! What I observed and experienced over the next six weeks was far more than that. I had the opportunity to observe and participate in wound management, having exposure to a large number of wounds, some of which I would have described as unimaginable. I was able to provide care and support to patients and their families in their last few days of life, helping to ensure that they had a peaceful and dignified death in their own homes.

One experience that will stay with me throughout my career is the trust that patients put into nurses and how humour can play an important role in communication. I offered a shave to a young EOL male who was too afraid to allow anyone to do this, by building up a rapport saying, “I’m good at shaving but if I’m not I’m A&E trained, so I can fix any bits I’m not too good at.” I learned so much in my time in the community, not only the clinical aspects of the role but also the importance of building a trusting relationship with your patients.

In community nursing there is a shift in nurse-patient power, as you are being invited into their environment and that is a privilege. You have the opportunity to gain an insight into your patient’s life. You see the story of their life in photos that surround them, you meet their families, friends, and pets. To understand their routines and ways in which their things are done, this is something that you never experience in a hospital setting. You speak to them about a family member as if you have met and know them because your patient tells you all about them every time you go, and when the unfortunate happens and you lose a patient, you are invited to say goodbye at their funeral even when numbers are limited in a pandemic because you had made a difference.

Not only do you feel part of the patient’s life, but I also felt like part of a team, from the manager down to each team member. In handover they would start by checking in on each other. I believe that this helped to contribute to them being a strong team. Everyone had the offer of support if required, even me as a student. During my time on this placement, I had the most inspiring assessor and supervisor, but I also felt that I had the whole team acting as my mentors, as each one was invested in my learning. It was evident that the lead for the team is so passionate about her patients’ care. This cascaded down into the team. Each DN would discuss the patients they had seen that day and, the manager knew each patient in their care from just a name. You could feel the excitement and satisfaction when they had the opportunity to say a wound had healed – this is seen as a team achievement.

Whilst on my placement, I had the opportunity to spend time with the advanced practitioner who sees patients referred by the DNs, the integrated respiratory team and I also had the opportunity to experience the need to escalate a safeguarding concern that resulted in a patient being safely removed and rehoused. At the start of this placement, I felt I was the new student here for 6 weeks and, at the end, I felt I was saying goodbye to my team. I didn’t just get the experience to practise my clinical skills, I got the experience of being part of the district nurse team at Winsford and that is something I’m forever grateful for.