How to fully prepare for your first nursing placement

You may be sent to placement within your first 6 weeks of your nursing course. It can be daunting. Qualified nurse and mentor, Chloe, explains how to prepare for placement and bury those nerves!

Topics covered in this video

1.00 Introduction

in this month's video, I wanted to talk to you guys about confidence and being confident as a student nurse, because it's something that you guys ask me about all the time. I get so many messages and comments from you guys saying about how you're really nervous, or how do I be more confident as a student? Particularly in relation to placements, which I completely understand. I think placements are definitely the bit that I was most scared about when I was a student.

If you haven't seen any of my nursing videos before, I am a mental health nurse and I've been qualified for over a year now. I've been working for about 14, 15 months, which just seems so surreal, quite frankly. I cannot believe I've been working on the wards for that long. If you're like me and you went into nursing it straight out of school, then as a student nurse, it might be the first time that you stepped foot on a ward, which of course is terrifying. I know that I was absolutely freaking out before my first day on the ward as a student. I was in uni for, I think it was six weeks before I went on my first placement, and I was just thinking, "What? I don't know anything. How can you send me onto a ward already? What if everyone hates me? What if the nurses think I'm terrible? What if there's an emergency and I don't know what to do? What if I don't like it?"

1.45 Terrified about your first placement?

If you're like me and you went into nursing it straight out of school, then as a student nurse, it might be the first time that you stepped foot on a ward, which of course is terrifying. I know that I was absolutely freaking out before my first day on the ward as a student. I was in uni for, I think it was six weeks before I went on my first placement, and I was just thinking, "What? I don't know anything. How can you send me onto a ward already? What if everyone hates me? What if the nurses think I'm terrible? What if there's an emergency and I don't know what to do? What if I don't like it?"

There were so many things racing around my mind that just completely knocked my confidence and left me pretty terrified. Whilst training to be a nurse is pretty hard work, there's also a lot of hard work that goes into it before you even start that course. You're doing whatever qualifications you're doing beforehand to get into university, choosing which university you want to go to, applying, going to interviews, doing all the paperwork, the student loan process. Like it is a big process before you actually step foot into university as a student nurse. So, that's a long time for all that emotion and worries to be building up inside you, and it's a big jump, so it is completely natural to be nervous.

If you're already a student nurse and there's any other students around you that are saying they're not nervous, then they're probably kidding themselves more than they're kidding you. So, please don't feel alone if you are worried or you're not feeling very confident, because I can assure you, most people, if not everyone, feels that way when they first start.

It's also going to be pretty nerve-wracking if, for example, you were a HCA or a carer before you went into nursing. Because even though you're going to be back in that sort of familiar environment, you're going to be in a very unfamiliar role. You're going to have to work out what the difference is between your previous role and your new role as a student, and the role that you're going to be taking on in two, three years' time as a qualified nurse. And with all those nerves running around, it makes complete sense that you're not going to be feeling that confident, but I want to help to change that, because I think it makes a big difference.

So, I've got a few tips for you guys, and hopefully you will find them helpful. The aim is to reduce your nerves and increase your confidence, because I have no doubt that all the people watching this are going to be fabulous nurses in the future. We just need to get you there.

3.23 Contact and visit your placement before you start

The first thing I would recommend is, as soon as you find out where your placement is going to be, which should be a minimum of, I think it's two weeks in advance, but hopefully you will find out sooner than that. As soon as you find out, contact your placement. Don't email them, phone them, because sometimes emails get missed, people are off sick, on leave. I know it can be scary making a phone call sometimes, but I believe in you guys. You can do this. Give them a ring, introduce yourself, say that you're a new student nurse starting soon, and preferably try and arrange to go and visit before you start your placement.

I visited all my placements before I actually started there, and I found that really helped to make me that little bit more confident on that first day. This way, you get to test out the route to get there, find out where the ward is, work out which bus or train or road you need to take to get there, where you can park. All those little kind of nitty-gritty things that you're going to be worrying about on your first day, get that all over and done with in your pre-placement visit.

It should also mean that you know a couple of people's names and faces before you arrive on your first day, which again is just going to make you feel that little bit less nervous. It's going to show that you're keen, which is immediately going to give your new placement at a good first impression of you. Everyone loves it when students are keen and ready to get stuck in.

5.00 Ask questions about your placement

It should also mean that you know a couple of people's names and faces before you arrive on your first day, which again is just going to make you feel that little bit less nervous. It's going to show that you're keen, which is immediately going to give your new placement at a good first impression of you. Everyone loves it when students are keen and ready to get stuck in.

It also means you've got a chance to ask questions, which again is going to boost your confidence. Some good questions to ask are things like, "What are the shift patterns like? Where do handovers happen?" That way you know where you need to head to on your first day. Find out how you're going to arrange your shifts. Some placements, they would just give me my shifts. Other placements would say, "Here's your mentor's shifts. Pick your own, but try and work with them as much as you can." Each place is going to have their own way of doing it, so try and find out early how the shifts for students are organized.

Ask what kind of patients this placement normally works with. What patient groups are you most likely to come across? What conditions, what medications, what treatments? Ask if there's anything you can research or read up about before you start your placement that's going to be really helpful to you. For example, if you're going to be on a ward that primarily has teenagers for patients, then it might be looking at competency. Or if you're going to be working in a dual diagnosis service that deals with a lot of drug and alcohol users, looking up things like the Orange Guidelines and NICE guidelines around drug and alcohol treatment are going to be really helpful.

If you aren't able to go and visit for whatever reason, then just ask these questions on the phone. Either way, it's going to be quite helpful. Obviously you won't get to do the face-to-face stuff, but actually finding out some things that you can research beforehand, and then going away and researching them, is going to make you far less nervous, and far more confident, because you're going to walk in feeling like, "Okay, I've got a basic knowledge now."

5.49 Understand the placement's specialism

If you're going to be working on, I don't know, a kidney specialist ward, make sure you know the ins and outs of the anatomy of the kidneys. What are the most common kidney conditions? What medications are used to treat those? What other treatments are there available? Having that basic knowledge really is key, and you're still going to have loads to learn when you get on placement. This is just going to provide that foundation. That way when you're in a meeting, for example, listening to them discussing different treatment options for a patient, you'll have a rough idea of what's going on. And rather than just sitting there and being like, "Whoa," while it all goes over your head, you'll be able to pick out the important bits of the information.

6.21 Practice your non-intrusive skills

Practical skills are also another thing that I know a lot of you worry about, which is understandable. For many people, it is a completely new skill. I know I did not have a clue when I first stepped onto that ward what I was doing.

In terms of your non-intrusive skills, these are a great thing to practice on your friends. If you've got some free time at uni, for example, and they allow you access to the physical health machines, it's a great idea to do a set of physical observations on your friends, and then document them correctly in like a muse chart.

This is also a really good thing to do when you're actually on placement. If you've got, again, a spare 10, 15 minutes, I know if you're on a busy ward that's sometimes isn't always possible, but you might find that you've got a spare 10, 15 minutes. Find HCA, find another student, find a nurse that's not busy, and just sit and practice things like physical observations, particularly manual blood pressure, because I know that's something that really worries a lot of people.

It is a lot less scary practicing initially on people that you know rather than patients. Practice makes perfect, and all of that practice is going to build up your confidence, so that when you are doing it on a real patient, you won't be freaking out as much, because you've done it multiple times before on your friends and your colleagues.

7.27 Tell your placement what you feel nervous about doing

But, there's obviously quite a few things that you can't really practice on other people, like injections, for example. I don't think any of your friends or colleagues are going to want to let you practice an injection on them. Understandably so, and I know that injections in particular are something that terrify a lot of you, and I will tell you now that they absolutely terrified me initially. My best advice about this is to make the nurses on your placement aware that injections are something you're nervous about or whatever it is that you're particularly nervous about.

Let us know, because I can tell you that, as a qualified nurse and as someone who mentors students, if you don't tell me what you're most nervous about, then I can't help. But at least if I know, then we can look at ways of supporting you so that you are more confident with with those skills that are making you a bit more nervous.

8.11 How to deal with your first injections as a student nurse on placement

1. Watch as many injections as possible

So, using injections as an example, I would recommend you watch as many injections as you possibly can. And obviously, this is going to depend on patients allowing you to actually observe. But, in my experience, most patients are more than happy for students to observe things like this. And if you do come across some patients that aren't okay with it, then don't worry, because there's always going to be more in the future.

2. If you're not feeling ready, be prepared to say that

I've met some student nurses that I know have had slightly less than ideal experiences with mentors, where the attitude has been a bit more, "Oh, you know, don't be silly, just get on and do it, you'll be fine." But if you know you're not ready, stand firm and just sort of say, "No, I'd really like to watch it a couple of times before I do it. I really want to know a bit more about the technique before I do it." Just be firm but polite, because I would hate for you to have a negative first experience because you weren't ready and then it completely knocked your confidence.

I know when I was a student, that happened to one of the girls in my class, and she'd been pushed to do it when she didn't feel ready. And whilst it she didn't harm the patient or anything like that, it didn't go particularly well, and it just left her completely flustered. And then when she went to do it again next time, she was even more petrified than she'd been before doing it the first time.

3. Watch injection technique videos

There's loads of videos and diagrams out there that show you techniques for things like injections. So, watch and read as much as you can. And when you're watching another nurse give an injection, it's worth asking them just to talk through what they're doing, because that way when you go to do it yourself, you'll kind of have that internal dialogue to remind yourself of, "Right, I'm going to do this first, and I'm going to do this next, and I'm going to do this next."

4. Ask your mentor to talk you through your first injection

It's also worth, the first time you do an injection, ask your mentor to talk it through with you. Then you can sort of build up to doing it a bit more independently, but maybe the first time you do it, ask them, can they talk you through it step-by-step.

5. Practice handling needles

Another thing that I would really recommend, particularly with injections to get you a bit more confident beforehand, is to have a play around with some needles. Safely, of course, and be careful what you're doing with them, but actually get used to holding a needle in your hand. Take it out of the packet. Have a look at all the different components. Maybe practice drawing up some water, squirting it back out again, and then disposing of the needle safely. And this is something that's really great to do on your own, because then you don't have that pressure of feeling like someone else is watching me.

Obviously, always check with the nurses where you're working, but I know if a student asked me, can they have a couple of needles to play within the clinic room, I would always say yes. You can also practice injecting into things. So I know some universities and some placement providers will have like fake arms and fake bums that you can use for practicing injections.

6. Practice on oranges

But if you don't have access to those, I've always been told that oranges are meant to be a good thing to practice injections on. I realized that it's not going to feel exactly the same, but apparently in terms of like the resistance against the needle, oranges are a good thing to practice on. I practiced on a couple of oranges as a student. It just gives you a chance to practice holding a needle and putting it into something, so you can find the most comfortable way for you to hold it, the most comfortable way for you to push the plunger in. It's all about finding what works for you and what feels most comfortable for you.

7. Ask the patient for feedback

And once you give your first injection, ask for some feedback from the patient. I know that that can be a little bit scary, but everything is a learning experience. Obviously, something like an injection is never particularly going to be nice for a patient, but just ask them, was there anything that you could have said or done differently that would've made the overall experience more pleasant for them? Ask them if there was anything noticeable about the way you gave an injection that was different from how they normally receive an injection, and that could be better or worse. Just ask if there's anything they noticed or anything that they think you could have done better.

8. Ask your mentor / attendant nurse for feedback

And then, once the patient's left the room, ask the nurse that was watching you the same thing. Was there anything they'd recommend that you could do better to make it easier or more comfortable for the patient?

11.27 Don't expect to be perfect

And then, the final thing that I would recommend for improving your confidence is just to keep telling yourself this mantra of, "I'm a student. I'm here to learn. I don't have to be perfect." Even as a qualified nurse, I'm always learning from my colleagues, from my patients, from even my students. There will never come a point in your career where you're not learning. No one expects you to be perfect because none of the nurses you're working with are perfect. We are all only human. I can promise you that. We all do or say things, and then in hindsight kind of think, "Oh, I wish I'd done that differently, or I wish I'd said that." Nursing is a journey. You're always going to be learning. You're always going to be developing. So, don't have so much pressure on yourself to be perfect. I, as a mentor, I'm not expecting any of my students to be perfect, and if you put that pressure on yourself, then it's just going to completely knock your confidence when you're never able to attain this level of perfection. Once you take that pressure off yourself, you're going to feel so much better.

Nursing is a journey. You're always going to be learning. You're always going to be developing. So, don't have so much pressure on yourself to be perfect. I, as a mentor, I'm not expecting any of my students to be perfect, and if you put that pressure on yourself, then it's just going to completely knock your confidence when you're never able to attain this level of perfection. Once you take that pressure off yourself, you're going to feel so much better.

No matter what point of your training you're at, it could be your first ever day you're on a ward, I can guarantee you now that there are going to be things that you are good at. So just focus on those. If your confidence is ever particularly low, just think about all these things that you know you are good at. Think about the positive feedback that you've had from patients previously. You are good at things, and we, as the qualified nurses supporting you, are just going to help you to pinpoint the things that maybe you aren't so good at, and the things that you could improve upon to help you become the best nurse that you possibly can.

We're not here to trick you out. We're here to support you and make you into a great nurse that we are going to want to be our colleague in a couple of years' time.

So, that is everything I wanted to mention in this video. I really hope you guys found it helpful. Like I said, how to be less nervous and be more confident are questions that I get asked all the time. So, I knew this is a really important video to do for you guys.

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