Last week I finished my nine week placement with the district nurses. I am happy to now have a break for summer but also upset that this placement had to end! I absolutely loved this placement. I have always envisioned myself working within a hospital setting until this placement. I am sure that once I have some experience of working in a hospital setting behind me I will return to the community setting.
For the duration of this placement I worked Monday to Friday. I would generally work from 8am to 4pm but also did late shifts which were from 2pm to 10pm. Below I have roughly outlined how my day with the district nurses would usually go but of course everyday was different and I haven’t included travel or paperwork time. Each day we would see between 9 to 19 patients so every shift was jam packed!
06:30 – Wake up! Get myself ready and have breakfast.
07:30 – Leave for the shift. I was very lucky with this placement, it only took me fifteen minutes to drive there so I didn’t have a long journey before and after every shift.
07:45 – Park up and walk to the office where I would meet whoever I was working with that day.
08:00-09:00 – I would check through our list for the day, collecting any equipment or paperwork we may need for our patients and discussing our patients with the member of staff I was working with. In this time slot we would usually see our diabetic patients to administer their Insulin.
09:00-09:15 – Take a blood sample.
09:15-09:30 – Waterlow assessment check, pressure area check and equipment check.
09:30-09:45 – Administer an enema.
09:45-10:00 – Give an intramuscular injection.
10:00-11:00 – Replenish a syringe driver.
11:00-11:30 – Complete a leg dressing.
11:30-12:00 – Provide palliative support.
12:00-12:30 – Pack a wound.
12:30-13:00 – Change a catheter.
13:00-13:30 – Lunch time! I would usually take a salad, some fruit and a cereal bar.
13:30-14:00 – Handover. We would all handover our morning patients and raise any concerns or positive news with each other.
14:00-14:30 – Complete a doppler assessment.
14:30-15:00 – Complete a new patient’s notes.
15:00-15:15 – Removal of surgical staples.
15:15-15:30 – Administer a subcutaneous injection.
15:30-16:00 – Dress a leg ulcer.
16:00-17:15 – I would go to the gym for an hour and then head home or do a workout once I got home.
17:15-18:15 – I would use this time to complete any research or update my online portfolio.
18:15-19:00 – Dinner time! After dinner I would make my lunch for the next day.
19:00-19:45 – I liked to take advantage of the warm summer evenings and have a walk around my village.
19:45 – 21:00 – Shower time and time to relax before I headed to bed!
I found this placement so valuable for my learning. Prior to this placement I had only practiced dressings and IM injections in the simulation weeks at university. I also had no previous experience of syringe drivers or caring for patients in their own homes. My knowledge of which dressings are appropriate for which wound is now huge compared to when I first started and I feel much more confident in my dressings and injection techniques. I enjoyed really getting to know and building a rapport with my patients, something I missed on my hospital placement when my patients were moving in and out of my care so quickly.
I also discovered that the community setting has its challenges. We were working in a fairly rural area so if we didn’t have the right equipment with us we either had to think on our feet and use what we had available or face driving a long way back to collect something. This meant that we had to be prepared in the morning and try to collect everything we may need. The nurses also carry a lot of equipment in their cars to avoid these situations.
Another challenge is the lack of signal! We were often out to houses without reception so the nurses have to be confident and adhere to policies as they are working alone. This is where I believe that I need to gain experience in a hospital setting first, particularly as a newly qualified, so that if I am unsure of anything there will always be someone around to support me.
A special mention must also go to the team. I settled into this placement so quickly due to their welcome, friendliness and support. Everyone in the team works so well together and it is clear that they all support one another. In handovers, everyone was happy to and felt comfortable to raise any concerns and discuss treatment plans or guidelines. I truly felt like a member of their team and I can only hope that one day I will be lucky enough to work with a team just like them! They are all fantastic health care professionals and their patients are very lucky to have them! I will miss them all greatly.