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What’s it like on placement at a nursing hom...

What’s it like on placement at a nursing home?

So, I’m thrilled to have passed my final placement at a nursing home. It was a struggle, I’m not going to lie. Each day felt, honestly, like it was a huge challenge. Waking up, I struggled to be enthused about the role’s slow pace and same same routine.

You know what I love? Change. Something new. A new experience every day. New faces, new people. And as someone initially torn between the choice of a fast-paced paramedic student or becoming a nurse, and more recently someone who thoroughly enjoyed my first placement in A&E, I went into my second, and last, graded placement of first year knowing it wasn’t going to be where I take my career going forward. After eight weeks, leaving with my PAD (mostly) signed and dated, I feel very much the same. More so, in fact.

So, what’s it like?

My placement at a nursing home

The nursing home I was placed in is a private home. Don’t get me started on how funding pays for each resident to live there, I honestly don’t have the time or inclination to even want to understand the difference between social services and council services and nursing need assessments private pay and means testing and all the intricacies of where the money comes from. It’s a private home, run by a private company, with its own procedures and paperwork. That’s just how it is. Even the nurses themselves didn’t fully know how everyone paid for their care.

I was unable to do any long shifts, or any night shifts as my mentor didn’t feel they were appropriate, so it was a 5am wake-up call every morning for early shifts, and getting home at 11pm for lates. Each shift was 7.5 hours long, over five days a week. As that was the case, each day seemed to drag on, building up to getting busy… and then home time. It was tough getting into the swing of things with such a segmented shift.

As I mainly did early shifts to tie in with the staff nurses (other shifts are covered by agency staff who float around different care homes all over the region) I’ll talk about a typical 7-3 shift. Each day started with a brief handover of the previous shift’s events, and as nothing much really happened on a good day, it was simply a case of documenting any issues such as behavioural changes and eating and drinking habits. Then, it was time to start washes and personal care. All residents, save three, were fully hoisted, non-verbal, and assistance of two, so it was heavy work. After each resident was washed and dressed and looking fresh-faced, they were sat at the table ready for breakfast all together.

SPOKE PLACEMENT IDEAS

Thinking about arranging a few days outside your nursing home placement? Try getting a shadow shift in these areas:
- Coroner's Court
- Safeguarding
- SALT
- OT/PT
- End of Life Facilitators
- Palliative Care

Many had been diagnosed with dysphagia (not being able to swallow normally) and so were on textured diets and thickened liquid – water and juice being thickened to about the consistency of wallpaper paste. Being unable to chew, we would sit with each resident spoon-feeding them and assisting with posture if they started to cough. Any food or liquid that gets into the lungs can cause aspiration pneumonia and be fatal. The nurse would pop out each resident’s pre-packaged medication and give each person the right dose as they ate.

After breakfast, the care support workers would assist residents with any activities such as colouring in and being out in the garden, as well as escorting them to their doctor and hospital appointments.

The nurses? Ah. Well, that was where the actual physical contact with residents predominantly ended. After breakfast and medication rounds, the nurses were swallowed up with mountains of paperwork. As no resident had the capacity to make their own care decisions, every aspect of their life was managed and, in many cases, a best interest decision was made on their behalf – something only the nurses could do. The nurses would update these, as well as medication alterations, hospital appointments and general paperwork.

My first few weeks were spent printing, filing, and reordering resident’s folders. While useful for getting an overall picture of each person’s health concerns and care needs, I very much felt like I did when I worked as admin in a clinic. To me, I’m familiar with paperwork and administration. Yes, there’s so much to do in every role, and yes we all know the adage ‘If it isn’t documented, it didn’t happen.’ But for me, I didn’t feel it was massively helpful in my learning as a student given my decade of experience prior.

As much as the staff and patients were lovely, I’m absolutely certain a career in a nursing home setting isn’t for me. And I don’t think there’s anything wrong with admitting that. Where some nurses know care of the elderly, or dementia, or mental health, or learning disability etc are the routes they will take once they get their elusive PIN from the NMC, I know wholeheartedly that it just isn’t where my ambitious plans will take me. I prefer a new and different challenge, and seeing the same faces and taking part in the same routine five days a week left me feeling tired and drained, more so than my 14 hour shifts at A&E during the winter crisis.

I have learnt a few things though. Before, I had no experience with hoists and slings, they intimidated me no end. But just yesterday at hospital while I was banking as an HCA I was able to lead a team of nurses to safely hoist a patient after they slipped off a chair. I discovered there are no-rinse washes that patients may have access to if they can’t physically get into a shower. I learnt that the smallest things can promote dignity, and that there are safeguarding concerns everywhere.

All in all, it was a bit of a slow pace to end a hectic and very busy nursing degree. With year one’s exams and assessments all passed and finished, it’s on to year two!


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