Management placement - Community/district nursing

Hi

I did my management placement in community and have stayed there happily ever since. Community nursing is fab, not easy but fab.

Don't worry about your competencies, you'll have ample opportunity to achieve them all. Yes you will have your own small caseload and go out to patients on your own but you will still have a mentor and you should still be visiting more complex patients with your mentor. You should be seeing end of life patients, patients requiring insulin, new patients and more complex wounds with your mentor. You will be replenishing syringe drivers with drugs such as morphine and midazolam, administering insulin and will probably give some IM injections, so that will cover medicines management. You will be carrying out pressure ulcer risk assessments, skin assessments, musts, obs (all ours are done at least 4 weekly) and various other assessments. When visiting patients with wounds you will be giving them advice on diet and nutrition, mobilising, pain control, as well as patient education on their wounds. You will be educating about leg ulcers and pressure ulcers. You will probably see some poorly patients, sepsis is very common in community patients, you may even have to ring an ambulance!

There is a good chance you will come accross some challenging situations and possibly need to use some conflict resolution skills. Then there's catheters, pleurex drains, pegs etc etc.

While I was on my management I would generally spend the morning with my mentor then go and see my own patients in the afternoon or vice versa. Also community nurses tend to stay in contact by phone or text message. Ask your team to let you know during the day if they have anything interesting and then you can go and meet up with them.

As a third year student I would be expecting for you to give anything a go under supervision (within your uni and placement guidelines of course). I would expect you (after a few weeks) to independantly carry out simple wound care safely and ask the patient relevant questions eg how do you mobilise, what is your diet, how much to you drink. I would expect you to give simple advice eg keeping legs raised for oedema, repositioning for pressure ulcer prevention, eating healthily for wound healing. I would expect you to be proactive in learning about different dressings and the basics of wound care. I would expect you to give medications safely and in the correct manner. I would expect you to show a reasonably confident and reassuring face to patients. I would expect you to make an effort to build relationships with patients. I would expect you to communicate with your mentor and your team effectively. I would expect you to behave considerately compassionately and professionally. Mostly I would expect you to show enthusiasm and be motivated and proactive in your learning.

I would not expect you to know everything and I would not expect your clinical skills to be smooth as silk, fumbling is fine! I would expect you to be safe and that means asking when you don't know.

Generally show willing, show interest, be a team player and get stuck in. Most importantly, when you go out on your own, remember your most important piece of equipment is your phone. Anything you are not sure about...phone someone from your team....ask the question, be safe! They will be expecting you to phone and ask questions and will worry far more if you are not asking questions. Make sure everyday that you are armed with several people's phone numbers. Don't just have your mentors tel number, it will be typical bad luck that when you need help, your mentor will have her hands full and be unable to answer.

All in all don't worry, you are going to have a wonderful placement. Hope you love it as much as I do.