I started part two of my mental health nursing degree feeling a bit deflated, self-conscious that I hadn’t had any ward-based placements, and not particularly looking forward to the year ahead.
On being allocated a nursing home placement in a mental health nursing home, I was initially unsure how much I could gain, working outside of the NHS. I took the approach that even if I didn’t get much out of it, I’d worked in social care before the degree and loved my time as a support worker, so the setting would be familiar at least, and “it’s only for seven weeks, isn’t it?” I had no idea…
From day one, I was hooked. I’d got back the enthusiasm I started this degree with.
I found it to be one of the best types of placements in which to get confidence in core nursing and clinical skills, while in a supportive and perhaps less intense – but not to be mistaken for quiet – environment. I thought I knew how care homes worked but had no clue of how extensive the nursing role is.
I was fortunate to be supported and guided by an experienced team of mental health nurses from the start. Quashing any notions that I (and I guess many other students) are guilty of carrying, that nursing in care homes means “de-skilling” in any way, or that it is an end-of-career option. The nurses in the placement were possibly the most resourceful and proactive that I have worked with, working autonomously using their own judgement and understanding of the residents as individuals.
There is the challenge of providing professional and clinical care, often for complex conditions, while still maintaining a homely environment for residents. Most stark of all, when an incident arises or a resident becomes unwell, nurses in care homes don’t have the close support of an acute hospital nearby, nor a star bleep to contact, nor a duty doctor onsite.
Reflecting on the learning opportunities in that placement highlights perfectly how extensive the nursing role is in social care.
These learning opportunities are so valuable, and from a mental health student’s point of view, particularly the experience gained in managing physical health conditions. I have become more familiar with legislation in practice, particularly the Mental Capacity Act and Deprivation of Liberty Safeguarding, but also section 117 aftercare of the Mental Health Act, including an understanding of continuing care and local authority involvement.
I understand more about the importance of both short- and long-term care planning in care settings. Care home placements provide a wealth of learning on medication management, possibly in a busy clinical setting. I learned about skin/ulcer risk assessments, continence management, diabetes management, including foot care and foot health monitoring, stoma care, managing long-term pain, dysphagia management and monitoring food and fluid intake.
In addition to caring for residents’ physical and mental health, as important is supporting individuals to access activities and opportunities in the community if they wish, and finding what is meaningful to them.
It truly is holistic care.
We’re taught about holism from day one when studying nursing, but it can sometimes seem difficult to pin down exactly what that looks like in practice, but perhaps like me, you’ll have an “ah-ha!” moment.
My next placement was on an acute ward, and while that brought with its own steep learning curve, I’m so grateful for what I learned during my social care placement. My care home placement highlighted the importance of getting to know the individuals that you are working with, be they patients or residents.
If you are unsure about how much you could gain from a nursing home placement, I recommend you try to go in with a curiosity about social care and a willingness to get stuck in. And get to know the residents who live there, as it’s a privilege to be able to learn from them in their own home! You may well find that any preconceptions you have about social care and the nursing role within it quickly become unfounded.
This week RCN Wales launched a report and film to raise the profile of care home nursing. Find out more.
