Interview with a Nursing Student: Clinical Placement in COVID-19 Times
Nursing Student Emma recently completed her final (3rd year) placement in an ICU unit as the COVID-19 pandemic emerged. Emma shared her thoughts with The Lamp on the experience and her tips for students about how to make the most of their clinical placement during these challenging times.
What inspired you to study nursing?
I wanted to study nursing out of high school but was talked out of it! I went on to have a great career as a project manager but one day I was sitting at work and realised that it was not fulfilling anymore. Almost on a whim I applied to university. I think a combination of factors led to me taking the step at that time, including my Mum’s diagnosis of ovarian cancer.
What area of nursing are you hoping to go into once you have graduated?
Tell us about where you completed your final placement for your degree?
I was in ED & ICU for 5 weeks in a Private Hospital in Victoria.
What were the challenges during this placement, as opposed to previous placements, where COVID-19 was now a factor?
The stress levels of the staff were evident. There also seemed to be almost daily changes to policy and procedure.
How did you feel going on this placement and how did that change as the COVID-19 pandemic evolved?
I was excited as this was my final placement and in ED/ICU! During my first week of placement (first week of March) COVID was very much ‘just a virus’ in my mind. By the second week I knew that things were escalating quickly, and we were starting to see suspected presentations as well as people with anxiety related to COVID. By the final week of placement things were very real and if anything, I was even more happy to be on placement as it meant that I was one step closer to graduating and being able to help.
How did you find your supervising RN/ the RNs on the ward responded to the COVID-19 crisis?
It varied a lot! Some seemed almost unconcerned and others were obviously quite worried and stressed. I think the hardest part for them were the constant changes. For example, when I started in ICU, we were not wearing PPE routinely and by the end of placement we were in PPE for all patients. We were also subject to a health screening survey and our temperature being taken each time we entered the hospital.
What support were you given?
Unfortunately, I did feel like students were a bit forgotten in COVID communication. I made sure to read any memos that I saw in staff areas and also did the online government COVID training and brushed up on donning and doffing PPE.
How did you and your fellow students support each other during this placement?
I was the only student in my area most of the time, so I made sure to call and text some of my fellow students to debrief. I have been doing this throughout my degree and those connections and conversations have been some of the best ways I have reflected and managed the stress of placement.
Did COVID-19 change any aspects of how your placement was conducted?
I was in a private hospital so at the end of my placement they actually cancelled all upcoming placements as it was as the announcement about elective surgery was made. They took a week off and then started taking students again but only on the wards. Specialty placements such as ICU, ED & theatre were not continuing due to both the risk to students, but also the need for conservation of PPE.
What advice would you give to students about to embark on placement during COVID-19?
Make sure you do the COVID training online. Make sure you know your facility policy about PPE and if you feel unsure about anything ask. Have a plan for how you will handle any items you take into the hospital. For example, I was not bringing anything that had been in the hospital back into my house. I was undressing in the garage and taking my clothes straight to the washing machine. I was then showering and changing before I spoke to my family. This may seem extreme, but I have an asthmatic son at home.
Do you have any tips on how you found you could as a student best support your RN?
I treated this like any other placement, I made sure my RN knew I was eager to learn and happy to help. Keep in mind that you don’t know their personal situation. I asked a few of my buddy nurses how they were feeling about COVID, that helped me empathise with how stressful the past month has been.
Did you experience any negative reactions to students being on placement at this time e.g. concerns for your safety, appropriateness of you being there? If so, how was this addressed?
There were a few raised eyebrows, but when people found out I was completely my last placement they were very keen to get me finished and registered so I could help! The only time I was unable to do something was when I followed my ICU patient through to theatre to watch her tracheostomy. I was scrubbed and in theatre and then asked to leave as they had decided to wear N95 masks for her procedure and would not give one to a student. I was quite frustrated as I had cleared attending the surgery with educators, the surgeon etc. and one nurse seemed to be the only one who objected. I made sure I let the educators know the next day so that they could chat with the theatre NUM and be clear on her stance, so no other students were put in the same position.
What practices in self-care or otherwise did you adopt during this placement that you felt helped you through the experience?
After the start of my 2nd year and a particularly challenging time I made some big changes to how I deal with placements. I now ‘meal prep’ all of my meals at the start of the week so I am eating well. I exercise every day, even if it is just a walk. Due to my gym closing I am doing a lot more workouts in my backyard (check out the FitOn app). I also make sure I talk with a couple of my nursing friends regularly. Oh, and when I finished, I popped open a bottle of bubbles!
How has being a student on placement during COVID-19 altered your perception or understanding of nursing?
I think my perception is probably the same, although I have a whole new appreciation for ICU nurses, their knowledge is incredible! I think that the public perception of nurses has changed for the better, people have never been more appreciative.
I guess the only other thing I would say to students is that if they have placement at this time, they should make the most of it and be thankful. There have been a lot of placements cancelled so the opportunity to attend placement at the moment is a privilege. Having said that, I do understand that people may have anxiety about going on placement. I would encourage them to have a think about if they need to defer their placement, especially if they feel they are endangering someone they live with, such as an immunocompromised family member.
Thanks for generously sharing your experience Emma and congratulations on your impending graduation!