10. Preparation – Competency questions 2

Candidate One's (Rachel) Response to the question:

"What was the most challenging thing you had to deal with on your clinical placements (or work experience) so far?"

Rachel dialogue: As a nurse I’m extremely compassionate and it’s my aim, I strive, to provide the highest quality care to all patients and relatives who come into my care. However, my ability to do this was particularly challenged when we had short staff on the wards. That happened many times during my placement. For example, we had a staff shortage where two people were ill and it meant that the tasks they would have taken on had to be given to staff members meaning that their workload was bigger than it usually is, and therefore their ability to prioritise patient care was challenged more than it usually is. It was difficult to stay in line with the literature and the policies around patient centred care and providing a family centred approach to care.

In order to overcome that, what I did as a student, I asked my mentor if we could sit down and have a reflective discussion on difficult decision-making and how to prioritise care effectively and I found that really helped as it allowed me to organise my thoughts around that and learning how not to compromise care too much when we are faced with challenges staff shortages. I also realised the importance of having a strong support network around me and working as a team and the importance of team working skills too. Because I am a person who does naturally want to help people as a nurse, and I want to achieve personal and professional development, I feel as though it’s about managing a situation to ensure that patient-centred care and family-centred care isn’t compromised.

Candidate Two's (Gemma) Response to the question:

"What was the most challenging thing you had to deal with on your clinical placements (or work experience) so far?"

The most challenging thing comes from the best thing I’ve experienced. So in our university we do a home and away Trusts so we go to two units. In the first year we go to one unit that we return to in third year. And in the middle we go to away another placement. On my second year placement I experienced a lot of normality and physiological birth and really consolidated my learning from university on what the physiological process of labour and birth is and I learnt a lot of things from that placement, a lot of new clinical skills and by the end of it I was very confident and competent in what I was achieving.

When I went back to my original trust I was very apprehensive about going in and working to the same standard that I was in the away Trust because the midwives there work very differently and as a team they have a different ethos and obviously I’m not going into it an autonomous practitioner, I’m going in as a student, and I had a new mentor to work with who works very differently to the previous one.

What I did was discuss with my mentor how I wished to work, so if there was a low-risk woman, how I wanted to promote physiological third stage and water birth and clinical skills that we didn’t do in the trust I worked in. We’d discuss it and then gradually as she got to know me as a student and got confident in my competencies she allowed me to practice this way and then taught her a few things and then we’d discuss it with the team and as a result one action that was taken was a bed was removed from one of the midwifery-led rooms because I had promoted that happening, so I really felt that I had made a lot of change but initially it was quite challenging to go back into to an environment where I wanted to practice a certain way but it wasn’t appropriate at the time. So I guess that I’ve learnt that when I go to a new trust eventually, that I need to take a step back and see how they work there and then discuss how I wish to work and certain ways of doing things and then we can work together as a team and come to compromises and then hopefully changes can happen over time.