My first year hub placement is on an elderly rehab ward in a community hospital. At Derby university in first year, we have one hub placement where we spend around 16 weeks throughout the year and a spoke placement where we spend 2 weeks.
The shift pattern at my placement is:
Early – 7am-3pm
Late – 1pm-9pm
Nights – 8:30pm – 7:30am
Long days are 7am – 9pm.
Below is a timeline of a typical day on this ward. Other placements will vary and I would love to hear about your typical days on placement!
The night shift nurses handover how the patients have been throughout the night and the patient early warning scores from the previous day. They also relay any information relevant to a patient for the day and if there are any care plan reviews outstanding. Before leaving the handover, we check the discharge board to see if there are any discharges planned for the day, these are often mentioned in the handover as well. HCAs are allocated patients that they will be responsible for assisting throughout the morning and students will often be allocated 1/2 patients as well. The nurses on the day shift decide which side of the ward they will be in charge of for that shift.
7:30 – 9
During this time, the nurses and HCAs are assisting patients to wash and dress. We encourage patients to wear their own clothes and to get out of bed. Information about how a patient mobilises/transfers is included on the handover shift and is also on the board above the patients bed. A number of patients come into the dining area for breakfast but the majority like to have breakfast in their own space. Around 8am, the nurses begin the medication rounds. As a student, there has been times when I have assisted with the morning medications and other times when I have been helping the HCAs to assist with patient personal care needs.
9 – 11:30
During this time, patient observations are completed and documented on the NEWS (National Early Warning Score) chart. Any patient scoring is reported to the nurse in charge and documented. We also document the reason as to why they were scoring and these patients will have their NEWS checked again later on in the day. Any dressings that need changing and UCAM (urinary catheter assessment and monitoring form) charts will be completed in this time. Daily evaluations are completed for each patient, as well as fluid/diet charts for those patients on them. Once my mentor has completed all her duties in this time, I chat to patients and get to know them a little better. The physio team will often be on the ward at this time, completing assessments on patients and helping them to gain confidence with their mobility. The tea trolley goes around the ward around 10:30 for the patients to have a cup of tea and a snack.
11:30 – 12:30
We use this time to assist with toileting any patients who need assistance and patients come into the dining area ready for lunch at 12:30. Patients are welcome to remain in their own rooms but they are encouraged to come to the dining area and socialise with other patients.
12:30 – 14:00
Lunch arrives at 12:30 and all the staff on the ward help to give meals out. HCAs and available students help any patients who need assistance with eating and drinking. At 13:00, the nurses and students go into the handover to provide information to the staff beginning their late shift. Any outstanding duties are handed over to the afternoon nurses to be completed on their shift. After the handover, the nurses on the morning shift complete the lunchtime medication round. The late shift nurses walk around the ward and check on the patients they will be responsible for that afternoon.
14:00 – 17:00
These hours are visiting hours so there are often lots of family members on the ward. I have often completed care plan reviews or personalised care plans within this time, chatting to patients and their families about their preferences. During this time, the nurses will complete any paperwork that needs updating. Morning staff leave at 3pm leaving the late shift on duty. Patients have a cup of tea and a snack around 3:30pm. Any patients scoring on their NEWS in the morning will have their obs taken and documented. Changes in scoring is reported to the nurses on duty.
17:00 – 18:30
Teatime. Patients often remain in their own rooms for tea, some patients may sit in the day room watching television whilst they have their tea. Patients are offered a hot and cold option and there are different choices each day.
Visiting time again, some patients who have had visitors earlier on in the day ask to be assisted into their nightwear at this time as they like to relax late evening reading a book or listening to music in their own space.
19:30 – 21:00
Patients have a hot drink around 8pm and some patients will ask to be assisted into bed around this time. At 8:30, the nurses’ go into the handover to relay any information onto the staff on night duty. At 9pm, the late shift finish leaving the night staff for their shift.
Let me know where your first placement is/was and if your day is different to mine 🙂
You can find out more information about NEWS here: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2