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DIS-FORUM  February 2007

DIS-FORUM February 2007

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Subject:

Re: Nursing student - placement difficulties

From:

Felicity Burgess <[log in to unmask]>

Reply-To:

Discussion list for disabled students and their support staff.

Date:

Wed, 28 Feb 2007 16:26:32 +0000

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (120 lines)

Dear Louise,

I'm a 3rd year Occupational Therapy student (which means that I have to 
write in nursing notes whilst on placement...)

I have used various strategies depending on the placement environment (I 
don't know about the nursing fitness standards, but for those of us under 
the Health Professions Order, the HPC (governing body) has made it clear 
that it is the outcome rather than the method which is important).

http://www.hpc-uk.org/publications/index.asp?id=111 and http://www.hpc-
uk.org/publications/index.asp?id=109 may prove useful as general reading 
(although you'd need to find out whether nursing has similar views).

With regard to drug names, there should be no issue with the student 
either referring to the BNF in paper format, or having the electronic form 
on a PDA (I know of a medical student who uses the latter - then you are 
more likely to get the spelling right due to being able to read what the 
drug is for.  If there are certain drugs commonly used on placement, the 
student may find it helpful to compile a list on computer and print it).

Confidentiality is an interesting point.  I have dictated notes/used a 
scribe in open ward areas (not ideal - but the noise level is usually such 
that if you speak quietly, you can't be heard anyway).  

The other thing that I've done is type on my laptop whilst my PA scribes 
into the nursing notes (which deals with the 'being overheard' issue.  
This usually improves as the PA gets used to it as well.  Your student may 
be able to use a PDA or even a mobile phone(?) for this if they have good 
motor control.  

Another low-tech method of getting round the confidentiality issues with 
PAs that I've found is openly dictating parts that do not contain patient 
identifiable data (e.g.) time, date, my designation/bleep/extension, 'OT 
initial assessment plan carried out with...', and then when it comes to 
confidential information finding (e.g.) the name/address/age/diagnosis of 
the patient/relatives already written in the nursing notes, and pointing 
at it (not my strong point as I have multiple disabilities, but your 
student may be able to manage that).

PAs can be expected to sign a similar honorary contract with the Trust as 
the student/whatever else the student has to do to agree confidentiality.

Independently shouldn't come into the equation - in that (at least insofar 
as the HPC are concerned - don't know about the nursing governing body), 
independently can mean with the assistance of a PA - I'd be unfit to 
practice without one.  Independently means without the supervision of a 
qualified member of staff as far as I know.

Functioning in a timely manner may be more difficult for your student.  I 
have a full-time PA on placement because I have multiple needs (also have 
vision issues and am a wheelchair user).  

I know other students who've had a PA part time, and that has caused 
timeliness issues (e.g. only writing up notes in the afternoon).  However, 
that also depends on the environment - if the student is somewhere such 
that notes generally only need to be written at end of shift, then having 
a designated time with a PA each day may be possible.  It's much harder to 
accomplish with a part-time PA on an acute ward (I am very glad that I 
have completed my one acute placement).

I have become more bold about asking if I can use an appropriate place for 
note-writing as I've progressed through the course - whilst making it 
quite clear that I'm not trying to monopolise the space.  For example, on 
my current placement I note-write in the handover room like everyone 
else.  However, I shut the door when I'm dictating, so that the words 
don't filter through the second door (if open) to the public area where 
clients could here.  I've disclosed to all nursing, pysch and OT staff 
what I'm doing, why, and that the door is not closed to keep them out, but 
to keep the sound in (as that can cause bad feelings).

It may be helpful for you to ask the Nursing School to quantify their 
objections more, so that you can determine which parts of confidentiality 
they're worried about etc.

Felicity
PS Hope that's helpful - I seem to have rambled a little.


Dear all

I wondered if anyone has experience of a nursing student successfully 
using alternative means of written communication on placement other than 
handwriting information. If anyone is aware of students who have continued 
to use alternative methods once they have started working as a nurse, this 
information would also be extremely useful. 

A student is studying at present who has difficulty recording anything in 
handwriting due to extremely slow (8 words per minute) handwriting. In 
addition, placement staff are having difficulties with the legibility of 
his notes. The student also struggles with spelling and this is causing 
concerns about misspelling of drug names which are similar.

I met with members of the Nursing School to discuss use of a recording 
device/transcription or the possibility/feasibility of an amanuensis being 
present with the student during placement hours, and they have raised 
concerns about confidentiality and the student being able to function 
independently and in a timely fashion as a nurse.

I would be grateful for any replies either on or off list 
([log in to unmask])

Many thanks for your time

Louise

Louise Thompson
Disability Adviser

Disability Support Office
University of Manchester
LG020 John Owens Building
Oxford Road
Manchester
M13 9PL

Tel 0161 275 8524
Fax0161 275 7018
Email [log in to unmask]

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