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Introduction to the Trust and Guide to the Profile of Learning Opportunities (PoLO) for nursing and midwifery students in practice

For nursing and midwifery students at our partner Universities:

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Contents: Page:

Introduction to the Trust 3

King’s Values and ‘My Promise’ 3

Host Trust Induction 3

How to get to our sites 4

Practice Placements 4

Definition of supernumerary status 4

Inter-professional learning opportunities 5

Patients who require specialing 5

Accompanying/escorting/transferring patients within the Trust 5

Medicines Management 6

Guide to the Profile of Learning Opportunities (PoLO) 7

Supporting your preparation for learning 7

Practice placement learning opportunities ‘hub & spoke’ 7

Learning Opportunity and Mapping Grid 8

How to use the Mapping Grid 8

An Example Learning Opportunity and Mapping Grid 9

What we expect from you 10

What you can expect from us 11

Process for raising concerns 13

References 14

Acknowledgments:

Thank you to all the Ward Managers, Practice Development Nurses, practice staff, and the

Corporate Communications Team at King’s College Hospital NHS Foundation Trust who have

participated in the development of the PoLO pack. Thank you also to the Link Lecturers and

Programme Leads from our partner universities - King’s College London, University of

Greenwich and London South Bank University - for their contribution and support.

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Introduction to the Trust

We are a leading teaching Trust, providing health care services for a diverse local

community, mainly serving the London Boroughs of Lambeth, Southwark, Lewisham and

Bromley.

Patients from a wider catchment area, both nationally and internationally, also access our

specialist: neurosciences, haemato-oncology, fetal medicine and liver disease and

transplantation services.

We promote shared values that underpin everything we do, not only in caring for patients,

mothers, and their families and in delivering our services, but also in the way we support

and develop our staff, and our students of nursing, midwifery, medicine, and allied health

professions.

King’s Values and My Promise

Our values have been created by the people of King’s - we see ourselves as a team, working

together for the benefit of our patients.

“We demonstrate ‘King’s Values’ by”-:

Understanding you

Inspiring confidence in our care

Working together

Always aiming higher

Making a difference in our community

King’s Values’ have been strengthened by ‘My Promise’, a guide which provides practical

examples of how we want everyone at the Trust to treat and interact with others.

Host Trust Induction

Before commencing your first placement, you will complete a ‘Host Trust Induction’. The

day provides you with an introduction to the Trust, to meet the Assistant Director of

Education and Research / Senior Nurse for Education, Support and Development, and

includes training from the Infection Control, Health and Safety, and Fire Awareness teams.

Midwifery students (KCL) will complete a separate induction with the Midwifery Practice

Facilitators (MPFs), and all midwifery students receive additional orientation to maternity

services. Please ensure that you bring your Pan London Practice Assessment Document

(PLPAD) with you for your attendance to be recorded.

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How to get to our sites

There is detailed information on how to get to King’s College Hospital (KCH), Princess Royal

University Hospital (PRUH), Orpington Hospital, Beckenham Beacon and Queen Mary’s

Hospital Sidcup at www.kch.nhs.uk

Practice placements

We provide a diverse range of practice learning opportunities for student nurses and

student midwives undertaking the following programmes with our partner universities.

Therefore you could be learning alongside a student from London South Bank University

(LSBU), King’s College London (KCL) or University of Greenwich (UoG) on one of the

following programmes.

Adult Pre-registration – BSc (Hons) and PG Dip Accelerated programmes in association with:

King’s College London

University of Greenwich

Child Pre-registration – BSc (Hons) and PG Dip Accelerated programmes in association with:

King’s College London

London South Bank University

University of Greenwich

Midwifery – BSc (Hons) and PGDip Accelerated programmes in association with:

King’s College London

University of Greenwich

Return to Practice programme – in association with:

University of Greenwich

Definition of ‘supernumerary status’

As a student in the clinical setting you will be actively involved in practice - based work, to

enable you to learn how to care for individuals, families and carers. You will be regarded as

‘supernumerary’, and during your shift you may be allocated patients/clients/mothers to

care for under supervision, appropriate to your learning needs and level of competence, and

relevant to the practice context of the placement.

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Inter-professional learning opportunities

Inter-professional co-operation is fundamental to delivering high standards of person-

centred care and services. We encourage students to work with and learn from and about

other professional groups involved in a patient’s health and social care pathway (CAIPE

2002). This allows you to gain valuable insight into the role and responsibilities of other

health and social care professionals.

Patients who require ‘specialing’

Inpatients may be cared for on a 1:1 basis by a nurse, midwife, mental health nurse or

healthcare assistant for challenging behaviour or if they are at risk of causing harm to

themselves or others. This care may be provided by the Central Specials Team (CST)

(Denmark Hill site), ward staff, bank or agency staff. The level of supervision required is

indicated via the ‘risk assessment – level of supervision algorithm’.

As a student, it may be appropriate for you to ‘special’ a patient, under the supervision of

your mentor as a learning opportunity. Students must not be left to -‘special’- patients

without supervision. You may find it useful to spend time with CST (Denmark Hill) or the

Ward Manager and clinical site practitioners / clinical senior nursing team, to look at the

decision making process and identify how therapeutic interventions are used to improve

patient care.

Accompanying / escorting / transferring patients with the Trust

Students may escort / transfer conscious patients in a stable, non-critical condition,

with minimal care needs, providing they have the required competence, and have

been assessed as such by the delegating registered nurse or midwife. This may vary

depending on the context of the placement (KCH 2015).

Students must be assessed as being fully prepared to manage

unexpected/emergency situations as a lone practitioner and therefore the mentor

will, with due care make the decision as to the appropriateness of delegating this to

a student, considering the safety of the patient/mother.

A student may not accompany / escort a patient alone who has an intravenous

infusion in progress.

Students are not permitted to escort patients alone outside King’s College Hospital

NHS Foundation Trust (KCH 2010).

Students should refer to placement guidance provided by the University (KCL, LSBU

& UoG) associated with the programme they are following.

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Medicines Management

Students must adhere to the ‘The Medicine’s Management Policy’ (KCH 2014) and the

Standards for medicines management (NMC 2008). Please consider the following:

8.20.1 ‘Student nurses should be given the opportunity to participate in the

administration of medicines by a supervising RN” (Level 1 competent), - ‘who remains

accountable for the student’s practice’ (KCH 2014)

8.20.2 ‘All medicine administration carried out by a student (under supervision)

must be countersigned by the RN’ (Level 1 competent) (KCH 2014)

8.8.2 ‘All medicines administered to children under the age of 16 must be

double- checked by two registered nurses,’ (Level 1 competent), ‘one of whom

should be a Registered Nurse (Child) or Registered Sick Children’s Nurse’ (KCH 2014)

8.20.3 ‘Student nurses must not prepare or administer intravenous medicines’ (KCH

2014). This includes flushes and setting the pump rate. However alongside the two

RNs (Level 1 competent) they are expected to calculate dosage / simple infusion

rates, check prescriptions, use available resources e.g. British National Formulary

(BNF) . Please note this is currently under review (April 2016)

8.9.3 ‘Student midwives may not administer medicines unless closely supervised by a

qualified midwife who takes responsibility for medicines administered’ (KCH 2014)

Those students with an existing RN qualification, undertaking a further

nursing/midwifery programme must not practise outside their current sphere of

practice as a student.

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Guide to the Profile of Learning Opportunities (PoLO)

As a pre-registration nursing / midwifery student, commencing a new clinical practice

placement is an exciting time as you prepare for new challenges, learning opportunities, and

the chance to enhance your existing knowledge and skills. We recognise that for some

students it can also provoke feelings of anxiety, due to the uncertainty of expectation, and

being exposed to a new practice context. Therefore the purpose of the PoLO is to contribute

to: ‘creating an environment for learning’ and ‘facilitation of learning’ (NMC 2008). Firstly by

supporting your preparation for learning before you commence a practice placement, and

secondly to identify learning opportunities within the practice area.

Supporting your preparation for learning

The PoLO will provide information to help you settle into the practice environment which is

an important aspect of the whole student learning experience. It will introduce you to the

practice context, identify members of the multi-disciplinary team, and present a range of

inter-professional learning opportunities.

In addition to the identified placement learning opportunities, there will be unexpected/

unplanned for learning opportunities/experiences. You are encouraged to take the

opportunity to learn from novel situations, to ensure you are supervised and working within

your competency limitations, and to engage with reflective practice.

We clarify our expectations of you whilst you are on placement, and highlight what you can

expect from your assigned mentor and the practice placement team.

Finally, through the process of self-assessment and reflection, the PoLO may assist you to

recognise areas of personal and professional strength and areas for development before

you commence this placement.

Practice placement learning opportunities – a ‘Hub and Spoke’ model

The concept of a ‘hub and spoke’ model will be used to provide a visual overview of the

practice placement learning opportunities, reflecting the patient’s health and social care

journey. The ‘hub’ (of a bicycle wheel) is defined as the practice area to which you are

allocated and where your named mentor is based (Millar 2014), and ‘spokes’ as identified

learning opportunities.

A separate ‘hub and spoke’ model may also be presented, identifying potential learning

opportunities which occur outside the ward / unit to which you are allocated or where non-

ward based health and social care professionals visit a patient/client/mother on the ward.

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Your mentor will discuss with you the appropriateness of you undertaking a ‘spoke visit’

outside the practice area and will contact the area/professional to make arrangements.

In addition to the visual hub and spoke overview and to assist you in identifying how you

can achieve the ‘generic and field specific competences’ (NMC 2009, 2010), the placement

learning opportunities will be mapped against the Essential Skills learning outcomes and

Professional Values in the PLPAD for your part of the programme e.g. part 1, 2, and 3. This is

called the Learning Opportunity and Mapping Grid.

Essential Skill Clusters (Nursing): ‘Care, compassion and communication’, ‘Organisational

aspects of care’,’ Infection Prevention and Control’, ‘Nutrition and Fluid Management’, and

‘Medicines Management’

Essential Skill Clusters (Midwifery): ‘Communication’, ‘Initial consultation between the

woman and the midwife’, ‘Normal labour and birth’, ‘Initiation and continuation of breast

feeding’, and ‘Medicines management’

Professional Values: ‘Professional attitude’, ‘Professional behaviour’, ‘Professional

responsibility’, and ‘Safe and compassionate care’

Learning Opportunity and Mapping Grid

A learning opportunity will be identified either as a core learning opportunity (CLO) or a

specific learning opportunity (SLO).

A CLO for example an ‘assessment’, occurs in all practice areas but will vary as to the

activities undertaken by you, depending on the practice context and patient need.

An SLO, for example, ‘care of patient with a tracheostomy’, will only be identified in

certain practice areas

Learning opportunities are mapped if appropriate to your part of the programme

and the learning outcomes/professional values to be achieved.

How to use the Mapping Grid

Firstly, identify your part of the programme in column 1 which is colour coded. This colour

code will relate to learning opportunities relevant to you.

The numbers in columns 2 and 3 are the number of each Professional Value and Essential

Skill in your PLPAD that the learning opportunity relates to, thereby assisting you to plan

your learning.

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An Example Learning Opportunity and Mapping Grid

Core Learning Opportunities (Under Supervision): ward/unit based

Participate in the assessment of individuals with a range of medical conditions / long term

conditions, for example:

Neurological conditions e.g. Parkinson’s disease & Motor Neurone disease

Haematological conditions e.g. Acute Myeloid Leukaemia, Lymphoma

You may participate in/observe (with context related examples):

Applying relevant knowledge / measuring & interpreting clinical observations e.g.

pyrexia

Developing skills in the use of related equipment under supervision e.g. dynamap

Observing diagnostic procedures e.g. MRI

Communication e.g. interpretation service involvement, enhancing listening skills

Obtaining specific specimens as required e.g. urine (MSU and CSU), stool, wound

swab

Documentation e.g. as communication tool for MDT working

Risk Assessment e.g. falls or infection control

Discharge planning

Identifying the patient’s health & social care needs

The learning opportunities above are mapped against the Professional Values, Essential

Skills and Practice Assessments in your PLPAD and are presented in the table below. This

will assist you to identify and plan for what you could achieve.

Adult Programme and Part 1, 2, or 3 as per PLPAD

Professional Values statements in PLPAD

Essential Skills PLPAD Outcome Number

BSc Part 1 and PGDip part 1

1, 2, 4, 5, 6, 8-10, 12, 13

1-4, 6-9, 12, 13, 19, 20, 21, 22, 25-27, 30 Part 1 Practice Assessment ‘Episode of Care’

BSc Part 2 and PGDip Part 2

1, 2, 4, 5, 6, 8, 9, 11, 12, 13

1, 3, 4, 5, 7, 9, 10, 11, 18, 22, and Part 2 Practice Assessment ‘Episode of Care’

BSc Part 3 and PGDip Part 3

1, 2, 4, 6, 7, 9, 10, 13, 14

1, 2, 13, 16, 17, 18, 23, 24, 27, 29, 43, 49, 52, 53, 54, 55, 62, 66, 69 Part 3 Practice Assessment ‘Episode of Care’ and ‘Medicines Management’

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What we expect from you

Before you commence your practice placement we encourage you to:

Contact the assigned practice placement one week prior to commencement to

arrange to visit the area, and be given your first week duty rota

Read through your PLPAD to identify learning outcomes/competencies/skills to be

achieved during the placement

Consider the context of the practice placement and the potential learning

opportunities

Plan how you will travel to your practice placement location

During your practice placement we expect you to:

Treat all people as individuals, with dignity and respect

Maintain patient confidentiality

Ensure the 6 Cs underpin all that you do (DOH 2012):

o Care

o Compassion

o Competence

o Communication

o Courage

o Commitment

Work with and alongside the multi-professional team to promote the health and

wellbeing of those in your care, their families and carers

Work with and alongside the practice team demonstrating an enthusiasm and

motivation for learning

Work at least 40% of your shifts with your mentor/mentors/sign off mentors to

ensure appropriate supervision (directly or indirectly)/facilitation of learning

Ensure you provide your mentor/sign off mentor with your PLPAD and related

documentation in a timely manner as required

Ensure you adhere to Trust policies and procedures which are available on the Trust

intranet (Kingsweb), using the generic log in at any hospital site to which you will be

given access.

Work within your own level of competence to ensure safe practice

Recognise your limitations as a nursing/midwifery student

Recognise when to seek assistance

Recognise the process for raising concerns (see flow chart, page 13)

Be punctual for your shift as negotiated with your mentor/sign off mentor

Experience a variety of shift patterns, to reflect 24 hour care, and/or the practice

context – which may include weekends and night shifts

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Inform the practice area, MPF (midwifery students) and university as soon as

possible if you are sick / absent

Make your practice placement shifts a priority over any part time work

Wear your student uniform with pride and abide by the Trust uniform policy - if

arriving and leaving to and from work in uniform, this must be fully covered

Ensure you wear your identification badge

Reflect on the learning experience, either independently or with the support of your

mentor/sign off mentor to identify knowledge and skills acquired, enhanced and

consider where further development is needed

After you complete your practice placement we encourage you to:

Evaluate your practice learning experience to provide constructive feedback, so we

know what we do well and where we can improve

What you can expect from us

Before you commence your practice placement we will:

Inform the clinical area of your allocated placement

Ensure your assigned mentor/co-mentor/sign off mentor has an appropriate mentor

qualification

Ensure your mentor/co-mentor/sign off mentor is meeting the requirements for

Triennial Review (NMC 2008)

During your practice placement you can expect:

To be orientated to the practice placement area to which you are allocated

Time with your mentor/co-mentor/sign off mentor to identify your learning needs,

discuss your current clinical competencies and areas for development

Time with your mentor/co-mentor/sign off mentor for your initial, mid – point and

final interview

To maintain supernumerary status

To be exposed to a variety of experiences relating to patient care and health and

social care related services

To receive timely and constructive feedback on your clinical and professional

development

To seek support from/to discuss any concerns or difficulties with:

o Mentor/co-mentor/sign off/associate mentor

o Ward Manager

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o University Link Lecturer and / or Clinical Teacher

o Practice Development Nurses (PDN) (in most areas) / Midwifery Practice

Facilitator (MPF)

o Trust based Personal Mentor (PGDip students KCL)

To access resources available:

o Library facilities PRUH (Education Centre) and Denmark Hill (WEC)

o Trust intranet for policies/procedures/guidelines

o Online Royal Marsden Manual available on all computer desktops

o Evidence-based resource folder in placement area relating to the practice

context and patient care

After you complete your practice placement we will:

Encourage your mentor (s)/sign-off mentor to evaluate their mentoring skills as part

of the Triennial Review requirements (NMC 2008) and their continuing professional

development

Receive feedback from the University on the evaluation of your learning experience

Respond to student feedback - commending mentors and practice teams where

students are well supported, and dealing with any areas of concern/issues raised

appropriately

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Process for ‘raising concerns’ regarding pre-registration student nurses / midwives on clinical

placement

Student issue To inform or be advised please contact:

Dr. Angela Grainger, Assistant Director of Nursing

(ADN) – Education & Research: 020 3299 1695 or

internal X 31695 angela.grainger@nhs.net

or Jo Goodchild, Snr. Nurse for Education, Support

& Development 020 3299 1690 or internal X

31690 jgoodchild1@nhs.net

Mentor / Sign Off

Ward Manager

To discuss concern on a ‘need

to know basis’

For support

For guidance

Link Lecturer

Mentor & student support,

briefing & evaluation

Competency document

(PLPAD) briefing & support

Lecturer Practitioner / Practice

Development Nurse / Clinical Facilitator

/Midwifery Practice Facilitator

Specific clinical training issues

Ongoing support and development as

required

ADN (E&R) liaises with: HEI Lead for

KCL – Adult , Child and Midwifery

LSBU - Child Health only

U of G - Adult, Child and Midwifery

For:

Competency / conduct issues

Student related adverse incidents

Link lecturer absence

Personal Tutor

Personal student issues

Competency / conduct issues

MUST ALWAYS be referred to

personal tutor

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References:

Centre For The Advancement Of Interprofessional Education (CAIPE) (2002) The Definition

and Principles of Interprofessional Education. Online available from: www.caipe.org.uk

Department of Health (2012) Compassion in Practice. Online available from

www.england.nhs.uk

King’s College Hospital NHS Foundation Trust (2015) Policy for the Safe Transfer of Patients.

Online available from http://kingsdoc/docs/policies KCH: London.

King’s College Hospital NHS Foundation Trust (2014) King’s Values. Online available from

www.kch.nhs.uk KCH: London.

King’s College Hospital NHS Foundation Trust (2014) My Promise. Online available from

www.kch.nhs.uk KCH: London.

King’s College Hospital NHS Foundation Trust (2014) The Medicines Management Policy.

KCH: London

King’s College Hospital NHS Foundation Trust (2012) Controlled Drugs Policy. KCH: London

Millar, L. (2014) Use of Hub and Spoke model in nursing students’ practice learning. Nursing

Standard. 28, 49, 37-42.

Nursing and Midwifery Council (2015) Raising concerns: Guidance for nurses and midwives.

Online available from www.nmc.org.uk

Nursing and Midwifery Council (2010) Standards for pre-registration nursing education.

Online available from www.nmc.org.uk

Nursing and Midwifery Council (2009) Standards for pre-registration midwifery education.

Online available from www.nmc.org.uk

Nursing and Midwifery Council (2008) Standards for medicines management. NMC: London

Online available from www.nmc.org.uk

Nursing and Midwifery Council (2008) Standards to support learning and assessment in

practice. Online available from www.nmc.org.uk

Practice Educators / Facilitators Coventry & Warwickshire NHS Trusts (2010) Learning

Pathway Toolkit. Coventry University: Coventry

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