"Self-rostering on placement changed my life"

Written by second-year nursing student Ruth Rawson.

I am now in the second year of my nursing degree, yet I only recently started my second placement. This should have taken place in my first year but was postponed because of Covid-19.

Going into the second placement of the first year of my nursing degree, I had the same dread as the first - would the shifts I was given be workable for me? Only this time, with Covid-19 restrictions disrupting before and after school clubs and the childcare plans myself and my husband had made, the chances of my shifts being compatible with my other commitments were far more remote. 

I considered deferring my course but decided to see how things panned out. My progress, however, was uncertain.

I am a mature student in my forties, a mother of three children aged nine, 11 and 13, and my husband works full time. My children all attend different schools and my husband’s job as a deputy head teacher leaves little flexibility for him to help with school runs.  

My parents, who are in their seventies, live nearby and are our main source of childcare. But I am anxious about putting my parents in harm’s way, potentially exposing them to coronavirus each time they look after my children.

My second placement is in a large surgical assessment unit at Royal Shrewsbury Hospital, about 20 miles from home. I have a theory module running alongside the ten-week placement, meaning I have to attend lectures on Thursdays to make up my 40-hour week. 

I am required to complete 32.5 hours of clinical practice per week, around my theory day. From experience, having a set theory day complicates matters, requiring a roster to be created just for me.  

I know of many prospective nursing students who chose not to apply for courses because the various shift patterns they would be expected to work over the three years would not be compatible with their personal situations. 

So when I read an article in Nursing Standard about the benefits of self-rostering, by second-year adult nursing student and team lead for @westudentnurses Natalie Elliott, I was completely on board with the benefits self-rostering can bring to nursing students and, in turn, the nursing profession.  

Seizing my opportunity, I asked if I could self-roster for my second placement, which started on 5 October. Expecting some resistance, I was relieved when the student lead for the placement, Sister Rebecca Hawley, was keen to trial self-rostering for students. With the full support of the ward manager Denise Bennett, it was agreed that this would go ahead.

Ms Hawley was keen to put a framework in place to ensure my roster provided quality learning opportunities. I was given a document with general information about the ward and how it operates, along with more details to help me choose individual shifts, such as clinic times, busy and quieter times, the availability of specific learning opportunities and how best to seek them out.  

I was also given the details of three supervisors and a practice assessor, including their off-duty rotas, to cover the first eight weeks of the placement. I needed to plan several shifts with my assessor to fulfill the requirements of my placement document and complete my placement orientation, a mid-term interview and final interview, and to agree learning goals as a minimum.  

In the meantime, it was my responsibility to plan shifts to allow me to achieve all my proficiencies and learning goals. In addition to my three supervisors, I was encouraged to plan shifts with other supervisors throughout my placement so that I could experience a number of different working styles.  

When planning my shift pattern, I decided to schedule two weeks initially to settle into the ward and allow time to identify nurses I would like to work with. I also wanted to see how well I worked with my supervisors, and whether their style of teaching suited my style of learning. My experience over the first two weeks then informed my next roster. 

So far, my shifts have provided a good balance between personal convenience and achieving my learning goals. My placement is in a busy assessment unit, where I have the flexibility to change supervisors on the spot and take advantage of learning opportunities as they present themselves.  

In terms of teaching styles, while one nurse may prefer to go about their duties and allow me to observe and ask questions, another may be more hands off, allowing me to take over the task under their watchful eye.  

I naturally gravitate towards nurses who challenge me to be hands on, as this is a more effective teaching style for me. I feel empowered to choose who I work with depending on what I want to achieve and have been more productive as a result.  

On my second shift, I carried out numerous clinical skills under supervision, including doing an electrocardiogram (ECG), aspirating a nasogastric tube, removing cannulas, writing in patients’ notes and filling in comfort and fluid balance charts. I also helped to settle a confused patient and comforted a patient in pain, and have had nine of my proficiencies signed off already. 

I have found many benefits of self-rostering during my current placement. Firstly, and most importantly, I am more focused on my learning as I am far less anxious about the pressure I am putting on my husband, and whether my children are safe and happy.  

Secondly, I have autonomy over my own learning journey, with self-rostering enabling me to create a strategy and organise my time to achieve my goals. This means choosing supervisors who enjoy teaching, who are effective educators, and whose approach compliments my preferred learning style.  

I can seek consistency or variation in supervision, depending on whether I am working towards a learning objective or want to experience a breadth of new skills, and have observed a variety of working styles. I feel I am beginning to navigate through these to find my own unique style, whilst making good progress through my practice assessment document. 

I would like to thank both Rebecca and Denise for their advice, support and encouragement, enabling my first experience of self-rostering to be an extremely positive one. I am eager to demonstrate the benefits this represents for nursing students and will not hesitate to ask if I can self-roster on my next placement. 

Denise Bennett, ward manager, says: "We are excited to trial self-rostering with Ruth. Nurses are autonomous practitioners and any quality experience we can provide to empower our students to take responsibility for their learning is a positive step. Responsible self-rostering, within an agreed framework, offers students the opportunity to develop many vital skills. Ruth has helped us to see the huge benefits for placement areas, as students seek facilitation rather than management of their learning journey." 

Ruth Rawson's blog post was has been published on the RCNi NS Student website.