If you are a student nurse with lived experience of disability, neurodivergence or long-term conditions, our placement adjustments passport guidance can help you get the reasonable adjustments you need on placements. Find out how it works on this page. 

"At our University we have three placements each year, which can be in different hospitals or community settings or with different independent providers, and it can be difficult to have the same conversations each time about support needs and adjustments. Being able to keep that information all in one place using the Passport, and having more prompts to think about things like transport and health and safety, makes those conversations much easier to plan, and I don't have to worry about forgetting something important or not getting my point across properly." - James, peer support network member

The RCN’s placement passport aims to help students with disabilities, long term conditions and/or neurodivergence get the support they need on placement. We are piloting the passport for one academic year from September 2024 and will be seeking feedback from users and other stakeholders to develop the initiative. 

If you meet the legal definition of ‘disabled’ under the Equality Act 2010 (or SENDO in Northern Ireland), you are entitled to ‘reasonable adjustments’ on placement. However, the RCN recommends that providers consider all reasonable requests. 

Your education provider and placement provider have a duty to implement reasonable adjustments. It is also important that you take ownership of conversations about your needs. 

Additionally, the NMC states in their standards for pre registration nursing programmes that:

‘Education institutions, together with practice learning partners must: take account of students’ individual needs and personal circumstances when allocating their practice learning including making reasonable adjustments for students with disabilities’ 

Support from your university

As the name suggests, the passport is designed to get you support on placements. Your university, particularly the Practice Education Team, should be willing and able to help you identify and implement reasonable adjustments on placement. Involve them where you can at the earliest stage.

Telling people about your disability, neurodivergence or long term condition 

Unless there is potential risk to yourself or others, you are not obliged to tell others about your disability or neurodivergence. However, telling others (disclosing) is a key step in getting the support you need on placement. 

This section is for use by university staff, to help plan and support you on placement. It will help them ensure you get appropriate placements. 

Speak to your university (academic staff or disability services) if you anticipate that some placements will cause issues for you. They should work with you to understand your access needs including:

• Physical environment accessibility issues
• Location and transport needs
• Specific needs around breaks/nutrition/shift patterns due to your disability or neurodivergence

And consider this when allocating placements. 

Use pages 1 - 4 of the passport document to record these conversations. The adjustments on this page may stand throughout your course. But in case your needs change it is a good idea to review before each new academic year.

Sharing:

Information you disclose to your university won’t be automatically shared with placement providers. Make sure you are aware of your university’s processes around sharing of information with your consent and any established tools they have to help you have conversations about your needs on placement. For example, some universities have a letter template or needs assessment template that you can share with your placement supervisor. You can keep a record of who has seen your pre placement plan using the table at the top of page 1.

About me:

This is a good place to ‘disclose’ as much as you feel comfortable. You might want to share diagnoses or symptoms. Feel free to add other things about you too.

Specific needs:

Some placements may not be suitable for you because of your disability, long term condition or neurodivergence. Establish your specific needs here. Examples might include distance of travel, medication breaks, access to required nutrition, shift length. 

This is for use by your placement supervisors and assessor, to help plan and support you on placement.

As soon as you’re able to, get in touch with your practice supervisor to let them know about your needs. Be sure to:

• Share information they may need about you to understand how to support you.
• Establish how information about you will be shared and who with. This is your choice but not sharing could make it difficult to implement some adjustments. 
• Ask any questions you need to help you proactively identify reasonable adjustments you will need.
• Identify actions and who is responsible for each action. Add in deadlines or review dates if needed. 
• Share the agreed way forward with stakeholders.
• When circumstances change or if adjustments are not working, address this again with stakeholders as soon as possible.
• Contact the RCN if you feel you are not being granted reasonable adjustments or are experiencing discrimination. 

Use pages 5 -7 of the passport to record these discussions and what is agreed. 

About me:

This is a good place to ‘disclose’ as much as you feel comfortable. You might want to share diagnoses or symptoms. Feel free to add other things about you too.

Things I often find helpful:

You will be more informed about what helps as you progress through your placements but even early on, there will be things that you already know help. Examples could be: short breaks for managing symptoms (specify time), A mix of sitting and standing.

Potential challenges:

this could include things like long periods standing, noisy environments when writing up notes, staying on task. 

Health and Safety considerations:

Could your disability/long term condition/neurodivergence put you at risk in the practice environment?  Make sure you and your placement supervisor consider any potential health and safety risks and detail these with their mitigations.  

You will have a new practice supervisor for each placement and should update your placement plan accordingly, taking in to account what has worked well previously and the nature of the placement. 

As mentioned previously, your requirements won't be shared automatically to your placement providers. Consider how and when to contact your next placement. It is often possible to arrange a walk-round before your first day. 

Peer support network member James has shared the accompanying email that he uses to contact new placement providers:

Good morning,

My name is [name], I'm a student who will be starting a placement at [placement site] on [date]. I'm a [year/stage of study] student, and started the course in [year you started the course].
I had hoped to ask a few questions, and potentially arrange a visit before beginning the placement to discuss my support plan and make sure I know where I'm going. I can be available [your availability]. I’ve attached my Placement Passport, which I’ve filled in with some information about me, but it would be helpful to talk with you before placement to make sure any adjustments are reasonable and would work for you and the team. I’m happy for this to be shared with [supervisor / assessor / placement co-ordinator / etc], but please let me know if you feel it would be helpful to share with anyone else!

If you have any sort of induction booklet or document for students or new staff, I would appreciate being able to read through it before starting placement to get familiar with how [placement location] operates.

[Any other information or requests, e.g., where should I go on my first day, is there anything I can do before placement to help prepare, etc.]

Thank you for taking the time to read this!
Kind regards,
[Name]

This is for you to use, reflecting on your past placements to plan what support or adjustments you would find helpful on future placements. We suggest completing this at the end of each placement. You could share this with your PAT (Personal Academic Tutor), Specialist Mentor or another appropriate stakeholder to start a planning discussion.

Here you can update your strengths and challenges based on your experiences on placement. 

You will change and grow as you progress through the course. Keep the completed documents for each placement together so you can use your learning to inform the next placement plan. 

Next steps:

With your academic supervisor and/or current placement provider, detail what adjustments and amendments will benefit your learning at the next placement.
They can also be helpful evidence should you need to challenge placement provider’s decisions.

This short video takes you through how to complete the placement adjustments passport.

Some references from the video:

• Disabled Students Allowance (DSA) guidance and Natasha's story on the main student peer support webpage
• How to contact RCN Direct if you need support with placement issues

As a practice supervisor, you play a key role in supporting students with lived experience of disability and neurodivergence on placement. Whilst students should remain in control of their information, the onus shouldn't be only on them to set up the reasonable adjustments they require. In fact, they often won't be able to do this without you. Your attitude is so important and has the power to encourage or discourage future disclosures.  

Make sure you are aware of:

• your duties under disability legislation and what 'reasonable' means. What advice is available from your employer on this? 
• How you will share information about the student that they give to you - remember your obligations under GDPR and ensure you include the student in these decision, obtaining consent. 
• where you can get support if you don't know what to do. This could be your manager, trade union, the university, occupational health, your HR & training teams. 
• the importance of fostering an inclusive work environment so all those in the team feel they can be themselves and share their challenges
• how a strengths and challenges approach can help you establish student's needs
• latest developments in equalities. You can't be an expert in everything, but this is far from a static landscape and professional development in this area will empower you to give the right support.
• Who your contacts are at the university and how you can improve communications between your placement and the university

You will need to think about what the students needs to do to complete the placement and to be able to practice in employment once they graduate. 

Take time to reflect on your experiences supporting students with lived experience of disability and neurodivergence and think about how you can share your learning to make your placement provider more inclusive in future.

You can download our sample passport guidance to see how the passport guide appears and share with stakeholders.