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“What’s the point of a placement in a care home?” I’ve been asked. “Won’t this just be about nursing skills I already have?”

Nursing students, many of whom already have extensive caring experience, quite rightly want opportunities to develop their skills during a clinical placement. But a care home placement is about far more than the fundamentals of nursing.

A care home provides a practice learning environment for students to see and experience first-hand the value of an extended nursing role. The highly skilled nurses that students work with are experts in care, experienced at supporting people in an unfamiliar environment and deft at preparing for assessments. They also have a deep understanding of governance arrangements and legal frameworks. 

There’s so much to learn from nursing staff who work in care homes who often have a high level of autonomy in clinical decision-making. In an emergency their residents are reliant on them until emergency services arrive. They don’t have an on-call bleep. 

You get to see the value of an extended nursing role

A care home is a unique and complicated environment where students will witness and learn skills hugely beneficial to their future careers, wherever they choose to specialise. It’s a chance to spend more time with people, build relationships with residents, learn about longer-term ways of working, while having the time to follow and better understand personalised care plans. 

But as with all other placements, my advice to students is to come prepared. Consider what you want to achieve from your time and make sure you have appropriate conversations with the right people to get the best out of your experience.

Busting myths

Within my team of three we’ve working with local authorities to engage care homes by encouraging them to support students and help them become practice learning environments. 

I expected my main challenge would be getting care home staff and managers on board. This hasn’t been the case. They’ve been quick to see the mutual benefits. Existing staff get the chance to develop their skills by implementing the Nursing and Midwifery Council’s standards for supervision and assessment, and we can provide contacts and relevant information to help other staff, including care workers, develop too.

By being open-minded and embracing a placement in a care home we can expand the learning opportunities for many students, while raising the profile of the essential work carried out in care homes and improving the lives of people who need them. 

Sarah Kingdom-Mills is a care home education facilitator at Health Education and Improvement Wales. She takes a stepped approach to creating a practice learning environment within care homes and is currently establishing a national CHEF steering group.
A care home placement is about far more than the fundamentals of nursing

Ready to start your care home journey?

Our interactive online learning resource allows you to follow a resident’s care home journey from pre-admission to end of life, outlining the clinical skills needed and knowledge gained. There are nine sections, demonstrating the role of nursing staff in:

  • pre-admission – assessing the person’s needs and supporting the family
  • admission – helping the transition by creating a sense of home and safety, including practical interventions such as clinical assessments, care planning and medicines management  
  • long-term care provision – ongoing assessment, care planning and risk management with the aim of delivering high-quality person-centred care that makes the person feel comforted and in control
  • short stay – providing respite, rehabilitation or end of life care
  • discharge – coordinating support services, arranging medicines and teaching self-care
  • providing essential care – understanding individual needs, showing compassion and sensitivity so all residents are cared for with dignity 
  • acute admission – acting quickly and in accordance with the resident’s wishes, providing life support to the deteriorating patient where needed
  • other transfer – co-ordinating continuing care with another home
  • end of life care – helping people to live as well as possible until they die, and to die with dignity.

A growing sector

“The complexity and value of nursing roles comes across strongly whenever I speak to nursing staff working in care homes. As Sarah has indicated, there are extensive opportunities for them to use a wide range of skills and provide person-centred care.

“Being in charge of a home requires a broad set of clinically complex skills and there’s only going to  be an increase in demand for these kinds of roles in the future.

It’s time for care home nursing staff to be recognised."

Pam Penman, RCN Wales Independent Sector and Community Adviser

Join our Care Home Network 

  • It provides members with a supportive environment to share best practice, offer solutions and help improve care. It’s for nursing staff who work in homes for the entire age range, across all clinical needs. Join the Care Home Network today.

This article was first published in May 2022.

Words by Sharon Palfrey
Photograph by Stuart Fisher 

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