Recently I had a third year student nurse ask me how to handle a situation on clinical placement. She had been on an elderly care/rehabilitation ward for 4 weeks & had a good relationship with her clinical mentor/supervisor & the other staff. She felt confident in the ward routine & what her duties were for both providing care for patients & meeting her learning requirements.
During one particularly busy shift the patients she had been assigned along with her mentor required a lot of additional support. One of the patients whose observations were being taken by a healthcare support worker dropped their oxygen saturations. Instead of alerting the student nurse, the healthcare informed another member of staff. The student nurse understood that the patient’s care needed escalating, but was disappointed that she had not been informed as well as she had been assigned care of that patient. During the rest of the shift her mentor then proceeded to work without communicating to the student nurse, which resulted in the student nurse missing an opportunity to observe a new procedure being done on a patient.
The student nurse felt upset after her shift that she had not been involved in the care of the deteriorating patient, & that she had missed a number of important learning opportunities. She was frustrated & hurt that information had not been communicated to her, despite her being responsible for the patients involved. She knew she had to address this with her mentor but was unsure how to approach it.
When a conflict situation arises in clinical placement like this there are a number of steps you can take to handle it more constructively & professionally. Although it can be very challenging & uncomfortable, conflict in practice is inevitable & you will likely encounter it once you are qualified as well. Often students don’t know what to do so they either bottle things up or go straight to their tutor, who just advises them to speak to their mentor. Although this is right, it can be difficult for students who don’t know what to say especially when they have never been in this situation before.
The first step is to give yourself some time to reflect on the whole situation first. It’s natural to feel emotional & you may well be feeling angry, disappointed, ashamed, hurt & upset. It’s helpful to recognise & acknowledge all the emotions you feel & allow yourself time to process them.
When you feel clearer emotionally, write a description of what happened from a very basic, matter of fact, point of view. Imagine you are an outsider just recording the main points of what happened. Then read through it again but put yourself in the shoes of the others who were involved. Try to imagine what they were thinking or feeling, or what might have influenced the things they did or said.
If you find yourself becoming emotional again when doing this, then stop & come back to it once you feel ready. It would be a good idea to continue onto a full reflection of the event as conflict situations in practice actually really help develop your learning & your nursing practice. The Student Nurse Guide Reflective Journal is perfect for keeping all your reflective accounts in one place & has prompts on every page to help guide your writing.
The second step is to plan how you are going to communicate to resolve the conflict situation. It’s important you always try to resolve any conflict in practice, otherwise it can be very damaging to working relationships, & ultimately affect your learning experience. You will also learn to recognise that unfortunately, in some situations no amount of conflict resolution or communication is going to resolve or improve issues. Luckily these situations are rare.
You should inform your mentor first if they are not already aware of the situation & ask for their support & advice on how to handle it. If the conflict is directly with your mentor then a good time to discuss it is face to face after handover before starting your shift together, or when on break together. Always ask to speak to them alone rather than in front of other staff. Explain to them what happened & that you wanted to discuss it to understand their point of view & give you an opportunity to explain how you feel.
Although it is a natural response, try not to get defensive or explain why you did certain things. Instead just listen to what the other person says objectively & take it on board to reflect on later. Even if it is criticism there may be something you can use to strengthen your skills in future. Remember not to take anything said to heart or be too critical of yourself. You are a student & learning all the time & can’t be expected to know everything. Always try to remain calm even if the other person becomes emotional, its important you remain professional in case the situation needs to be escalated.
The final step is to agree how you can move on from the conflict even if you disagree with each other’s point of view. Hopefully an informal discussion is enough to resolve the situation & move on. But if you feel it hasn’t then it’s important you seek further help from either a more senior member of staff or your personal tutor.
Going back to the third year student nurse, she went to her mentor the next day & asked to discuss what had happened. She explained she wanted to learn more & understand everything so she would know what to do in future. She also calmly explained that she was disappointed that she missed some valuable learning opportunities due to the lack of communication.
She asked that in future she could be more involved in the decision making process, as this will help her indefinitely once she is qualified & responsible for her own patients. Her mentor apologised for not communicating & involving her in the patient’s care. She then took the time to go through the management of the patient that had deteriorated the day before, so the student nurse learnt more about the assessment process & all the interventions carried out. Although the student nurse was extremely anxious about discussing the issue with her mentor, she was glad she did as she learnt a lot & it helped boost her self-confidence.