School of Community and Health Sciences
RN/Diploma in Nursing
RN/Degree in Nursing
Negotiated Placement
E
Handbook
Practice Theme (Nursing)
Year 2
Delivery of Professional Care in the
wider Context
Table of Contents
Contents
Introduction
3
Example Letter of Application
4
Negotiated Placement Experience
5-6
Personal Learning Outcomes
7
Learning Contract
8
Negotiated Placement information
9
RCN Overseas Placements for Nursing Students
2
10-16
NEGOTIATED PLACEMENT
During Year 2 you will spend a four-week period on a negotiated placement of your choice
either in the UK or in another country. This placement should provide you with the
opportunity to observe and participate in practice related to your programme. This negotiated
time should be planned and you will be required to submit the attendance sheets found in
your Portfolio of Practice to demonstrate that you have undertaken this learning experience.
You may wish to include in your Portfolio any learning contract/agreement you have with the
professionals supporting you and complete one of your activities from the Portfolio if this is
appropriate.
Should you wish to undertake your negotiated placement locally you will need to
approach the individual organisation directly or negotiate a Trust placement through
the local Practice Education Facilitator/Manager.
You need to pay attention to some guidelines and agreements in seeking/carrying out your
negotiated placement.
If you intend to travel abroad for your placement you are strongly advised to find out
about the visa requirements for the intended country of destination before making
affirmative plans. This is the student’s responsibility, although personal tutors and
module leaders are willing to help where possible.
Confirmation of indemnity insurance provided by your professional body or union (e.g. RCN
and Unison) may be requested. If travelling abroad it may also be necessary to take out
malpractice cover as the RCN and Unison indemnity does not cover some countries. This is
particularly pertinent when undertaking placements in America and more details can be
obtained regarding malpractice insurance from the American Nurses Association:
http://www.nursingworld.org/.
Attached to this handbook are the following:
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Letter of Application (to be given/sent to the receiving organisation)
Negotiated Placement Experience Agreement (to be given/sent to the receiving
organisation)
Honorary Contract (to be completed if required by the receiving organisation)
Personal Learning Outcomes (to be filled by the student in negotiation with the
personal tutor and be sent/given to the supervisor/mentor on placement)
Placement Specific Information Sheet (for you to fill in)
RCN Information Pack for Overseas Placement Including the UKCC Standards
If you require a letter confirming that you are a student at City University (School of
Community & Health Sciences) this can be obtained from the student helpdesk at
West Smithfield. Please allow two working days for the letter to be produced.
3
Letter of Application
City University London
School of Community & Health Sciences
20 Bartholomew Close, London EC1A 7QN
Tel: 020 7040 5780 Fax: 020 7040 5717
Address of Placement
Name and Address of Applicant
Date
Dear
Re: Negotiated Placement
I am a student on a Diploma/Degree Nursing Course leading to a qualification as a
Registered Nurse. As part of my programme, I have a four-week period for which I can
negotiate a placement outside my usual placement areas. This is to provide me with an
opportunity to observe and participate in practice in an area related to my nursing
experience.
I am writing to you to enquire whether it is possible for you to provide me with a placement
for observation purposes.
The dates for the placement are from …………………………… to …………………………….
I acknowledge that all costs incurred with regard to the placement are my responsibility.
I enclose the protocol for negotiated placements, negotiated placements experience
agreement and my personal outcomes.
Yours sincerely,
(Signature)
(Name in Capital Letters)
4
NEGOTIATED PLACEMENT EXPERIENCE AGREEMENT
This agreement provides the students and their receiving organisations with an outline of the
central policies that usually relate to Trusts and organisations. You must present this signed
copy to the receiving organisation. You may, however, be required to sign an agreement /
honorary contract relevant to the organisation that provides you with your placement.
Name of student
…………………………………………………………………………………………
The agreement is effective for the period of the placement dates:
commencing on ……………………………….
completion date .………………………………
Address of placement:
…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………………………………………………………………………
The agreement is for the period of the negotiated placement, and the student requiring the
experience must comply with the following conditions:
1.
During the placement the student will be allocated to named employees who will be
responsible for implementing the Trust’s/organisation’s requirements in respect of the
placement.
2.
During the placement the student will be expected to undertake observation and
participation in practice.
3.
Whilst on placement confidentiality as to the diagnosis and treatment of patients,
individual patient/staff records and details, prices and terms must be maintained and
no information must be divulged or passed on to any unauthorised person(s). Breach
of confidentiality may result in the termination of the placement.
4.
Misconduct or poor performance will result in the termination of the placement, or in
the event of any gross misconduct, a requirement to leave the premises.
5.
The supervisor/mentor or the senior member of the relevant department/organisation
must be notified of any absence, which prevents attendance for the purpose of the
placement.
6.
During the placement students are required to comply with the policies and
procedures and any other rules for contact and administration of work as are
prescribed by the trust/organisation. This mainly includes:
(a)
an obligation under the Health and Safety at Work Act 1974 to provide safe
and healthy working conditions and methods. Such responsibilities should be
set out in the relevant policy whether in this or another country though the
details vary. It is the student’s responsibility to acquaint themselves with the
contents of the policy.
5
(b)
It is the student’s legal obligation to take reasonable care of their health and
safety and of those who may be affected by their acts or omissions at work,
and to co-operate by complying with the safe working practices within the
workplace. It is also the student’s responsibility not to intentionally or
recklessly interfere with, or misuse, anything provided by the
trust/organisation in the interest of the health, safety and welfare of the
employees and other persons on their premises.
(c)
The student must notify the named Trust/organisation employee of any
untoward incident or accident, which occurs whilst on the trust premises. An
accident/incident form must be completed in accordance with the
Trust/organisation/s policy.
(d)
The student must read and adhere to the fire regulations and precautions of
the relevant Trust/organisation in order to practice and promote fire prevention
and know the right action to take in case a fire breaks out.
7.
The Trust/organisations do not normally accept liability for loss or damage to personal
property. The student is expected to provide their own insurance cover against such
risks. The Trust/organisations usually provide cover for public, employer and product
liability claims for their own buildings and equipment.
8.
Students will not accept gifts or hospitality from individuals or organisations with
whom they come into contact during a placement, which might be interpreted as
seeking to exert undue influence to obtain preferential consideration.
9.
Students must comply with the Trust’s/organisation’s policy as regards smoking on
the premises.
10.
All students are expected to observe the Equal Opportunities Policies or similar
policies, which concern discriminatory practice or action or harassment. Students
also have a duty in this country to report any accident to managers.
11.
Failure to comply with the requirements of this agreement may lead to termination of
the placement.
Signature and designation (on behalf of the Trust/organisation)
………………………………………………………………… Date ………………………………..
I have read and understood the conditions of my Negotiated Placement Experience
Agreement and confirm my acceptance of them.
Signature (Student) ……………………………………… Date …………………………………
6
Personal Learning Outcomes
In preparation for the negotiated placement you will agree personal learning outcomes with
your personal tutor. These learning outcomes are specific to your placement taking into
account the area of speciality and must reflect the reasons for seeking the placement.
You may use the space below to record your learning outcomes.
7
CITY UNIVERSITY LONDON
School of Community & Health Sciences
Negotiated Learning Contract
Negotiated Placement: ……………………………………………………………………………
Dates of negotiated placement: …………………………………………………………………
Breakdown of hours during negotiated placement :
Reason for choosing negotiated placement?
What previous experiences are you bringing to your negotiated placement?
How will you achieve your learning outcomes? (list what you would like to do / see during
the placement)
Signature (Student) ……………………………………………….…Date ……………..………
Confirmation that student achieved learning outcomes & hours agreed in learning contract :
Signature (on behalf of Trust/organisation)……………………..………………………………
Designation…………………………………………………………… Date ……………..………
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Negotiated Placement Information
Name of Student ……………………………………………………………………………………….
Email address ………………………………………………………………………………………….
Name of Hospital/Health Centre/Project …………………………………………………………….
Address: ………………………………………………………………………………………………..
……………………………………………………………………………………………………………
Contact Person: ……………………………………………………………………………………….
Telephone No. ………………………………………… Email ……………………………………….
Placement Provider’s Link to University/School of Community & Health Sciences (if
applicable):
Name of Contact Person at City (e.g. Practice Facilitator): ……………………………………...
Telephone No. ………………………………………Email …………………………………………
Special Requirements of Placement area: (e.g. dress code at work; in general) ……………..
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Precautions: (e.g. immunisations; notes on safety) ………………………………………………..
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Student’s Next of Kin
Name: ……………………………………………………………………………………………………
Address: …………………………………………………………………………………………………
……………………………………………………………………………………………………………
Tel No: ………………………………………………………………………………………………….
9
PLEASE RETURN TO THE STUDENT SERVICES TEAM AT WEST SMITHFIELD PRIOR
TO THE COMMENCEMENT OF YOUR NEGOTIATED PLACEMENT
10
ROYAL COLLEGE OF NURSING
OVERSEAS PLACEMENTS FOR NURSING STUDENTS
This information pack has been put together by the RCN International Office, which
acknowledges the kind assistance of the International department of the British Medical
Association (BMA).
If you have any further information or helpful advice for nursing students, which you think,
should be included, the International Office would like to hear from you.
Introduction
This information is intended to help you plan a successful placement by pointing out the
major factors you need to consider and giving some sources of further information and
assistance.
The chance to undertake an placement outside the United Kingdom (UK) as part of a pre- or
post-registration nursing course is one that has become available fairly recently to nursing
students in the UK. The United Kingdom Central council for Nursing, Midwifery and Health
Visiting (UKCC) has now issued standards on overseas placements for the guidance of
institutions and students (Appendix 1).
The majority of nursing students now are aware at the beginning of their course whether they
will have the chance to undertake an overseas placement during the second half of the
course; this leaves plenty of time for the all-important planning to be done.
The ultimate responsibility for the success of an placement is yours. Allow yourself plenty of
time to decide where you want to go, what the expected learning outcomes are and above all
to make the necessary preparations
Planning where to go
A good many factors will influence your choice of destination, including finances, language
ability and the area of health care and nursing that you want to look at.
In theory you could go anywhere in the world, provided you could afford the fare, had a good
command of the language of the country and knew that you could get the experience you
wanted in the destination country of your choice.
As you start to develop ideas about what you want from an placement, try to gather
information about the way in which this particular subject is dealt with in other countries,
which you might want to visit to find out more. For example, there are a much higher
proportion of home births in the Netherlands than the UK, and visiting the country to find out
why this may be so could be a very interesting exercise for a UK student.
A literature search is a logical starting point. The RCN library at RCN headquarters is the
largest in Europe and stocks English-language books and journals from all over the world. A
special trip to the library could be very helpful to our research. Call the library on 020 7872
0840 to check opening times.
Some institutions have been offering nursing students the chance to do overseas placements
for several years and can offer advice, contacts and information gained from students who
have already done overseas placements. Take every possible chance to discuss your plans
with teachers and with students who have already done their placements and to read their
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reports. Medical students also do overseas placements and may have useful advice to pass
on.
Many education institutions and NHS Trusts have international links for various reasons, and
you may be able to use a local link to organise a placement. Your town or region may be
‘twinned’ with a counterpart in another country and you could also use this kind of link. The
local town hall can give you information about local town twinning arrangements.
The International Office has details of national (and specialist) nurses associations in other
countries, which may be able to identify potential hosts for RCN student members to
approach direct to negotiate a placement. The national nurses associations belong like the
RCN to the International Council of Nurses (ICN). Some countries have no national nurses
association.
The RCN International Office also has details of RCN members living and working in other
countries who are prepared to act as contacts for other members going to that country. This
network has been used successfully to arrange professional visits before.
You may decide to go to a particular country because you have family or friends there who
can provide accommodation and help with arrangements for the placement.
Some students wonder whether to go to another developed country or a developing country.
Valuable experience can be gained in either setting, but communication and setting up the
placement may be easier to arrange with a potential host in another developed country.
Students also need to consider the impact of their presence in a poor community; local hosts
are often overwhelmingly hospitable and generous yet the expense of providing food and
lodging for a visitor may be significant for them. It may also be difficult for a visitor from a
developed country to accept some practices; for example, shortage of funds and equipment
may mean that disposable items are reused. You must be aware of and respect cultural
differences.
Language
There are many other English-speaking countries apart from the UK, and many people in
non-English-speaking countries who have a good command of English. The fact remains
that if you want to undertake an placement in a non-English-speaking country, you will need
to have some knowledge of the language. Even if health workers were able to speak English
to you, patients might not. This lack of communication could reduce the value of your
placement experience and therefore affect your learning outcomes.
You may already speak another language or have studied a second language at school. If
you decide to go to a country where that language is spoken, use the months of preparation
to study the language as much as possible in your pare time. Your education institution may
be linked to a language-learning centre; find out whether you can have access to this.
Counting the cost
Costs involved in undertaking an overseas placement include:
 air fare (or surface travel) to the destination country
 cost of your living expenses while there, including food, lodging, pocket money,
emergency funds
 charges for visas and vaccinations
 telephone and postal charges for the communication involved in setting up the placement
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 the attached checklist mentions other items you might need to buy specifically for the
placement.
Your local travel agent and the RCN Travel Club (Tel: 0500 008080) will be able to give you
approximate prices for air/surface fares for the country or countries you are considering
going to. They will also be able to give you an idea of the cost of budget accommodation
and of travel/health insurance. Remember that you can get reductions with an International
Student Card, available through the RCN Association of Nursing Students (ANS).
Major bookshops carry copies of numerous travel guides for those on a budget (Rough
Guides, Lonely Planet Survival Kits) with very useful detailed information on the country,
often updated annually. A quick browse and note-taking session in the shop may be enough
for an initial costing, but purchasing one of these guides to the country you finally settle on is
likely to be a very good investment.
Remember that in many countries it is not the practice to provide staff accommodation.
Hosts may be able to recommend budget price hotel accommodation in the area so
remember to ask if they can help.
Making initial contact
The letter should explain clearly the dates of the proposed placement, what you hope to do
for that period and how the placement fits in with the particular course you are doing. You
could enclose details of your course, the curriculum and the objectives for the placement.
It is confusing to state that you want to ‘work’, as potential hosts may think that you are
applying for paid employment. It could also be helpful to include brief information about
yourself, such as a curriculum vitae (CV) and if possible a copy of a letter of support form
your education institution. Explain that you do not expect payment or to put the host to any
expense on your account.
Presentation is important. Your approach will be easier to understand if it is neatly typed on
white A4 paper; ‘foreign’ handwriting can be difficult to understand. Keep copies of all
correspondence.
When writing to a national nurses association, identify yourself as a member of the RCN and
explain that you approaching the association on the advice of the RCN. When writing direct
to a potential host, you should send the same kind of letter and enclosures and mention how
you came to hear of them.
You should be making these initial approaches several months before you hope to start the
placement. It may take some time to receive replies. You can buy International Reply
Coupons from post offices to enclose with your letter; the respondent can exchange these for
a stamp, which will bring their reply to you by airmail.
It is better to find out the name of a contact person rather than sending a letter ‘To whom it
may concern’, as the latter may be passed from one person to another and never replied to.
Despite the expense of overseas telephone calls, it is well worth telephoning the institution to
get a suitable contact name if you do not already have one, such as the person who is head
of nursing in the institution. In the USA, the title is often Vice President for Nursing.
If you have not received a reply after five or six weeks, write again, enclosing a copy of your
original letter. If there is still no reply, it is worth making a telephone call to find out what has
happened to your request.
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It can also be useful to provide a contact fax (facsimile) number for correspondence and to
find out the fax number of the potential host. You should be able to give the fax number of
your education institution for contact; make sure the administrative staff know that you have
done this and how they can get messages to you at short notice!
Indemnity Insurance
A RCN leaflet explains about indemnity insurance for RCN members, including student
members. Potential hosts in the USA and Canada, where there is a higher level of legal
actions against health professionals, may need to know that you have this kind of insurance
to help them make a decision about whether they feel able to let you enter clinical area sand
have contact with patients. The International Office can supply, at our request, a letter
confirming that you have indemnity insurance as a member.
Funding your placement
Once you have worked out a rough budget for your placement, you may realise that it would
be very difficult for you to save all the necessary money yourself. Unless you have a
generous bank manager, you may need to seek outside financial assistance.
Any person or institution that you approach will want to see that you have thought out
carefully why you want that particular experience, that you have calculated the costs involved
and that you intent to finance as much of the cost as you reasonably can.
It would not be realistic to hope to obtain the total funding needed for the placement from an
outside source. Asking for financial help is a skilled art and a sample letter is attached to give
you an idea of the kind of information to include.
Your educational institution may be able to give you information on potential local assistance,
ranging from funds held by the institution itself, local NHS trusts and local charitable
organisations such as the Rotary Club.
Local RCN branches sometimes have funds (raised by members) available to support
members with various projects and it is worth contracting your local branch to see if they can
help you. They will usually expect you to make a presentation to a branch meeting about
your placement in return for any financial support they have given you.
There are various publications which contain information about possible sources of funding
and which should be available as reference books in your college library or nearest large
public library:
‘Directory of grant-Making Trusts’ published annually by the Charities Aid Foundation
‘The Grant Register’, published by MacMillan Press
‘Charities Digest’, published by the Family Welfare Association
Some students have been successful in obtaining financial assistance for placements from
companies, which produce drugs or medical equipment. Others have approached major UK
companies which also operate in the destination country and which might see financial
assistance in this respect as a good public relations exercise.
Local newspapers or radio stations may be interested in publicising your planned placement
and in contributing financially or at least publicising your need for funding. A group of
students could make the approach together, with the support of their education institution. It
14
is a good idea to explain how you think the experience you gain will help not only you but
also your colleagues and the local community.
Passports, visas
Make sure that your passport will be current for the length of your trip abroad.
You may need to obtain a visa to travel to the country of your choice and your travel agent
will be able to advise you about this. Embassies usually charge a fee for providing visas.
UK citizens do not need visas to visit other EU countries. Some embassies take weeks to
process visa applications and you may need to telephone, write and visit to follow this up.
If you are in the UK on a student visa and are not sure how undertaking an overseas
placement would affect his, contact the RCN Immigration Advisory service on 020 76371828.
Nursing students who state in visa applications that they want to ‘work’ in a health care
setting for a short period are very likely to confuse embassy staff and immigration officials
into thinking that they are looking for paid work in the country. It is much more accurate to
state that you want to spend time in a health care setting in the host country as part of your
course of education in the UK. Misunderstandings can be inconvenient; in many countries
immigration officials have the right to refuse you entry to the country if they believe that you
plan to work illegally and also to fine the airline that brought you there.
It is useful to be able to supply a letter from your host confirming that you will be doing a
placement with them.
Health Care & Insurance
The country you hope to go to may have very different health care facilities and health risks
from the UK and you need to prepare yourself in advance.
The following
publications/services are useful:
The Department of Health (DOH) produces a comprehensive booklet Health Advice for
Travellers (T5, April 1994) available free of charge from post offices and by calling 0800
555777. It contains useful general advice, including vaccinations required for most other
countries, malaria and health insurance advice. It contains an E111 application form for free
or reduced-cost medical treatment elsewhere in Europe.
The Medical Advisory Service for Travellers Abroad (MASTA), validated by the London
school of Hygiene and Tropical Medicine, provides written health briefs for tourists and
travellers. Telephone 0891 224100 or, if passing through more than six countries, 01705
553933.
British Airways runs a chain of travel clinics. Telephone 020 78315333 for details of the one
nearest to you.
Travellers on a budget often think of economising by not taking out health and travel
insurance. This is foolish; unexpected illness or theft causes a great deal of inconvenience
and worry.
Other points
Hosts who welcome you to their countries and workplaces are usually doing this simply to
help you; it is not part of their job description and is usually well beyond the call of duty.
15
Please make sure you repay this kindness by being friendly, flexible. punctual and respecting
the culture of the country and the customs of your hosts. To them, you are an ambassador
for UK nursing and they will remember what you have said and done for a long time.
Find out what kind of dress/uniform you would be expected to wear when in clinical areas
and whether the host will provide this.
Take a camera with you to record your visit. Disposable cameras produce good quality
prints and avoid worries abut looking after expensive fragile equipment. Always ask
permission before taking photographs, especially if patients might appear in the photograph.
Whether you are going to a developed or developing country, it is a good idea to take small
gifts to give to people who are helping you. Take more than you think you will need!
Examples include;
 postcards or brochures about the town/area of the UK where you are a student (tourist
offices can be very helpful with this)
 literature about your education institution
 lightweight gifts such as key rings, bookmarks and tea towels (hospital leagues of friends
sometimes have items like this)
 Writing paper, pens and pencils
 free RCN publications, available from your regional office
In poorer countries it is very difficult for nurses and nursing students to get access to good
quality education materials. Appropriate textbooks would be a special and lasting gift as a
memory of your visit and there is a UK charity, which produces excellent materials especially
for developing countries, including a ‘Village Pack’.
TALC (Teaching Aids at Low Cost)
PO Box 49
St Albans
Herts AL1 4AX
Telephone: 01727 853869 to order a catalogue.
When writing after your return to the UK to thank your hosts, include a copy of your report
and copies of photographs you took during the placement.
Negotiated Placements in the UK
Financial and domestic commitments may make it impossible for some students to undertake
an overseas Negotiated Placement. Remember that elsewhere in the UK can also be a
valuable experience; a nursing student based in a city could learn a great deal form an
placement in a rural area and vice versa.
Sample Letter Requesting Financial Assistance
If possible, your letter and any enclosures should be typed. If you are not able to do this,
write neatly. Try and use A4 size plain white paper, rather than decorated writing paper, or
get permission to use your education institution’s headed paper. Photocopies should be
clear.
Your name, address and contact telephone number/fax number if available.
Address of person/organisation you are writing to.
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Date
Dear Sir/Madam (contact name if you have it)
I am a nursing student at (name of institution) and expect to complete the course and qualify
as a registered nurse (state branch) in (month, year). I have the chance to undertake an
placement overseas as part of my course and I am making arrangements to go to (name of
country) in (month, year). I am writing to ask whether (organisation) would be prepared to
contribute towards my costs.
I have chosen this destination as I am very interested in the subject of (state are of interest)
and some very good work is being done in this field in the place, which I am hoping to visit. I
believe that the experience I will gain from this placement will be relevant to my course. My
college supports my plans (some institutions provide students with a letter on college note
paper confirming this).
I have calculated the expected cost of the placement as follows:
Travel (e.g. student discount fare)
Insurance (travel, health)
Visa
Vaccinations
Accommodation
Living Expenses
TOTAL
My annual income is a bursary of (amount) and I hope to be able to save (amount) toward
the cost of the placement. (If you do part-time work to earn extra money it could be helpful to
mention this too). I would be very grateful for any contribution to my expenses. In return I
will be happy to give you a copy of the report of my placement and to acknowledge your
help.
Thank you for taking the time to consider this request. Please feel free to contact me for any
other information. I look forward to your early reply.
Yours faithfully (if you have no contact name)
Yours sincerely (if you are writing to a named person)
Signature
First and last name in block capitals
encs (if enclosing documents relevant to the placement)
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Overseas Placements for Nursing Students - Planning Checklists and what to take
The list is not exhaustive. You may think of other action/items to take
PLANNING
ACTION/PROGRESS
Country
Potential host
Accommodation
Funding
Passport
Visa - if required
Introductory letter
Initial approach
Letter from host confirming your placement
Appropriate clothes for the weather conditions
Phrase book
Alarm clock
International driving licence (available from the AA or RAC £3.00)
Camera and film - it may be more expensive abroad
Statement of good health, UK police check - necessary for some
countries
Paper for note taking - can be expensive
Air mail paper and envelopes
Torch
Basic necessities like bath plugs, sewing kit or loo paper necessary in some countries, so check
Small items as gifts
Vaccination certificates (if required)
Flight/travel tickets etc
Insurance documents - travel, health, car etc
Travellers cheques and credit cards/local currency
Letter from RCN confirming insurance cover (if required by host)
Medicines you usually take plus paracetamol, plasters etc
Emergency telephone numbers British Consulate in host country,
host country institution
Names, addresses, telephone and fax numbers of contacts
Reminder: Leave contact addresses with relations or friends and your education
institution.
Adapted from Royal College of Nursing
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The Practice Education Facilitators/Managers will endeavour to facilitate you in securing a
negotiated placement however, this will depend on how many other students are placed in
your choice of placement at that time and it may not always be possible to offer you a
placement.
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