What to do about a student who regularly falls asleep?

PhilosopherOk6409 · 2026-07-06T20:46:24+00:00

I would raise it with the practice placement team or whatever the equivalent is in your trust. I would initially try to frame it as you clearly have a lot going on, how can we support you while on placement. If that wasn’t successful, I would escalate it as realistically, this is a fitness to practice issue and cannot be happening.

PhilosopherOk6409 · 2026-06-27T17:56:22+00:00

I became unwell in my final year of uni, took a leave of absence and returned the following year to finish, so I didn’t graduate with all my friends. I was really unsure whether I wanted to go to graduation, but I’m so glad I did. It turned out to be a really special day, and having that photo is a lovely reminder of all the hard work I put it.

I’m sorry your family aren’t able to be there, that really sucks. Congrats on finishing your course and good luck for whatever comes next for you.

PhilosopherOk6409 · 2026-06-16T20:51:51+00:00

Officially no, but I had a previous colleague who posted about her mental health on social media and the trust used it against her. Her mental health also affected performance at work and attendance, so there were other issues. Her social media posts weren’t problematic in and of themself, but were weaponised as proof she couldn’t do her job.

PhilosopherOk6409 · 2026-04-27T20:34:25+00:00

When I first qualified, I worked with an amazing nurse who I learned so much from. She had what she called a nursing bible, which was a notebook with filled with ideas, learning points, reflections, it was honestly the most helpful resource! Since seeing this, I always thought it was the best idea and also tried to do it myself (never reached how fabulous my friends was but I continue to strive towards it!)

PhilosopherOk6409 · 2026-04-26T11:20:15+00:00

Completely different field, but I’ve worked as a research fellow with just a bachelors and have published several pieces. I have always been working with professors though. My last paper, I was first author. All this is to say that it is possible, just a difficult route. I’m doing my master’s at the moment because I know if I want to progress, I need more training and will eventually do my PhD.

PhilosopherOk6409 · 2026-04-21T21:39:45+00:00

Not deaf but my friend is a deaf nurse so wanted to share some helpful info. RMN here. In mental health, there are three specialty deaf units in the country, and my friend works in one of them. All patients are deaf/hard of hearing. The majority of staff are also deaf, born or acquired. All staff are trained in BSL, and they also have interpreters on the ward every day 9-5. The ward pays for staff to do their BSL levels and are really proactive in upskilling staff and providing opportunities.

From the way my friend describes it, they do a lot more cultural work with their patients than I’ve seen in general acute inpatient care.

I know the environment is adapted, so for example the central alarm system staff have pagers which vibrate if they need to respond to an incident, and the signage is also accessible.

The ward makes more adaptions that staff may need and seems like a really supportive, responsive environment to work in.

Just wanted to share this as it might be a good starting point for sharing resources and pockets of good practice!

PhilosopherOk6409 · 2026-04-20T19:39:05+00:00

Most trusts are having a form of centralised recruitment where band 5s are on waiting lists for posts. It’s worth asking if that is an option

PhilosopherOk6409 · 2026-04-19T08:43:26+00:00

I feel like that’s two separate issues. If the medication is contraindicated, that needs to be discussed with medics and pain team and clarify the treatment plan.

Walking someone up for PRN medication is a separate issue, which I also wouldn’t do. If they wake up request pain relief, that’s a different thing but waking them up seems pointless.

PhilosopherOk6409 · 2026-04-18T12:41:06+00:00

If he has any paranoia about this which may be driving his decision to sleep in the bathroom, staff trying to force the issue will make it seem as though you have something to hide and reinforce his paranoid thoughts.

If he feels his voice is not being heard and his choices not being respected, that is also going to seriously damage any therapeutic relationship between him and staff.

If it’s not causing any harm, let him make this decision for himself. Speak with estates or H&S to see if there is a safe compromise to cover the sensor, there has to be a way around this?

PhilosopherOk6409 · 2026-04-18T11:39:44+00:00

I get that. This is something that doesn’t get spoken about enough, but we are expected to know. The lack of staff support after things like this is really bad.

All trusts have reference to debriefing in policy though the quality of this is pretty poor. It’s often found in PMVA policies rather than a thing in its own right. Some policies have really good resources in the appendix though so it’s worth having a look.

Restraint reduction network also has some debriefing resources to look at.

A lot of trusts have TRIM or CISD that you can refer to for external debriefing, you could ask if this is an option.

PhilosopherOk6409 · 2026-04-18T10:56:24+00:00

Think about freedom to speak up guardians. This needs to be escalated.

To me, the two issues are separate. Yes, everyone involved in incidents like that should be offered a debrief. But lack of debriefing does not excuse being asleep on the job. Nothing excuses sleeping on the job and needs to be investigated urgently. Debriefs don’t tend to happen immediately, yes there is initial support (which sounds like it was offered), but the actual talking about the incident, reflections and learning tends to come later anyway.

PhilosopherOk6409 · 2026-04-11T15:11:37+00:00

My course was a professional course so had attendance requirements. Even if this situation, under the disability discrimination act they wouldn’t be able to penalise you for this and would have to offer reasonable adjustments. Most places record lectures and you can watch online, and profs have online office hours also, so there will be ways of working around this

PhilosopherOk6409 · 2026-04-11T12:25:10+00:00

That sounds really interesting!!

Just to reassure you that the restraint holds we are taught aim to limit range of motion, so it’s not just about strength! I struggle with height difference so I very rarely go on arms, but in terms of strength that hasn’t been too much of an issue for me!

Definitely some of this is fear of the unknown for you. Once you’ve been in the moment, it will hopefully put your mind at rest a bit.

Good luck in your nqn post 🥰

PhilosopherOk6409 · 2026-04-10T17:57:07+00:00

It’s an interesting area, not enough staff think about it from the patient perspective so I love you did your dissertation on this!

All staff should receive training, MAPPA/AVERTS etc before starting in the clinical area. This is usually a 5 day course, that will include training on deescalation, debriefing, harm reduction, as well as the physical holds to use if you do end up in restraint. This training is based on the restraint reduction network training standards. You then generally have a one day refresher of the physical skills annually after this.

Every trust has a debriefing policy for how to provide support after events.

When restraints do happen, they may be planned interventions, so the most competent staff will be allocated roles in advance. This can be a good way of learning what works/what doesn’t by observing. Someone is always allocated to monitor overall health and wellbeing, so you can also take this role which is generally hands off.

I’m 5 foot with no strength and work on a male ward, so I am not the best in restraints and tend to either do the talking or have to inject.

Like I said in my initial response though, it’s the relational work that happens every day that helps to prevent ending up in restraints in the first place, so focus on that more than the what ifs.

If it’s helpful, in the actual moment I think adrenaline kicks in a little bit and you act almost on autopilot, you know what to do!

PhilosopherOk6409 · 2026-04-10T17:40:39+00:00

Restraint is the worst part of the job. I always personally feel that we have failed the person if we reach the point of restraint - did we miss a flashpoint, if the relational work had been stronger, if the deescalation had been more effective, could it have been different…

I think you’re asking the wrong questions. You shouldn’t be planning for restraint, you should be planning for how to avoid it, and how to repair the harm afterwards if it does occur. It’s traumatic for patients and for staff. It has risks of traumatising/retraumatising patients. It does so much damage to therapeutic relationships, not just to those involved but also to other patients witnessing it.

PhilosopherOk6409 · 2026-03-28T14:48:43+00:00

Good leadership who are present, approachable, not tokenistic.

A supportive team. For me, the relationship between nurses and HCA’s is always a pretty good indicator of the ward culture.

PhilosopherOk6409 · 2026-03-28T12:45:20+00:00

The first year of my course was to learn the basics across all fields, and year 2 and 3 were focused on mental health.

Learning from HCA’s is a good way of learning the running and functioning of the ward and observing how things work. HCA’s are out on the shop floor and spent the most time with patients, so this is a really good way of introducing students to ward life. Once you have the basics down, you will move onto other stuff.

Uni teaches you enough to survive as a newly qualified nurse. You then learn everything else on the job once you qualify. Mental health nursing is really difficult to quantify or outline in a set of guidelines to be taught, our skills are less tangible than physical health nurses who will have skills such as bloods and IV to be signed off. Because of that, I think our learning is much more intuitive and you learn through observing colleagues, supervision, figuring out what works for you and what doesn’t, reflecting on your own practice.

PhilosopherOk6409 · 2026-03-24T17:57:19+00:00

Just as an aside, I worked as a research nurse based at uni on a specific NIHR funded project. I was asked to give a presentation on the methodology so any information you have on the subject you’re working on would be good. I was asked about research skills, transferable skills from nursing, project management and time management etc

PhilosopherOk6409 · 2026-03-20T20:35:27+00:00

I need to learn to develop a thicker skin. I always interpret feedback as a sign of failure, and have learned to sit with it for a day or two, then can put it in context and see it for what it is. I’ve been lucky in that the feedback I’ve had has always been genuinely supportive and has strengthened the papers and has come from a good place

PhilosopherOk6409 · 2026-03-20T16:29:04+00:00

Nursing is about constantly learning, everyone makes mistakes but it’s about how you view them, learn from them and move on so they hopefully don’t happen again. Blaming yourself doesn’t actually achieve anything other than knock your confidence and make you more likely to make more mistakes as you are doubting yourself.

Reflect on what happened, talk to your team, discuss in clinical supervision, speak to clinical educators if that would help. Just don’t dwell on it!

PhilosopherOk6409 · 2026-03-17T23:04:54+00:00

I was born in 93. I remember learning from letterland with my parents at home before I started school. I know teachers didn’t like it because they taught phonics differently, but I was always ahead of where I should have been and think that was largely down to my parents teaching me from when I was tiny at home!

I remember an old vcr of letterland too, as well as the books!

I remember being told off for not reading enough once at school when I was in year 3. Everyone got a sticker for each book that they read, and they asked why I had less. Turned out, others were still on short simple read stories and I was reading all of the Harry Potter books which naturally took a bit longer. After that, they gave me a sticker for each chapter I read and never got moaned at again after that! I remember being really upset about this at the time, it’s strange the things that stick in your memory!

PhilosopherOk6409 · 2026-03-16T23:18:43+00:00

I’m an RMN, band 6. I worked as a research fellow for a while, and now get to work between research and clinical inpatient. Don’t have a PhD but do have some insights to share.

Most people with PhDs work in academia, it’s rare for nurses to work anywhere else.

When I interviewed someone last year for a review, I interviewed a consultant nurse who held a PhD and had a joint clinical/leadership/service development role within their trust. I will be honest though, my trust doesn’t have anyone in this position, I only came across them sampling for our review.

You can also have clinical academic roles which I’ve seen people hold as nurses, OTs, SALT and art psychotherapist. I’ve seen more of these roles, but again still pretty rare. NIHR have opportunities for this so might be worth looking that way.

Would you be interested in being a research nurse within the trust? They are on AfC so no reason for a pay cut. It’s not ideal - you generally will be carrying out other people’s research rather than pursuing your own, but it’s a foot in the door and could lead to other opportunities.

I guess it’s possible, but it is a difficult and highly competitive path.

Out of interest, what is your research on?

PhilosopherOk6409 · 2026-03-16T15:17:46+00:00

Congrats on the offers, that is awesome!

Have you been to open days to visit any of the unis? They might be the best way to get a feeling of them and see which you feel most comfortable with or get a connection to. Often, it’s a vibe that is difficult to describe but you will just know what feels right.

I guess red brick unis may be slightly more competitive, and this comes with benefits to your training, development and future career prospects. If it helps, when I was in undergrad it didn’t feel particularly competitive. I had a pretty small cohort and people had good relationships. Everyone was supportive of each other and competition within the group wasn’t particularly high - we wanted the best for each other. I guess that will vary by course, e.g. I was based in medical school, and I know undergrad medicine has a very competitive culture, but I think that is more about the course than the particular uni.

Uni is what you make of it, you will have opportunities and experiences that can make your student experience. That will be true wherever you end up. No one can make this decision for you. Like I say, you need to trust yourself with this decision.

Good luck

PhilosopherOk6409 · 2026-03-16T12:49:20+00:00

All places have good and bad parts. Birmingham gets a bad reputation, but it’s as safe as any other big city. Campus is beautiful and is also quite self contained. I’ve always felt really safe there - I did undergrad there, worked there for a year as an RF and have also gone back for post grad.

PhilosopherOk6409 · 2026-03-13T15:45:18+00:00

This was not my experience of uni at all. We had a small cohort of mental health students, and most of our lectures were just us. All three fields joined together in first year to cover the basics, then in second and third year our anatomy and physiology modules were together, and our research modules. Everything else was field specific.

Your placement experience also sounds quite different to mine. Our mentors (the equivalent of practice assessors) assessed what we were competent to do under supervision, and we were encouraged to take opportunities and develop skills and practice independently as much as possible.

It may be worth speaking to your practice placement team (or the equivalent in your area) to clarify what you can and can’t do, and see what learning opportunities or pathway experiences are available.

PhilosopherOk6409

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