)
Being a healthcare professional learner is personally demanding, stimulating growth but also creating stress and distress at times.
As well as stressors that impact all university students such as managing finances, relationships, loneliness and homesickness, placement experiences can present challenging situations and issues that learners have never encountered before, or which might trigger memories of difficult previous experiences. Expectations of professionalism can sometimes feel confusing and take time and guidance to understand and develop. Juggling academic deadlines alongside placements and the demands of often complex personal lives can be physically strenuous as well as emotionally draining. These and many other issues may impact on a learner’s personal wellbeing, which can present in a range of ways.
Whether you are another learner, an academic or supervising a learner on placement, being alert to the signs of declining wellbeing in a learner can help to identify and address problems early and enable them to access the support they need.
Look out for the following signs, which may indicate a wellbeing problem:
Changes in behaviour and performance. This might present as disengagement or disinterest, reluctance to perform care or interact with others, an increase in errors, inability to concentrate and retain information, and frequent sickness, absence or arriving late/leaving early.
Emotional indicators of anxiety, distress, low mood or burnout. This might present as tearfulness, conflict with others, frustration, low confidence, self-criticism, detachment, among other ways.
Physical signs, such as persistent fatigue or low energy, changes in appearance (e.g. weight loss, poor hygiene), somatic complaints (e.g. headaches, gastrointestinal issues) or sleep disturbance.
Direct disclosure, such as feeling overwhelmed or anxious, mentioning personal worries (financial, health, bereavement, bullying), accessing harmful social media content, consideration of leaving the course. In extreme situations, a learner may even share ideas or intentions of self-harm or suicide.
Be aware that at risk groups include those who are recently bereaved, who have been abused or who have been personally affected by suicide, asylum seekers and refugees, those who identify as LGBTQ+, and males (UUK, 2018).
What to do:
Do not ignore signs of declining well-being and always take disclosures seriously.
Red flags might include expressions of hopelessness or distress, thoughts of self-harm or risk-taking behaviour, substance misuse, significant deterioration in functioning, or any other concerns about personal safety. If you identify red flags, please follow the ‘crisis reporting for learners on placement’ process. The UEA guidance ‘What to do if you are concerned about a student’s mental wellbeing’ can be accessed from this page and provides further guidance for UEA staff and learners who are worried about the mental wellbeing of a UEA learner, whether they are on placement or not.
If you believe that any of the concerns you have may constitute a safeguarding issue, you must also report it to:
The Safeguarding Lead of the organisation in which the placement is situated
The University, using the process outlined on this page: UEA Safeguarding
If your concerns do not represent a ‘red flag’:
If you do not feel confident approaching the learner yourself, you can report your concern directly using the HSC practice education email address: hsc.practiceeducation@uea.ac.uk. This will direct the concern to the learner’s UEA Advisor.
If you can, find a private space and invite the learner to talk to you about how the placement is going, if there is anything they are finding difficult and what support you can offer them to enhance their placement experience. These non-challenging and non-judgemental questions might help the learner to open up about how they are feeling or any concerns they have. Reassure them that recognising issues affecting their own wellbeing is important and represents positive professional behaviour.
Let them know that you plan to inform the university that they require wellbeing support (agreeing with them the level of disclosure about specific issues) and encourage them to complete a Student Life and Wellbeing self-referral form if they are willing.
Report the wellbeing concerns to the HSC practice education email address hsc.practiceeducation@uea.ac.uk to ensure the Advisor is informed and can support the learner and escalate accordingly. Ask the learner if they would like their UEA Advisor to be informed directly and email them if this is the case and you have their details.
If the learner continues their placement, check in with them regularly and show an interest in their wellbeing and progress.