New to teaching/vent

[UnionRN2]

I decided to dip my toe into teaching and see how I liked it and so I took a clinical teaching position. The students are in their last semester. The lead instructor was adament in her lecture to the students (and me) that she did not want the students bogged down with bathing and making beds, instead they needed more experience with passing meds, assessments, and charting. Since I do not work in the hospital in which I have students, I job shadowed for a few days with the floor nurses to learn the rountines, policies, procedures, routines, etc.

Then classes started:

Day 1: Posted student assignments and focus was passing meds, assessments, and charting. The day went well.

Day 2: Did the same. However, the day went horrible! Three things happened.

1. One nurse made allegations that a student was impaired because she asked questions about the MAR and use of equipment. An immediate investigation by the lead instructor and myself found no impairment; just a student who had never been in the facility and had normal questions. The RN went to the nurse manager who without investigation wanted the student removed from the floor. I explained what the lead instructor and I had found. The NM did not seem happy, and announced she had to go to a meeting and would talk to me later. (She never did.)

2. One nurse turned out to be the type that eats her young. After a huge and very loud argument with the ward clerk she turned rabid on the student. It was late in the afternoon so I stayed with the student, had her report off, and put her in the conference room with some pertinent articles with post tests. And we had a discussion about the types of personalities in nursing and lateral violence.

3. One CNA was angry that the student did not bathe the patients in her group. She made several nasty comments about the student "neglecting" the patients. The RN for that group said the CNA is extremely lazy and tries to get out of her work all the time and to ignore her. I made a point of sitting down with the patient and asking her how her day went. It turns out she had wonderful things to say about the student, but not so nice things about the CNA, including the CNA swearing and and slamming things around in her room. The RN reported several successful learning experiences and showered praise on the student's ability and suggested a bright future. Since the NM was unavailable, I approached the assistant NM and explained this situation. He had a smirk on his face the whole time and it was obvious he didn't care to hear what I was saying.

I have since found out that I am one of a long line of instructors on that floor because of the problems there. The NM prefers to blame problems on the students instead of recognized the staff contributions.

So now I am not looking forward to next week (or the rest of the semester). I know I will never put students with the two nurses again. I question the ability of the first nurse when she couldn't recognize normal student questions and jumped to an extreme conclusion. And I cannot have a nurse performing lateral violence on the students. However, I am not sure I can successfully avoid placing students in the CNA's group.

There appears to be dysfunctional nurses with a nurse manager who has no control over the staff. With limited places for student's to get experiences, I know I have to slap a smile on my face and play nice with these people so the facility is open to future students. It is frustrating to not be able to confront people in an attempt to alleviate the problems.

Any suggestions? Would you have handled things differently?

[UnionRN2]

Thank you everyone for your support!

I like many of the suggestions I have received. I had a date for an initial meeting with the NM prior to clinicals starting, but she stood me up d/t more pressing matters. (I was understanding.) We ended up talking by phone and I verbally outlined the college's expectations from the students. However, I will make an appt to talk to her prior to going back for clinicals next week and discuss the student's goals and ask how we can collaborately meet those goals. I will also prepare something in writing outlining the student's goals and what is expected from the students prior to the next clinical date and hang it in the staff locker room and conference room.

I have already planned a post conference discussion on dealing with difficult people and situations, as well as, lateral violence.

(As far as an orientation goes that already took place and was completely lead by the lead instructor. As this is my first time teaching, I have been taking notes to add or change things for next time.)

Again, thank you for all the suggestions and the support. I literally cried when I came home and thought I was the worst teacher in the world. With your support, my head is back up, shoulders back, and I will carry on. Thank you! Thank you! And Thank You again!

[fiveofpeep]

you sound like you are on the path to becoming an excellent teacher. your responses to the situation seemed right on point. As a new grad, I thank you for being so great because I definitely remember how hard or easy it could be depending on the teacher.

[reginahayes]

That is very discouraging for you and your students. I think you did well. Did you meet with the NM beforehand? That may help in the future. For now keep a diary of what occurs and the NM response to it and then take it to the CNO at the end of term. If you can hold out that long. What did the lead instructor have to say? Was she aware of the enviroment on that unit? Reinforce to your students that most units are not like that. I have been an RN for 26 years and a unit like that is the exception.

[RN-MPH]

You've done great as far as protecting your students and making sure they get professional nursing experience. Actually what's what we call "reality shock" when they transfer directly from theory to clinical, where students learn the ideal things in theory and they get totally shocked when they face the reality on the floors.

If the NM doesn't respond to you, i think you should meet with the nursing director to explain your point and that you want the students to learn from the expertise but the nurses on the floors are creating a barrier for them to progress and get some experience. Maybe they will give some incentives (either monetary or recognition) to the nurses who couple and teach the students while working with them. This might increase their motivation and allows the nurses to get more involved.

Or your director, maybe she can help create some incentives for nurses who teach your students during their assignments on the units like thanks you letters, or award "best resource nurse on the floor" something symbolic.

I know it can be tiring for you but remember you're helping young minds grow, get experience and be great nurses one day!

best of luck

[Batman25]

You are a wonderful teacher. They are out of control because management is out of control. Accusing someone of impairment based on a few questions of a new student is outrageous. If a patient has negative things to say about the CNA I would bring their boss into the room to hear it. The patient shouldn't be on the receiving end of bad behavior because the CNA was too lazy to do their job.

You might want to ask the DON to be present at the meeting. The NM doesn't appear to have the incentive or inclination to care and/or make things work out.

Keep on protecting your students. They are learning a sad but valuable lesson and many might turn out to be great nurses and preceptors due to it.