VERY close to failing senior clinical

[Sterlink]

I am freaking out. I am in a my 2nd year of a 2 year program and all has gone well up till now. I have passed every course with a B and have always received satisfactory evals for clinicals. I have only 3 weeks left in an 8 week clinical, and I am failing. The instructor had harsh words on my eval. At first she was encouraging saying "you can do this" and "you are a smart man," but all of a sudden she has changed her tone. Her mid clinical eval was so harsh that I think there is nothing I can do to recover. She wrote that I couldn't perform nursing care independently and needed a lot of guidance and direction in all aspects of care. She wrote that I have tunnel vision and can't see a overall plan of care for clients; that I can focus on only one client at a time.

I am ready to drop out. I am at wits end. I am thinking I shouldn't have started this if I am this bad, but I am also mad that I got this far without the school letting me know there may be problems or deficits in my abilities. What should I do???

[meownsmile, BSN, RN]

I would think it is up to the instructor to coach you through your rough spots some. You should get constructive feedback from the instructor as to where and what you need to try to do better, more of, change direction in. It is up to her to help you progress as a nurse and see the big picture.

Not so sure you shouldnt have a meeting with the department head and find out just where you stand and what you can do to help remedy the situation. Maybe a 3 way meeting between you the instructor and the department head.

[HM2VikingRN, RN]

I wouldn't quit. I think everyone hits a crisis point (or 3) in nursing school. (Mine was Peds clinical.) I think sometimes instructors shake students up in order to push them to the next level in either professional behavior or thinking. It sounds like she was trying to help you learn to think about the big picture of cares. I think that asking her for help in meeting her expectations would go a long ways towards opening the communication lines about how to meet her expectations. HTH.

[dream'n, BSN, RN]

Goodness sakes, don't throw in the towel. As you said, all of your other instructors have thought well of you. This instructor is only one person. Do your very best, ask for her feedback and opinions on improvements, then use this as a test for yourself, one that you will overcome. After coming this far, I would fight like heck for myself and my career by working myself to the very bone if needed.

[Sterlink]

Well, I am definately shook up over this...I gotta hit one out of the park this week...she wrote that her basic concern was my lack of preparation...I hadn't adjusted my prep much since freshman year...I was foolishly expecting more handholding, I guess. I get new assignments on Wed afternoon. I need to do excellent prep work; excellent in her eyes, and excellent as a source to keep me on track on Thursday, on the floor.

[Batman24]

Don't quit!! You are almost done and clearly have done well to this point with your grades and clinicals. I liked the idea of a sit down with the instructor and department head to get things on track.

Ask for additional feedback and expectations from your instructor. If there are a few areas that are lacking perhaps you can spend some extra time on them ASAP. Show the effort and initiative to improve. I bet you'll be just fine. Good luck!!

[HM2VikingRN, RN]

Has she given you student prep sheets? I would ask for specific guidance on what she considers to be adequate preparation for clinical. You have a right to know what standard she expects so you can attempt to meet it.

[elprup, BSN, RN]

A similar thing happened with me! My last med surg clinical instructor told me flat out, "You worry me, I would not let you take care of my mother, maybe nursing is not for you". I was soo upset...then mad.

I went to my lecture instructor for the class and spoke with her. Plus I was getting a B in her class! She pulled me through. Supposedly I "Only passed"because my clinical instructor got good feedback from my theory instructor.

Try to talk to someone about the situation. The next higher up person is who I would go to. Take all of your flow sheets/prep sheets and explain what you do, how you do it and why.

Like the others said, unless she can give you specifics - it's a gray area. Don't give up now - prove her wrong, but in a professional way.

best of luck, you are soooo close.

[Becca608]

Don't quit! Find a classmate that is doing well with this clinical instructor and get some feedback from them. Every clinical instructor is different and some are sticklers for certain areas. Example: A good friend of mine was receiving poor feedback on care plans at the beginning of this semester. She found someone else who had already had that clinical instructor and reviewed some of those care plans. The next week, her care plans were rated excellent. I was surprised at her lack of detail myself, but apparently none of the previous three instructors were sticklers whereas all of mine were. Keep the faith!!!

[jjjoy, LPN]

Great, concrete, practical advice JediWitch! Maybe she has a thing for a certain type of nursing diagnosis and you didn't include enough of that type. Maybe she's particular about descriptive charting and your notes were too concise for her taste. See if you can find out what other students are doing that is winning them points with her.

Several others have suggested (and I concur) that you specifically address the instructor's concerns and critiques with the instructor and ask what you can do specifically to improve. Just by doing this, in and of itself, might bring her estimation of you up, because that shows initiative on your part.

Instructors are only human and have their own tunnel vision at times. Sometimes, some little something catches their concern and *boom* it seems like out of nowhere you're now "not safe" or "not prepared enough" or "not seeing the whole picture" or "maybe not cut out for this"... whereas the week before, the month before, the semester before... no major problems. It can happen in the "real world" as well, unfortunately, and if a colleague or nurse manager gets a bee in their bonnet about you & is harranguing you over something that's either a non-issue or a simple learning point, you'll have to deal with it, just like you are with this instructor.

A nurse isn't made overnight and a student isn't unmade overnight... so don't let this one person's limited perspective on your performance and potential unmake you. At some point, you may decide that nursing isn't for you... but it shouldn't be based upon this one experience. If you took a microscope to any student, to any nurse, you could find things to critique and things to improve upon. I disagree with the instructor's approach, but consider it practice in dealing with feedback and evaluating it & clarifying it & moving forward, as opposed to assuming the worst and giving up.

[santhony44, MSN, RN, NP]

Several others have suggested (and I concur) that you specifically address the instructor's concerns and critiques with the instructor and ask what you can do specifically to improve. Just by doing this, in and of itself, might bring her estimation of you up, because that shows initiative on your part.

I agree completely with this advice. Showing that initiative and taking responsibility will make a difference.

I think students also should expect instructors to be tougher, or more particular, or however you want to term it, as you get closer to finishing. It's not unreasonable to have much higher expectations of a senior student in his or her last semester than you'd have of a beginning student.

You wrote that you haven't adjusted your prep much since freshman year; that definitely needs to change, immediately. She wants to see that you have progressed since then.

Don't give up, and don't fall into the trap of believing that she's just picking on you. Use it for an opportunity to learn and progress. Even if you still think she's being too harsh, acknowledge that you have some things to learn and to do here. You may find, down the road, that this experience could be one of the best things that happened to you.

You can do this! Don't give up, don't quit!!

[RNfromMN, BSN, RN]

Something very similar happened to me. I'd been doing fine in my previous clinicals & then I had a clinical where the instructor told me constantly I wasn't going to "be successful" in her clinical, that nursing wasn't for me, etc.

And I kept what she'd been telling me all to myself because this instructor had such a great reputation that I figured it had to be me, I kept trying to go above & beyond each week & it never seemed to be enough - every week, she would still tell me she was going to fail me.

I finally confided in one or two of my classmates & asked them how they were writing up her careplans. That was very helpful - they were willing to go over my careplans with me & told me little tricks they found that seemed to impress this clinical instructor. I don't know about you, but getting help from my classmates was something that was very difficult for me - I didn't get along with most of the students in my program & up until then, had been keeping to myself with my schoolwork. But I had to suck it up & ask for help because my grade was on the line.

I also called the nursing department at my school & found out what would happen to me if I did fail this clinical - just to prepare myself. I found out that this clinical wouldn't be available to me for another year, so I prepared myself to fail, then sit out of the program for a year until I could take this clinical again. It was terrifying, but after being told every week that I was going to fail, I just had to prepare myself for the worst. The head of the nursing department instructed me to give it my all for the remainder of this clinical & reassured me that failing would not be the end of the world. I know it probably seems like it is, but it truly isn't - in the end, it will just be a bump (although a fairly large one) in the road.

Something else - my best friend reassured me every night that if this woman truly wanted to fail me, she would have done it already. You have to keep that in mind - at that last evaluation, your instructor was giving you a chance to let you know he/she was concerned - this is your chance to prove to that instructor what you're made of. Toward the end of my clinical, I was grabbing random charts off the rack & staying up until 4 in the a.m. writing up extra care plans for them, just to impress that instructor. She claimed it didn't make any difference, but I just had to do something to prove that I was willing to go above & beyond - that I deeply valued this clinical grade.

So in a nutshell, here's my advice:

-talk to your classmates about what's going on; see what they're doing to make this instructor happy.

-really give this instructor something to look at - to "wow" him/her; get creative, if you have to: GO ABOVE & BEYOND

-if the instructor had already made up his/her mind that he/she was going to fail you, he/she would have done it already. The instructor obviously still feels you can pull this off - he/she has given you an opportunity to turn things around for him/her - DO IT!:nuke:

-you can't be afraid to fail. You just can't be. I know it sucks, but failing is not the end of the world - if it happens, you just start back from where you left off. I look at it this way (& this is how I feel about failing my NCLEX the 1st time, as well): Okay, so you have to take the clinical again - I have to take my NCLEX again. IT SUCKS, but here's the thing: Maybe you'll pick up just one little thing in your next clinical, or maybe I'll pick up just one little thing in studying again for my NCLEX that will truly make a difference in a patient's life one day. Failing sucks, but it happens & you just have learn from it & go back & do it again.

DON'T GIVE UP - GOOD LUCK! Please keep us posted :)