precepting assignment- need advice

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Hi everyone,

I am in my last semester for my BSN, the class I am in has been weeded down by 50%, those of us precepting at this time did not get any acknowledgement of our 1st, 2nd, or 3rd picks. However given our small class size, most of my peers were placed in critical units. I was set to precept at a magnet status institution, last minute this fell through and as a result I got switched onto a basic medical/surgical floor at our local, rural hospital. One that I did clinical on in my 1st year. This is the lowest level of acuity available in this area and in many ways is not what you think when you hear medsurg floor. I am the only person working this level of my class, yet I'm top of my class.

Beyond how devastated,I am trying to come to terms with it. What I'm wondering is how much will this effect my future career opportunities? I want to work in a critical care unit eventually and am concerned this will come across as a red flag on a résumé if I did a clinical there, then clinical on critical care units, now precepting back to a basic floor that doesn't even have a name... (Please know I am not downing medical surgical floors, as in this case I don't even know what to categorize this floor as....) any advice is much appreciated!

Specializes in ICU/ Surgery/ Nursing Education.

I believe that it wont matter on your resume one bit. I was placed on a med/surg floor watching low acuity patient for my preceptorship and still got hired to the surgical unit in the same facility. Units talk to each other and the surgical unit hired me because of my professionalism, determination, and attitude, not because I showed great skill in a trauma unit.

What I said might have sounded rough but it is the truth. During my interview they never once asked about where I did my clinicals or the preceptorship. It would have been neat to do it in ICU or the ED but in the end I am employed and it worked out. Just get it done, take the NCLEX, and move on.

Specializes in Maternal - Child Health.

I am going to issue a warning that my answer will be perceived by some as overly harsh. It is not my intention to be "mean." It IS intention to open the eyes of any student who believes that s/he may not have the opportunity to benefit and learn from a particular clinical situation. I am a blunt person by nature and not prone to prettying up my comments to appease others, especially those who state that "any advice is much appreciated." If you don't wish to be subjected to a critical response, please scroll on to the next topic involving kitties and puppies.

I gather that you are proud of your academic and clinical achievements to date, and you should be. I also gather that you are disappointed with your new clinical assignment, perhaps because you believe that it has little to offer a student of your caliber, or because you desire something more challenging and prestigious. I urge you to quickly dispense of those notions and alter your mindset to one of gratitude for having a clinical site at all.

Finding clinical placements for basic nursing students is a challenging prospect for a multitude of reasons, not the least of which is that students represent a liability on a clinical unit. Not from the standpoint of clinical malpractice, but from the standpoint of time, space and interference with the smooth functioning of the usual work group of nurses, physicians and ancillary staff. Accepting, planning for, interacting with, supervising, and following up after students is a time consuming and thankless task for managers and nursing staff alike. Please be grateful that you have a place to go, regardless of whether it is your first, third, tenth choice, or the last place on earth you want to be. And be aware that there are staff on the unit for whom a student is the last person on earth they want to spend time with, perhaps because some who have come before you have conveyed an attitude of disappointment with placement at a small rural facility instead of Shiny Big City Magnet Hospital ICU.

Please also be aware, that regardless of degree obtained (diploma, ASN, BSN, MSN, PhD), the licensed nurses on the "I Don't Know What To Call It Med-Surg-like Unit" of Small Rural Hospital are just that: licensed nurses. They have completed their educations, earned their credentials, and go about the business of practicing nursing every day. By virtue of the fact that you do not yet hold a nursing diploma or license, it stands to reason that there is plenty that they can teach you every hour of every day that you will spend there, if you will work hard to learn from them.

In the 28 years since graduating from my nursing program, I have worked in settings ranging from 50 bed ICUs in major metropolitan teaching facilities, to tiny rural hospitals, to small town school nursing. I can assure you that the nurses in every one of those settings had expertise and knowledge not shared by others. Frankly, the school job was the most challenging I ever held, as I was the sole provider of any sort of healthcare for miles around. No other nurses to back me up. No physician to call. No hope of EMS arriving promptly. Please familiarize yourself with these circumstances before you decide that any one setting is more desirable or education-worthy than any other.

Lastly, I no longer work in the nursing field. I now own a business and spend a good bit of my time recruiting, hiring, training and evaluating employees. As both a former nurse manager and a current business owner, I will assure you that your clinical placement in your Senior Preceptorship matters far less to a potential employer than the attitude you convey regarding your educational experiences as a whole. If a future interviewer perceives that you looked down on the people and places that educated you and offered you clinical experiences of any type, s/he will quickly move on to the next candidate.

A new grad is a new grad. You're all the same and not qualified to do anything independently right out of the gate - so you will learn *something* on that unit. Absorb everything you can for all it's worth.

Thank you for your reply. I know that in any setting there is a great deal to be learned for me as a student. I am simply disappointed in the lack of planning that put me in a situation which could have been prevented. I believe that those that work hard should be acknowledged for their efforts vs. those that put in minimal effort, in a "fair" world that would be ideal. That being said I know that isn't always the case. I would never speak so candidly to a potential employer as I have here and know better than to do that. I just came here to speak honestly and get informed about the potential implications this would or would not have on job opportunities. I have approached the situation with positivity and expressed my gratitude in all professional settings and plan to make the best of it.

Honestly, I don't think it will hurt your future career at all. I am a new grad who got straight into the MICU without any previous hospital experience and NO preceptorship in an ICU.

That makes me feel much better! Thank you!

Specializes in public health, women's health, reproductive health.

Others have already answered you and I agree with a lot that has been said. However, I wanted to say that I can understand your disappointment and think it is something many people would feel in the same situation. You seem to have a great attitude despite the situation and I'm sure that attitude will shine through as well as your professionalism. I wish the best for you in your preceptorship.

Specializes in Hospital Education Coordinator.

Do you really think future employees care where you did clincial rotations? They just want to know you have a license.

That said, I believe you have a real opportunity here. The most important thing a nurse can learn is how to do GOOD assessments and when to recognize changes in condition. Ask tons of questions. If you are doing any leadership in this semester, find out about scheduling and productivity and dealing with difficult people/situations. Ask staff what they would change on their unit and why. Some of your answers will be highly biased, but that is still good data for you to analyze. Good luck!

I think you are much better off on a unit with good preceptors who will teach you good assessment skills rather than on an ICU just for the same of it being an ICU. Often students are given less responsibility on a critical care unit by necessity. Moreover, you will have much less of an opportunity to develop good communications skills with patients on a critical care unit, because so many patients are vented or very sick. As many posters have said, you should be grateful for such an appropriate placement. You can learn in any situation as long as you have good preceptors and make an effort to learn.

I did my school practicum/preceptorship in a community health center that provides primary care, & I just took a job in an ICU (with a long orientation). I would be disappointed too though. In response to some other posts: I think you pay A LOT of money for school & are, thus, owed a quality education. I also think you can still get that quality education right where you've been placed if you make the most of it.

Specializes in Critical Care, Education.

One of the most difficult aspects of the transition from student to practicing nurse is time management. It would seem that OP's placement, while not as 'task oriented' as ICU, is an ideal setting to learn how to deal with the rhythms of patient care; learning to plan, delegate, communicate, supervise, adapt and prioritize events as they occur. Critical care is my stomping ground.... believe me, learning the tasks is small potatoes compared to actually stepping in and learning to manage care... and that is the role of the RN.

This unexpected placement could be considered a gift for the OP - one that will add much more career value than a stint in ICU.

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