The Wicked Politics of Clinical Practicum in Nursing School - page 3

Nursing school is not always fair. And, in my honest opinion, the most unfair aspect of the nursing school experience is the clinical practicum portion, also known as 'clinical rotations.' Here is... Read More

  1. Visit  Feistn} profile page
    2
    So what? Guess what, you're going to work for people in the field who don't like you, humiliate you in front of patients, never take your side, and are hypercritical of your work. And those people will be especially difficult when you are starting out and genuinely do NOT know everything. You don't like your clinical instructor critiquing you in front of others, yet you called out her skills in front of others. You have to give what you want to get. And if you recognize that a clinical instructor "has it out for you," did you throw up your hands, sit down and have a little girl fit about things not being "fair," or did you try to figure out what YOUR contribution to the situation was? Were you defensive every time she said something? Did you argue every little point? Did you at least TRY her suggestions? Did you badmouth her to other classmates and faculty, and have it reach that person? Instructors that you don't "gel" with are going to happen. It will also happen in the real world, and then you have to deal with that person a lot longer than 17 weeks. Think of it as practice for that reality.
    GrnTea and elkpark like this.
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  3. Visit  TheCommuter} profile page
    5
    Quote from Feistn
    So what? Guess what, you're going to work for people in the field who don't like you, humiliate you in front of patients, never take your side, and are hypercritical of your work. And those people will be especially difficult when you are starting out and genuinely do NOT know everything. You don't like your clinical instructor critiquing you in front of others, yet you called out her skills in front of others. You have to give what you want to get. And if you recognize that a clinical instructor "has it out for you," did you throw up your hands, sit down and have a little girl fit about things not being "fair," or did you try to figure out what YOUR contribution to the situation was? Were you defensive every time she said something? Did you argue every little point? Did you at least TRY her suggestions? Did you badmouth her to other classmates and faculty, and have it reach that person? Instructors that you don't "gel" with are going to happen. It will also happen in the real world, and then you have to deal with that person a lot longer than 17 weeks. Think of it as practice for that reality.
    To whom are you responding?

    I am the person who originally wrote the article, and the events described (such as calling out skills in front of others) were hypothetical scenarios that didn't happen to me. I'm describing stuff that has happened to other current and former students.

    I'm way past nursing school and have been working in the 'real world' of nursing as a licensed nurse for 7 years, so I certainly know how the real world works. Many students are not knowledgeable about nursing school politics, which is why I wrote the article.
    milfordmom, ampela, vintagemother, and 2 others like this.
  4. Visit  melizerd} profile page
    1
    Quote from SleeepyRN
    Like the Commuter stated, things can and do still happen with rubrics in place. In my case, I was placed on probation for something I didn't do. If you got 2 probations, you were dismissed from the program. I was late to class one day because I was in the process of an orientation to go from patient care tech to ED tech and I had to be at work that day as part of orientation (my hopes were to work my way up the ladder from sitter to PCT to ED tech to ED nurse). After I was put on probation, there was 1 day of class I would have to miss completely for part of this orientation. If something were to happen and I was late or had to miss 1 more day of class after that, I would be put on my 2nd probation which would result in me being dismissed from the program. So I gave up being an ED tech deciding not to risk being late or missing a class. Can you tell I'm bitter? My point is things happen beyond our control, and even if we are hard working, follow the rules type of people, life can be unfair. Instructors have our futures in their hands. I decided not to fight back because by that time, I had such a fear of being kicked out. I had just one more semester to go. Sigh...if that were only the end of my nursing school troubles.
    Addressing the part where you said you would have to be late one day and miss one day: That's not nursing politics, that's attendance. We know going in that unless you or someone you love is dying (almost quite literally) there are no missed days, Period. We know the policy on attendance going in, it is spelled out.
    elkpark likes this.
  5. Visit  SoldierNurse22} profile page
    7
    Quote from itsnowornever
    Correcting anyone in public is bad form and should earn you some scorn. As an adult and person you should know better than to do that. Also, thinking this is the right thing to do, will gain you some well earned hatred once you become a team lead, charge nurse or manager.

    Posting from my phone, ease forgive my fat thumbs!
    That's a nice theoretical stance to hold, but reality isn't quite so simple.

    For example, if you accidentally put the BP cuff on the patient incorrectly or you give them the wrong lunch hours for calling in their meal order, I'll correct you outside in private and let you fix it later.

    However, if you fail to wash your hands between patients, program an infusion rate incorrectly or are about to do something that could cause harm to the patient, I will stop you on the spot.

    I will show you how to do it correctly and then explain myself further outside if need be, but don't think for a second that correcting someone in public is always a bad thing.
    danceyrun, nikkidevries, Halcyonn, and 4 others like this.
  6. Visit  tobjur} profile page
    0
    nice post. well this is a problem everywhere as i see it now. with due respect to all you nurses in big country's, who has the broadest aspect of nursing. i smiled a lot when i read this post and the thread that followed. i remembered a lot of incidents during my phase of life as a nursing student especially the times when we lucky tipped for a clinical procedure and how i always used to pick up the senior staffs.it always worried me sick to do my sign outs with the senior lots for the fear that they might find out the smallest of mistakes and send me out with a 'repeat' which was the worst nightmare during student life. all those memories flashed back...thank you..
  7. Visit  elkpark} profile page
    0
    Quote from SoldierNurse22
    However, if you fail to wash your hands between patients, program an infusion rate incorrectly or are about to do something that could cause harm to the patient, I will stop you on the spot.

    I will show you how to do it correctly and then explain myself further outside if need be, but don't think for a second that correcting someone in public is always a bad thing.
    Again, though, this is something that can (and should) be done without calling the attention of everyone within earshot to the fact that you're doing it.
  8. Visit  SoldierNurse22} profile page
    1
    Quote from elkpark
    Again, though, this is something that can (and should) be done without calling the attention of everyone within earshot to the fact that you're doing it.
    I don't believe I ever indicated that I would try to draw the attention of "everyone within earshot". Not quite sure where you got that impression.

    There is a difference between gentle correction designed to change a behavior/thought process and humiliation.
    milfordmom likes this.
  9. Visit  elkpark} profile page
    0
    Quote from SoldierNurse22
    I don't believe I ever indicated that I would try to draw the attention of "everyone within earshot". Not quite sure where you got that impression.

    There is a difference between gentle correction designed to change a behavior/thought process and humiliation.
    I agree with you, and wasn't suggesting that you implied that -- the OP's article described a student nurse criticizing/correcting the nursing instructor in front of the whole clinical group, in a public setting.
  10. Visit  SoldierNurse22} profile page
    1
    Quote from elkpark
    I agree with you, and wasn't suggesting that you implied that -- the OP's article described a student nurse criticizing/correcting the nursing instructor in front of the whole clinical group, in a public setting.
    Ah, gotcha. Yes, I agree that is in very bad taste and doesn't accomplish much of anything but a headrush for the instructor.
    elkpark likes this.
  11. Visit  ThePrincessBride} profile page
    1
    Very true article. My clinical instructor hated me (and I wasn't mouthy or disrespectful), talked about my performance to other students behind my back and was overall a complete *****. She failed me and made false accusations about my performance, but I have since had two awesome clinical instructors.
    milfordmom likes this.
  12. Visit  GrnTea} profile page
    12
    I don't see anyone here posting from the instructor perspective. I have been a student, too, and remember it vividly, good instructors and not so good ones (my psych instructor had a breakdown halfway through the semester and had to leave... oy). And I have also been a staff nurse, a manager, and an instructor, which students have not. No matter what you think you know about the performance issues of other students, all you know is what the student tells you, loudly and aggrievedly.

    Your student friend is not likely to tell you that the reason she was put on probation by the department, not just by me alone, due to poor clinical performance was because her care plans were late, incredibly poor, completely illegible, and/or missing the required elements of assessment and planning.

    Or that her "med cards" had nothing more than the name of the drug on it, and she wasn't able to tell me why her patient was getting any of them, and couldn't figure out the dose.

    Or that because she was an LPN and knew how to make an occupied bed with both eyes closed, she thought that meant she knew everything there was to patient care.

    Or that, having being incompetent in all these IN ONE WEEK, after missing one or two of them in the previous three weeks, she was put on an improvement plan and committed to making up the missing work, knowing her meds, and knowing her patient's diagnosis next week....and did none of it. Showed up at clinical without having done any of it at all.

    So yes, when you walked past me at the med cart with her and heard me tell her that it was inexcusable that she had not done what she had agreed to do, in writing, in front of me and the program coordinator, then you might not really know what was going on and think I was a terrible person. But when you heard her tell it later, I was the world's biggest soandso because I got mad at her just because she didn't know one medication. And I was mean to her because my best friend was the coordinator (um, not so much), or because we were of different ethnic groups (oh, puhleeze). And the program was prejudiced against her because she came from (some other region of the country). Or some other BS.

    Just sayin'. Sometimes they really are terrible students and they really do deserve to get put on probation and they really do flunk out.

    Would you want us to do otherwise? Is your mother in that bed? Believe me, no matter what it looks like to you or what anecdotal things you hear, people do not go into teaching nursing (which pays a lot less than being a working nurse on a floor) to make life miserable for students. We do it because we care deeply about our profession and want to see how many, if any, of our students will have that spark and catch our passion for it.

    We are also evaluated by our managers, and if we have a larger than average number of failing students we have to account for that. Yes, we discuss students among ourselves, just as you discuss instructors. We work hard to read and critique care plans, journals, papers; we take continuing ed ourselves to help us be better teachers. As I said, we've been students, we know how it is. It's probably not reasonable for you to think about what it's like to be instructors and deal with the groups we see. But it wouldn't hurt to think, just for a moment, that you don't really know much about what you're talking about so cavalierly.
    AmyRN303, ProfRN4, AOx1, and 9 others like this.
  13. Visit  nguyency77} profile page
    1
    Quote from GrnTea

    Just sayin'. Sometimes they really are terrible students and they really do deserve to get put on probation and they really do flunk out.

    Would you want us to do otherwise? Is your mother in that bed? Believe me, no matter what it looks like to you or what anecdotal things you hear, people do not go into teaching nursing (which pays a lot less than being a working nurse on a floor) to make life miserable for students. We do it because we care deeply about our profession and want to see how many, if any, of our students will have that spark and catch our passion for it.
    My clinical instructor said today, "You learn more from your mistakes than from your successes." It's much more helpful to remember what NOT to do...

    I would rather get called out in front of my classmates than make a potentially dangerous mistake. Maybe it's embarrassing, but really?
    Last edit by nguyency77 on Mar 6, '13
    nikkidevries likes this.
  14. Visit  SleeepyRN} profile page
    1
    Quote from blackvans1234
    I have a classmate who thinks our clinical instructor hates her. I personally think this girl has extra thin skin (last semester her clinical instructor said that she might be better off doing physical therapy or something! )
    That's not thin skin. That's an instructor telling a student she isn't cut out for nursing. I had an in instructor who told me she didn't think I would pass nursing school. I passed, and at the top of my class at that. Instructor's subjective opinions needs have no place. Objectively tell us what we've done wrong, and and we will fix it. That is a terrible example of someone having thin skin. The comment was inappropriate
    milfordmom likes this.


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