The Wicked Politics of Clinical Practicum in Nursing School - page 5

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  SleeepyRN profile page
    1
    Quote from SRDAVIS
    Rule of thumb praise in public and reprimand in private. It is NEVER a good idea to correct your instructor, boss or even a co worker in font of others, this situation will always end "sticky". Not just in a clinical situation.
    There has to be safety issues well documented to fail someone in clinical. Good luck with trying to navigate politics but they are everywhere not just in clinicals..
    Not only is it rude, but we have to think about the patient overhearing a correction or reprimand . If I have a patient and am corrected or reprimanded in front of that patient, the patient might lose trust and confidence in my knowledge and skills, creating a barrier for my care for him/her.
    ProfRN4 likes this.
  2. Visit  SummitRN profile page
    2
    Quote from milfordmom
    I've been known to say that what the nursing profession needs is more male nurses to get away from all the cattiness/rudeness that the women give to each other, guess I need to rethink that thought ;/
    Men as a population do differ from women, but men as individuals are prone to human failings including the failings often attributed to female population by posters on this site.

    That said, how about some male nursing professors and clinical scholars? Talk about underepresentation... they seem as common as male nurse midwives! That is to say, I've never seen one in a world where men are approaching 10% of the new RN population.

    If you ask me, males are what nursing academia needs to shift its culture.
    Last edit by SummitRN on Mar 8, '13
    workinmomRN2012 and Sadala like this.
  3. Visit  TheCommuter profile page
    0
    Quote from SummitRN
    How about some male nursing professors and clinical scholars? Talk about underepresentation... they seem as common as male nurse midwives! That is to say, I've never seen one in a world where men are approaching 10% of the new RN population.

    If you ask me, males are what nursing academia needs to shift its culture.
    I had a couple of male nursing instructors while attending an LVN program at a trade school in California 8 years ago. I had no male professors during my time in an RN completion program in Oklahoma.
  4. Visit  elkpark profile page
    0
    Quote from SummitRN
    Men as a population do differ from women, but men as individuals are prone to human failings including the failings often attributed to female population by posters on this site.

    That said, how about some male nursing professors and clinical scholars? Talk about underepresentation... they seem as common as male nurse midwives! That is to say, I've never seen one in a world where men are approaching 10% of the new RN population.

    If you ask me, males are what nursing academia needs to shift its culture.
    There are plenty of male instructors and academics "out there." I had male instructors in my hospital-based diploma school >30 years ago, there were several male faculty in my graduate program, and there were a few male faculty at the last BSN program in which I taught.

    However, I would not be too quick to assume that more males in nursing academia would do anything to improve the "culture" (of course, I'm not one of those who thinks the culture is so dreadful as it is).
  5. Visit  workinmomRN2012 profile page
    0
    As the saying goes, " you are who your with". The men ending being just as mean as the women because it rubs off on them.
  6. Visit  rkstar00 profile page
    0
    Quote from Amnesty
    Why should anybody have to be silent when s/he knows that she's not learning the correct thing? There is a such thing as tactfully bringing it up and phrasing questions in less offensive ways, but I don't think any student should be penalized for gently pointing out that she's learned a different way to do something and asking questions.
    I have to agree, I cannot tell you how frustrating it is to be in one clinical rotation and learn something only to be told in your next clinical rotation that you are doing it completely wrong. I think that a uniform way of grading would be perfect, at least you would know what the expectation was from the get go. There are ways to speak your mind but to be honest, no one wants to be called out (public or private) on what they are doing wrong, especially if they are the teacher. I have had awesome clinical instructors who, if they did do something wrong, they would laugh it off and probably ask someone to show them how they thought is should be done. Then I have had others with such control issues that they spend so much time telling you that you are so inept that you should still be in NUR101, that they could NEVER take any critisism or suggestions.

    I don't know what the answer is but I do know that thankfully we are in a 13 month accelerated program and I will only have to deal with any of it for only 4 more months!! Whoop~whoop!
  7. Visit  blackvans1234 profile page
    0
    I've been catching more and more flak from my clinical instructor
    It's annoying because I don't agree with his opinion (I respect it though). However I keep my mouth shut.

    Example: Everytime I go into a patients room, I break the ice, usually typical introduction,
    then a little later ''do you live around here?" Yes, I live in town X . ME "oh, I live in town Y, right up the road"
    Are you married? ''yes, been married for 38 years" ME "Wow, what's your secret? " , then i'll ask about kids, etc etc.

    I guess my instructor was walking by the room during this and later he told me I was being too ''buddy buddy'' with my patient, I am here to take care of them, not be their buddy.


    The kicker-
    In post confrence we were talking about having theraputic communation with our patients and he (the instructor) said, "It will take longer than one day to develop rapport with your patient"

    Yeah, maybe the way you treat them.
    LOL
  8. Visit  elkpark profile page
    0
    Quote from blackvans1234
    I've been catching more and more flak from my clinical instructor
    It's annoying because I don't agree with his opinion (I respect it though). However I keep my mouth shut.

    Example: Everytime I go into a patients room, I break the ice, usually typical introduction,
    then a little later ''do you live around here?" Yes, I live in town X . ME "oh, I live in town Y, right up the road"
    Are you married? ''yes, been married for 38 years" ME "Wow, what's your secret? " , then i'll ask about kids, etc etc.

    I guess my instructor was walking by the room during this and later he told me I was being too ''buddy buddy'' with my patient, I am here to take care of them, not be their buddy.


    The kicker-
    In post confrence we were talking about having theraputic communation with our patients and he (the instructor) said, "It will take longer than one day to develop rapport with your patient"

    Yeah, maybe the way you treat them.
    LOL

    I'm not criticizing your approach to, as you put it, "breaking the ice" with your clients, but would just point out that that kind of social chit-chat is not the same as what we mean when we talk about developing "rapport" with clients. FWIW (and, again, I'm not criticizing at all, and superficial chit-chat has its place), that kind of superficial chit-chat is considered non-therapeutic in terms of therapeutic communication skills.
    Last edit by elkpark on Mar 12, '13
  9. Visit  blackvans1234 profile page
    0
    I like to view my patient as a whole person, not just a patient with medical problems.

    I don't know how theraputic it would be for me to enter a room, introduce myself, sit down and say ''so how does it make you feel to have a bilateral mastectomy?"
    And then silence.......

    Then i'll tell them ''ill just stay here for a while"
    More silence...........
    "It seems to me like you're a little apprehensive right now, tell me more about that..."


    GET OUT!!!!!!!!!!!!


    What really gets me is the ''its my way or it's wrong"
    Just like the type A vs type B personality nurses, or the quiet nurse, etc.

    I've been working in a hospital for over 2 years, have had people tell me they're scared to die alone, they feel ashamed, etc.

    There's more than one way to skin a cat, I think my instructor jumped to a conclusion too quickly
  10. Visit  sarasievert profile page
    1
    I failed my clinical for LVN and was dropped from school.7 months into the nursing programe. I tackled my clinical teacher for always calling me YOU - I am 57 and she didn't like me. She got me so rattled I made mistakes in clinical one week and was out of the course and at my age - don't feel up to starting all over again
    workinmomRN2012 likes this.
  11. Visit  AOx1 profile page
    2
    Quote from GrnTea
    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.
    All of this! I have been told that I am evil for failing a student who twice tried to perform skills outside the scope of practice despite warnings. A student tried to poison her entire class against me by claiming I am a racist and targeted her (she was caught stealing and dismissed). The vast majority of students are great, but just as there are terrible instructors, there are also terrible, incompetent students. Never once have I heard the dangerous student admit that failure was his/her fault. It is ALWAYS the instructor's fault. I make about half of what I could in full-time practice because I am dedicated to the future of nursing. I can say that I've never seen a student failed out of clinicals that I would want caring for me or my family.

    There are scary, incompetent, and hateful people who are instructors, students, and members of every profession/group under the sun.my experience is that this is a small percentage and not the norm.
    ProfRN4 and elkpark like this.
  12. Visit  SleeepyRN profile page
    0
    Clinical portion was difficult for me. Typically there were 6 to 8 of us students per clinical. I was quiet in school. Most of the students in my small program were part of a clique. It should be noted that most were hispanic. I'm white but I speak Spanish well. I can't count how many times I heard "this white girl this" "this white girl that." That did not help me want to make friends. (Oh the surprised looks on their faces when they saw I understood them when they spoke spanish) I was about a decade older, so they were young. Most very gossipy. I despise gossip. I remember watching students laughing and talking to each other, to then see one of them walk away, and the remaining girls laugh behind her back. Bottom line, I stayed out of it. I remained cordial, smiled at my class mates, laughed when appropriate, Participated in group conversations. But, staying out of gossip made me an out cast.

    During clinical the other students cliqued up while I focused on the work. I still made sure I worked as part of a team. We didn't have to like each other, but I respected them on the job and offered and accepted assistance when needed.

    I recall during one of my clinical reviews, my instructor saying that I did not act as part of the group. I wanted to say, "your point?" But, she herself being young and gossipy even with the students, apparently judged me by this. Not by my clinical skills, judgement, paper assignments, presentations...I don't believe she even noticed how frequently I offered my assistance to both classmates and staff; she had already made her mind up about me. I wasn't trying to be buddy buddy, and that really affected how 2 of my instructors viewed me.

    It wasn't til a year after I graduated that I met up with an old clinical instructor who then admitted to me that when I came to her clinical rotation the other instructors "warned" her about me. She told me that all during clinical, she could not see what those instructors meant AT ALL. This instructor gave me an incredible letter of recommendation and allowed me to take her NRP class for free.

    ***SOME**** instructors have preconceived notions about students, and it meant the world to me that my OB clinical instructor said to me in reference to those other instructors, "screw 'em."
  13. Visit  TheCommuter profile page
    1
    Quote from SleeepyRN
    I recall during one of my clinical reviews, my instructor saying that I did not act as part of the group. I wanted to say, "your point?"
    Something similar happened during my time attending an LVN program back in '04/'05. My clinical instructor would ask, "Why don't you eat lunch with the other girls?" and "Why don't you talk to the other girls more?"

    I didn't tell her that the other 'girls' were too giggly, gossipy and immature for my tastes. I didn't mention that the 'girls' spread horrible rumors and talked behind peoples' backs.

    It's a sad day when one is expected to conform to the lowest common denominator.
    SleeepyRN likes this.


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