The Wicked Politics of Clinical Practicum in Nursing School - page 2

by TheCommuter 23,771 Views | 76 Comments Senior Moderator

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 why. The grades that students... Read More


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    My school also has clinical rubrics, and I've rarely heard of a student failing clinical at my school. When students fail a class it's usually the theory classes, which are considered harder than clinical

    The students I have seen who have problems with instructors are habitually late to clinical and don't come prepared. Then they get upset and claim the instructor is out to get them because they showed up 30 minutes late without any of their homework done. I'm not saying there aren't cases where instructors are unfairly targeting a student, because I know it happens. However, I hear too much students claiming an instructor is out to get them when it turns out the student is late every week and doesn't get their work in on time.

    I feel bad for students who have instructors that may be doing a procedure the wrong way... It's hard to bring something like that up to the instructor without feeling like you're going over the line. Luckily, most of our clinical instructors seem very knowledgable and I haven't encountered a problem like that yet.
    texasmum, VickyRN, and elkpark like this.
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    Quote from elkpark
    You make some interesting points and I'm sure there are some "dishonest" clinical instructors out there (although I've never run into any, myself), but I would argue that knowing (or learning) how not to "rub his (sic) instructor the wrong way" is just as useful a skill as anything else one masters in nursing school. Are you suggesting that clinical in nursing school is the only situation one will encounter in one's career in which one will need to adjust to a superior's expectations and values? I've been doing it fordecadesnow, in every job I've ever held. That is just a basic expectation of functioning in any professional/employment setting, IMO.

    Ditto for the "correcting the instructor in public" issue. I don't think one has to be "old-fashioned" to object to a student/subordinate correcting you publicly. Please explain to me who likes that. There are chains of command and appropriate ways to do that sort of thing. Anyone who doesn't understand that that should be addressed privately probably is going to have problems with lots of other aspects of nursing school, and, IMO, shows pretty poor basic judgment and social skills. Frankly, I'm not sure that penalizing a student for exhibiting these kind of behaviors (esp. if it continues over time, despite being counseled about them) is at all out of line or reflects poorly on the instructor or represents "wicked politics" -- indeed, it seems to me that is an example of the instructor doing her/his job.

    I agree. One should have already learned these very basic social skills while growing up. I often like OPs posts, but I found this one to be a no brainer. Better examples could have been used. I had a great dislike for the admin assistant of our nursing program, and she very much didn't like me. WELL, she just happened to be buddy buddy with my clinical instructor. My instructor admitted to me "I thought I was going to have problems with you." and she proceeded to admit to me that when she found out she was going to have me as a student, she TOLD the admin assistant, "Don't worry, she'll be in my clinical group this semester. And she said all of this while our entire clinical group was gathered at a table. So she said it in front of everybody. Now THAT is political BS. Pretty much telling her little snotty friend "I'll get her" before she even knew me. Thank God she was professional enough to eventually form her own opinion of me and pass me.
    nikkidevries likes this.
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    Best 7 songs ever: Wonderful, Don't Get Me Wrong, Whiter Shade Of Pale, Fortress Around Your Heart, Sweet Child O' Mine, First Day, Graceland.
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    Quote from nyteshade
    My nursing school had clinical rubrics, so I respectfully disagree with the purely subjective part. Forgetting to wash your hands or not have the proper supplies resulted in an automatic "F" for the day, and this was made known prior to attending clinical. However, I'm sure sadly that this probably occurs in other schools.
    Even with clinical grading rubrics, an unscrupulous clinical instructor could accuse a student of being unprepared, and therefore, grant a failing grade for that particular clinical day. It is often the instructor's word against the students.
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    Nursing, learn when to step up; learn when to shut up.
    ampela, Rebekah1882, nguyency77, and 2 others like this.
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    Quote from TheCommuter
    Even with clinical grading rubrics, an unscrupulous clinical instructor could accuse a student of being unprepared, and therefore, grant a failing grade for that particular clinical day. It is often the instructor's word against the students.
    So true, and I experienced it. I had an instructor that treated me terribly. Other students saw it and would occasionally comment on it to me, but I wouldn't ask them to go on the record for me for a formal complaint because I'm sure they would say no due to fear of retribution. The clinical component of nursing school has left me somewhat traumatized to the point of anxiety over working. I need therapy to help me move on from what I went through. One thing that happened was I was put on probation because a nurse (a new grad herself) told my instructor that another student and I did something that I DID NOT do. The other student, however, did do it, and admitted it. I know the nurse wasn't lying, she I'm sure just was mistaken. First, the way I was put on probation....my right to having the dean of nursing present (according to our handbook) was not followed. It was the administrative assistant and my instructor present. I've already discussed our mutual dislike for each other (the assistant). The admin assist was incredibly rude to me, standing, her hands on her hips and pointing her finger. My instructor pulled out the paper for me to sign. I said to my instructor, tears in my eyes "I've always been honest and fessed up when Ive made a mistake." Then I gave her an example of when I had done that with her. I said I wasn't going to sign the paper. The dean of nursing just happened, by coincidence to walk in the office at that moment. So she did not get to witness the threatening, bullying manner in which the way the admin assist had treated me. I then told them if it comes down to me signing that paper that says I did this (it was not just a paper for me to sign acknowledging that I was on probation) then I am quitting the program and transferring schools to do LPN to RN. I was adamant. The dean was professional about it. She asked if I would be willing to sign the paper if I got to write on it that I disagreed with the accusations but would be willing to do the 1 basic lab day that went along with the probation. I agreed, signed the paper, was on probation and did the lab day. To top it off, this all occurred immediately before an exam (and they knew I had an exam and thought it was an appropriate time to call me in the office and put me on probation.) I cried throughout the entire exam and couldn't concentrate well. Oh, and furthermore, my instructor for the class I had just taken the exam in, THEN told me to come in her office after class. I did and she told me she was writing me up for being late to class the week before without advance notice. I told her that I DID give her notice and reminded her when I did so. She said I was right, then ripped up the paper and threw it away. What a day that was. Unfortunately it wasn't my only emotionally turmoiled day due to instructors. It is said that if everything is "always someone else's fault", then it is probably you. However, I worked at a hospital as a patient care tech for 3 years and was well valued by all my nurse managers. I never had a problem. Nor did I ever have authority issues when I attended NIU or high school or middle school. I swear to this day, the issues I had in nursing school stemmed from 3 unprofessional faculty members. How am I allowing 3 people from a year ago have such a negative impact on my life today?
    milfordmom likes this.
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    Thanks for the advice. I am a "follow the rules, do what I'm told, and fly under the radar" kind of student.
    ampela likes this.
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    We also have clinical rubrics. Almost all allotted points are part of various specific skills (with their own rubrics), math quizzes, and care plan maps (which also have rubrics for specifics).

    The only time I've heard of a person failing clinical is because they did not meet the math requirement of 80% on math tests which is required even if all other requirements are met.

    It was done that way to avoid the issues you've talked about between instructor and student.
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    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.
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    I love this article. I'm fortunate enough to not have had these instructors in nursing school (or maybe I was just never on their bad side), but some of my classmates had instructors who would for no other reason than to "toughen them up" would make them cry at clinical, in front of staff. Yes, you need a thick skin for nursing in general, but I think that's going a bit far (I'm sure others have had worse). Other instructors, I heard, when giving their student evaluations, would accuse them of incompetence for things that were otherwise understandable ("Wow, you couldn't even get that IV stick right?" or "If I'm talking to you, you listen to me, I don't care who else is around, it could be the patient, and it doesn't matter."), and then without missing a beat say, "Stop crying. You look pathetic."

    Regardless of the field, there are some people who shouldn't be teaching students at all.
    Jillsma and SleeepyRN like this.


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