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

by TheCommuter Asst. Admin

21,225 Views | 69 Comments

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


  1. 0
    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.
    Why would see people posting from an instructor's point of view? You're in the student section. And there HAVE been people stand on the side of the instructors when it comes to calling instructors out in front of everyone.
  2. 0
    Quote from SoldierNurse22

    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.
    Very different than calling someone out in front of the nurses station after the fact in front of everyone, especially if you are a subordinate. What you are referencing is called an "on the spot correction" the other I simply called being a jerk. (See, I too have "life experience" and most of it is in precarious situations in which I have been both the student and the instructor).

    Posting from my phone, ease forgive my fat thumbs!
  3. 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.
    Because the OP mentioned calling their instructor out at the nurses station after the fact, and mentioned doing it in a haughty fashion which many would consider jerky behavior

    Posting from my phone, ease forgive my fat thumbs!
  4. 2
    Quote from itsnowornever
    Because the OP mentioned calling their instructor out at the nurses station after the fact, and mentioned doing it in a haughty fashion which many would consider jerky behavior

    Posting from my phone, ease forgive my fat thumbs!
    I'm the OP. I hope you're cognizant that I never personally called any nursing instructor out during my time in nursing school, which was many moons ago. The 'calling the instructor out' scenario was simply an example and a hypothetical situation.
    AmyRN303 and SoldierNurse22 like this.
  5. 0
    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..
  6. 0
    Sounds like my school. I had 2 instructors for lab that behaved in a similar way. Glad to hear I'm not the only one. This is a common theme in nursing not just at the school level. Women just being mean to one another, not in every school or job- but it certainly is a big problem.
  7. 0
    Great Article! I have have to agree with it whole heatedly As a nursing student I had to 'tread carefully' the entire semester because of one comment that my instructor made about me to another instructor at orientation. I was called a "know it all", that didn't bode well and I was determined to keep myself from answering too many questions or speaking too much. I knew that doing that was crippling my learning process but I didn't want to flunk out of nursing school after busting my butt to get in. I earned my entry and I was not going to allow instructor bias to hold me back. This instructor told our class upfront that they never give out A's and so a B was as good as it would get. I did well with my patients on the floor and managed to earn my B. It was on the day of our final evaluation, after I signed my grade form indicating my grade, that I spoke up and told them what I had overheard before clinical had even started. They apologized for the unprofessional behavior, and said they hoped it did not interfere with my learning. I felt better after letting them know but a new student not knowing how their instructor may react or respond, it certainly can make learning difficult.
  8. 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.
    Their are also really bad clinical instructors that have no business teaching students when their real motive is to belittle a human being...Just sayin'
    I had 7 clinical instructors for nursing school, 2 of them just wanted to rip you apart. The other 5 were AWESOME!!!
    morte likes this.
  9. 3
    Quote from milfordmom
    Sounds like my school. I had 2 instructors for lab that behaved in a similar way. Glad to hear I'm not the only one. This is a common theme in nursing not just at the school level. Women just being mean to one another, not in every school or job- but it certainly is a big problem.
    My husband works in a small electronic retail store with all guys. I can't believe the stuff he comes home telling me the bickering and gossip that goes on. I know women are often viewed this way, but I was quite surprised, and amused, when my husband started telling me about stuff at his work. I used to joke with him when he got off the phone by saying "was that your jealous girlfriend?" His friend was male, just acted like an extremely jealous gf.
    Hygiene Queen, elkpark, and milfordmom like this.
  10. 0
    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 ;/


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