What do you want and need from your clinical experience?
- 0Oct 18, '08 by LuvCatsRNI would like to have suggestions from the LPN to RN student about clinical experiences at a facility. I am a clinical instructor for an advanced Med/Surg class. All the students have their LPN license, but 2 of 7 have been practicing as LPN's for over 2 years probably in a LTC facility. Five of the group have just passed their board for the LPN but are continuing on to the RN portion. Basically bridging.
The facility that we are going to use is smaller (70-80 beds) and the clinical is on Friday and Saturdays. Part of the problem is that the unit we will be stationed on is Surgical and may not have enough patients in order for each student to have an individual patient assignment on Saturdays. Also the clinical runs for 10 hours. I have proposed and been offered to use the ER, CCU, and OR areas of the hospital. The lead instructor does not want to do this as they state that branching out may be a liability and that students do not feel that they learn from going to other units.
Does the student learn from staying just in one unit and having to double up on occassion? My plans were to incorporate a SWAT position so that each student will also have the opportunity to see what it is like to manage and help their co-workers.
My intent is not to fill in down time with additional paperwork. Does one actually learn from extra paperwork or assignments? My problem is I feel that I have no autonomy with designing the best possible clinical experience for students. One thing that I left out is that the 3 of the 5 clinical groups are going to larger facilities. I want to keep a good relationship with the lead instructor, but want to keep the learning experience at it's very best.
Thank you for responding.
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- 0Oct 19, '08 by ShannonRN2010Personally, as a LPN going back to be a RN, I need to learn the clinical skills that a RN has that I don't. I need to know how to insert a huber needle or access a port, I need to know how to push and hang meds on a central line, I need to know how to hang blood, basically anything that nursing practice in the state says that a RN has to do.
- 0Oct 19, '08 by CapNurse09Quote from Shannon77I agree with the above. I also feel rotation to different areas is needed. We learn skills on med-surg, but not all of us are going to work on med-surg. I think rotating through the different areas (even one or two days) allows one to look at all their options. Since rotating thru Hospice I'm pretty sure I may want to pursue this type of work. I do understand though that my med surg skills will be critical in this area.Personally, as a LPN going back to be a RN, I need to learn the clinical skills that a RN has that I don't. I need to know how to insert a huber needle or access a port, I need to know how to push and hang meds on a central line, I need to know how to hang blood, basically anything that nursing practice in the state says that a RN has to do.
As much as I hate to admit it, we do learn by doing the paperwork. Everyone gripes about doing it and they feel it is a useless waste of time, but there will come a point when we see its benefit.
- 0Oct 19, '08 by LuvCatsRNI agree with obtaining the skills necessary to function as an RN. When I graduated from Nursing school I needed additional skills to work on my unit. Thank goodness for a wonderful preceptor. I along with the other new grads coming from so many different schools lacked all the skills to enter the workforce and be able to function independently. This is normal. The one thing that I would suggest is to work an internship if planning to work in the hospital. Two reasons: 1. your foot is in the door, 2. You gain so many opportunities to practice your skills with an RN.
I think that being able to practice your skills and see how the nurses' critical thinking is from one area to the other is crucial. The focus from one unit to another is very different. Do students double up on a frequent basis and does that hinder the learning process? I fear loss of interest for my students. This is a hospital that sends all cardiac and neuro out. It is not a Level 1 or 2 hospital. To give you an idea of the unit it is a split unit with 1/2 surgical and 1/2 peds.
Thanks again for your feedback. :wink2: It is really helpful being able to gather information and replies to back my decisions.
- 0Oct 19, '08 by CapNurse09"Do students double up on a frequent basis and does that hinder the learning process? I fear loss of interest for my students."
We just came off a LTC rotation and I see this both ways. Some of my fellow students work LTC and did seem somewhat bored. I have been an LPN for many years and never worked LTC and had been out of the hospital for a very long time. The student I was assigned with had been working LTC and I think it was pretty boring for her, but she herself was able to teach me quite a bit. I felt pretty confident having her along side me.
I'm sure I will also see this in the hospital. Part of my class work at the local hospitals and I'm sure they will be able to teach me things along with the instructor. I think in the beginning of rotations especially, buddying up is best ... gives you confidence and you don't feel so lost or unsure of yourself. Especially true of the new LPN grads and persons like myself who have not worked on the floor for a long time.
The internships they have available are great ... these were not around when I first graduated LPN school and went straight to ICU at a small hospital.... I think I'm giving my age away here...LOL
- 0Oct 25, '08 by rotteluvr31I'm an older student in an LPN-ADN program. I completed the LPN portion in May, and I believe many of our clinical experiences mirrored what is available for your students. Our 2 local hospitals are small, one has a split Med/Surg floor, the other has two separate floors, but census can be so low that one floor is closed and all patients are then located into the same unit. There were two groups of clinical students at the hospital last semester when the floor closed due to low census, causing 3rd semester students to buddy up with 2nd semester students. I think it was frustrating for everyone. Other days we needed to buddy up within our own group - less frustrating, but still very limiting as I think we tended to stumble over each other.
I feel that floating to other units is a great idea, sometimes it is the only opportunity students get to see how other departments work. As for gaining practical skills, I truthfully feel most skills are learned after school, either at work or through an internship. I am thankful for my internship on a daily basis as it provides me with all the hands-on opportunities I will never get at school. I believe in our area, many hospitals recognize that new grads have limited skills, which is why they have preceptorships and new grad orientations.
For me - one of the best learning tools on clinical days was the review of pathophys as it related to the patients we saw on the unit. It is so different to read the info in the text and then it is to actually see the pt and understand why we did what we did to make that pt better. My favorite clinical instructor was the one who made us work by presenting our pt and then as a group we went thru the disease process. She really helped us to understand it. My least favorite clinical instructor is the one who sits and eats donuts with the staff, doesn't review our paperwork, and we never discuss what we did and why.
I apologize for the length of this - but I commend you for looking at effective ways to reach and educate your students. I wish I had more instructors like you.
- 0Oct 26, '08 by Perpetual StudentMajor extra assignments are not especially helpful as there are only so many hours per day in which to study, especially when doing clinicals. Small assignments such as researching a unique pt condition or surgery and giving a quick informal presentation to fellow students can be helpful and informative for all without requiring much time beyond what should be researched prior to caring for the patient and writing a care plan, anyway.
I highly recommend rotating your students around to the various units available. Just set clear guidelines for what can be done without your presence and you should have no liability issues. I found that I actually had the BEST learning opportunities in various other units, including the ER, where I actually got to implement the most skills. The nurses in special areas such as the cath lab and PACU seemed more able/willing to lend a few minutes to explain things, probably because they weren't juggling 8 patients at a time. Being in an ER or ICU would offer MUCH better learning opportunities than having two students to each patient (especially when the students are already LPNs). Be sure to have a pager or phone available so that your students can contact you as needed.
Your idea for having a leadership/support type role for a student each day is excellent. I recently did something like that and it was very helpful on several levels: I improved my ability to supervise others; refined my techniques for giving feedback to others; learned some about each of the patients, thereby increasing my knowledge of what to expect in various types of patients; and became better acquainted with the facility.
Thank you for attempting to provide a great learning experience for your students!