Dear Nursing Student

I am your soon-to-be instructor. Here are my golden rules to my students. Take what you like. Discard the rest. But understand why each is important. Apply them and perhaps you will make the most of our 12 short weeks together. Nurses Announcements Archive Article

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Dear clinical student,

I am your soon-to-be instructor. Know that I love this profession and have dedicated my life to it and to my patients. I consider this profession to be a calling. I did not come to this profession for money, for prestige, or for the title. I came to it for the love of caring for people at their worse. Along the way I discovered that I love to teach the next generation this love as well, while at the same time instilling in you all the importance of taking this seriously, understanding that people live or die by your decision.

Nursing today is about much more than turning a patient and washing them (although I seriously doubt it was ever about only this, despite what the movies would have you think). Nursing is about understanding the medical and nursing diagnosis, medication recognition and administration, symptom management, pathophysiology, procedures, and most importantly how the nursing process fits into all of this. Is it a daunting task for us to teach all of this to you in 12 weeks, yet somehow we are expected too.

I ask for your help in all of this. Some things are basic. Show up on time. Come in uniform. Make sure it is washed and pressed. Look your best. Remove your piercings and cover your tattoo's. Wash your hands before and after entering a patient's room. Imagine your grandmother in the hospital and the nurse comes in with a nose ring or a tattoo. Or doesn't wash their hands. Or is unclean. Would you want that person caring for your family? Furthermore, come awake, with passion and motivation to learn. I, like you, have a personal life. However, once we come through those doors to the unit, all of that has to be put aside and we must give all we have to caring for our patients. If we don't, who will?

Furthermore, we challenge you mentally not to show you how much we know, but to stress how much you need to know. It is not enough to report a vital sign. You must be able to tell me the normal ranges, which ones are abnormal, and most importantly why. If you cannot, what good does that do your patient? It is not enough to know that a lab value is abnormal. If you cannot tell me why your post-op patient has a low hemoglobin, what good does that do your patient?

It is certainly not enough to tell me the patient has a history of diabetes. You must tell me why it is so vitally important to understand the pathophysiology of hyperglycemia (high blood sugar) and how it affects the healing process, how it affects the ability of the body to fight infection, and the most accurate way to treat it. If you cannot, your patient will suffer.

To prepare for clinical is not easy. I emphasize that it takes a long time to write a care plan, and that you think it may not be as important as studying for that exam coming up. I understand that each instructor grades your papers differently, and that it feels unfair that you must change and conform to what each instructor wants. However, what you don't understand is that nursing is an ever-changing profession. Each patient is unique, and your ability to care for them needs to change for each patient you see. Some will love you, some will loathe you. It is not personal; they are patients who need different things, much like we are as your instructors. You ability to adapt to out of control situations and dangerous scenarios will define you and your career, not your ability to complain about the amount of work you have.

Golden Rules For Students

Take what you like. Discard the rest. But understand why each is important. Apply them and perhaps you will make the most of our 12 short weeks together.

  1. Come prepared and ready to work.
  2. Your hygiene and appearance means everything to your patients.
  3. If you haven't spent 8 hours on your care plan it is likely incomplete. Coordinate the care plan. Link the pathophysiology, labs, and nursing diagnosis. Show us you understand how they are all related. If you don't know, say it. but give an educated guess that shows us you are trying. I give just as much value to trying as I do to getting it correct.
  4. If you know your patient has a foley catheter, nasogastric tube, chest tube, etc... look up and prepare for how to care for those. Print out the care from the book. Include it on your care plan. make an effort. Saying I don't know to an instructor tells us you didn't care enough to look it up.
  5. Know the 5 rights of medication administration in and out. Be ready to tell them to me during med pass. know your medications. Write down the important information and be ready to discuss it at the pyxis, in the room, in the nursing station.
  6. It is never personal. remember that your patients are there to get better, not provide you with an opportunity to learn. That is a gift that can quickly be taken away by your attitude.
  7. Watch what you say in the hallway and the volume of your voice. sound carries. your patient does not care about your lunch, your day, how mean your instructor is.
  8. If your instructor provides constructive criticism to you, do not take it personal. listen to what they are saying and improve. show them you can internalize criticism and get better.
  9. Love your profession. if you are in it for anything except caring for patients, leave now. If you are in it for the money, leave even faster.
  10. Love nursing. every day. take every opportunity to improve your practice and the profession. This is your shot to make a difference in a world where for many it is difficult to even go to work each day. don't sell yourself short, you are about to enter the most rewarding profession there is.
  11. Smile, the hardest part was getting in.

8 hours? I guess I beat that. I took 5 hours at the hospital to get all the patient data that I needed, such as H&P, pathophysiology, labs and dx, and medications. And then it took 3 1/2 hours to fill out the purpose of the patient's medications, cluster all abnormals, and finally come up with a nursing diagnosis and 5 interventions. Oh, and I went to the hospital well before everyone else did because I was unsure of whether I had to write down an inhaler drug that my patient was getting. All in all, got 4 hours of sleep. Somehow I didn't fall asleep throughout the day.

Specializes in ER, Critical Care, Paramedicine.

I thought 8 hours was conservative, but when someone said it was way too long I had to really go back and ask my students about it.. There is so much to learn and so little time to do it in, I can imagine it taking 12 plus hours easy..

Thanks for the comments... It's my first try at writing an article and I hope it was well taken... I took out the "yell" comment as it was a figure of speech... What it says now is what I think is the way it is, criticism is good, but belittling someone is just wrong!! 1100 plus views, I'm still hoping for more comments!!!

Eight hours for a care plan? I wish! I think the least amount of time I've spent on a care plan yet is about 14 hours (I'm in my 2nd semester in an ASN program). In addition to pathophys (on 3 different medical diagnoses, including s/sx, tests, medical tx and nursing tx for each one), lab results (with interpretation), and outcomes & interventions for 3 priority nursing diagnoses, our careplans include a complete rundown of Gordon's functional health patterns (with separate columns for objective and subjective info) for that patient along with any and all nursing diagnoses that may apply (this section alone usually runs about 8-10 pages), a page on discharge planning, complete info on all meds the patient is taking, and a page listing and explaining ALL treatments the patient receives. My careplans usually average about 25 pages (and get A's :D), but one of my classmates did one that was 50 pages long :eek:. Fortunately, we only have to do 2 careplans for the entire clinical and usually have a week to work on each one. I won't go so far as to say that I LIKE careplans, but I do understand why we have to do them -- all of that in-depth info really helps me understand what's going on with my patient, how to prioritize my care and just why I'm doing what I do -- all that 'critical thinking' stuff my instructors love to talk about. :nurse: Nursing school isn't easy, but for the sake of all of our future patients, I'm glad it's not!

Specializes in Education and oncology.

Greetings- especially to "A New Start"! Wow!

I am humbled but still asking my students to be respectful. I do have huge expectations of my students- but I have grace. They must complete a care plan (concept map) but ask me for direction- of course. I love teaching and know that when my students are stressed- they don't learn. I try to challenge and not stress my kids. (Er, my adult learners.) Bottom line- they will be responsible and mature.

I do hear what you guys are saying when you talk about having a good care plan. It. shows ME AND my instructor if I'm just guessing. I don't want anyone guessing on me or one of mine.

I Love what one of my instructors says about nursing plans. "You can stop writing them when you don't need them."

Personally, I love research and problem solving. I know! It's weird. Students aren't supposed to like that kind of stuff. But then I like healing and mercy and other corny stuff like that too.

For you instructors out there-- One of you took me into confidence a while back and discussed a job opportunity with me. You said, "I don't know if I'm making a difference doing this. The students give me those blank stares when I lecture. It doesn't seem like they care!" I didn't give you advice because I've quit that for the most part. But I wanted to scream this! Hear me now!

Don't give up on us. We need you. We need you whether we know it, look like it, or act like it.

I've enjoyed watching the other "kids" as we've struggled through your tough assignments. I've watched them grow in their commitment and care. I was your top student. Some of them are passing me now. They look over to see how I'm reacting. They study me and call me a weird old man when I do more than you ask of me. Please don't quit. I remember and still use great lessons taught to me 35 years ago! They will too. There's nothing wrong with them that a little time won't cure.

Thank you. I know you can make a lot more money doing your old specialty. But don't quit on us little knot heads. Please.

A New Start

Thank you for your letter Marty! I am currently a nursing student in my second semester and I thoroughly enjoy coming on this website and reading about different things. As far as care plans go, at my college we research our patients for about an hour or so on Monday evenings. Then we have clinical Tuesdays & Wednesdays. Our reports, which consist of full pt. history including x-rays and and diagnostic testing, full assessment of patient, list of 10 prioritized nursing diagnosis', all meds researched and written, all abnormal labs defined and related to pt., one nursing diagnosis written out in full care plan form and I am sure a few others I am forgetting, are due on Thursday at noon. All of this also includes researching topics that you have not yet encountered and understanding them so that you are prepared at pre-conference at 6:45am on Tuesday morning after you researched 24 meds until 2am! Tell your students 7 days to hand in their reports is a gift ;) Thank all of you for your posts and keep them coming!!!

What an excellent post! I must say, as an incoming nursing student, this has certainly opened my eyes to what may be expected. I will certainly print this "letter" and pin it to my wall! Thank you for your honesty.

Specializes in ER, Critical Care, Paramedicine.

The best part of teaching for me is that you folks just coming in are so excited about learning this amazing craft and it really is infective... Everytime I get a bit down about my day, week, month, etc I just watch my students in action... Drawing the first IV medication, flushing that first central line, and it brings me back to my first day and keeps me going!!!

I'm also enjoying coming on here and reading the posts from all the nursing students and instructors... This is a difficult profession to make your mark in, and to see folks actually taking the time to comment really makes my night!!! Thanks for doing all you do to keep me doing all I do!!!

Specializes in Med/Surg, Academics.
marty6001 said:
remove your piercings and cover your tattoo's....imagine your grandmother in the hospital and the nurse comes in with a nose ring or a tattoo. .... would you want that person caring for your family?

liked the letter, and I laughed at this part (not in a bad way). ?

there will come a day when all the patients are tattooed and have the tell-tale pinprick scars of youthful piercings. just you wait and see....

I just want to say that this is a great letter to students. You sound like the kind of instructor I would love to have. And as for the care plan taking 8 hours... right now in my clinical rotation we have 2 patients, we do research on Monday's as long as the patients are there and we can do it... so far I have only been able to research for one patient on Monday's and the other is left for Tuesday and Wednesday while we are caring for our patients. Then we have to do the pathophysiology, analyze labs, medication research, 4-6 nursing diagnoses with 5 interventions for each and this is all due by Wednesday at the end of clinical. Then we have a journal that is usually between 4-6 pages due Sunday night. I don't got to bed till after 1-2:00 am Monday's and Tuesdays and up by 5 Tuesdays and Wednesdays. If I had a week to hand this stuff in I would be in heaven. Thanks for the inspiration!

I enjoyed you post greatly, It has touched my past and will impact my future. I am a recent graduate of methodist college of nursing, with your permission i would like to forward this to all my past intstuctors. I think it would be a nice addition to any sylabus at any nursing school. I have had wonderful instructors: and in your writing i can tell that you are a wonderful nurse and instructor, my regret is that i didn't get to take one of your classes or clinicals.

Laurance - RN/BSN

Specializes in ER, Critical Care, Paramedicine.

I'm sure Laurance that there are lots of dedicated nursing faculty and professors who have written much more touching and thoughtful stories than mine.. I put this on here for everyone to have, flame, like, hate, print, burn, etc :)... I'm just suprised that folks actually enjoyed reading it, makes me want to write a few more ?