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.
Sounds nice.... personally I have never in my life met a group of people (RN Instructor's) that want to smash a student's hopes and dreams. Alot of these instructor's act like students are in the military. I do not understand this mentality.

It's not really smashing students' hopes and dreams, it's called 'weeding people out'. It's just the way it is, they do it, because they CAN. It's not necessarily the faculty who 'kills the dreams of students,' the nursing program is already set up that way. The exaggerated 'nursing hype' for years has enabled them to do it. As long as there are plenty of nurse wannabes, nursing schools will continue to do it --- AND nursing students will continue to put up with it. It's like an 'initiation' process I guess. In their eyes, it's like a 'passage to be a nurse?' I don't know, since I've never been faculty. But, in a way, they do it because it produces good results. I understand the reasoning behind what nursing schools do. But, it doesn't mean I like it.

Oh yea, since you mentioned the military.... people only go through 'basic training' for a FEW months, in nursing schools-- it's two years of pure h*ll! Funny huh? Initiation process is a b**ch :rolleyes: And oh, here's the kicker: If you survive all that nursing school stuff, you MAY OR MAY NOT land a job. Even if you do land a job, it most likely won't cover all your bills and the worst part is --- you've just added another $$ loan under your name. I guess one has to like torture to go to nursing school, you might say.

It's true, nursing is a diversified field and I personally like it. It's got the stress just like any other job but I don't know if it's a smart choice anymore.

Tattoos don't make you look "dirty" or unprofessional. Your mannerisms and intelligence in your field radiate professionalism. 90% of the population has a tattoo. If you are going to tell me with all my knowledge and experience in nursing, that I don't qualify as a respectable, professional representation for the field because of my tattoos, I fear the welfare of our clients are in grave danger. Let's not think skin deep.

Thanks for sharing instructor-to-be as new nursing student-to-be(Fall 2010) I want to be prepared for school. If you have any suggestions like any books to read in summer. Please share with us. Thanks

Specializes in Hem/Onc/BMT.

It was very nice to read such heart-felt writing from an instructor's perspective. I only have one gripe about it though -- care plans, but my complaint is not about how much time is deemed sufficient to spend on them.

Care plans were very much emphasized when I went through school to become LVN. But never did I see them serving much purpose as I worked in acute care and long term care facilities. There's this little tab labeled "care plan" in the charts, never getting attention from anyone except by medical records and whoever's auditing the chart and harping on us if incomplete. In other words, they do not have much practical function other than being more paperwork for the sake of paperwork. Whether in a hospital or a nursing home, nurses working in today's condition of health care field simply do not have the time to sit and produce a writing composition. Please teach us relevant skills. Help us be efficient nurses and prepare us for the reality of nursing these days, not the outdated or irrelevant nursing models.

Now, if the purpose of writing care plans is specifically to train us in critical thinking, then please forgive my impudence. However, if we're expected to believe that the plans themselves are actually important in our work, other than being yet another useless paperwork to be completed, I can't help but roll my eyes. I am extremely excited to start RN program this fall, but I dread for the vestigial parts of nursing education that will not see the light of day once we go out in real world.

Specializes in Med/Surg/Tele/Acute Rehab.

Care plans in your work leave a "paper" trail. The purpose of which is to cover the ass of the facility/staff in the event of a lawsuit. They "prove" you addressed problems specific to the care of that particular patient.

Specializes in Med/Surg/Tele/Acute Rehab.

While in school, the primary purpose of care plans is to train you to think using nursing process. And, it works too.

They're not easy to do, but yes they work though. They're a good practice to enhance one's analyzing skills. My problem has always been, coming up with the interventions. They are hard to figure out for LTC residents, since they HAVE been there for years. Care plans have to be realistic.

Specializes in Hem/Onc/BMT.

I just finished reading through an older thread that had a very interesting debate on whether nurses in advanced practice rely too much on medical model than that of nursing. That made me think very hard about nursing philosophy, and why I would not spare a glance at medical school in favor of pursuing nursing career.

And yet, I never cared much for writing care plans. I now realize that's because I continued to think in terms of medical intervention. There were even times when I did not take nursing diagnoses and interventions seriously, which all seemed like nothing more than common sense to me. If I really think about it though, they are exactly why I wanted to become a nurse to do, written out on paper.

In other words, HJS27 and vegas2009, you're right, care plans have their place and train us in line with nursing philosophy.

My complaint still remains though. More often than not, we nurses are so busy putting out fires minute by minute on the floor, and barely having time to finish the required documentations, the care plans end up being just another annoying paperwork to finish and then ignored.

I wished people would get over being so judgmental about tattoos and piercings.

As I understand it, one of the biggest rationales for care plans in nursing school is to teach us the little bags of tricks that we'll be able to use as nurses. Obviously experience will teach us more, but they get the ball rolling. I frickin HATE care plans, and they're a royal pain in my patootie, but I can see their value in school. Whether or not we use a written care plan in practice is another argument altogether. I suppose that depends on where we choose to practice. But the care plan will always be there; it may just be in our heads because by then, it'll be second nature to us. I know I used my own version of a care plan in my job as an UAP, and I even used the same process. I just didn't call it a care plan and it certainly wasn't in writing. Assess the situation through subjective and objective data, come up with a "diagnosis," determine goals that need to be accomplished, what can I do to fix the issue at hand (complete with rationales), and constantly re-evaluate. Yep, that's a care plan, and I did it for years before I knew what a care plan was all about.

Wow, I didn't expect to take such a beating here.. LOL.. All I was trying to do was to tell students that they are not alone, that most of us out there teaching them were in their shoes as well, and that all we're trying to do is give them 10 years worth of education in 12 weeks in most cases.. I suppose I should have typed "if you are given constructive criticism, don't take it personally"... I'm really taken aback that the first 2 folks to comment have found fault. Sorry about that...

Edit: I fixed it as I really meant to say constructive criticism.. As all my students hopefully would say, I am passionate about this profession, probably to a fault. My wife and I both have given a good portion of our adult lives to advancing the profession where we can, and really love what we do!! Thanks for opening my eyes to that one, I re-read it and shuddered!! LOL

Unfortunately, there are many instructors (and nurses in general!) who HAVE forgotten what it is like to be a nursing student...

Specializes in ER, Critical Care, Paramedicine.

Wow, what a great bunch of comments... I enjoyed reading all of them, and did not expect this article to take off like this... Thank you all for the kind words. I am very passionate about nursing and teaching, and agree that an instructor's goal should not (and usually is not, even when perceived that way) to crush students. I am tough on mine on the unit. When they ask a question, I ask it right back to them. They are expected to get into the literature and their patho section rivals a medical student write-up. That is how a nursing student learns.

One of my students and I were talking the other day. Here's what we came up with: If a student if afraid of their instructor, they will never learn. However, being afraid of the patient's illness, disease, or trauma is ok, use that to better your care.