Advice Needed - Clinical Instructor on New Unit With Eight Students in My Group

  1. This question goes to everyone.

    I am instructing at a new unit, I will have 8 students. I am a very engaged instructor and want the best for my students to learn. When I asked the educator if the nurses are receptive to students and will they have an issue if the students follow them, she said the students are not assigned to an RN, but assigned to a pt. I find this is impossible for me to be able to listen to 8 reports (esp if they are happening at the same time (7am start!!)

    I will be there at 6am choosing pts but besides the students taking vitals in the morning and writing an assessment note, i feel they wont have much to do if they are not following an RN or asking them questions. I can take 2 students under my wing and give out meds, but that is it

    How can I have the RNs be more engaged and have the students follow them without getting the evil eye from the nurses. I DO PLAN to check up on them, but this not being my hospital/unit I want the RNs to help out.

    Last edit by VickyRN on Jan 20, '12
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    About Carrollrn

    Joined: Sep '11; Posts: 59; Likes: 7


  3. by   VickyRN
    Several points of concern I have for you and your situation:

    1) In both nursing programs in which I have been a clinical instructor, I am the one solely responsible for my students on the clinical floor. I have had up to 10 students at a time on a unit, so it is definitely a challenge keeping up with all of them. An assigned patient's primary nurse sometimes will elect to help a student with a patient task when I am very busy, but the staff nurses are never expected to do so. It is simply not in their job description. It is, however, in my job description.

    2) Can you plan to spend a shift or two on the unit orienting, since you are not familiar with this hospital or the unit? It is almost unsafe for you or your students to be on this unit without this period of orientation. You need to get familiar with the policies and procedures, equipment, protocols, etc. It will give you a chance to get to know some of the staff on the unit as well.

    3) I get recommendations for patient assignments for the students in my clinical group from the charge nurse and/or unit case manager the afternoon or evening before my students come to the unit. I thoroughly research each patient assignment the afternoon or evening before our group comes to the unit. I pore through the resident notes, history and physical, nurses notes, respiratory therapy notes, labs, vital signs, I & O, etc., so I feel that I am very familiar with each assigned patient. I then make up my patient assignment grid with information recorded about each patient (diagnosis, code status, allergies, activity level, diet, pertinent lab values, when vital signs are due, special concerns, when medications are due, etc.).

    4) The day of my clinical, I always arrive to the unit at least one hour before my students. During this time, I find each nurse taking care of our assigned patients and get a short report/ update for each of the patients on my list. If a patient has been sent home or transferred to another unit, I will then get another patient assignment. I carefully let the nurses know the names of the students who will be taking care of the assigned patients, how long we will be on the unit, if we are giving medications, what tasks we plan to accomplish while on the unit (such as head-to-toe assessments, taking vital signs, I & O, computer charting, etc), which procedures we are allowed to perform (such as inserting NG tubes, discontinuing IVs, giving subcut or IM injections), and which procedures we are not allowed to do (such as hanging chemotherapy, giving IV push narcotics, or changing the settings on a PCA). I also make sure the charge nurse and unit secretary have a list of the students and assigned patients for the particular clinical day. On the list, it is clearly delineated how long we will be on the unit.

    5) Does your program have a liaison with the clinical agency, who can discuss the obvious differences in perceptions of your role on the clinical floor and who has primary responsibility to educate your nursing students? Obviously, there is a serious miscommunication that needs to be immediately addressed.

    Hope these pointers help. Wishing you the best as you embark upon a new semester on a new unit.
    Last edit by VickyRN on Jan 20, '12
  4. by   Carrollrn
    thank you Vicky!
    I was there today orienting on the floor.
    the NM told me to call in advance to get the pt list from the night before and got the feel of the days flow. the nit is used to students and know what is expected of them which is a relief!!
    you are absolutely right. the students are my responsibility. and the grid dictating the tasks of the day for each pt is a fab idea.
    i will let you know how the clinical goes!!!
  5. by   VickyRN
    Carollrn, the attached clinical work sheet may be of help to you as you gather data on your patients and organize your patient assignments for your clinical group. This is the form I have used for years - my "brains" on the floor. I wouldn't dare be on the clinical floor with a group of students without it.
    Attached Files
  6. by   VickyRN
    You may also find the attached clinical assignment sheet template helpful.

    Please keep us updated as to how it is going for you and your students.

    As always, best wishes to you
    Attached Files
  7. by   Carrollrn
    LOVE IT!!!!
    THANK YOU!! I love the clinical assignment shhet
    I can use that in my file weekly
    and the clinical worksheet to keep track of my students that day!
    ur a lifesaver
    I love it!
  8. by   VickyRN
    Quote from Carrollrn
    LOVE IT!!!!
    THANK YOU!! I love the clinical assignment shhet
    I can use that in my file weekly
    and the clinical worksheet to keep track of my students that day!
    ur a lifesaver
    I love it!
    So glad these are helpful to you, Carollrn
  9. by   Carrollrn
    This semester my clinicals have been running less rocky. We have difficult patients, upset Rns and esp bossy techs who see students as slaves to do their work- even if its not the patient assigned to my students.
    We ended the day today and I am relieved.
    I have a question for you- AND FOR THOSE READING!!
    I want to teach FT in a classroom. I am a PACU trained RN- never worked Med-Surg (however my clinicals were in a Med Surg unit)
    I care for pts post op Ortho surgery with many comorbities and even those who have appliances -trachs-ostomy-foleys etc

    you think I can be hired for a Med Surg Faculty Proff?
    Must I know the info in and OUT- or can I refresh my learning as I go along teaching??
  10. by   VickyRN
    Yes, I definitely think you can be hired as Medical-Surgical Faculty. The main thing TPTB are looking for in faculty is the ability to be flexible and adaptable in many roles and a positive nurturing attitude towards students. If you are that way, then you should be a shoe-in (that is, if the college or university has need of med-surg faculty). Many, many faculty are teaching content in clinical areas in which they do not directly practice. If you are like me (and most I know), you will learn as you go along (often 2 weeks ahead of the students!).
  11. by   Carrollrn
    i will make that jump!!