Any Suggestions for a 1st time Clinical Instructor??? - page 2

I am interviewing for a temporary position as a Clinical Instructor. It will be 4 weekends spread out with two in Feb, one in March, and the last in April. I have not taught formerly at a college or... Read More

  1. by   zambezi
    As a staff RN that precepts students/new grads and not being too far out of school myself, one thing that I have consistently heard is that they wish that their clinical instructor is more in tune with current practice/working the floor unit...not to say that one person should have to know all the ins/outs of each floor/specialty but I have seen/heard of those that have been teaching for so long (and are good teachers) that they forget some of the stuff that comes up while working on the floor/unit. My suggestion would be to keep your practice current by working at least one shift every couple of weeks or so if possible (I know, easier said than done...), just to keep in the loop...
  2. by   zambezi
    Quote from aellyssa
    hi,
    the suggestions here are great and very much with what i have done over the last 20 odd years. i would add:
    1. praise in public, scold in private.
    2. have an interruption phrase. i have always told my students that if i was supervising them doing a skill and i said to them i'll take over now, they were to step back and let me. this meant that they were compromising patient care in some way. when i had finished, i would take them aside somewhere private and discuss it with them.
    3. document everything
    4. have the students keep a small address book with them, when they find a med about which they have limited or no knowledge, they can put that in the book, look it up & add it in the book. that way they can keep an up to date knowledge base.
    5. get the students to do a daily planner - so it helps with their time management - use it with them.
    6. if you have a "weak student", try and get them allocated the same patient(s) on consecutive shifts, it allows you to assess them more easily and it helps (hopefully) boosts their confidence & competence
    7. tell the students that you will always go into to bat for them. but that also means being scrupulously honest in any situation that arises.
    8. have fun with your students as well as being their teacher. learning can be difficult but it should always be fun as well.
    9. always remember the students' vulnerability. they will watch every nuance of your behaviour, and will read into it their own interpretation - often to their own detriment.
    10. always tell the students if you don't know the answer but that you will investigate it to find out. you aren't the font of all knowledge and making up an answer to save face doesn't facilitate good learning. be a good role model.
    11. always tell your students that there is no such thing as a stupid question.
    12. finally, put people up not down.

    being a clinical teacher is the most frustrating and rewarding position in nursing education. i love it.

    aellyssa
    i think that these are fantastic suggestions...
  3. by   rainbow
    One thing that I found extremely helpful during clinicals was during the last weeks we took turns being in "charge". This meant that we had to review the charts of the patients that the students had and coordinate all the preps, procedures, labs, appts. etc. This was extremely challenging trying to keep track of all the things going on and to make sure that they were carried out. It gave me a sense of all the things a "charge" is responsible for and expected to do. It also meant learning some tactful ways to encourage your fellow students to do what needed to be done. Of course, the clinical instructor was the person I reported to and let know how things were going, but it still was a very educational experience for a student. Good luck to all the instructors out there, you have a difficult job at times, but it can also be very rewarding I'm sure.
  4. by   ProfRN4
    Quote from aellyssa
    hi,
    the suggestions here are great and very much with what i have done over the last 20 odd years. i would add:
    1. praise in public, scold in private.
    2. have an interruption phrase. i have always told my students that if i was supervising them doing a skill and i said to them i'll take over now, they were to step back and let me. this meant that they were compromising patient care in some way. when i had finished, i would take them aside somewhere private and discuss it with them.
    3. document everything
    4. have the students keep a small address book with them, when they find a med about which they have limited or no knowledge, they can put that in the book, look it up & add it in the book. that way they can keep an up to date knowledge base.
    5. get the students to do a daily planner - so it helps with their time management - use it with them.
    6. if you have a "weak student", try and get them allocated the same patient(s) on consecutive shifts, it allows you to assess them more easily and it helps (hopefully) boosts their confidence & competence
    7. tell the students that you will always go into to bat for them. but that also means being scrupulously honest in any situation that arises.
    8. have fun with your students as well as being their teacher. learning can be difficult but it should always be fun as well.
    9. always remember the students' vulnerability. they will watch every nuance of your behaviour, and will read into it their own interpretation - often to their own detriment.
    10. always tell the students if you don't know the answer but that you will investigate it to find out. you aren't the font of all knowledge and making up an answer to save face doesn't facilitate good learning. be a good role model.
    11. always tell your students that there is no such thing as a stupid question.
    12. finally, put people up not down.
    excellent tips. having just completed my 3rd day as an instructor (with a preceptor), i can see how every one of these are true.

    now, my question to you (or anyone) is this: i am truly amazed at how slow students do things. i am dealing with 2nd semester freshmen (adn). i know, they know very little at this point, and are still very nervous. but how on earth do i motivate them to move a little faster? i only had half the group, and i feel like it took me forever to get meds done. i don't want to rush them, but i feel the transition from one patient to a whole district (when they graduate in a year) will be almost impossible.
  5. by   ProfRN4
    Quote from rainbow
    one thing that i found extremely helpful during clinicals was during the last weeks we took turns being in "charge". this meant that we had to review the charts of the patients that the students had and coordinate all the preps, procedures, labs, appts. etc. this was extremely challenging trying to keep track of all the things going on and to make sure that they were carried out. it gave me a sense of all the things a "charge" is responsible for and expected to do. it also meant learning some tactful ways to encourage your fellow students to do what needed to be done. of course, the clinical instructor was the person i reported to and let know how things were going, but it still was a very educational experience for a student.
    our program has that, with a senior student coming to the freshman class as a resource. it seems to work pretty well. the senior acts sort of as charge- fields questions, assists students with transfers, specimen collection, finding things (which can take up a lot of time). she informs the student if a new order was written. i think it gives the charge student a good idea of what they are in for as a staff nurse (managing 8-10 pts), without actually taking them all.
  6. by   mattsmom81
    Just want to wish you much luck and success in your new endeavor.
  7. by   crb613
    Quote from bonemarrowrn
    excellent tips. having just completed my 3rd day as an instructor (with a preceptor), i can see how every one of these are true.

    now, my question to you (or anyone) is this: i am truly amazed at how slow students do things. i am dealing with 2nd semester freshmen (adn). i know, they know very little at this point, and are still very nervous. but how on earth do i motivate them to move a little faster? i only had half the group, and i feel like it took me forever to get meds done. i don't want to rush them, but i feel the transition from one patient to a whole district (when they graduate in a year) will be almost impossible.
    think back to when you were a student. how slow were you?? were you nervous about making a med error? how many times had you passed meds, charted, & how familiar were you with all the diff. meds? did you know how to read a mar? could you spout off the s/e & know off the top of your head what to watch for? why you were giving the med in the first place & the action you wanted? what nursing action to take if something did go wrong & making sure you had the right pt, right dose, right route, right time, right form, right documentation. also double/triple checking that the calculations were done correctly. i am a student & all this stuff goes through my head when i pass meds & alot more. i am sure with time & practice i will be faster & alot of this will be second nature but for now i am learning, i want to do it safely & i want to learn how to do it right, then i will work on speed. let me learn to walk in tennis shoes before you put me in heels. this is my view as a student & yes i am slow but with a patient instructor that teaches & explains i will be right where i need to be come graduation day. god bless us all
  8. by   Aellyssa
    hi,
    one of the hardest skills that a clinical instructor has to learn is patience. this means waiting whilst students practise slowly and keeping your hands behind your back.

    yes, they are slow and as the student above has stated, going through all the steps in their minds. they are nervous and no matter what we say or do, they are nervous having us watch them, even if they know we have to be there. believe me, they will get faster as they learn the meds and the nursing care required for them. i did my masters' thesis on nursing students' perceptions of clinical teaching and learning. what came out was the very concrete thinking and narrow focus of the students when they first do a skill. it is like a thumbnail photo for them, they don't see anything else around them. then as they become proficient at a skill, slowly they see a normal photo and finally the whole scene. pushing them to see the whole scene too fast causes them to become very anxious.

    one of the biggest criticisms about new graduates is their lack of time management skills, but i believe that is because of unfair comparisons with nurses of many years experience. it takes time to settle into a new place, find out all the overt and covert rules & politics of the area and give good nursing care. all i can say is be patient, encourage them to note all their meds in their address book and let them take their time. remember also that your body language has to also show patience. if the students detect your frustration, it will increase their anxiety and it will take longer. it's only been three days......

    keep 'em coming & please pm me if you feel the need to.

    blessed be,
    aellyssa
  9. by   VickyRN
    Quote from rainbow
    One thing that I found extremely helpful during clinicals was during the last weeks we took turns being in "charge". This meant that we had to review the charts of the patients that the students had and coordinate all the preps, procedures, labs, appts. etc. This was extremely challenging trying to keep track of all the things going on and to make sure that they were carried out. It gave me a sense of all the things a "charge" is responsible for and expected to do. It also meant learning some tactful ways to encourage your fellow students to do what needed to be done. Of course, the clinical instructor was the person I reported to and let know how things were going, but it still was a very educational experience for a student. Good luck to all the instructors out there, you have a difficult job at times, but it can also be very rewarding I'm sure.
    We have this in place ("Teamleading clinical experience") during our students' 4th and 5th semesters (second to last and last semester in the ADN program). This is a fantastic learning experience for the students and an immense help to the clinical instructor - a "win-win" situation all the way around.
  10. by   VickyRN
    Quote from aellyssa
    hi,
    one of the hardest skills that a clinical instructor has to learn is patience. this means waiting whilst students practise slowly and keeping your hands behind your back.

    yes, they are slow and as the student above has stated, going through all the steps in their minds. they are nervous and no matter what we say or do, they are nervous having us watch them, even if they know we have to be there. believe me, they will get faster as they learn the meds and the nursing care required for them. i did my masters' thesis on nursing students' perceptions of clinical teaching and learning. what came out was the very concrete thinking and narrow focus of the students when they first do a skill. it is like a thumbnail photo for them, they don't see anything else around them. then as they become proficient at a skill, slowly they see a normal photo and finally the whole scene. pushing them to see the whole scene too fast causes them to become very anxious.

    one of the biggest criticisms about new graduates is their lack of time management skills, but i believe that is because of unfair comparisons with nurses of many years experience. it takes time to settle into a new place, find out all the overt and covert rules & politics of the area and give good nursing care. all i can say is be patient, encourage them to note all their meds in their address book and let them take their time. remember also that your body language has to also show patience. if the students detect your frustration, it will increase their anxiety and it will take longer. it's only been three days......

    keep 'em coming & please pm me if you feel the need to.

    blessed be,
    aellyssa
    thank you for a truly fantastic post, aellyssa. it really helps to see things from the students's perspective - as stephen covey says, to "seek first to understand." one of our textbook authors (bastable) advises that students should not be interrupted with cognitive questioning during a psychomotor skill. they need that time to just concentrate on performing that skill alone. any cognitive questions should be asked either before or after the skill, but not during. (for instance, don't quiz the student about insulin's onset, peak, and side effects during the time the students is actually pulling up the insulin in the syringe.) also, remember benner's stages. we should always encourage accuracy before speed. i always tell my students, "take your time to do it right." research has shown that constant hovering by the clinical instructors over the students is detrimental to their learning. so, even if i feel a student needs to be watched very carefully, i try to not make it so obvious.
  11. by   ProfRN4
    Quote from crb613
    think back to when you were a student. how slow were you?? were you nervous about making a med error? how many times had you passed meds, charted, & how familiar were you with all the diff. meds? did you know how to read a mar? could you spout off the s/e & know off the top of your head what to watch for? why you were giving the med in the first place & the action you wanted? what nursing action to take if something did go wrong & making sure you had the right pt, right dose, right route, right time, right form, right documentation. also double/triple checking that the calculations were done correctly. i am a student & all this stuff goes through my head when i pass meds & alot more. i am sure with time & practice i will be faster & alot of this will be second nature but for now i am learning, i want to do it safely & i want to learn how to do it right, then i will work on speed. let me learn to walk in tennis shoes before you put me in heels. this is my view as a student & yes i am slow but with a patient instructor that teaches & explains i will be right where i need to be come graduation day. god bless us all
    i apologize if i came off as impatient, or wrong, if you will. i just really forgot how things were 'way back when', and it kind of took me by surprise. while i do appreciate your perspective (and yes, the whole student experience is slowly coming back to me), i was actually looking for an educators perspective, and tips form an educator. i have been quite patient thus far, but i do have a number of other students that need my attention too (and all need to get their things done in a somewhat timely fashion). i am new at this, and have yet to experience the connection between new student and graduate nurse. if you were my student, wouldn't you want me to know how to accomplish this (so you can indeed become a competent graduate nurse). again, i'm sorry if i offended you (or anyone else). as a staff nurse, i can definitely appreciate the new grads perspective now. at the same time, i know the reality of the expectation of the new grad, and want to make my students as prepared as possible. with the shortage, new grads do not get the proper orientation they deserve, and are expected to perform at the same level as i (i have over ten yrs experience). sometimes, i cannot handle the assignment i am given, so i can only imagine how a novice nurse feels in the real world!!

    vicky, thank you for the bastable reference (i have the book, and actually quoted that very line in a lesson plan assignment). i guess that will be my summer vacation reading. i really tried not to hover over them, because i'm sure that makes them feel even more nervous. but then again, i'm sure they want to know thet i am watching, to make sure i see tham doing the right thing.
    Last edit by ProfRN4 on Apr 15, '05 : Reason: more to say!!
  12. by   crb613
    bonemarrowrn, the reason I replied was this post by you...
    "Now, my question to you (or anyone) is this: I am truly amazed at how slow students do things. I am dealing with 2nd semester freshmen (ADN). I know, they know very little at this point, and are still very nervous. But how on earth do I motivate them to move a little faster? I only had half the group, and I feel like it took me forever to get meds done. I don't want to rush them, but I feel the transition from one patient to a whole district (when they graduate in a year) will be almost impossible".
    No offense taken, I just wanted to remind you how a student feels & yes jog your memory. In doing so, I hoped this would help you to help your students.
    When you are comfortable & proficient with your skills it is sometime easy to forget the struggle often encountered to become skilled. I am sure you will become a great instructor as you seem to have the student's best interest at heart.Also I did not mean this as an attack on you & I am sorry if I came across that way. Good luck to you.
    Last edit by crb613 on Apr 16, '05 : Reason: typo
  13. by   lowerypenny
    I am currently in clinicals for my LVN/LPN rotations. This is my second round of clinicals with just one more to go. I have had 6 instructors for the last two rounds and will get 4 more. I have found that for me that every experience I gain, whether it is a lessoned learned or brushing up on my skills, is more valuable to me then all the paper work. I would rather experience things on the floor and be put into situations where my judgment is critical as a student nurse then get on the floor and have to go through it with out having someone there that will educate me. Give them every procedure and complicated case you can find. This will give them courage and knowledge for when they are on the floor for the first time. Today I got my first IV. Man it was great and it wasn't on an easy pt. So I not only got the thrill of starting my first IV, but the thrill of starting my first IV on a roller. Praise and Praise. For every one thing they may do wrong praise them for two right things. This really makes a difference in their moral.

close