First suggestion: before you begin, investigate the floor in which you will be having the clinical. It is our responsibility as nurse educators to facilitate our students' education (in other words, we partner together with our students for their learning). It is our responsibility to create the best environment possible for learning. I would advise you to meet with the unit manager and informally chat with some of the nurses just to get a "feel" for the floor. Attend one of their unit meetings or change of shift report meetings, just to help them get to know you better and to be comfortable with you. This little bit of "PR" work up front can earn tremendous dividends later. You may want to "shadow" on the unit for 6-8 hours; this will help you become familiar with supplies, policy and procedures, medication delivery systems, IV pumps, charting, doctors, etc.
75% of the difficulty we have had with clinicals at our school have been because of unsupportive/ outright hostile clinical environments (actually, it was just one hospital :uhoh21: ). The vast majority of clinical sites, I am happy to say, are very supportive of students and clinical instructors. If you do, indeed, encounter a problem with one of the nurses (or nursing assistants, etc.) on the floor, don't just ignore the problem, but address it at the point of conflict in a professional manner. Go up the chain of command if you need to, until the problem is resolved to your satisfaction. Strive to have constant good communication with the patients' nurses and the unit manager. That good rapport on a unit is worth its weight in gold, but sometimes takes a lot of work.
Always treat your students with dignity and respect. Strive always to be fair. I hate intimidation--it makes for poor learning. We certainly cannot be personal friends with our students or cross professional boundaries by being "buddies," but we should always be encouraging and let the students know that we desire their success. There is a right way and a wrong way to correct a student. When you have to correct a student, (if at all possible) never do so in front of the patient, staff, or other students. Do so in a private area, as soon after the incident as possible. Start out with a positive statement, then gently bring correction. For instance I stated this to a beginning nursing student, "Your patient care is excellent and I can tell you really care about your patient, however, I am a little concerned about your saying to the patient 'You are going to be my guinea pig today.'" (This actually happened!!!
) One thing that can never be compromised are any issues concerning patient safety. This requires immediate intervention. Also, I do not tolerate an "I do-not care" attitude, sloppiness, being late for no valid reason, being unprepared, or treating the staff/ patients rudely.
There is a big difference, of course, between the performance of beginning students and senior students. The expectations of senior students will be much higher. If you have any questions about student performance (i.e., what they should already know at this level, doubts about them being "where they should be to graduate," etc., etc.)--address your concerns to the director of the school of nursing. Always maintain a united front with the faculty at your school. Say only positive things about the school of nursing to the floor nurses or to your students. Also, never say negative things about your host facility to the students. If a nurse behaved in a perceived unprofessional manner, allow the students to discuss the situation in confidence during post-conference, but only for the purpose of learning. Never allow a student to "downtalk" another faculty member in your presence, and do not be drawn into those type of conversations. Simply state, "if you have a problem with so-and-so, you need to talk to him/her about it." End of conversation.
It is a good idea to have a "quick" pre-conference before the students go out on the floor, to go over patient assignments. You can also quiz the students as to which of the patients has the top acuity, etc. Have reasonable expectations. Make your expectations crystal clear and stick to them. Be consistent and objective, and follow the facility's and your school of nursing's protocols and guidelines. It's nice to have a post-conference after the student shift is finished for the students to debrief and discuss patient concerns and valuable knowledge and insight that they have gained. You can also question them about patient diagnoses and other pertinent matters: "What does congestive heart failure mean in your own words? How has this affected your patient? Why is such-and-such in the patient plan of care?" Try to inspire enthusiasm and critical thinking in your students.
One last thing, if you do encounter an unsafe or unprepared student (which is a generally rare occurrence), patient safety is always number one and can never be compromised. Always make sure you document, document, document well on the student's competency form.