Finding Places To Do Clinicals

llg, PhD, RN · Dec 7, 2005

I'll give you a glimpse of life on the other side of that question -- as my job is to coordinate student placements at my hospital.

I am very frustrated with the proliferation of programs that leave it up to the student to find their own clinicals. The clinical portion of an education is very important and requires time and effort to provide. Hospitals are increasingly being asked to provide experiences and supervision for students from a wide variety of programs -- adjusting to fit the demands of each school -- supplying the education for the students for free. The school collects the money while the hospital provides the education.

Receiving too many requests to handle ... my hospital has decided not to accept such students unless there is a special reason to do so. For example, we will bend over backwards trying to meet the needs of our current employees who are enrolled in such programs. They are our top priority for such placements. We also place a high priority on students from schools with which we have ongoing relationships and who have provided us with students and employees in the past.

Our lowest priority is the student who calls up out of the blue, with no previous connection to our hospital, who asks us to provide her with a free education in exchange for nothing. I'm always surprised by the ones who call at the last minute and expect us to have all the extra resources sitting around that we can donate for her convenience.

In most cases, I don't really blame the students for their lack of appreciation for the hospital's perspective -- but I do blame the schools. I think it is highly unethical of them to market these programs and collect the students money -- and then to leave it up to the students to find hospitals to donate their resources to provide the student's education. When you give the school your money to take a course, the school should be providing you with access to the resources you need to complete the requirements.

If I were you, I would keep that in mind as you try to arrange your placements. Do you currently work for a suitable institution? (If not, you might want to get a job somewhere.) Where would you like work in the future? etc.

Good luck,

llg

krisssy · Dec 7, 2005

I'll give you a glimpse of life on the other side of that question -- as my job is to coordinate student placements at my hospital.
I am very frustrated with the proliferation of programs that leave it up to the student to find their own clinicals. The clinical portion of an education is very important and requires time and effort to provide. Hospitals are increasingly being asked to provide experiences and supervision for students from a wide variety of programs -- adjusting to fit the demands of each school -- supplying the education for the students for free. The school collects the money while the hospital provides the education.
Receiving too many requests to handle ... my hospital has decided not to accept such students unless there is a special reason to do so. For example, we will bend over backwards trying to meet the needs of our current employees who are enrolled in such programs. They are our top priority for such placements. We also place a high priority on students from schools with which we have ongoing relationships and who have provided us with students and employees in the past.
Our lowest priority is the student who calls up out of the blue, with no previous connection to our hospital, who asks us to provide her with a free education in exchange for nothing. I'm always surprised by the ones who call at the last minute and expect us to have all the extra resources sitting around that we can donate for her convenience.
In most cases, I don't really blame the students for their lack of appreciation for the hospital's perspective -- but I do blame the schools. I think it is highly unethical of them to market these programs and collect the students money -- and then to leave it up to the students to find hospitals to donate their resources to provide the student's education. When you give the school your money to take a course, the school should be providing you with access to the resources you need to complete the requirements.
If I were you, I would keep that in mind as you try to arrange your placements. Do you currently work for a suitable institution? (If not, you might want to get a job somewhere.) Where would you like work in the future? etc.
Good luck,
llg

llg-Thank you very much for your answer to my question. I totally agree with you. I had a feeling this might be a problem, and that is why I put the question on the board. I am curious about how other online students find clinicals. Tomorrow I have a phone conference with my advisor, and I asked her to please look up all the affiliations in my area where they can get me clinicals. So I am looking forward to her answer. I hope you don't mind if I ask you a few questions since this is what you do. I will appreciate your honesty and your time.

Does one call nurse recruitement when you are lookng for a placement?

I am not working now. Would it make a difference if I was working as an RN on a psych unit while I am taking the pre clinical coursework? I have no experience except as a school nurse teacher, an elementary school teacher, clinicals in my BS program and a recent refresher course. So I would have to be oriented and preceptored first anyway. Would hospitals be more apt to hire me if I am going to school in the area of psych nursing ? Or wouldn't that matter to them?

What do you think a hospital would think if I signed a contract to work for them after I get my degree?

What if the student was willing to give her time, without being paid, to work as a licensed RN on a psych unit?

What if the student was willing to pay the hospital in order to be preceptored?

I know these sound like very untraditional solutions. But I am an untraditional student, and I want to do this very very badly. If this school cannot provide me with clinicals and I can't find any on my own, I will probably transfer my credits to a school in my area that is associated with a hospital. I am very committted to being a psych nurse, and I will do anything I have to do to be one.

What geographical area are you working in? If you don't want to say, it is ok. If you want to ask me anything else, please ask. You can post it here or PM me. I need all the advice I can get. I appreciate you taking all the time to write what you have. Thanks again. Krisssy RN MA

spaniel · Dec 8, 2005

LLG- You said it perfectly. So many online programs taking the money from students leaving them in the lurch for clinical sites. I got accepted to one well-known program that absolutely would not address the issue with me,despite emails and phone calls. The director of the program indicated in psycho babble that my question was "inappropriate".

Krissy-I've been reading your posts and congrats on admission. Now- one idea might be to try to do clinicals at a public health or free clinic, and then "promise" or contract a specific time that you might "owe" them afterwards. Since you are very experienced with school aged children, you might even be able to do clinicals at a residential site for children (or adolescents). I believe you underemphasize your potential strength in this area, given you many years of teaching. You probably have way more experience with ADHD kids (for example) than most psychiatrists.

llg, PhD, RN · Dec 8, 2005

Krisssy,

I think that all of your "non-traditional" ideas are good ones. Anything that you can do to provide the facility with some reason for donating their resources toward your personal education is worth mentioning.

What you want to do is to find the person within the facility (within nursing if possible) who is in the best position to help you arrange something ... and then set up a meeting with that person. Demonstrate your willingness to do the types of things you mentioned in your post and see if there is anything he/she can do to help. If someone approached me that way, it would give a favorable impression and I would be thinking, "Gee, this person seems very reasonable and is doesn't want to take advantage of us. Is there any way I can help her?" ... rather than thinking ..."Oh, here is another one who didn't plan ahead for her educational needs and now she wants us to bail her out by giving her a free education that she will use to get a job somewhere else."

Finding that key person is the first step. Nursing Recruitment is not a bad place to start, particularly if you are really interested in working there long term. You should lead the conversation with "I want to work for your facility in the long run and was hoping to be able to arrange some of my clinical expereiences for school here as well. I'd be interested in learning about any job opportunities for me while I am still in school as well as for after graduation. I'd also really appreciate it if you could help me connect with whomever I should speak to about arranging student clinical experiences."

Depending on the particular facility, some of your ideas might work ... and some probably won't. For example, "working as an RN for free" is difficult because of federal laws and legal/liability issues that regulate employer/employee relations and insurance coverage. However, signing contracts promising employement is certainly not unheard of. If they only provide such experiences for employees, you may need to delay your academic progress until after you have worked a certain length of time, etc. You won't know until you have that meeting with the right person.

A few final tips: If going through the Nursing Recruitment door doesn't work, you might want to try an upper-level nursing administrator or staff development educator. They often know how to negotiate the system. Also, I wouldn't try to accomplish it all on the phone or through e-mails. You want to give yourself a chance to impress them (like a job interview) so that they want to make a little extra effort to help you. An voice over the phone from a stranger or a faceless e-mail doesn't give you much chance to do that.

Another idea just hit me ... I once precepted a grad student who had no possibility of working here (She was a midwifery student and I work in a pediatric hospital.) because she was willing to help with my "scut work." She needed to work on a research project and I had a project that I involved data collection that I didn't want to do. So she did my data collection for me and we both got our needs met. You might be able to hook up with someone who needs help with a project -- if you can be flexible enough about the specific activities that you do for your clinicals.

Good luck,

llg (I live in Virginia, by the way.)

SharonH, RN · Dec 10, 2005

Hi Krissy. It's great that you are asking this question right now because you can see from llg's post that it is a problem. Here is the perspective of a student:

I attend grad school in Alabama but I live in the Atlanta area. When I chose this school I was told that I could do my clinicals near where I live, that it would be no problem and that I would only have to find a preceptor. It was not explained to me at all that the school and the hospital would need to contract with each other and all that this would entail. So because I hate to wait until the last minute, I found a preceptor 6 months in advance of starting clinicals. I did this by calling the nursing office at that particular hospital and asking for the name and number of the manager for the CNS' which they willingly gave to me. I contacted her and she was very nice about it and agreed to precept me. That was the beginning of the end. I got the paperwork from my school after 3 months of asking my advisor who told me to calm down and wait until we were closer to that class date. The school and the hospital went back and forth because they could not agree on the terms of the contract. 1 month before the start of the clinical course, the negotiations were called off because they just couldn't make a compromise. Ooooooookay. No problem, right? There are at least 20 hospitals in Atlanta.

Well, I called around to various nursing offices. Always start with nursing services and they will direct you to where you need to be. Some of them were full until 2006. Some of them did not even bother to return my phone calls. Some of them do not use clinical nurse specialists. One hospital told me that they sent their employees who were in school to another hospital. Finally I found one small community hospital which agreed to take me on and I did do a semester there but unfortunately I could not stay there for the whole time because they are so small. So moving on.....

I found another hospital and met with another preceptor. She agreed to take me on. I am well aware of what a sacrifice this is, so I am very, very grateful. I give her the paperwork I have and contact my school to send the paperwork for the contract for the clinical. We never hear from these people again. I called, I e-mailed, my advisor called, she e-mailed. They refused to respond. How unprofessional is that? By the way, this is one of the top hospitals in Atlanta. I could have dealt with a simple refusal, at least I could have moved on. But no, they couldn't give me that courtesy.

So now I have found yet another hospital. I made the first contact in August so I could do my residency there in January. The contract has been signed almost......we need one more signature. I'm still waiting.

Long story short (I know too late), start early, check on the need for contracts and if you find someone who is responsive to you be grateful. Be very grateful.

krisssy · Dec 10, 2005

Thank you all for giving me some very good ideas on how to go about this.

Yesterday, I had an appt. with my advisor for a telephone conference. She said she only had a short time to talk to me, because she had a meeting to go to. So we talked a little and rescheduled for Mon. She told me to call the secretary to find out if they had any contracts in my area (Long Island). They didn't. So I can see, I am on my own to find clinicals just like you all said. I am taking Theory in Jan. She said I could take Brief Individual Psychotherapy for Mental Health Nurses after the theory course. She said that I could find a Psych NP, a psychiatrist, psychologist or psychiatric social worker. How do you feel about that? I was surprised that I didn't need to precept under a NP. I was also surprised that I didn't have to take assessment, pathology and pharmacology before starting any clinicals. They appear to have different practicums all requiring different prerequsites.

My questions to all of you:

How far in advance should I start looking for clinical sites? Should I start looking before I know exactly when I will be taking the clinical course just to set up a contract for the future?

Should I take Assessment, Pathology, and pharmacology before starting clinicals no matter what the school says?

Thank you. Krisssy

gauge14iv, MSN, APRN, NP · Dec 10, 2005

As for precepting with others besides NP's - our program allows us to precept with MD's, PA's and NP's of any specialty. We just have to use an NP in our specialty at least one (maybe it's twice) in the program.

SharonH, RN · Dec 10, 2005

My questions to all of you:
How far in advance should I start looking for clinical sites? Should I start looking before I know exactly when I will be taking the clinical course just to set up a contract for the future?
Should I take Assessment, Pathology, and pharmacology before starting clinicals no matter what the school says?
Thank you. Krisssy

Start now and YES to both questions!

jeepgirl, LPN, NP · Dec 10, 2005

I just got accepted into the University of Missouri-Columbia for my MS in Psychiatric Nursing (NP). I was wondering if anyone has had clinical experience going to that school or any other online schools. How did you find sites for doing your clinicals? Thank you. Krisssy

I'm currently attending mizzou as well for my MSN. I did their RN-BSN option as well. During that time, they were very easy to set up clinical areas in places that were close to my home and that peaked my interest. That may be a little more different with our more focused degrees this time, Overall, I have had good experiences. My advisor this time around told me that they have some clincal sites set up already all over the state. Are you in MO? If the site is not close or feasible, they will most likely work very closely with you to work out something that is! I am waiting until the Fall of next year to do any clinical time.

jeepgirl, LPN, NP · Dec 10, 2005

Thank you all for giving me some very good ideas on how to go about this.
Yesterday, I had an appt. with my advisor for a telephone conference. She said she only had a short time to talk to me, because she had a meeting to go to. So we talked a little and rescheduled for Mon. She told me to call the secretary to find out if they had any contracts in my area (Long Island). They didn't. So I can see, I am on my own to find clinicals just like you all said. I am taking Theory in Jan. She said I could take Brief Individual Psychotherapy for Mental Health Nurses after the theory course. She said that I could find a Psych NP, a psychiatrist, psychologist or psychiatric social worker. How do you feel about that? I was surprised that I didn't need to precept under a NP. I was also surprised that I didn't have to take assessment, pathology and pharmacology before starting any clinicals. They appear to have different practicums all requiring different prerequsites.
My questions to all of you:
How far in advance should I start looking for clinical sites? Should I start looking before I know exactly when I will be taking the clinical course just to set up a contract for the future?
Should I take Assessment, Pathology, and pharmacology before starting clinicals no matter what the school says?
Thank you. Krisssy

If you feel that clinical sites will be in short supply in your area, it would not hurt to start looking now. You have to start the contract process at least six weeks in advance at mizzou to get everything through the legal departments. A lot of facilities like to add riders, get drug tests, etc, so that is why so much time is needed.

jeepgirl, LPN, NP · Dec 10, 2005

BTW, if your preceptor is interested in an ongoing relationship with MU, Mizzou will set them up and recongize them as adjunct faculty and allow them to use the resources they have available (depending on distance, etc).