Junior nursing student in trouble with clinicals - page 2

OK, so I'm the stressed father of a nursing student who is sinking. They have a 3.7 GPA and is doing fine with classwork, but is having difficultly with med/surg. I can't believe they grade... Read More

  1. by   KeeperMom
    I'm an older student and I am the mom to a step-child I put through college.

    Nursing school is unlike my previous experience in college. In a NP (nursing program) you have to have the "intelligence trifecta" - book smarts, common sense, and critical thinking skills. With those three, you have to be able to put it all together too.
    I'm wondering if there is more to her story than what she is telling you. If her teachers are anything like most others I've heard of, they don't put up with standing around, being late, or not having your clinical paperwork done, etc.
    I have never heard of a student failing clinical if he/she can't perform the skills. Now, if week after week the student is unprepared for clinicals or isn't caring for the patient at all then, yeah, maybe the student won't pass.
    Could there possibly be more to her story? Most clinical teachers give a mid-term evaluation so students know where they stand. If the student is given a "fail" at the mid-term, the teacher should be giving advice and direction on how to improve.

    As far as you being a parent to a college-aged student, I totally understand your concern. We want our kids to do well and when we are investing thousands of dollars toward that child's education, we want to make sure we are getting our monies' worth out of the deal. It is very hard to NOT be involved when we think our babies are being treated unfairly or are being hurt.
    I do think you might want to talk to her and make sure she is telling you the whole story. I am not saying she is lying, but I have noticed that a lot of the young 20-22 year olds I go to school with have one version of the story while I may see it a little differently.

    good luck..... to you both!
  2. by   elkpark
    Quote from FatherOfStudentBS
    suethestudent, I can tell you are young because you make rash assumptions. The mistakes were detailed, and the issues are that time mgmnt will be worse when you move from 1 patient to 6 or 8. This school has very tough requirements and I have admitted that my daughter has weaknesses with time and some org. But to me colleges should then add additional training courses that you could pay more for. It seems pretty tough to be cut from your major. There may be other majors that do that, but I don't know of any. And there were upperclassman that up to the very end, didn't know if they would graduate. That just seems unbelievable to me. Frankly I doubt the school cares what I pay.
    Education and the standards and requirements within the healthcare professions are unlike any other kind of education, as already noted. Nursing programs have a v. difficult time offering "additional training courses" because it's v. difficult for them to provide the standard clinical opportunities in all the clinical specialty areas for all their students. As a nursing educator (at times), I can tell you it's a constant struggle every semester to get appropriate clinical rotations worked out. There simply isn't any "wiggle room" to make extra opportuntities available. The only way "additional" clinical happens is by a student having to repeat a course (which isn't always the worst thing that could happen).

    In both my original nursing program and in my graduate school, there were students who didn't know up until the last minute if they would graduate. That's not uncommon in nursing. And it's not uncommon in healthcare education in general. The last time I taught a (nursing) clinical rotation, I witnessed a medical resident get kicked out of his residency -- that's after four years of undergraduate education, four years of medical school, and getting accepted into a residency program. And it's highly unlikely (basically, impossible) that he'll be able to get into another residency program after getting kicked out of one. The reason? His communication skills weren't up to the standards/expectations of the faculty/attending physicians. I was told he had been counseled about this previously but had not improved. The final straw?? He flirted with two of my nursing students on a day that they were all on the same unit, and this was observed and reported to the physician supervising him (not by me or my students -- it was a complete surprise to me when the physician approached me and asked about it. I was aware of the flirting, but the students and I didn't consider it any big deal). For that, his future in medicine is over. But the larger issue wasn't the actual flirting so much as it was that he had been told clearly what the expectations were, more than once, and he had (repeatedly) failed to meet them and, in doing so, showed v. poor judgment. That's not something that can be tolerated in healthcare, where there is little margin for error (I feel silly saying that to an engineer, when there is also v. little margin for error in engineering, but people really don't get how serious all of this is until they experience it firsthand).

    Lots of schools do clinical courses as pass/fail, and students only fail if they're really not able to hack it (if they're really not able to provide minimally adequate, basically safe care). Despite all the talk one hears about casual, cavalier "weeding out" in nursing programs and mean-spirited instructors who fail people just to prove a point, I've taught in a few different nursing programs at this point (ADN and BSN) and, in my experience, there has been tremendous pressure on faculty not to fail students. There really would have to be a serious problem for that to happen (in my experience, that is), and it's certainly possible that your daughter may not have been completely forthcoming with you about all the details of her situation.

    I hope things will work out well for your daughter. Having to repeat a course isn't the end of the world, if it comes to that (although I know it can seem like it at the time). Best wishes!
    Last edit by elkpark on Oct 21, '10
  3. by   FatherOfStudentBS
    Thanks Elkpark. Its really a different world. I'm surprised that there is so much difficulty getting clinicals setup. An outsider would think that there is some free labor to be received, understanding that supervision is needed. She knew she needed to get more clinical experience, but with the economy, she didn't get a job. And although she was willing to work for free, thats not allowed. So she volunteered, but of course you don't get to really do anything. The professor told her if she had another 6 sessions she would probably be fine. But of course thats impossible. Her Mom took quite awhile to get settled in to her job as a nurse, but then worked ICU for ~5 years. IT seems my daughter may have the same issues, and that they are really concerned that if you are slow with one patient, it won't work with many. Plus there is the issue that if you try to speed up and rush there is the greater likelihood of making a mistake. Anyway, how do you learn more organizational skills and speed? Any tips. You professors must see this. I know some tips are to use checklists and SOP(standard operating procedures) to develop routines and rhythm. Other clues?? Lastly I do wish that the schools gave the students AND parents a clear one sheet statement with the risks and additional challenges spelled out. Most people(myself and wife included) had no idea. This could ruin some families or saddle the student with debt and not enough $ to complete another degree. I doubt they would spell it out so starkly for fear they would lose too many more students.
  4. by   FatherOfStudentBS
    I should have added that she is quiet by nature, which also seems to hurt her. And no, she's very quick to take blame on herself, not to point it. I on the other hand certainly am biased for my daughter, but also know that no-one should think they are passing and then be surprised at mid-term to be told they are not. As a manager, I would be reprimanded for that at my job.
  5. by   Sugar-Phosphate
    I have read a few remarks, and I think some of the aspects of the original post are being missed. I agree with some posts that there is a reason your daughter is failing clinicals, and I agree that there is something she could be doing to fix it. I also agree with workinghard09 that she should speak with her instructor. I know it is not the same, but when I was failing a course, I met with my teacher and needed to know what I was doing wrong, what the teachers expectations were (elaborated) and what I can do to meet those expectations. The teacher said your daughters chances were poor of passing, not impossible. There is still a chance.
    If by chance she does not make it, try again. I know it can be discouraging,and I understand the money thing. If your daughter really wants to help her sister, and become a nurse it CAN happen it just might take a bit more time. If the lost cost of education is adding up, perhaps a state school would be better.

    Here in Canada a "private" school is no better than a state school, at least where I live. I also think becoming a CNA until the new enrollment comes around is an excellent idea. This will give her real-time practice and might help her come-over your daughters fears or whatever held her back in clinicals.
    Now my opinion is simply that, and I am not in nursing school yet. I was declined due to a poor GPA from high school. I retook my high school classes and now have a 4.0 GPA, and will be reapplying for Fall 2011. It was discouraging to not be accepted, as I was changing my 3rd year biology degree, but I want this bad enough I am going for it. I think your daughter can do anything she sets her mind to, as well as anyone else. If you want it bad enough go an get it. Sometimes there are a few obstacles in the way, but I believe she will overcome it. (Not trying to sound preachy just glass half full)
    Good luck, and I believe you have every right to be concerned about your daughter, that is what daddies do.

  6. by   elkpark
    Quote from FatherOfStudentBS
    Thanks Elkpark. Its really a different world. I'm surprised that there is so much difficulty getting clinicals setup. An outsider would think that there is some free labor to be received, understanding that supervision is needed.
    (Not to go too far off-topic, but student nurses are definitely not "free labor" -- they are there for their own educational purposes, and are more a burden to a hospital unit than a help. Allowing students to do clinical in your hospital/facility means taking on quite a bit of additional liability without any compensation (although I have heard rumors of some hospitals starting to charge schools for clinical sites ), and there is no requirement that hospitals agree to allow student clinicals (many hospitals and outpatient agencies just won't do it). Also, facilities have to meet specific requirements and be approved by the state BON in order to be used as clinical sites for students -- you can't just send students anywhere that you like. Additionally, in any city of any size these days, there are so many nursing programs that there is huge competition for the few available clinical sites. Many existing nursing programs significantly increased their enrollments in recent years, and new nursing programs have been springing up like mushrooms after a spring rain, in response to the last alleged nursing "shortage" (which was never really a shortage, anyway, but that's a whole 'nother discussion) and the huge demand. The state BONs limit the number of students one instructor can supervise in clinical, so a larger overall class means that many more separate clinical groups per class, and hospitals and other agencies limit the number of students they are willing to have in a single unit/department. The last time I taught in a BSN program, in a medium-sized Southern city, there were two BSN programs, a diploma program, and six or seven ADN programs in the immediate area, all good-sized programs, all competing for clinical sites in the same few hospitals. Representatives of all the schools sitting down with the hospitals to negotiate the clinical requests each semester was like the Paris Peace Talks. It wasn't that hard to work out the general medical-surgical clinicals, but finding appropriate clinical opportunities for students in specialty areas like psychiatry, pediatrics, obstetrics, critical care, etc., is becoming more challenging each year.

    I realize that's probably a lot more information than you wanted, but, as we keep saying on this thread, most people "on the outside" have no idea how complicated all of this is. )