Forgive me, but I've noticed on these boards when a student is afraid of a overly harsh clinical instructor, there seems to be a running theme: angry clinical instructors that embarrass students, intimidate them, and make them afraid of them are the clinical instructors you want, because they make you work hard?
Huh?
This is grossly incorrect, in my humble opinion. I had a clinical instructor who picked on only me in a class of eight people. She would actually chart for other students, was kind to them. When it came to me, she embarrassed me in front of patients, their families, and other staff. She talked down to me, she consistently made me feel that I was not going to be a good nurse.
Absolutely EVERYTHING I did was wrong, and nothing I did was right. Even when there were no mistakes on my charting, she made it a point NOT to tell me how well I was doing, yet did it with other students.
It had a horrible effect on me: I lost 25 pounds, I was stressed out beyond belief. I was not sleeping, and it took a toll on other classes I was taking. I am an A student, and I began to get grades that were below that. It was then that I took control of my life.
I realized that when there is a person, instructor, boss, manager, who you can NEVER, EVER PLEASE, despite how hard you work, and how correct your work may be, there may be a personality disorder there, and you may need to simply talk to other faculty who may be able to talk to the instructor. You may just need to realize that IT'S NOT YOU, IT'S THEM. And that's ok. It's ok to realize that you are doing your best, and there are people who you cannot please. But lateral violence, nurses being mean and cruel to each other, and younger nurses accepting this attitude and even praising it is baffling to me.
This harshness and uncaring attitude that some clinical instructors show to students is what fuels lateral violence in the nursing profession, and it makes being a nurse more about personality conflicts than taking care of patients. In nursing school, I have seen more times than I care to remember other nurses who are mean and cruel to new nurses, or me as a nursing student. I don't cower in a corner like many nursing students, I stand up to nurses like that, and demand to be treated with respect.
I can understand that nursing students may be afraid to cross these clinical instructors, but what kind of nurse will you be, and how can you advocate for patients, if you cannot advocate for yourself? You need courage to be a nurse, and it seems that the message on many boards is: "do what you can with mean clinical instructors, be silent, accept the abuse, and move on". This just seems strange to me since as nurses, we need to be strong for our patients.
There is a nursing shortage going on, and we don't need students dropping out of programs because they have clinical instructors stuck in the past who think it's acceptable to embarrass and intimidate students and create a hostile class environment. It's unnecessary, and we as nurses need to acknowledge it.
I think it's high time that abusive instructors and nurses who practice lateral violence to other nurses and CNA's realize just how they are making this nursing shortage worse, by discouraging bright and talented nurses who don't need the cruelty. For those of you who are reading this who practice this behavior and you know who you are: Stop It.
And we wonder why so many nurses leave the profession.
Honestly, my first two were good as gold, I am still in touch with them and they have become friends and professional mentors. The one I've had most recently is just, so inpatient and unnecessarily rude to students. Condescending. But I think it all goes back to that she graduated almost 15 years ago and that's what she maybe faced then. She is a very capable nurse and she has much knowledge, but she herself has admitted she can come off as "moody". Personally, it is this kind of catty, competitive, superiority nursing personality disorder that sometimes turns me off from the whole profession. Why do nurses treat each other so badly and not hesitate to throw each other under a bus to save themselves, it sucks.
I've been a clinical instructor for the past 4 years and struggled early on with what kind of instructor I wanted to be. There has to be discipline for the safety of the patient, but where is the line drawn. My favorite instructor was the one who was not afraid to tell me I was screwing up, who would shoo me back into the room with a few choice words, but would also go the extra mile to ensure I was getting enough procedures, who hugged me when my patient coded and died. Where is that line drawn?
With my students I use a bit of both. The first day I tell them about all my experiences. as an ICU nurse, as an ER APRN, and ICU APRN, a paramedic... How I will push them to look past the procedures, past the care plans, to look for the things that will kill their patients and fix them. I push them to memorize assessments, to write better care plans, to take the time to walk their patient down the hall remembering all the while to look for the signs of them falling before it happens (the dizziness, the slumping back, etc). I tell them fear is good, it will save lives.
But I also take the time to tell them they did their best. To tell them that screwing up is normal, that no one is perfect. I let them know that I can see they are trying, maybe not getting it right, but that the hours and hours of lost sleep and worrying is getting them somewhere. To know that they can text me, email me, call me when they ahve questions, and that while I usually will not give them the answers, I will give them the tools to find those answers.
I think the best preceptors toe both sides of the line. To push is good, to shove is wrong. Am I a great preceptor, no way. Somedays I wonder if I'm even doing the right thing teaching the future of our profession. Ok, most days. However, every Tuesday and Wednesday I man the floor, putting my license on the line for those that will walk the same halls I did, and maybe, just maybe, they will have the same passion and desire that I do.
I'm glad you said it that way... I may (if I get into the program) be doing clinicals next year and hearing about all that abuse was really starting to make me worry but you made a really good point. Thanks.
What do I do when my abusive nursing instructor is one of the higher ups, who do I go to then? I'm seriously thinking about not continuing with this program because of this person.
Wow I'm glad I'm not the only one who's going through this.
Last semester we weren't expected to do much at clinicals and I didn't have a mean instructor, but I could kinda tell she didn't like me. I don't know why. I've always been early, willing to help others, never gotten written up for anything.
This semester though, my instructor seems to have singled me and another student out to be the losers of the group. I get high grades in class, but when I'm at clinicals I feel like a complete failure. At the beginning I was talked to about lack of organization, I can honestly say that I have fixed that problem right away and have not fallen behind once. My instructor never spends time with me at my patients, but if anything's not right and she sees it by the door, even if I wasn't there when it happened, I get chewed out for it.
I keep telling myself how much I want to be a nurse and that my patients all love me, so I can't be that unlikable of a person right? All my patients have raved about me and I'm fortunate enough to have the experience. I'm not even going to contemplate dropping out because it's too important for me.
It's just disheartening though, when both clinical instructors I've had don't like me. I'm typically a very likable person too. I just don't get it.
Be careful thinking that your instructors are out to get you. I've been teaching for 4 1/2 years now and have met hundreds of preceptors and instructors. I can tell you that ones that single people out, or are blantantly mean or lazy do not last long teaching. What I percieve happening is this: these instructors want to get more out of you. Remember that the patients you are caring for are not there for you to learn on. They are there to get better. We as instructors are there to make sure you learn, but also that you are involved in the nursing process and the care of the patient. We expect (and ok some demand) that you are prepared for all aspects of patient care, especially if you haven't seen it before.
An example is this. You have a patient with a Nasogastric tube. Day one you learn they have it. Do you go home that night and study the policy for caring for a patient with a NGT? Do you print it and bring it to clinical to show your instructor you went home and realized a hole in your knowledge base? Do you focus your nursing diagnosis on it, put it in your weekly journal. And above all else, are you able to verbalize what's needed to your instructor. If you did all this for me, I would praise you then push you even harder to show your collegues how to care for them too.
All in all I hope, and I say HOPE that all instructors are there to teach you. We may push, single you out if we feel your not putting in the effort we want, and may even give bad reviews if we're not getting what we want out of you. But deep down, we LOVE that your in this profession, we LOVE the drive and motivation to do this work, and we are here for you. Good or bad. I spend 6-10 hours a week grading care plans, reading journals, printing research articles for students, preparing post conferences that are relevant and interesting. and I bet half my students say I'm too pushy and mean. That I expect too much. However, when you graduate, that instructor that pushes you the hardest will be the one you value the most.
Hope the rest of you time goes well. Go above and beyond. Get into the literature. Take 8 hours to write your care plan. Show your instructors that you want to be a nurse, not only a good one, but the BEST you can be!!
Wow I'm glad I'm not the only one who's going through this.
Last semester we weren't expected to do much at clinicals and I didn't have a mean instructor, but I could kinda tell she didn't like me. I don't know why. I've always been early, willing to help others, never gotten written up for anything.
This semester though, my instructor seems to have singled me and another student out to be the losers of the group. I get high grades in class, but when I'm at clinicals I feel like a complete failure. At the beginning I was talked to about lack of organization, I can honestly say that I have fixed that problem right away and have not fallen behind once. My instructor never spends time with me at my patients, but if anything's not right and she sees it by the door, even if I wasn't there when it happened, I get chewed out for it.
I keep telling myself how much I want to be a nurse and that my patients all love me, so I can't be that unlikable of a person right? All my patients have raved about me and I'm fortunate enough to have the experience. I'm not even going to contemplate dropping out because it's too important for me.
It's just disheartening though, when both clinical instructors I've had don't like me. I'm typically a very likable person too. I just don't get it.
I agree with marty601. Start thinking less about "liking" or not (because it's really not about whether your instructor wants to sit and have coffee with you to shoot the breeze, they're judging your performance) and really critically look at your performance. If you can't find any fault at all with your performance (not compared to others around you, but compared to what you know is right)...then make an appointment with your instructor and ask for ways you can improve.
I had a very difficuly clinical rotation last semester, this is my 4th clinical assignment. This is kind of different, I really need to know what the instructors look for in a good nursing student because i did everything and the more I tried the more get pushed and simgle out. Other student do not even get hail of the critics i get for the same thing. I really want to know, i love to be a nurse it is my dream all my live, I will be ready to improve my skill and enrich my knowledge.
I'm almost done c school now and all I can say is know your stuff, and I mean know it. If you have questions ask. Show no fear, that is what one of our instructors thrives on. Her thinking is that, if you are to scared of her to stand up for yourself when you know your right, how are you going to stand up to that doctor when you know their wrong? Honestly, I can see her point, and I think I will be a better nurse for learning that lesson.
i wrote this as an article, but i think it fits here as well... i would love some feedback from the students in this thread..
dear clinical student,
i am your soon-to-be instructor. know that i love this profession and have dedicated my life to it and to my patients. i consider this profession to be a calling. i did not come to this profession for money, for prestige, or for the title. i came to it for the love of caring for people at their worse. along the way i discovered that i love to teach the next generation this love as well, while at the same time instilling in you all the importance of taking this seriously, understanding that people live or die by your decision.
nursing today is about much more than turning a patient and washing them (although i seriously doubt it was ever about only this, despite what the movies would have you think). nursing is about understanding the medical and nursing diagnosis, medication recognition and administration, symptom management, pathophysiology, procedures, and most importantly how the nursing process fits into all of this. is it a daunting task for us to teach all of this to you in 12 weeks, yet somehow we are expected too.
i ask for your help in all of this. some things are basic. show up on time. come in uniform. make sure it is washed and pressed. look your best. remove your piercings and cover your tattoo's. wash your hands before and after entering a patient's room. imagine your grandmother in the hospital and the nurse comes in with a nose ring or a tattoo. or doesn't wash their hands. or is unclean. would you want that person caring for your family? furthermore, come awake, with passion and motivation to learn. i, like you, have a personal life. however, once we come through those doors to the unit, all of that has to be put aside and we must give all we have to caring for our patients. if we don't, who will?
furthermore, we challenge you mentally not to show you how much we know, but to stress how much you need to know. it is not enough to report a vital sign. you must be able to tell me the normal ranges, which ones are abnormal, and most importantly why. if you cannot, what good does that do your patient? it is not enough to know that a lab value is abnormal. if you cannot tell me why your post-op patient has a low hemoglobin, what good does that do your patient? it is certainly not enough to tell me the patient has a history of diabetes. you must tell me why it is so vitally important to understand the pathophysiology of hyperglycemia (high blood sugar) and how it affects the healing process, how it affects the ability of the body to fight infection, and the most accurate way to treat it. if you cannot, your patient will suffer.
to prepare for clinical is not easy. i emphasize that it takes a long time to write a care plan, and that you think it may not be as important as studying for that exam coming up. i understand that each instructor grades your papers differently, and that it feels unfair that you must change and conform to what each instructor wants. however, what you don't understand is that nursing is an ever-changing profession. each patient is unique, and your ability to care for them needs to change for each patient you see. some will love you, some will loathe you. it is not personal; they are patients who need different things, much like we are as your instructors. you ability to adapt to out of control situations and dangerous scenarios will define you and your career, not your ability to complain about the amount of work you have.
here are my golden rules to my students. take what you like. discard the rest. but understand why each is important. apply them and perhaps you will make the most of our 12 short weeks together.
1. come prepared and ready to work.
2. your hygiene and appearance means everything to your patients.
3. if you haven't spent 8 hours on your care plan it is likely incomplete. coordinate the care plan. link the pathophysiology, labs, and nursing diagnosis. show us you understand how they are all related. if you don't know, say it. but give an educated guess that shows us you are trying. i give just as much value to trying as i do to getting it correct.
4. if you know your patient has a foley catheter, nasogastric tube, chest tube, etc... look up and prepare for how to care for those. print out the care from the book. include it on your care plan. make an effort. saying i don't know to an instructor tells us you didn't care enough to look it up.
5. know the 5 rights of medication administration in and out. be ready to tell them to me during med pass. know your medications. write down the important information and be ready to discuss it at the pyxis, in the room, in the nursing station.
6. it is never personal. remember that your patients are there to get better, not provide you with an opportunity to learn. that is a gift that can quickly be taken away by your attitude.
7. watch what you say in the hallway and the volume of your voice. sound carries. your patient does not care about your lunch, your day, how mean your instructor is.
8. if your instructor yells at you, do not take it personal. listen to what they are saying and improve. show them you can internalize criticism and get better.
9. love your profession. if you are in it for anything except caring for patients, leave now. if you are in it for the money, leave even faster.
10. love nursing. every day. take every opportunity to improve your practice and the profession. this is your shot to make a difference in a world where for many it is difficult to even go to work each day. don't sell yourself short, you are about to enter the most rewarding profession there is.
Thank you so much for posting that!! I will follow those golden rules. The one I have to focus on is not taking it personal when I get yelled at. It's hard not to. I want to learn, and I love what I do, but I don't want to work in fear.
amodeldiagnostician
6 Posts
Honestly, my first two were good as gold, I am still in touch with them and they have become friends and professional mentors. The one I've had most recently is just, so inpatient and unnecessarily rude to students. Condescending. But I think it all goes back to that she graduated almost 15 years ago and that's what she maybe faced then. She is a very capable nurse and she has much knowledge, but she herself has admitted she can come off as "moody". Personally, it is this kind of catty, competitive, superiority nursing personality disorder that sometimes turns me off from the whole profession. Why do nurses treat each other so badly and not hesitate to throw each other under a bus to save themselves, it sucks.