Advice needed about clinical instructor

Nursing Students Student Assist

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I'm having some trouble in a clinical course with one of my instructors... My confidence is somewhat low, but I feel like she hasn't given me a real chance to demonstrate what I am capable of.

For example, I was going to do an IV start on a patient. Before we went into the patient's room, I asked if I should explain what I was going to do beforehand.... She didn't think this was necessary, but then at the bedside she told me exactly what to do for every single step. I felt like I didn't get a chance to demonstrate what I actually knew about the skill. I also felt like having everything described in front of the patient may have been scary for this pt. I understand that some of this was necessary, but maybe not for every step. I should have been able to insert the IV bevel up with a 30-45 degree angle and then lower w/ flashback on my own without being told all of that right in front of the patient. I get flustered easily (which I realize is something I need to improve on), but this just made it worse... especially since she had a different way of doing things than I was taught. During the skill, I was able to insert the IV ok and advance the cathlon but ran into problems when she told me to hold on to the cathlon and "not to let go." I felt so frazzled about what I was doing... She started holding on to the cathlon, so I thought it would be okay to let go... anyhow, this didn't work out so well..... Afterwards, I expressed my disappointment about my performance to the instructor but I think this just reinforced my low level of confidence....

Another example: During an admission of a patient w/ a language barrier, I didn't feel like I had a chance to demonstrate what I actually knew about communication. As soon as we ran into trouble, the instructor told me exactly what to say next... She didn't pause and allow me to work through it. I could have worked through this on my own! She even told me when to thank another student for helping me out... I could have done this myself!

In the first half of the course, I barely saw my instructor because we were on another unit... (long story). Now she is telling me that she doesn't think I have the confidence to preceptor in the ICU... but I feel that her judgment is based on situations in which she didn't give me an opportunity to show what I know.

My confidence is low, but I will do whatever it takes to be successful. She tells me she "doesn't want me to fail" but I'm in my 4th year and have been very successful so far and earned this placement. I know I will have to deal with lots of scary equipment in the ICU and that this will take some getting used to. But I don't think the teacher is judging me based on a fair assessment of my capabilities....

What should I do? I am so frustrated and at a loss of what to do as I only have a few more clinical days left to change her mind.

Specializes in Adult Internal Medicine.
GrnTea, some of what you said is correct... but some of it is taken out of context... Yes, I agree with the instructor that my confidence could use a boost. No, I don't agree with her that I should not preceptorSHIP in the ICU - I work hard at school and will do whatever it takes to succeed.

Apparently everything short of assuming that because you are a good student you know more than your preceptor.

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Specializes in NICU.

But with language barriers, you may think you're meaning one thing, but the patient is hearing something else. With language barriers, tricks only get you so far...a translator ought to be used for best accuracy.And like with skills, there is a benefit to observing or following the direction of others when communicating with your patients. Just because she does things differently than your other instructors does not mean its incorrect - it may be frustrating because it's not what you're used to, but stepping back and trying to understand what she is trying to teach you can help you see the benefits in her methods.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
This has nothing to do with whether I like the instructor or not. I actually do. As far as safety is concerned, I can understand that she needs to show me how to do the IV. However, talking to a patient with a language barrier was not a safety issue, and she didn't have to tell me how to do this. She could have given me a chance here.

I think I'm learning that I shouldn't let others know that I have self doubt. It's ok to ask questions when I'm unsure... but I should never show a lack of confidence in myself.

I think you are trying to spread your wings and develop that confidence she says you need and you felt she didn't give you that opportunity. If you got that ICU preceptorship.....you will be stiffled...alot. ICU nurses are very territorial when it comes to their patients.

Talk to your instructor and tell her you felt she stepped in too soon and you really want to prove to her that you are worthy of the ICU......that you know you are worthy and capable o the ICU you just need to prove it. Confidence is one thing...... be careful you don't become overbrearing.

You maybe in your last year of school but you are at the beginning of being a good nurse.

Good Luck!

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Specializes in ortho, hospice volunteer, psych,.

thank you, earthcrosser. you were able to say exactly what i was trying to say above.

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Specializes in HH, Peds, Rehab, Clinical.

Hmmm, we learned that the catheter goes in at a 15 degree angle, LOL

That said, it's her JOB to instruct you. Period. Since you have not yet passed the NCLEX and don't possess a nursing license of your own, you are doing every single thing in that clinical under HER license. It doesn't sound to me at all like this instructor was "judging" you. Sounds to me like she was doing what she's paid to do...

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Specializes in HH, Peds, Rehab, Clinical.

You DID do the performance. Correct? YOU inserted the IV and it didn't go so well. THAT'S what you're evaluated on. To me it sounds like you're looking to place the reason for your feelings of being easily flustered onto someone else

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Specializes in APRN, ACNP-BC, CNOR, RNFA.

Okay everybody, let's ease up a bit. It's her last semester of school, she's anxious, and she wants an ICU placement.

2bnurse, I think if you relax and take some of the suggestions of the previous posters, I think you'll do fine. Practice is all you need to gain that confidence. I prefer a student who is a little unsure and says so, instead of one who pretends to know what they're doing and then screw it up. How are your classmates faring? Are they having any problems with this same instructor? Could it be that she treats everyone this way? If she decides against an ICU placement, how about 1/2 a semster on another unit (IMU, Step-down, etc.) to show her you've got the skills, and the other 1/2 in the ICU. To be honest, nursing students rarely get to do anything susbstantial in the ICU anyway, the nurses don't allow it.

Relax, enjoy the learning experience. Take any and all advice given, attitude is SO IMPORTANT. Most importantly, don't **** off the instructor, she can make your life hell. Good Luck!

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Specializes in trying to figure it out.

Dear 2bnursebet... I completely understand where you are coming from. Before going into a room to do a procedure for the first time. It was our standard to verbally go over the steps out in the hallway with our instructor before going in to room. At that time the instructor would give me tips and or pointers. Then go in to see patient, let them know what I will be doing and begin the procedure with the instructor "overseeing" what I was doing. If I started doing something out of order, or improperly she would say "take a second "my name" , think of what we talked about earlier and you'll do fine". It was awesome. Without making me feel inept or self conscious, she would calmly give you a second to make sure you were thinking things through. Therefore, I could certainly remember what we just went over 5-10 mins ago out in the hall and if I DID fumble she would remind me, or step in gracefully and help. I felt that was very confidence building. Sounds like she never even gave you a chance to intellectualize then verbalize what you were going to do. I am i no way saying she isn't a good instructor and YES you are working under her license until you get your owm. But by far a little positive reinforcement goes a long way! I think those kind of instructors anymore are the exception to the norm. Just as so many unit nurses are overwhelmed and in a rush. So are Nursing instructors most of the time too. But I also had an instructor that seemed to get off watching us squirm and get frazzled. Well, I have to say I learned WAY more from the patient instructor!!! so here is a big hug for you:kiss okay a friendly kiss on the cheek LOL I couldn't find the hug. If you could politely say to her out in the hall. "Ms. nurse Instructor can we please just take a moment now before we go into the room to mentally walk myself through it. I'd be much more prepared and less nervous". Might work. Good luck and god bless.

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Specializes in trying to figure it out.

OKAY.. agrees with kguill whatever you do don't get on your instructors bad side!!!

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I think that your instructor is doing just fine. Be happy for practice and guidance. Remember when she is teling you what to do that you are working under HER license, she has to be sure you don't mess up.

That is incorrect. Haven't we been over this a million times on this forum?

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Hmmm, we learned that the catheter goes in at a 15 degree angle, LOL

That said, it's her JOB to instruct you. Period. Since you have not yet passed the NCLEX and don't possess a nursing license of your own, you are doing every single thing in that clinical under HER license. It doesn't sound to me at all like this instructor was "judging" you. Sounds to me like she was doing what she's paid to do...

I learned 30 or less... and then my instructor instructed me to insert at 45. This threw me off, and I started to doubt myself. Yes I would have liked a chance to discuss it before going in the room.

I didn't say she was "judging" me. I would have liked a chance to intellectualize the skill with her beforehand. Whoa-now got it right - I needed a few minutes to explain to her what I was going to do so that we would be on the same page.....

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Specializes in Occ. Hlth, Education, ICU, Med-Surg.

here's the thing...no instructor is going to make a determination of preceptor placement based on these two events (i.e. IV placement and an isolated communication event)

what does make sense is that your instructor has made a determination based on a period of assessment and has determined that you are currently lacking or need development in areas that he/she feels are necessary for successful completion of ICU preceptorship

there is more to this than what the OP is revealing

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