I need some honest opinions from people outside my circle, as all of my fellow students share my same opinion and all the faculty blow sunshine up my you know what, when I even hint that the situation isn't right. So here is the deal...
Me: Adult senior student in BSN program at local university
Preceived problem/issue: Clinical assignments
History:
Fall semester junior year - 10 wks clinical mostly focused on CNA duties w/some assessment
Spring semester junior year- 7 wks med/surg where I passed meds 3 times, then 7 wks mental health where I observed patients (not shadowing nurses) in different settings (eating disorders, adolescence, geriatrics, etc)
Fall semester 2011 -
14 wks med/surg at a nursing home, where I (a BSN student) shadow an LPN whose primary duties is to administer medications to 30-45 patients in their 8 hours shift.
*LPN's, please don't be offended or turn this thread into an arguement of LPN's vs BSN"s. I fully appreciate that I can learn a lot from an LPN and these people bust their A** all day, every day. My issue is that my university placed me in a clinical situation where I am shadowing a nurse who 98 % of the time is handing out PO meds to long term residents, who are primarily stable (because they take 17 meds 3 times a day...OMG).
Community clinical-public health nursing- 7 wks at a local health dept whose budget has been desimated, so we spend our time watching CD's, observing employees in the Lead Poisoning program, or shadowing health inspectors. One was lucky enough to do an at home visit w/an actual nurse meeting w/an at risk mother.
My feelings- I am ANGRY. My primary complaint is that I feel like I am paying a ton of money to learn how to do everyone elses job. My mental health clinical taught me the job of behavioral health specialist (the counselors), my current med/surg clinical is teaching me what it is like to be a full-time CNA (as when I am done assessing and medicating my patient I answer call lights all day, as there are never enough CNA's to help the residents and my community clinical, where I am learning the jobs of health inspector and other misc health dept personnel.
The final thing I will say is I appreciate that all of these people are part of the health care team and I need to have an understanding of what they do, but I have a finite amount of time to learn NURSING, and it feels like I am learning anything but. While I think every student nurse would do well to be exposed to a nursing home setting, I am spending the greatest chunk of my clinical experience there, while my classmates in other clinical groups are one on one w/ICU nurses, in IV clinics, and in hospitals with acute patients, experiencing hospital nursing.
Am I wrong? Should I believe my instructors who give me the party line of "it's a good opportunity to learn____" fill in the blank. I feel like the clinical portion of this nursing program is substandard and I keep getting sunshine in an attempt to deflect the fact that I am in fact right. Please tell me what you think, as I am about to lose it!
Specializes in General surgery ,Vascular, Orthopedic.
Like others have previously posted you do have to consider clinical opportunities your nursing school was able to obtain for their students because it is a competition ...not only that but finances and legal liability also play a part in this but enough of the business aspect of nursing school there are a few things that I need to know about you senior status: 1) Are you in your last semester/preceptorship 2) How many semesters are in your nursing school program. The best way I know how respond to your post is to compare it to my clinical rotations. I graduated Spring(april)2011 from a BSN program in Alabama, so I'm still technically a new grad, but retracing my steps to Spring 2009 1st semester ( Foundations/Pharm/Assessment) clinical assignments for that semester included LTC (where we participated with CNA,LPN, and RN) we also worked hand and hand with our instructors at the LTC to practice our assessment and other fundamental elements in nursing. 2nd semester (Med-surg/Patho/Peds) clinical assessments included Med-surgical hospital rotations, Pediatrics, county Health dept, Flu shot drive, a local Same-day surgical facilities ( where we participated and shadowed pre/intra/post operative RN duties, yes that did include IV's). 3rd semester (OB/PSYCH/Patho 2) clinical rotations included a mental health facility, Nursery/L&D/Post-Partum rotations and County Health dept (but this time it was more focused on women's health, STD screening, pap smears, and education related to this topics also venipuncture procedures. 4th semester (community health and med-surg 2 aka critical care) clinical rotation included hospice/wellness clinics/ER/MICU/SICU/Cath lab. 5th semester (Transitions/preceptorship) depending on how well you did during nursing school you could have gotten an ICU/ER internship or another medical floor (med-surg, transplant, etc) and then after that you graduated....we also had research, leadership, and Geronimo classes that you could elect to take during summer break or during your other courses (which would have been suicide for me) .....so yeah....don't feel as if your nursing school department has failed you it is what you make it to be and if you feel as if changes need to be made then let them know that ...I'm sure you have course evaluations at the end of the semester (right?) ...and when you land a job there will be plenty of oppurtunities to start IV's, coleus, blah blah blah what you need to do is focus on your weakness and try to strengthen them to the best of your ability while you can still use your "Hi, I am a student nurse" card, ya get me. Also this was not a opportunity for me to boast about my school blah blah blah so PLEASE don't take it that way ok, best of luck you're halfway there!!!
Reading these posts explains a lot. I feel really grateful to have graduated from a three year hospital school of nursing diploma program. The hospital was across the street from the nurses residence. Yes, we students lived in the residence and did not have the situation so many have of commuting from home to school. We were immersed in the nursing education process. Our hospital was a teaching hospital similiar to the Cook County hospital one used to watch on ER. So we had all the various specialities of acute care such as OB, GYN, ortho, GU, etc. as well as Med-Surg. We also had clinics. Students rotated through all the clinical areas. Our psych rotation was three months in length and the psych hospital was also just across the street. As Seniors we had the experience of being the Charge Nurse.
I don't understand totally what some mean by 'CNA duties' - sounds like fundamentals of nursing. I don't understand why some nursing students seem to have an aversion to bedside nursing. But we have all been around those nurses who seem to think they are too good for hands on nursing.
It really does seem like some students are being cheated out of the clinical experience you should be getting and are paying dearly for something you are not getting. I do take exception to the comment about hospice being boring. Most hospice patients are cared for in their homes and you will find these patients to have a wide range of medical conditions. Plus you have the added impact that they are dying and all that adds to the situation for the patient and their loved ones.
I wish all of today's nursing students the best. It does seem there are a lot of issues with the programs being offered today!
I would love to have been able to get my nursing education as you describe but there are no more of those programs in my area.
We all understand that "CNA duties" are a part of nursing but the point I am trying to make is that I ALREADY have those skills. I don't need to pay thousands of dollars to practice them at a hospital 2 hours from my home.
Hospice isn't for everyone. I don't like it at all. In my limited clinical experience in clinical, it was more like social work than anything else. All we did was TALK to the patients and I know that social contact is very important but filling up some liquid morphine syringes was the highlight of the day. I'm sure there is a huge variety of conditions that hospice patients suffer from but for me, it was sitting in stinky, cigarette smoke filled homes with lung cancer and COPD patients. I know that sounds terrible but I HATED it. I don't care for home health nursing, either.
You are missing a lot if you don't get to experience critical care, trauma, cv, neuro, general icu stuff, ER. Critical care is all about assessment and thinking. You also should see peds, labor and delivery, post postpartum, nursery, cath lab, surgeries, mental heath... It's important to see which kind of nursing your interested in, not to mention just sheer exposure, even if the stuff your doing wouldnt take a RN license to do. I was in Houston area, so maybe I was just lucky.
Like others have previously posted you do have to consider clinical opportunities your nursing school was able to obtain for their students because it is a competition ...not only that but finances and legal liability also play a part in this but enough of the business aspect of nursing school there are a few things that I need to know about you senior status: 1) Are you in your last semester/preceptorship 2) How many semesters are in your nursing school program. The best way I know how respond to your post is to compare it to my clinical rotations. I graduated Spring(april)2011 from a BSN program in Alabama, so I'm still technically a new grad, but retracing my steps to Spring 2009 1st semester ( Foundations/Pharm/Assessment) clinical assignments for that semester included LTC (where we participated with CNA,LPN, and RN) we also worked hand and hand with our instructors at the LTC to practice our assessment and other fundamental elements in nursing. 2nd semester (Med-surg/Patho/Peds) clinical assessments included Med-surgical hospital rotations, Pediatrics, county Health dept, Flu shot drive, a local Same-day surgical facilities ( where we participated and shadowed pre/intra/post operative RN duties, yes that did include IV's). 3rd semester (OB/PSYCH/Patho 2) clinical rotations included a mental health facility, Nursery/L&D/Post-Partum rotations and County Health dept (but this time it was more focused on women's health, STD screening, pap smears, and education related to this topics also venipuncture procedures. 4th semester (community health and med-surg 2 aka critical care) clinical rotation included hospice/wellness clinics/ER/MICU/SICU/Cath lab. 5th semester (Transitions/preceptorship) depending on how well you did during nursing school you could have gotten an ICU/ER internship or another medical floor (med-surg, transplant, etc) and then after that you graduated....we also had research, leadership, and Geronimo classes that you could elect to take during summer break or during your other courses (which would have been suicide for me) .....so yeah....don't feel as if your nursing school department has failed you it is what you make it to be and if you feel as if changes need to be made then let them know that ...I'm sure you have course evaluations at the end of the semester (right?) ...and when you land a job there will be plenty of oppurtunities to start IV's, coleus, blah blah blah what you need to do is focus on your weakness and try to strengthen them to the best of your ability while you can still use your "Hi, I am a student nurse" card, ya get me. Also this was not a opportunity for me to boast about my school blah blah blah so PLEASE don't take it that way ok, best of luck you're halfway there!!!
There is no competition in my area so that isn't a factor.
Here is what we get/got for clinical. First semester we were in a LTC.
Second semester we were on med surg at 2 different hospitals. We also got one day rotations in home health, OR, ER, and endoscopy.
Third semester was peds, mother-baby, and L&D. Lasted 6 weeks so we didn't see much.
Fourth semester is now. We're on the most boring med surg unit on Earth with one day rotations through OR, ER, Endo, dialysis, wound care, home health, hospice and health department. Some people are only on med surg and don't get any of those other rotations.
Fifth semester we are at a major metropolitan hospital and we choose from cardiac, pulmonary, trauma (not major trauma), or neuro. We don't get to rotate through them all or switch. Whatever we pick is what we get for the entire semester.
Today, we drove our 2 hours one way to clinical and we... sat in the conference room. That's right, folks.
i am such a tease, but before i give you the update, i would like to comment of a few things i've read from new posters since i last wrote.
regarding the post that said:
"dear am i crazy, what exactly were you expecting from your clinical rotations? just because you're an"adult senior student " was that suppose to make a difference? in order to be a well rounded nurse yes, you do have to learn everyone's role in patient care, so you don't become a nurse who looks down at lpns and cnas because you are holding the clipboard!!! what did you think nursing is?"
what i was expecting from clinical rotations was to be taught nursing. i wasn't expecting to go to my mental health rotation and spend all of my time observing "behavioral counselors" and watching art therapy. i wasn't expecting to go to my community health clinical to shadow the restaurant inspector. while i completely agree with you that to be a well rounded nurse you do need to know everyone's role, that does not mean you should have to spend the little precious clinical time you have learning their job. for example, health inspectors are vital to community health, but i am never going to be hired to do that job, so why should i be spending an entire day observing him, instead of observing a public health nurse???
with regard to my being an "adult senior student", i only included that to give the reader a basic understanding of who was authoring the post.
with regard to looking down on lpn's or cna's... character, not education, dictates how people treat each other.
to the person who wrote:
yes, we know answering call lights and giving baths are going to be part of the job but, really, watching the nurses in the hospital.....most of them don't. so don't tell me i can learn something from answering call lights and giving baths.
thank you!
to the person who wrote:
it might seem like following a med pass is not a good learning experience, but...did you know that this med pass needs to be completed within a certain time frame? did you know certain drugs have parameters, like taking a pulse with dig, checking an inr with coumadin, what is the blood level for the pt on phenobarb?
okay, this in encouraging, because i did know this...woohoo! and btw, i am doing some of the things you suggest and what i am not doing, i will. thanks!
i transfered in w/an aa from a local comm. college. my bsn program goes like this...
junior year:
fall:
fundamentals (w/6 wks of cna & health assessment clinicals on a med/surg or ortho/neuro floor)
health assessment
into to nursing (a writing/theory class)
lab time for fundamentals & assessment
spring:
fundamentals ii (w/7 weeks of clinicals on med/surg floor-passed meds 3 times)
pharm
mental health (w/7 weeks at mh hospital-observing counselors entire time)
senior year:
fall
med/surg (w/14 wks of clinical, all of which i have spent at a nursing home)
community health (w/7 wks of clinicals at local hd whose work force has been cut by 60% due to funding)
research (learning about nursing research-how to do it, how to review research articles)
spring
med/surg ii (w/7 wks of clinicals...where i do not know?)
nursing mgt
ob/peds ( w/14 wks of clinicals-7 ob, 7 peds)
what i can tell you about our hiring rate...they told us back in august that 80% of the seniors had gotten jobs, but i do believe some of that has to do w/the economy. our nclex pass rate is between 97 -100%, if that stat helps.
okay, here's the update...
our med/surg instructor, who oversees all of the clinicals & adjunct faculty came to observe our clinical 2 wks ago. the dean of nursing was scheduled to come today to observe, but instead we were called together this morning and told that he was not coming. instead we were advised that our school would not be using this clinical site again! i am not crazy-woohoo!!!!!!!!!!!!!
while i am still wicked ticked (and that's not the real word i wanted to use) that i've had to go through this, i am consoled by the fact that none of my fellow classmates will have to go through this. while i think it would be beneficial for them to spend one or two weeks there, to observe how not to do things, and how not to treat people, i am glad they won't spend their final clinical in this hell hole. please understand me, i know there are a lot of great nursing homes, with fabulous, hard working people, but where i have been isn't one of them.
highlights of my time there...
watching a cna clean an incontinent resident w/the dry corner of the diaper.
going to the linen room for a blanket and finding a tiny closet filled floor to ceiling w/donated blankets that looked like they came from the homeless shelter.
walking in early at 4am (so i could hang an ivp) and seeing half a dozen residents already up, dressed, and sleeping in their wheel chairs.
finding a resident fully dressed, under the covers in bed at 5am.
seeing the med cart full of little paper cups full of medicine w/room numbers written in the bottom of the cups.
watching the nurse give an insulin shot as i am about to take the blood sugar.
cleaning a wound with toilet paper and water.
having one thermometer for 100 people.
having the chart say the resident is in room 65 b, when they are in 78 a.
having the front of the chart say nkda, only to look inside and see they are allergic to 3 different drugs.
and, not yet seeing one toothbrush in the 11 weeks i've been there.
good times i tell you!!!
thank you all so much for your kind words of encouragement, support, and advice. and to all of the lpn's out there who do their best to care for their 30-45 patients during a shift, i respect the hell out of you and wish you well!
Specializes in Mental Health/Oral Surgery/Medical Detox.
Well let me say that you sound like an EXCELLENT nurse already and just pass the boards girl. You will be sitting for them before you know it. I for one and proud of you and wish you all the best.
PS, i'm an LVN and when I got IV certified, at a private class there were all RN's there and me. The class was supposed to be 16 hours. They had each of us start an IV and we were certified. It happens all the time. I was already starting IV's as an MA, (I know RN's you can freak out now). I had nothing to loose then. You choose Just keep on keeping on.....:yeah:
Specializes in General surgery ,Vascular, Orthopedic.
I'm really glad that the "higher ups" got involved because honestly after reading that update I really didn't know what else to say that was constructive about.your situation don't let this discourage you though and "tsk tsk " to those instructors
quit complaining . or is it because you are working toward your bsn .
listen to you talk "14 wks med/surg at a nursing home, where i (a bsn student) shadow an lpn whose primary duties is to administer medications to 30-45 patients in their 8 hours shift. "
reading this alone make me realize : you are too full of yourself and be careful before you hurt a patient in the process on your nursing journey .
you knew you were going off on your thinking so you asked in advance that this turn not into a discussion but really that what your entire post is asking for a debate i am guessing you see and think of yourself as being more than other nurses hun?
how do you explain what you wrote ? quote " where i (a bsn student) shadow an lpn whose primary duties is to administer medications to 30-45 patients in their 8 hours shift. "
this speaks volume of you again watch yourself not to wear that title over your head .
read again what you wrote below
" i fully appreciate that i can learn a lot from an lpn and these people bust their a** all day, every day. my issue is that my university placed me in a clinical situation where i am shadowing a nurse who 98 % of the time is handing out po meds to long term residents, who are primarily stable (because they take 17 meds 3 times a day...omg). "
are you serious ???? these people ???? bust their a** at your level ( bsn student ) shouldn't you know a proper way and language that will fit to adress any compliment if at all sincere to your fellow nurses ?
ok what wrong with lpn passing po meds 98% and you shadowing her ? are you sure you are in this field for your love of nursing or is there a hidden agenda? money may be ???? a nurse by heart will wipe butt with satisfaction a complete 8 hrs shift if that what requires for the pt comfort and no complaint.
you are complaining ????? you can take advantage of the time and learn all there is info ( action, adverse effect / side effect / drug interaction ect...all about those meds being passed and while there share your knowledge as a bsn student with the lpn who in view has no better things to do than pass meds 98% 8 hrs a shift.
did you had to end your quote with omg ???? really???????you sound like those nurses who wear their title on their head yet have no compassion for the patients and know little to nothing about hands on practical nursing care .
it also clear from your wrinting that you went straight to the higher degree you never been in the cna's lpn's position to realize what nursing is truly about .
caring for the patient and that you can do whatever you are . in home, nursing home , in a car traveling... you don't have to be in the hospital to practice nursing .
it sad from your post i can feel resentment not just for the dedicated nurses you have to shadowed but for the patients as well .
did you realize that you have just said outloud that being there to help resident take their meds is a waste of your time omg!!!!!
being that you are a step higher in education take time to read about the resident hx and illness , discuss that with the lpn , help her understand and learn what you know and she may not about the various condition and disease process + tx . make your time there a learning experience .trust me you will do yourself a favor instead of being here complaining. you are missing the point of your clinical. i believe your assignment has to do with you taking on a role of supervisor, teacher , and perhaps to break you down who knows your instructor may have seen in you someone who 's full of herself forgetting that it all about the patient. therefore you need to walk in cna's , lpn's shoes just like you are and i am sure you feeling it !
Just read your update and what did you do about these situations? or did you just ignore them and walk off ? You sound much better this time or should i say broken . You have seen and experienced also learned some stuff hein? and now
Specializes in General surgery ,Vascular, Orthopedic.
quit complaining . or is it because you are working toward your bsn .
listen to you talk "14 wks med/surg at a nursing home, where i (a bsn student) shadow an lpn whose primary duties is to administer medications to 30-45 patients in their 8 hours shift. "
reading this alone make me realize : you are too full of yourself and be careful before you hurt a patient in the process on your nursing journey .
you knew you were going off on your thinking so you asked in advance that this turn not into a discussion but really that what your entire post is asking for a debate i am guessing you see and think of yourself as being more than other nurses hun?
how do you explain what you wrote ? quote " where i (a bsn student) shadow an lpn whose primary duties is to administer medications to 30-45 patients in their 8 hours shift. "
this speaks volume of you again watch yourself not to wear that title over your head .
read again what you wrote below
" i fully appreciate that i can learn a lot from an lpn and these people bust their a** all day, every day. my issue is that my university placed me in a clinical situation where i am shadowing a nurse who 98 % of the time is handing out po meds to long term residents, who are primarily stable (because they take 17 meds 3 times a day...omg). "
are you serious ???? these people ???? bust their a** at your level ( bsn student ) shouldn't you know a proper way and language that will fit to adress any compliment if at all sincere to your fellow nurses ?
ok what wrong with lpn passing po meds 98% and you shadowing her ? are you sure you are in this field for your love of nursing or is there a hidden agenda? money may be ???? a nurse by heart will wipe butt with satisfaction a complete 8 hrs shift if that what requires for the pt comfort and no complaint.
you are complaining ????? you can take advantage of the time and learn all there is info ( action, adverse effect / side effect / drug interaction ect...all about those meds being passed and while there share your knowledge as a bsn student with the lpn who in view has no better things to do than pass meds 98% 8 hrs a shift.
did you had to end your quote with omg ???? really???????you sound like those nurses who wear their title on their head yet have no compassion for the patients and know little to nothing about hands on practical nursing care .
it also clear from your wrinting that you went straight to the higher degree you never been in the cna's lpn's position to realize what nursing is truly about .
caring for the patient and that you can do whatever you are . in home, nursing home , in a car traveling... you don't have to be in the hospital to practice nursing .
it sad from your post i can feel resentment not just for the dedicated nurses you have to shadowed but for the patients as well .
did you realize that you have just said outloud that being there to help resident take their meds is a waste of your time omg!!!!!
being that you are a step higher in education take time to read about the resident hx and illness , discuss that with the lpn , help her understand and learn what you know and she may not about the various condition and disease process + tx . make your time there a learning experience .trust me you will do yourself a favor instead of being here complaining. you are missing the point of your clinical. i believe your assignment has to do with you taking on a role of supervisor, teacher , and perhaps to break you down who knows your instructor may have seen in you someone who 's full of herself forgetting that it all about the patient. therefore you need to walk in cna's , lpn's shoes just like you are and i am sure you feeling it !
wow, you didn't have to bite her head off, this is not a professional forum where apa format is required. when i read her post i saw a frustrated person who is probably just "venting" his/her frustrations with nursing school. calm down it's ok :)
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you're halfway there!!!
:yeah:
bleubutterfli
8 Posts
Like others have previously posted you do have to consider clinical opportunities your nursing school was able to obtain for their students because it is a competition ...not only that but finances and legal liability also play a part in this but enough of the business aspect of nursing school there are a few things that I need to know about you senior status: 1) Are you in your last semester/preceptorship 2) How many semesters are in your nursing school program. The best way I know how respond to your post is to compare it to my clinical rotations. I graduated Spring(april)2011 from a BSN program in Alabama, so I'm still technically a new grad, but retracing my steps to Spring 2009 1st semester ( Foundations/Pharm/Assessment) clinical assignments for that semester included LTC (where we participated with CNA,LPN, and RN) we also worked hand and hand with our instructors at the LTC to practice our assessment and other fundamental elements in nursing. 2nd semester (Med-surg/Patho/Peds) clinical assessments included Med-surgical hospital rotations, Pediatrics, county Health dept, Flu shot drive, a local Same-day surgical facilities ( where we participated and shadowed pre/intra/post operative RN duties, yes that did include IV's). 3rd semester (OB/PSYCH/Patho 2) clinical rotations included a mental health facility, Nursery/L&D/Post-Partum rotations and County Health dept (but this time it was more focused on women's health, STD screening, pap smears, and education related to this topics also venipuncture procedures. 4th semester (community health and med-surg 2 aka critical care) clinical rotation included hospice/wellness clinics/ER/MICU/SICU/Cath lab. 5th semester (Transitions/preceptorship) depending on how well you did during nursing school you could have gotten an ICU/ER internship or another medical floor (med-surg, transplant, etc) and then after that you graduated....we also had research, leadership, and Geronimo classes that you could elect to take during summer break or during your other courses (which would have been suicide for me) .....so yeah....don't feel as if your nursing school department has failed you it is what you make it to be and if you feel as if changes need to be made then let them know that ...I'm sure you have course evaluations at the end of the semester (right?) ...and when you land a job there will be plenty of oppurtunities to start IV's, coleus, blah blah blah what you need to do is focus on your weakness and try to strengthen them to the best of your ability while you can still use your "Hi, I am a student nurse" card, ya get me. Also this was not a opportunity for me to boast about my school blah blah blah so PLEASE don't take it that way ok, best of luck
you're halfway there!!!