Published Oct 28, 2003
I am a nursing student in my 2nd year of the adn program. We are starting our clinical rotation on a local med-surg floor, until now most of our clinical experience has been in LTC.
We have a new clinical instructor this year, our class is broken up into two groups, AM's and PM's. The AM group receives their clinical patient assignment on Monday @ 1pm, they start clinical @ 7am the next day. The PM group gets their clinical assignment @1pm on Tuesday and clinical starts @ 3pm the same day. All of us on the PM clinical are quite upset about this, the AM group gets a whole evening to do their prep work, yet the PM group gets 2 hours, not fair in our opinion. We voiced our opinion to the instructors and were told, "well when you get to the real world you won't even have the two hours to prepare" We all understand this but we are students, not RN's yet, and that is not the point, still the other group is getting an advantage over us PM'ers by having a whole entire evening to review pathophys, meds, dx, h&p, etc....
Would you create this type of problem in your classroom?? Do you have any suggestions as to what us PM'ers should do?? I obviously hit a brick wall with the instructors.
As a credentialed/experienced clinical instructor, my first thought is:
What are the expectations of the group that has just two hours to prep? Are they the same as for the first group; if so, this is just not realistic?
I suspect there is a very good reason for not being able to give you more than two hours to prep. I'd advise going with it for a while, just doing your best with a positive attitude; a reasonable clinical instructor will understand the issues and adjust accordingly.
I feel you might get an easier clinical rotation this way, if not the depth of experience you deserve, but also suspect you'll learn other, very-useful-in-the-real-world skills this way.
Change your attitude to the problem and the whole issue may look very different.
Little Prep time....
I am sorry you can't see the whole picture. Choices have to be made.
"We have to split the class,(sigh) that means less prep time for the second group. It is either that Ms ONtheFloor instructor, or we will graduate less nurses...and there is such a shortage.
We want to thank you Ms OntheFloor instructor, we know we are saddling you will extra responsibility, but the truth is, the morning group will most likely spend less time looking up their patients and spend that precious time to eat and sleep and get up at 5am to be on time for the early clinical.
We are sure, Ms OntheFloor instructor that you will spend enough time with each student to make sure they are prepared, of course you will Ms OntheFloor instructor, you have to take it like the rest of us real world nurses"
We have the opposite problem. We are the am'ers who are REQUIRED to come in the night before. Oh helloooo, Sunday evening I have to come to the hospital for my assignment? Whatever for? The clinic is scheduled from 0650 to 0200, and if that isn't enough time for them to prepare us to nurse then they need to change the hours so we are doing clinic the same amount of hours the afternoon clinic people do.
We are the am'ers who give all the meds, do all the am care and prep for procedures. BUT we come in at 0600 because even though we were there the night before, the docs always change orders in the afternoon. OR the patient gets dc'd and we have a new one to work up.
The afternooners come in right before clinical. They don't have am care. Most of the meds are usually given in the am so they don't have to give 20 meds, they are lucky to give 5! Then, to top it off, we give them report with all the labs, etc. that we looked up the night and morning before. OH, my instructor says, BUT YOU ARE LEARNING MORE. Nevermind that we get NO breaks, even to pee and that the afternoon group has NOTHING TO DO so hangs around the break room.
My advice to you is, if you really want to spend more time to learn all this stuff switch your hours. I don't agree with having to come in the night before, but I wouldn't want to hang around like the afternoon clinic does doing nothing either. So, I stay with mornings.
Hey ...............Time out!!!!!!!!!! Reality Check time!!!!!!!!!!
Hospitals are open 24/7 365 and orders change on all shifts. Do you really think your are learning how to be a nurse in clinical?
Clinical is exposure to how hospitals work. You get to see and do things on people with pulses.
So when do I learn how to be a nurse ol' dinosaur BarbPick?
You are gathering up information and you will process it after you pass your Boards.
The real education begins your first position as a graduate nurse or a registered nurse.
Stop the squabbling of who gets what. Pay attention to all you see hear and smell. (Especially the smell). You will have to pull from this memory when you have done all the book studying, take the boards, then the easy stuff will be over. Yes I said the easy stuff.
Why is it that some nursing students in New York see grand cases , mega grand rounds of Professors with medical students and get to tag along. And a small nursing class in west cupcake Egypt USA, only go to a hospital with 2 wards, combined med surg, peds and OB, all on one floor, yet all students from NY and West Cup Cake take the same test and both pass with flying colors?
THEIR NURSING INSTRUCTORS PREPARED THEM FOR THEIR EXAMS AND THEIR FUTURES.
NOW, KNOCK IT OFF, STUDY YOUR BOOK ASSIGNMENTS AND BE THE NURSES YOU ARE SUPPOSED TO BE!!!!!!!!!!!
My suggestion is to stop worrying about any advantage/disadvantage someone else or some other group has. Get the most of the opportunities provided. Unfortunately it is not a perfect world.....
"It is wise to direct your anger towards problems - not people; to focus your energies on answers - not excuses."
I will be starting my 3rd semester in my BSN nursing program...all info was from last semester....
I was a pmer for my middle adult clinical which took place in the SPCU of a local hospital.......I got lots of post op cabg pts. (CT&DB)a few traumas that all seemed to not need a lot of pm work...few meds were given in the PM while we were there...I GAVE NO IV MEDS....my only IV experience came one day when I saw my instructor in the room of a patient who did not belong to a student whose IV was running out and beeping and needed a new one...I got the bag, spiked and hung it...I got to suction a trach..I gave 1 injection (one) the entire semester for this particular clinical...(I did way more in my elderly nursing clinical...many many IMs and SQs a few PPDs.. and got to do a straight cath at the nursing home)....we were not required to go in the night before either am or pm group..on a few occasions we were given information about our patients the night before through email which said about what they were in for, their meds, treatments etc..I would only ever go to the nurses station to chart...I would go around to my fellow classmates and helped them out with their patients and that's where I got to see more. I must say that I have cleaned up my fair share of #2 which to be honest doesn't bother me as much as chewed up food...(another story for another day)...I might not have done it, but I got to see it which is better than nothing at all....We did actual charting and the thursday clincal which was at the same hospital but different floor and different instructor did not do any of their own charting other than meds..Would I have rather have had the AM shift...absolutely...but I didn't and I can't change it..I was always worried about learning new things.....anyway it's down to chocolate world with the little munchkins in january to a level one trauma center...which is a better facility than up here....
I agree with Barbpick though I may not have said it all quite that way she is right on the money. Absorb what you can and hit the floor ready to learn reality once you pass your boards.
AM/PM??? We go from 7-5! Next semester will be 7-7! I am glad, because I feel the only way I will gain the experience I need is to be there for a complete shift.
I'm sure your instructor had a reason for the different scheduling. I would do as someone else suggested, try it out first, then if there is a LEGITIMATE problem, talk to the instructor. I'm not talking about a fairness issue. I think that is the WRONG place to put your focus.
We do go in the evening before clinical, but I have no problem with that. I LIKE the extra time to prepare. I wouldn't want to go in and feel rushed and harried. As a student I like the idea of being able to have some time to digest the information before taking a crack at my "victim":D
Well said Barb. I agree :)
When I was in school we had no prep time and we had alternating clinicals. This way we all learned am to pm nursing and at the end we had night shift clinicals. We got a well rounded clinical portion of the program.
When time comes to evaluate your clinical instructor you may want to suggest that if their are am/pm clinical groups, they should alternate weeks so that both groups get equal experience. But for now you are so close to graduating that I suggest you do not but your head on the brick wall you have come across. Best of luck.
Switching weeks...that's a really good idea....I think I will email my past clinical instructor and mention in...I will never have her again, but maybe she might talk to the senior instructors about it..
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