Clinical instructor/student 10:1?

Nurses Safety

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Just curious....in my state, it is a BON rule that there can be no more than 10 students per instructor for clinical settings. If a school is in violation of this rule, what happens to the school? I feel that the rule is in place to protect the patients. If anyone knows, please respond. Thanks!

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Don't think it's a BON issue (maybe someone will enlighten me) I know it's a safety/burden issue with the clinical hospital sites. They will not allow more with a given instructor in my area. An instructor is supposed to supervise all of ya (if you are lucky) and, having much more than 10 little chicks on a unit at a time is going to absolutely annoy all staff/patients on that unit.

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Specializes in multispecialty ICU, SICU including CV.

I think when I was in a clinical setting it was more like 8:1. 10:1 seems like alot.

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Specializes in LTC and Acute.

State of California requires no more than a 15:1 on clinical instruction. Luckily my clincal groups are only 8:1.

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It is a Board of Nursing issue, specifically related to a state's Nurse Practice Act. In that document, it specifies the maximum number of students that a faculty member can supervise in a clinical setting. Many states, Georgia for one, allow up to 10 in a clinical group. Alabama decreased that number several years ago from 10 to 8. As you can imagine, there are implications for these numbers, as they dictate how many faculty a school will need in a clinical setting, and going to smaller groups will cost the school more in faculty salaries. There are some clinical settings that have their own maximum number of allowed on any particular unit or floor at one time.

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I've run into both 8:1 and 10:1 ratios in different states over the years, and there may be other ratios "out there." Yes, these ratios are state BON rules, and a school that was found to be violating the rule would be at risk of losing its BON approval (and therefore, basically, its ability to operate, since its graduates would not be eligible for licensure), although that is usually a lengthy process, with the school being given opportunities to correct the deficiencies found and then re-evaluated. I've taught in situations where clinical sites allowed a lot fewer students than eight or ten on a unit, regardless of the BON expectation. In those situations, we would typically divide the clinical group among two or more units and the instructor would circulate among the units during the clinical day.

Those rules are in place not so much to protect clients as they are to ensure that students are getting adequate instruction and supervision in the clinical setting -- the hospital's staff are ultimately responsible for the safety of their clients. BON rules for nursing schools are typically in place to protect students. (Although, certainly, unsupervised or inadequately supervised students do present a risk to clients.)

Of course, I've seen situations where an instructor had the appropriate, "safe" number of students but spent the bulk of the clinical day sitting on her butt, schmoozing with pals in the clinical site, and it wouldn't matter in the least how many or how few students the instructor was responsible for, they still would not be getting appropriate instruction and supervision.

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I am the first class for LPN in my school. They are waiting on accreditation. I am 4 weeks out from graduation, and am concerned that this may affect my licensure, if it is reported.

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Specializes in Cardiac care/Ortho/LTC/Education/Psych.
I've run into both 8:1 and 10:1 ratios in different states over the years, and there may be other ratios "out there." Yes, these ratios are state BON rules, and a school that was found to be violating the rule would be at risk of losing its BON approval (and therefore, basically, its ability to operate, since its graduates would not be eligible for licensure), although that is usually a lengthy process, with the school being given opportunities to correct the deficiencies found and then re-evaluated. I've taught in situations where clinical sites allowed a lot fewer students than eight or ten on a unit, regardless of the BON expectation. In those situations, we would typically divide the clinical group among two or more units and the instructor would circulate among the units during the clinical day.

Those rules are in place not so much to protect clients as they are to ensure that students are getting adequate instruction and supervision in the clinical setting -- the hospital's staff are ultimately responsible for the safety of their clients. BON rules for nursing schools are typically in place to protect students. (Although, certainly, unsupervised or inadequately supervised students do present a risk to clients.)

Of course, I've seen situations where an instructor had the appropriate, "safe" number of students but spent the bulk of the clinical day sitting on her butt, schmoozing with pals in the clinical site, and it wouldn't matter in the least how many or how few students the instructor was responsible for, they still would not be getting appropriate instruction and supervision.

Same thoughts here. I have always from 8-10 . Our hospital does not allow more than 8 on one unit so I have to put them on other units or organize somehow. So true about instructors. This job can be very stressful and letting students go on their own without supervision is just plain wrong.

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Specializes in Gerontology, nursing education.
Same thoughts here. I have always from 8-10 . Our hospital does not allow more than 8 on one unit so I have to put them on other units or organize somehow. So true about instructors. This job can be very stressful and letting students go on their own without supervision is just plain wrong.

Agreed. However, as a clinical instructor I have had students who were split between two floors and I spent a lot of time in the stairwell, going from one student group to another. It wasn't really fair to me, as a new CI, and it certainly wasn't fair to the students. I've had ratios of 10:1 and 8:1 and ran my backside off.

I don't think it is going to hurt the OP's ability to sit for NCLEX or get licensed if there is a complaint about the school after she (or he) graduates. But I could be mistaken on that....

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Here in Virginia it is a BON/ Nurse Practice act issue.

About 5 years ago when the 'nursing shortage' was very much in the news, a legislator submitted a bill to increase the ratio to 15:1 thinking that this would mean that schools could educate more students at the same time and increase the output of RNs. Mr. Legislator was surprised to see the Virginia Nurses Association (as well as the state hospital association) oppose the legislation.

We operate at an 1:8 ratio in inpatient settings for pre-licensure students. Graduate classes have a 1:6 precepted ratio (one professor oversees the precepted experience of 6 students).

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Specializes in LTC, Psych, Hospice.

WOW! When I did my LPN clinicals, our ratio was 5:1

10:1 seems like a lot to me.

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Specializes in Hospice / Ambulatory Clinic.

We had 15:1 at the LTC and that worked fine. At the acute hospitals we had about 10-12:1 on one unit. My final term is was down to 8:1 Spread over 2 units and 2 sent down to the ER. Supervision was minimal but everyone was supervised when administering meds with the exception of the ER but as LVN's I only gave one med in ER IM Toradol for a drugseeker (lucky me they felt comfortable delegating that ha)

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