Clinical Instructors and lecturers with no hospital experience?

[Libby_09]

With the rapid increase in Nursing students in the last few years, schools are forced to hire clinical instructors (CI's) and lecturers even though they have zero work experience. While a lot of them are likely very competent and versed in Nursing theory, I can't help but wonder if ill-prepared lecturers are part of the reason why Nursing in our country has deteriorated.

The salary is part of the allure while a lot of nurses, especially newly licensed ones, want to be a CI. In our economy right now, 20,000 - 40,000 pesos is a big amount but unless they want to be a CI forever, these new CI's are doing a disservice to their career buy not looking for work in a hospital. What's the hospital employment prospects of someone who graduated say, 5-10 years ago and has worked as a CI since then? Probably no better than someone who just earned their RN.

[suzanne4, RN]

I have a CI friend and he told me he took the job because our nursing school's affiliate hospital would count the hours he put into teaching as work experience. So more and more new grad RNs grab this chance and be CIs for a year or so, since it's freeze-hiring everywhere in Metro Manila. They'd then write resumes for abroad saying they had hospital experience.

The CIs are good teachers though. It'll only get problematic for them if they lose confidence in their skills coz they never practiced, if not having practiced for years back and need a refresher.

But writing that they had hospital experience when they actually did not could get them fired immediately for falsifying information submitted for a job. This would also then mean that they would be falsifying information given for immigration and is grounds to get everything cancelled out immediately. One signs that all information that is provided is truthful to the best of their knowledge. If they have not worked as a staff nurse, then they do not have experience as a staff nurse.

Just because a hospital is helping them file bogus information, this is not helping anyone. Their skills and time management skills will quickly show them up.

Sorry, but this is a very bad idea and thanks again for posting about this so that more hospitals in the US are aware of this practice. HR people do much reading on this site.

[NurseCubanitaRN2b, BSN, RN]

I graduated magna cum laude and did well on the board exam.

Because of this, the HR department of our school has been calling me nonstop to apply as a clinical instructor... I refused of course, knowing an effective clinical instructor is one that teaches from experience and not someone who is pumped up with theories like me.. However, its been months now and after a lot of attempts (seems like backers weigh more than credentials! ), trainings and volunteer work, im still "lost in the dark" as I would like to call it,

Now, Im beginning to wonder if I made the right decision or not...

I think you made the right decision because even though you graduated with honors...You know that you don't have clinical experience so how can you teach? You would be doing a disservice to yourself, your students and most of all the patients because you can't be a clinical instructor with out experience...The nursing schools are looking at the $$$$$$$ and nothing more....I hope you find a job soon....I just hate to see educated people volunteering when they're short of staff nurses....Good Luck

[armidevs]

I just filled in for another CI, one of the students was amazed when I asked her to look up certain clinical values, at the end of the night, she said how did you know? I knew from years of clinical experience. No, CI instructor is going to be good with no clinical experience, sorry they are only reading from a book. For this reason I know that this is a major reason Philippine students struggle with NCLEX. You have no clinical experience to refer to.

NCLEX is by the book, and not by experience.

[lenjoy03, RN]

And we ask why schools produces incompetent nurses!

Everything roots with money. Boom of nurses+ many student-nurses = needs CIs (even without experience)

This should be stopped! What would a newly graduate CI teach a student in a clinical set-up? Yes they might be equipped with theories, but what would they do when a code calls! When a curious student ask questions not found in the book! LEctures is diffirent from clinical exposure itself! I remember my sister once told me that a CI taught his student wrong information about a certain procedure. And it so happen that the supervisor passed by.. Then boom! The rest is history... BUt what if this is not correct? The student will apply the wrong procedure taught to them from COllege. For me, hiring CI without a clinical experience is a joke! It's just wasting precious time and money... BEcause if you dont hire a competent CI, there's no use putting up a nursing school!

[Ginger's Mom, MSN, RN]

The NCLEX is application based not booked based. It applies principles for nursing practice.

[armidevs]

What i meant by book based, is that the correct answers in NCLEX questions are derived from the book, and not from your experience. That's where the nurses usually go wrong when answering NCLEX questions, they based it on what they have experienced during their duties.

[Ginger's Mom, MSN, RN]

As an educator this is were I disagree with you. When I am in clinical with my students I often ask application based questions, I often say this is the type of situation where you will read a similar situation in your boards.

I also talk about the NSPGS and relate them to their patients and review the delegation of care process. Studies have shown that placing an experience makes for higher retention of knowledge. My students have a very high pass rate ( close to 100%) and most don't take a review course. I personally only recommend a rule class to students who are struggling.

I am not trying to put anyone done, I am not trying to degrading, I am just stating my experiences as clinical instructor.

[armidevs]

Hi Alexk49. If I were still a college student, I'd like to be put in under your supervision 'cos surely I would learn a lot. :)

Well, I agree with you Alexk49 that retention will be better if it is not only memorized but also put into action. But there, you are referring to student nurses, whereas, I am referring to staff nurses, those who have actual experience already.

Isn't that they say that some answers in the NCLEX questions and some information from nursing books are way too ideal? That in an actual hospital setting, it is sometimes impossible to apply it. For example, doing handwashing before you go from one patient to another for infection control. However, in an actual hospital setting, we don't get to apply that usually because we are busy.

I also had CI's before who would tell me that "this is the ideal or what is says in the book... but this is how we do it in the hospital," because probably they don't have enough supply of materials or something else is more convenient.

[Ginger's Mom, MSN, RN]

Hi Alexk49. If I were still a college student, I'd like to be put in under your supervision 'cos surely I would learn a lot. :)

Well, I agree with you Alexk49 that retention will be better if it is not only memorized but also put into action. But there, you are referring to student nurses, whereas, I am referring to staff nurses, those who have actual experience already.

Isn't that they say that some answers in the NCLEX questions and some information from nursing books are way too ideal? That in an actual hospital setting, it is sometimes impossible to apply it. For example, doing handwashing before you go from one patient to another for infection control. However, in an actual hospital setting, we don't get to apply that usually because we are busy.

I also had CI's before who would tell me that "this is the ideal or what is says in the book... but this is how we do it in the hospital," because probably they don't have enough supply of materials or something else is more convenient.

Sounds like you have had good CI, I do point out the differences in practice, most of the time the short cuts do not violate principles, so we discuss what principles have been violated. And handwashing is not an acceptable short cut, I carry alcohol sanitizer in my pocket that doesn't violate any principals unless the patient has cdff. I can walk and and sanitize my hands at the same time.

[Daly City RN]

Hi Alexk49. If I were still a college student, I'd like to be put in under your supervision 'cos surely I would learn a lot. :)

Well, I agree with you Alexk49 that retention will be better if it is not only memorized but also put into action. But there, you are referring to student nurses, whereas, I am referring to staff nurses, those who have actual experience already.

Isn't that they say that some answers in the NCLEX questions and some information from nursing books are way too ideal? That in an actual hospital setting, it is sometimes impossible to apply it. For example, doing handwashing before you go from one patient to another for infection control. However, in an actual hospital setting, we don't get to apply that usually because we are busy.

I also had CI's before who would tell me that "this is the ideal or what is says in the book... but this is how we do it in the hospital," because probably they don't have enough supply of materials or something else is more convenient.

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It is NOT A GOOD EXCUSE not to wash your hands because you are "busy". That's why in many U.S. hospitals there are many hand sanitizers available in the hallways, medication room, outside and inside the patient rooms. If a nurse's hands are obviously soiled, then the nurse MUST wash his or her hands with soap and water.

I spent many hours observing the nurses and CNAs in my unit and submitted my formal reports to our nurse manager and to the Integrated Leadership Nursing Program. The former deals with patient safety, among other things, in hospitals in the San Francisco Bay Area, California.

Also ALWAYS asking the patient's name and birthdate before giving medications or a procedure is mandatory. This is to correctly identify the patients and prevent errors. Always means always. If a nurse practices this diligently it becomes a habit, and a good and safe one at that.

If a clinical instructor has no hospital experience, then these importants things may not be familiar to the instructor and cannot pass these and other things on to his or her students.

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[NurseCubanitaRN2b, BSN, RN]

In nursing school we were taught that the most effective way to prevent the spread of infection is handwashing...When passing the state exam for CNA we had to perform handwashing for the proctor...If we didn't pass that then we would automatically fail the skills portion of the exam...In nursing school we were taught handwashing again and that it was the most effective way to prevent the spread of infection....I have to agree with the previous poster, IT'S NOT A GOOD EXCUSE not to wash your hands because you're busy...When out on the floor I'm always using the hand sanitizer that the hospital provides and I don't just wipe it clean, I use friction...Once I get back up to the nursing station, then I wash my hands...So I'm constantly washing my hands and sanitizing it...Always remember that if it were your family member would you not wash your hands because you were too busy?

[armidevs]

It was just an example okay. Of course if your hands are soiled, you really have to handwash... before giving medication, you handwash.. for obvious reasons, whether your busy or not, you handwash. i was just trying to give an example where a book says something so ideal and you don't get apply it in real situations.

You handwash whenever you can.. but hasn't there been a time when you forgot to handwash because you were so busy to do it? Again, you just forgot to do it.. and NOT intentionally did not do it for an excuse of being busy.

I guess I should've just given another example.. and besides my point there wasn't about handwashing or infection control.. but the difference between the ideal and the reality..