Clinical Instructors and lecturers with no hospital experience?

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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.

Specializes in Neuro-Surgery, Med-Surg, Home Health.

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There are thousands of things that an experienced clinical instructor can teach to his or her students. This doesn't mean that the instructor will be able to teach them all, but the experienced clinical instructor can teach his or her students the appropriate things when an opportunity, a case or an incident presented itself at an opportune time. These can be discussed, debated or even spoon fed if needed be for the benefit of the students.

If the clinical instructor has no hospital experience then this C.I. will be scratching his or her head along with the students when they don't know the answer. This is the perfect example of a dangerous school of nursing who allows inexperienced C.I.s to teach green students.

(By the way I received an email from allnurses.com this Christmas morning stating that I haven't been active lately. OK, I'm scratching my head now because I posted at least a couple of comments just this past week alone. I hope the moderators will clarify this.)

Merry Christmas to everyone!

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Specializes in ICU, Coronary ward.

Hospitals here in the Philippines now require CI's to undergo 2 months of training before they can be allowed to handle students in the hospital. I know, that still isn't enough but it could be a solution to the problem of having seasoned nurses as CI's . A seasoned nurse would probably be abroad or already a nurse supervisor who would mostly do paperworks..

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Specializes in Nurse Anesthetist.
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.

Hello Armidevs.

I understand your point so much like I understand the point of Alexk49.

I am a product of a Philippine Nursing school, and so I understand that what filipino nurses are practicing in the actual area may not as always be the ideal nursing skills that is being scripted in nursing books. Filipinos practices nursing in a flexible and resourceful way brought about by the limited resources. That is why I agree when a C.I will say that what is being practice in the actual setting, maybe very different with what is ideal. In NCLEX, questions must be answered based on what is ideal, on what is proper, and on what is written in the book and is considered as a universal practice in our profession. Thus, Nursing theory is also important. Plenty of new graduates passed the NCLEX on first try simply because their knowledge gained in nursing school is still fresh.

As what I have observed, newly graduate nurses has high probability of passing the NCLEX at first take, as compared to nurses who had been out of school for long time and is actively working as a staff already. Learning and memory retention sometimes follows the law of recency. Though I'm not holding facts to hold my claim. Just my opinion.

Alexk is also right, knowledge without the skill is quite unsafe and is deleterious. Thus, A clinical Instructor who only posseses the Knowledge, without the skills, is so much dangerous.

The nurses in USA almost as always follows the ideal nursing SKILLS. Nursing practice is Rigid and strict simply because we are dealing with patient's lives. Once you get to work in accordance to what is ideal, then your experience will be exemplary. That is why Alexk49 is making a good point because this is what nursing is all about in USA. As we go along with our practice, we render nursing care with the ideal nursing skills, the one that is written in the books.

So be it in USA or in the Philippines, It is highly recommendable that CIs must have both, the experience, and the knowledge. So He/She could be so much beneficial to his/her students.

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Clinical instructors should have actual hospital experience as a Registered Nurse, plus all the other appropriate qualifications related to the job. You cannot teach what you don't know. It will be both a disadvantage to the clinical instructor and the learner if the clinical instructor is unqualified. It's like having surgery from a surgeon who passed all his exams and knows all his books very well as well as the facts by heart , but never performed surgery on anyone!

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Working in home care a nurse also has to improvise. Many times families don't have enough money to buy supplies. This is why most home care will only hire experienced nurses so they can apply theory.

As a CI you have to complete the orientation process. I have been at one hospital for 3 years, next month I have to complete another orientation. It is a safety measure. I won't be learning nursing skills but I will be learning their policies.

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Specializes in surgical, trauma, emergency, educator.

Hi to everybody! After 10 years of working in the hospital setting, I worked as a Clinical Instructor for a year thinking that I can survive from that amount that I earned, sad to say it is not enough. In my experienced 2 years ago as CI, I can say that "Experienced is the best teacher", especially if you worked overseas from an organization that is accredited by the JCI. You can teach your students even without reading a book....:nurse:

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my university offers clinical teaching jobs even to fresh graduates only if they graduate from our school and has acceptable credentials..i was taught by clinical instructors who were just a few years ahead of me, some of them were my student nurse seniors during my RLE's..but as far as im concerned, they were able to teach as well..well enough for us to be confident to feel that we can be efficient staff nurses right after we graduate..i guess it all depends on the quality of nursing education given to these newly graduate clinical instructors and how the dean of the college of nursing deals with their clinical skills..maybe that's why they don't hire graduates from other schools..so as not to jeopardize the quality..i believe it was easy for my clinical instructors to teach us since the 4th year nursing students in our school who undergo RLE's for nursing management act as clinical instructors for the 3rd year and 2nd year students..the lower years are the staff of the seniors..so when you graduate, managing a staff and teaching them won't be such a difficult task..

i was surprised to read here that some fresh graduates were not able to experience COMMON nursing skills as suctioning?!?! does not all nursing schools have a skills checklist to accomplish?! when i was in my senior year, we were required to accomplish the whole list of common nursing skills else we wont graduate..so skills such as suctioning, feeding, ngt insertion, ifc insertion and the like are not new to me when i graduated..and we were supposed to do it to actual patients, not dummies..our school did not have enough funds to buy us high end types of dummies thus we were required to do skills on actual patients..

i do believe that experience is the best teacher..but basics are taught in nursing schools right?! and basics can be taught by any other REGISTERED NURSE..you graduated from a BSN course and became registered because it means that you're competent enough to handle patients..in the BSN course, we are being prepared to be nurse GENERALIST and i believe that general nursing can be taught even by a newly graduate nurse..

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Actually in some hospitals in the US you have to have several years experience as a Registered Nurse before you can take on a new graduate...Even then, you have to go through some extensive hospital training in order to be able to take a new grad under your wing...Whether it's generalist or a specialist, you still need that training and years experience...and rightfully so, the New Grad is going to rely on the experienced nurse to train them on the floor...So I don't believe that general nursing can be taught by a new grad other than bed making, and basic ADL's....which is something very basic...

Just because one is a BSN graduate doesn't mean that they're competent enough to handle patients...No matter which country you graduated from...All it means that they're able to pass the program and then obtain their license...IMO I think competence comes with experience...There are things that I'm incompetent on, it doesn't make me a bad person it just means that I need the experience. For example, I have a Bachelors Degree (non nursing) and I could become a teacher if I wanted to. Just because I hold a Bachelors degree doesn't make me competent as a teacher? Why? I have no experience as a teacher...There are several things I need to complete in order to do so, I need to complete student teaching and also need to have a teaching credential...Even then, I lack the teaching experience and credentials so therefore I'd be incompetent as a teacher. Just because I hold a Bachelors degree doesn't mean that I'm competent enough to handle students...That comes with experience, and again it's not a bad thing...I just lack the skill...I believe that if you're called words like "imbecile, stupid, retarded, idiot" then that's where the problem arises...

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the goal of any nursing school is to produce competent generalist nurses..but i guess, the measure of competence is quite relative..im not saying that experience is not needed, that's vital to any profession or occupation..im just trying to point out that newly graduate nurses can teach with quality..coz i've experienced that when i was a student nurse..if quality related learning experience was given to these newly graduate nurses, then i believe they would be able to teach their students well..'teaching and learning' is part of the nursing management curriculum offered during the last semester of the BSN curriculum..it is ENHANCED during post-graduate studies which is required when you land a job as clinical instructor..

the sad truth for a lot of nursing schools lately is that, they focus more on quantity rather than quality..i heard that some universities cater nearly 2000 students per year level..how in the world can you be assured that each and every student that got her nursing diploma from that school has the knowledge and skill of a competent nurse..

as they say..you cannot teach what you don't have..garbage in..garbage out..

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Fundamentals doesn't require much clinical experience, all the other courses require a competent nurse.

Using Benner's theory

http://www.carnegiefoundation.org/about/sub.asp?key=10&subkey=247

It takes years to be a competent nurse.

Also in the US you must hold a degree one level higher than the students so most CI have a MSN.

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I believe you said that experience is the best teacher...I should have acknowledged your statement and stated that I agree with you on that part so there wasn't confusion on my understanding of your post....I just differ with you regarding a new grad having the ability to teach...I do believe that they can be taught what they were taught, but most likely they're not going to be able to apply clinical experience with theory beyond what they were taught and what they actually experienced on the floor...In nursing school you can't be taught everything, all that comes with years experience on the floor...As a nursing student sometimes you have questions that even an experience nurse can't answer...

I do agree with your statement about 2000 nursing students coming from one university per year...That just seems so outrageous and with schools always fighting for clinical sites what really is the ratio per student:patient...and how many schools are in the same facility day in and day out? With so many graduates per year it's a wonder why they can't find a job and why they're treated as slave labor once they do graduate...

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yes..that's was the only thing i'm trying to point out..newly grads can teach what they were taught..i believe that's why not all newly grads can qualify as clinical instructors..they also need to qualify to certain standards..i'm not saying that they will be better than those who spent years already in the nursing profession..but they do present better lectures..easy but book-based..but the skills i guess can be better taught by nurses who spend time in the clinical area 'coz even senior nursing professors are not that reliable anymore in that aspect since they're spending much of their time in the academe rather than on the floor..

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