Clinical Rotation Expectations

londonflo · Nov 14, 2022

I am probably not answering your questions but here goes:

Ask each hospital involved to send you what their handbook says.....for ex. can students give medications without an instructor after being checked off so many times? What about procedures such as caths? What about floating students off to areas such as ER, Cardiac Cath Lab, the OR? (check with your OR, they get so many requests.)

Then you can develop your clinical expectations. Develop what works best for your school, mindful of staff, room accommodations, and develop the student's experience that might attack them in the future as employee etc. And Please let the staff know the guidelines. I had students rotate through surgery and I was told to tell them--they can only go to surgery ONCE at that hospital. Then the OR staff would ask them back and I had to tell them they could not go back...even with their assigned patient.. WOW!

Tait, MSN, RN · Nov 14, 2022

56 minutes ago, londonflo said:

I am probably not answering your questions but here goes:

Ask each hospital involved to send you what their handbook says.....for ex. can students give medications without an instructor after being checked off so many times? What about procedures such as caths? What about floating students off to areas such as ER, Cardiac Cath Lab, the OR? (check with your OR, they get so many requests.)

Then you can develop your clinical expectations. Develop what works best for your school, mindful of staff, room accommodations, and develop the student's experience that might attack them in the future as employee etc. And Please let the staff know the guidelines. I had students rotate through surgery and I was told to tell them--they can only go to surgery ONCE at that hospital. Then the OR staff would ask them back and I had to tell them they could not go back...even with their assigned patient.. WOW!

Excellent answer. I need to clarify. I am a Coordinator for Education Affiliations for the hospital system. We are having issues with professionalism in terms instructors and students. This is one reason for needing a lit of professional expectations of these instructors and groups on the units.

Home Health Columnist / Guide · Nov 18, 2022

Tait:

Found these resources:

Pacific Lutheran Univ: Student Clinical Practice, Policies & Expectations

UPMC Schools of Nursing Expectations including Purpose of the Position: Essential Functions of the Position (in the clinical area

Utica Edu: What Instructors Expect of Nursing Students During Clinical Placements

John Hopkins: Expectations for Clinical Groups and Instructors revised 2023

Quote

Professionalism-
o High level of communication between clinical instructor, students and unit staff. Please notify if leaving unit at any time, for breaks and lunch, and at end of day. Students should not be performing any patient care if clinical instructor is off unit.
o Arriving on-time, or early if unit recommends. Leaving clinical day at designated time.
o Wearing appropriate scrub attire and identification for clinical area. Identifying self as instructor and Identification for students as Nursing Student.
o We encourage a high level of engagement/activity for students and instructors in their patients care and needs. In general, we don't anticipate your clinical group to experience a lot of "downtime".

Chain of Command
o In the event of student questions, please advise students to first attempt to locate clinical instructor before inquiring with JHH bedside RN. Our staff is always willing to help, but may not always have availability to discuss student questions.

Chester County Hospital: Clinical Instructor Expectation

How to Be an Effective Clinical Instructor

Sharp Healthcare:STUDENT NURSE + CLINICAL INSTRUCTOR EXPECTATIONS & PROTOCOLS

Hope these can strengthen your processes and Clinical Instructor expectations. Setting the nursing student on a path to PROFESSIONAL success is important along with minimizing staffs frustration with students, especially in today's fast paced inpatient environment.

Still remember my 1970-80's student experiences: one teaching facility treated us students as no nothing "in the way" while another inner city teaching site was eager to have students: "another pair of hands"..."come see what the doctor is doing".

sleepRN, ADN, BSN, RN · Nov 27, 2022

I am a clinical instructor. We have a student handbook that our students are expected to follow. I would think you be able to access the handbook for the schools you work with. When I begin with a new group of students, I review the student nurse guidelines the hospital has given me as part of our orientation. I must sign off that the students agree to "work" within their guidelines. Most of the information refers to professionalism in some way or another.

It is my job to make sure my students always act professionally. If they have any problem/concern they are to come to ME.

I organize my clinical experienced based on ensuring they will be safe, practicing, novice nurses when they graduate. I have the seniors so I focus on passing meds (5 rights and 3 checks), head to toe assessment, recognizing abnormal findings and what to do about them, critical thinking, SBAR communication with providers, and documentation.

Often times, staff will ask if my students can do bed baths and feeding, etc. Of course we help out with ANYTHING on the hospital unit but that is less of a priority for what I NEED to teach them in a short amount of time (accelerated program).

cali_nurse_1976 · Apr 2

I know this post is old, but I'm hoping Tait, MSN, RN may see my comment. I am embarking on this same project at my facility. After taking a position teaching clinicals at 2 of the local RN programs, I realized that it's a very haphazard experience and often puts a lot of stress on the RNs who have been dealing with several years of poor staffing and orienting new grads. I hope to help make some changes that will improve the process for both students and nurses as well as create a more welcoming atmosphere that helps to recruit these students once they graduate. Do you have any input or resources you can share? The ones provided by NRSKarenRN, BSN, RN are great!!

Home Health Columnist / Guide · Apr 3

Hope Tait sees your reply, hasn't posted in awhile. Hope links I posted still active for you.

Tait, MSN, RN · Apr 27

Sorry had some issues getting it to let me post! OK so I did manage to create a 30 minute Faculty Onboarding program. I resourced the handbooks of several of our partners and pulled that together with our hospital policies. We have had some great success since starting this. Overall it went like this:

We had 61 current faculty meet with us, some one-on-one, some in groups to review the handbook and ask questions, and now we onboard new ones as they start.
We also have the handbook in ACEMAPP for them to attest to.
The meetings are 30 minutes or less.
We go over the expectations of the students:
- No lab coats
- Where to park
- General appearance expectations
- Pass meds with your preceptor/faculty
- Be proactive
- No phones unless cleared (that was in most of the handbooks)
- Be aware of where your stuff is and don't leave it lying all over
- Be respectful
Expectations of the faculty:
- Be with your students
- Get a tour of the unit each semester to ensure they are comfortable there
- Understand the process of students receiving EPIC access and which email they will receive that information to
- How to escalate problems (unit leadership, me, my boss)
- Who to report any incidents to (charge RN) for documenting
Expectations of the unit (we presented at the monthly Nursing Education Council and recently at our new New Nurse Educator Residency meeting):
- Be nice
- Be welcoming
- Look for opportunities to support the students
- Remember this pipeline supports your future workforce
- Know how and who to escalate to (and in real time!)
- Be ready to offer preceptors several times per year
- Always reach out to us with questions

So far it is going really well. I have work to do with EPIC, but that is a huge project in its own right (older instructors are nervous to let students document even though it is all co-signed, and other units don't like it etc).

Sorry for the slow response! I really need to come here more often, I am just so burned out lately but life is getting better!

Tait

londonflo · Apr 27

londonflo said:

develop the student's experience that might attack them in the future as employee etc.

I apologies for the work "attack", must have been a typo.

Your orientation plans for faculty sound so good. Believe me, you are a breath of fresh air! I went to one faculty orientation where a new faculty asked about "sliding scale insulin" and was loudly and strongly rebuked for not using 'correctional insulin'.

Tait, MSN, RN · Apr 28

I do want to say that, in relation to this comment: And Please let the staff know the guidelines. I had students rotate through surgery and I was told to tell them--they can only go to surgery ONCE at that hospital. Then the OR staff would ask them back and I had to tell them they could not go back...even with their assigned patient.. WOW!

Unfortunately with the sheer number of students, we have this same situation. We can have undergrad nurses, surgical techs, residents, and EMTs all in OR in the same day, so we have to keep the rotations tight.

Also our orientation takes into account that the schools and units will make sure policies are followed. My department works to create a connection between the unit and the faculty so they can get started in the best way 🙂