clinicals

jena5111, ASN, RN · Jul 23, 2015

Wow, what a thread!

In my first semester clinical group, we ate lunch together, along with our CI, at a prescribed time. Honestly I was relieved because it was...first semester and I felt overwhelmed 100% of the time. My CI was insightful enough to see that our whole group would benefit from the togetherness.

Second semester, I texted my CI and gave report to my assigned nurse before breaking for lunch. It was 30 minutes long, and students could not leave the hospital premises per school rules. Never occurred to me that this could be an issue; I brought my lunch every day and was happy to sit for a few minutes while texting my fiance and scarfing down a salad. And maybe a piece of chocolate.

Third semester--we had three different clinical sites in 16 weeks, so a nursing school whirlwind! I gave report to my assigned nurse in peds/mental health/L&D, then spent 30 minutes sitting down to eat my home-prepared lunch. We could not leave our clinical sites for lunch due to time constraints. Again I (and no one in my class) considered this an issue. We were happy to sit down and put food into our faces, even if just for half an hour. And sometimes we could sneak down to grab a coffee at "off" times--teacher/nurse sanctioned, of course. Yes, I took advantage of this.

Going into my final semester this August, I will do whatever it takes to complete my program. Nursing school is temporary. I have great respect for the people affiliated with my program who secure clinical sites year upon year; it can't be easy, especially in our competitive city.

Can't leave the site for lunch? No problem. Didn't assume I could in the first place. I will bring days worth of food/coffee/motivation to every shift.

cnmbfa · Jul 24, 2015

Did it not annoy you that you were being treated like a child? I need a break from the instructors, classmates, and hospital to clear my mind.

Bring your lunch, eat quick and go browse in the gift shop for 10 minutes. They often have cute stuff, so leave your credit cards at home.

cinlou, BSN, MSN, RN · Jul 31, 2015

I have tried. I have gotten the same response "rules are rules" and " I don't know what to tell you, there is nothing for anyone to do". Since it is a clinical site, can they take us to another part of the hospital where they may need some help? I don't know, that's why I am asking. Is this an allowable alternative?

So much of what you are experiencing really depends on the state, the facilities, the school, and your instructor.

As an adult learner, you, like most just want to know the what and why, and when one feels like it makes sense then no questions asked, but if the response does not make sense you need to ask more questions. Nothing wrong with that. Some instructors do not know how to teach older adult learners, and some are great.

I am a Director of a PN program, and my students get most of their skills checked off in their first semester. In our state they are assigned to nurses on the units, once they have been signed off in the clinical setting they are able to work with their nurse. Starting IV's etc.

When I was in school in Tx. my instructor had to be with me for any invasive procedure. So each state is a little different. Know your states rules and regs.

If I have students at a facility that does not have enough patients I try to find other sites, but in deed they are limited.

As an adult student, take the opportunity to listen, do rounds with the nurses when the doctors are on the floor, ask questions, review charts, medications, labs. I tell my students that there is always something to do. If the patient population is low, my clinical instructors may decide to have longer post conferences with the students, do NCLEX questions, discuss scenarios, review questions that students have about tests they have taken.

It sounds to me that your school has either limited the autonomy of the CI or your CI has limited herself.

I think you should request a meeting with your director. But before you meet, have questions written down and offer suggestions for the problems. Do not go in with complaints and no resolutions. Most want to hear students opinions for improvement of programs. They may not be able to change during your time do to state board and HLC constraints. Also, when you are given your end of semester surveys fill them out honestly and give constructive criticism, the school and state board looks closely at these for accreditation.

futurepsychrn, ADN · Jul 31, 2015

So much of what you are experiencing really depends on the state, the facilities, the school, and your instructor.
As an adult learner, you, like most just want to know the what and why, and when one feels like it makes sense then no questions asked, but if the response does not make sense you need to ask more questions. Nothing wrong with that. Some instructors do not know how to teach older adult learners, and some are great.
I am a Director of a PN program, and my students get most of their skills checked off in their first semester. In our state they are assigned to nurses on the units, once they have been signed off in the clinical setting they are able to work with their nurse. Starting IV's etc.
When I was in school in Tx. my instructor had to be with me for any invasive procedure. So each state is a little different. Know your states rules and regs.
If I have students at a facility that does not have enough patients I try to find other sites, but in deed they are limited.
As an adult student, take the opportunity to listen, do rounds with the nurses when the doctors are on the floor, ask questions, review charts, medications, labs. I tell my students that there is always something to do. If the patient population is low, my clinical instructors may decide to have longer post conferences with the students, do NCLEX questions, discuss scenarios, review questions that students have about tests they have taken.
It sounds to me that your school has either limited the autonomy of the CI or your CI has limited herself.
I think you should request a meeting with your director. But before you meet, have questions written down and offer suggestions for the problems. Do not go in with complaints and no resolutions. Most want to hear students opinions for improvement of programs. They may not be able to change during your time do to state board and HLC constraints. Also, when you are given your end of semester surveys fill them out honestly and give constructive criticism, the school and state board looks closely at these for accreditation.

Thank you so much for your input. The class decided we needed to speak to administration about our clinical experiences, which we did. They are now trying to initiate some changes to our benefit. Especially things like having to search for an instructor to fix a beeping IV (we don't have a clue what to do), and trying to get more experiences in clinicals. I appreciate your suggestions and agree that being an adult learner is very different from being just out of high school. Thank you so much.

They have also decided to start a study group for us to help with the critical thinking skills we need! That's absolutely awesome as most of the class is struggling with these types of questions.

cinlou, BSN, MSN, RN · Jul 31, 2015

Thank you so much for your input. The class decided we needed to speak to administration about our clinical experiences, which we did. They are now trying to initiate some changes to our benefit. Especially things like having to search for an instructor to fix a beeping IV (we don't have a clue what to do), and trying to get more experiences in clinicals. I appreciate your suggestions and agree that being an adult learner is very different from being just out of high school. Thank you so much.
They have also decided to start a study group for us to help with the critical thinking skills we need! That's absolutely awesome as most of the class is struggling with these types of questions.

Awesome, sounds like you are heading in the right direction. Good Luck

gooseylooseyrn · Jul 31, 2015

I actually like having lunch with my instructor. We are a really small group. We only have 15 students so it gives us time to sort of regroup and go over any issues we are having, ask any questions we may have and get her take on problems if we have them with our preceptors. We are spread out over the hospital and don't get one on one time with her any more so it is invaluable information she can offer us in the middle of our day on how we might change things for our patients, or correct things from our preceptors point of view. Remember that if you aren't performing the way the nurse in charge of you thinks you should, your instructor will know about it before the clinical day is over. This is a wonderful opportunity to correct it and leave a better impression. So far this has only happened once to one fellow student and it was as simple as a misunderstanding. Had we not been able to have that window of time to meet with the instructor she would have never known, and therefore would not have been able to leave that day on a better note.