Clinicals on the unit you work on?

[DayDreamin ER CRNP]

My middle name is Worry so I can't help but worry about this little situation.

I took a job last semester on a family practice unit in the hospital that is within walking distance (almost) from my home. I pretty much got the job through the clinical teacher I had at the time.

Fast forward to last week....our teachers placed us in our clinical groups this year and I was placed on the same unit I work on for my med-surg 2 clinical. I really do not like my job on this floor so I'm not too thrilled about doing my clinical here. I'm also working nights and I have a family so I'm not even sure how much I will actually be able to work next semester.

I keep hearing from former students that they don't like you to work and do clinicals on the same floor. No one has "officially" told me that. This is where I'm having the dilemma. If I say something, I might risk getting moved to a hospital that is almost an hour away or to a hospital with a clinical instructor that I absolutely H A T E.

So, would you keep your mouth shut? Part of me thinks the admin knows since our previous clinical teachers helped place us but I don't want to get 2 weeks into the program and have to change everything.

Should I just try to transfer to another department for work or just keep on going like nothing is wrong? Like I said, no one has officially made any announcement or comment about this.

m

[SonorityGenius]

I worked nights on my floor and did clinicals in am.. it worked beautifully as I changed into uniform and everything while at work and arranged my schedule in a way to have a day off during week when it was theory classes.. I loved the floor I worked on though so I had no problems.

[TheSquire, DNP, APRN, NP]

Part of the point of clinical rotations is to expose you to different work environments, not only in different types of floors, but at different institutions as well. If you're working on that unit, you really should not be placed on that unit for clinical.

In your situation, I would do things in the following order:

1) Since you hate working on the unit, see if you can transfer to a unit you think you'll enjoy working for. This will alleviate the conflict - additionally, if the day staff is different from the night staff, you might find that being on the unit during the day as a student is a much different experience.

2) Alert your school, and get yourself placed on a different unit in the same institution, if possible. I don't know how your school does Med Surg II, so I don't know if it's feasible. (I never really had that particular rotation myself - instead, we did a half-quarter in an inpatient physical rehab facility where we essentially were the nurses for our patients while we were on the floor and then we did a full quarter in an ICU).

3) Alert your school, bite the bullet, and campaign heavily for the hospital that's an hour away, especially if you've never had a clinical rotation there yet. I'm all for avoiding clinical instructors that you don't mesh well with - why subject yourself to the same problems? Further, you'll be exposing yourself to a different institution and a different way of doing things, which is not a bad thing. Also, if you're a competent student, that may help you out when you start looking around for employment in a year or so. Clinicals are often the first exposure a future employer has with a nursing student, so having that positive experience with their institution can pay off later.

Then again, I'm coming from a grad-entry program where we register for clinical sites like we do sections for any other class; plus I am single, have no family, and live in a major city with decent public transport that many of my clinical sites are on/near, so my perspective on the situation may different from yours.

[llg, PhD, RN]

Never hide anything like that. If found out, it could make any problems worse if you weren't completely honest and open. Nurses are expected to "report themselves" if there are ever any professional issues, such as a conflict of interest, mistake made, etc. While this is not that exact type of situation, the expectation of a professional is that they will "police themselves" and report anything that might compromise their practice.

So ... start living up to that professional expectation now as a student and discuss the situation with your school. If they decide to keep you on that unit, be sure to maintain that openness and work with your school and with the unit's management to prevent/minimize any role conflict or role stress that might occur.

[DayDreamin ER CRNP]

Never hide anything like that. If found out, it could make any problems worse if you weren't completely honest and open. Nurses are expected to "report themselves" if there are ever any professional issues, such as a conflict of interest, mistake made, etc. While this is not that exact type of situation, the expectation of a professional is that they will "police themselves" and report anything that might compromise their practice.

So ... start living up to that professional expectation now as a student and discuss the situation with your school. If they decide to keep you on that unit, be sure to maintain that openness and work with your school and with the unit's management to prevent/minimize any role conflict or role stress that might occur.

Did you miss the part that I wrote that my clinical teacher got me this job and our clinical teachers placed us for the next semester? Did you also miss the part that I mentioned that no one has ever officially said that we cannot work where we have a clinical; that there is no policy about this? I really don't feel like I am hiding anything but that it is a rather gray area. I do, however, feel like you are insinuating that I am doing something unethical. The only information I got regarding any type of conflict came from another student that I a semester ahead of my class that I work with. I'm not sure she is 100% reliable either because I just don't know her well.

I guess I am just asking folks what the downside of the situation could be. The only real negative I can see is what Squire mentioned and clinicals should be an opportunity to be exposed to different areas of nursing, not just one.

m