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Dealing with Students in Clinicals: What would you like to see?

Nurses   (5,769 Views | 58 Replies)
by bsf312 bsf312 (New) New

365 Profile Views; 13 Posts

Hello all!

I'm starting in an ADN program Spring 2019. The beautiful and frightening thing about ADN programs (or at least mine) is that you start clinicals the second semester.

I'm 30 years old, an LMT, Licensed Esthetician, and trained electrologist in Texas. I hear all sorts of things from "friends of friends" about how they like older nursing students, etc.

My question to all nurses that work with students during clinicals: what behaviors do you like to see in students? What makes you most willing to extend help? What information that may not be commonly covered early on should I familiarize myself with?

I know a lot about people and my current specialties, but I also know enough to know that I know nothing about the world of nursing. I am interested in all of your thoughts and experiences!

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325 Posts; 4,530 Profile Views

Just don't be doing anything with patients that you shouldn't or without asking your instructor or the patient's nurse. Some nurses are pretty crabby when it comes to students in general. Don't take it personally.

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AnnieOaklyRN is a BSN, RN, EMT-P and specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

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I am surprised, usually ADN programs start clincials in the first semester, at least in my area!

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Nurse SMS has 9 years experience as a MSN, RN and specializes in Critical Care; Cardiac; Professional Development.

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What we want from students and what I tell them when they orient here:

1. You are in scrubs. Therefore, in the eyes of the patients, you are a nurse. They don't differentiate between a student and a "real" nurse.

2. In the eyes of the patients, you are also representing this institution. Your behavior here will reflect on us, your hosts. We aren't obligated to host you and you can indeed wreck it for everyone else by any problems you cause. Behave professionally and if you don't know what that means, find out before hitting the floor. I am happy to help, without judgment.

3. With the above two points in mind, do NOT use your phone in any area where a patient or visitor may observe you doing so. If you need to text, take a call, check an app for lab values or med information, call your instructor or whatever.... step into the break room, the med room, a closet, anything but do NOT pull that phone out on the floor.

4. Clinical time is not the time to do your homework. Care plans and other school work needs to be completed outside of the hospital. You need to be using this time to learn how to care for patients, hands on. It is the only chance you get to do that, so take advantage.

5. Bathing, vital signs, toileting etc are all part of the clinical experience and if you want to make a good impression you will seek out opportunities to do these things.

6. Having a student is not "helpful" to the nurses. Some students seem to think it is. Recognize that you represent one more variable the nurses have to balance out in their day. Be cognizant of that, be grateful to them, be kind and definitely don't think you are entitled to time, attention or accommodation. At the end of the day, the responsibility for the patients lies with them, not you. Everything about you being there is a charity to you. Nobody is getting paid extra to have you learning from them. All they get in terms of compensation is your attitude and desire to be a good nurse. For many, that is enough.

7. The break room belongs to the nurses who are at work. Don't take up space at the table for longer than necessary and definitely do not use it to do homework.

8. The nurses need the computers to chart. Don't linger.

Edited by not.done.yet
formatting and typo

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13 Posts; 365 Profile Views

AnnieOakleyRN: From what my A&P II prof told me, the state wanted them to lower the amount of time needed to ready students for professional programs, so we're down to only A&P I, Microbiology, English Comp, and General Psychology as prerequisites and A&P II, Lifespan Growth and Development, and a Humanities course a corequisites. We don't take Pharmacology until first semester so I think that is why clinicals start second semester.

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13 Posts; 365 Profile Views

What we want from students and what I tell them when they orient here:

1. You are in scrubs. Therefore, in the eyes of the patients, you are a nurse. They don't differentiate between a student and a "real" nurse.

2. In the eyes of the patients, you are also representing this institution. Your behavior here will reflect on us, your hosts. We aren't obligated to host you and you can indeed wreck it for everyone else by any problems you cause. Behave professionally and if you don't know what that means, find out before hitting the floor. I am happy to help, without judgment.

3. With the above two points in time, do NOT use your phone in any area where a patient or visitor may observe you doing so. If you need to text, take a call, check an app for lab values or med information, call your instructor or whatever.... step into the break room, the med room, a closet, anything but do NOT pull that phone out on the floor.

4. Clinical time is not the time to do your homework. Care plans and other school work needs to be completed outside of the hospital. You need to be using this time to learn how to care for patients, hands on. It is the only chance you get to do that, so take advantage.

5. Bathing, vital signs, toileting etc are all part of the clinical experience and if you want to make a good impression you will seek out opportunities to do these things.

6. Having a student is not "helpful" to the nurses. Some students seem to think it is. Recognize that you represent one more variable the nurses have to balance out in their day. Be cognizant of that, be grateful to them, be kind and definitely don't think you are entitled to time, attention or accommodation. At the end of the day, the responsibility for the patients lies with them, not you. Everything about you being there is a charity to you. Nobody is getting paid extra to have you learning from them. All they get in terms of compensation is your attitude and desire to be a good nurse. For many, that is enough.

Thank you so much, that is a great list. I've been a paralegal and worked as a massage therapist under a chiropractor, so I don't take it lightly when someone else is ultimately responsible for my actions. I would never presume that students make the job of the nurses teaching them easier; it is always easier to do something yourself than teach someone new. Thank you for your willingness to teach!

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meanmaryjean has 40 years experience as a DNP, RN and specializes in NICU, ICU, PICU, Academia.

3 Followers; 7,575 Posts; 65,674 Profile Views

To not.yet.done's point- here's the analogy I use:

Having a student nurse for a bedside nurse is like having a 3 year-old 'help' you cook Thanksgiving dinner. More work- not less.

My other bit of advise is anything and everything a patient needs is ultimately the nurse's job. RNs can and do (I hate this phrase used as it is in nursing education) "wipe butts".

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113 Posts; 1,751 Profile Views

Welcome to the nursing world! I obtained my ADN last May, so the needs of the program are still very fresh in my mind.

My best piece of advice is to always keep your cool. As Accolay alluded to, many instructors can be 'crabby', to put it mildly. In clinicals, for example, maybe you're taking 5 min at a computer to look up the lab values/new orders/ test results for your patients, because you just finished your rounds and know you have to give a full SBAR report on them before you can go to lunch....the instructor comes by and loudly chides you in the hallway for sitting around when you should be doing patient care. You give them your reasoning, but they don't want to hear it, so you log out of the computer, go find something hands-on to do with the patient...and then you get a second tongue-lashing for being unprepared to give SBAR later!

Keep your cool. Be professional. Sometimes it feels like they WANT to see you fail, or like they are doing everything in their power to break you. I saw so many students crack and run off at the mouth because they could not keep their cool and got overwhelmed... and for whatever reason, they didn't make it though the program. You have your reasons for doing what you do, and so do they. Like not.done.yet said, they feel the pressure of preparing you for an independent nursing role in a limited amount of time, and they also feel the stress of keeping in the clinical site's good graces....they will be HARD on you. I always found it helpful to "debrief" later, off the floor - either during lunch, in their office the next day, or asking them to meet with you quickly after clinicals: don't complain, ask pertinent questions like "My understanding is that you were upset I took too long looking up lab values for this patient. Is there an easier and quicker way to obtain this information you could help me with?" Sometimes I got short, sharp replies, most times I got helpful answers, and rarely, I got an apology for misunderstandings. But I always showed a willingness to communicate professionally and self-improve.

My room mate is going though the "semester from hell" in our local program. I reminded her that at the end of it all, when you pass the class, when you pass the NCLEX....you will then likely need to ask your clinical instructors for one last favor - job references. Sometimes you'll ask them for a letter of recommendation, sometimes to fill out an emailed survey from your prospective employer, maybe just a phone call.....but you will be asking them for a BIG favor: they are your friends, even when it does NOT feel like it :dead:

As far as the classes themselves, my advice is roughly the same: keep your cool, come prepared, organize your time to make room for study. Don't get discouraged if you don't make the grade you want: turn to your instructors for help - most might seem like battle axes, but they are happy to help a student who asks!

You seem like a mature person who has a lot of personal experience with professional communication to draw on - you got this!

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13 Posts; 365 Profile Views

Welcome to the nursing world! I obtained my ADN last May, so the needs of the program are still very fresh in my mind.

My best piece of advice is to always keep your cool. As Accolay alluded to, many instructors can be 'crabby', to put it mildly. In clinicals, for example, maybe you're taking 5 min at a computer to look up the lab values/new orders/ test results for your patients, because you just finished your rounds and know you have to give a full SBAR report on them before you can go to lunch....the instructor comes by and loudly chides you in the hallway for sitting around when you should be doing patient care. You give them your reasoning, but they don't want to hear it, so you log out of the computer, go find something hands-on to do with the patient...and then you get a second tongue-lashing for being unprepared to give SBAR later!

Keep your cool. Be professional. Sometimes it feels like they WANT to see you fail, or like they are doing everything in their power to break you. I saw so many students crack and run off at the mouth because they could not keep their cool and got overwhelmed... and for whatever reason, they didn't make it though the program. You have your reasons for doing what you do, and so do they. Like not.done.yet said, they feel the pressure of preparing you for an independent nursing role in a limited amount of time, and they also feel the stress of keeping in the clinical site's good graces....they will be HARD on you. I always found it helpful to "debrief" later, off the floor - either during lunch, in their office the next day, or asking them to meet with you quickly after clinicals: don't complain, ask pertinent questions like "My understanding is that you were upset I took too long looking up lab values for this patient. Is there an easier and quicker way to obtain this information you could help me with?" Sometimes I got short, sharp replies, most times I got helpful answers, and rarely, I got an apology for misunderstandings. But I always showed a willingness to communicate professionally and self-improve.

My room mate is going though the "semester from hell" in our local program. I reminded her that at the end of it all, when you pass the class, when you pass the NCLEX....you will then likely need to ask your clinical instructors for one last favor - job references. Sometimes you'll ask them for a letter of recommendation, sometimes to fill out an emailed survey from your prospective employer, maybe just a phone call.....but you will be asking them for a BIG favor: they are your friends, even when it does NOT feel like it :dead:

As far as the classes themselves, my advice is roughly the same: keep your cool, come prepared, organize your time to make room for study. Don't get discouraged if you don't make the grade you want: turn to your instructors for help - most might seem like battle axes, but they are happy to help a student who asks!

You seem like a mature person who has a lot of personal experience with professional communication to draw on - you got this!

Thank you for the warm welcome!

This was a very helpful answer and has illuminated some skills I can work on leading up to clinicals. I am very type-A and organized, but tend to be pretty non-confrontational and easy-going in regards to people above me. The ability to mentally prepare for this experience with be very valuable. I expect nothing less than high standards of myself, and I know they will expect the same. Patient care is not a game, and I would rather have someone be hard on me to make sure I am prepared.

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1,381 Posts; 10,608 Profile Views

Some nurses like teaching, some don't. Even if you have a crabby nurse, there are things to be learned. Be attentive. Be appreciative if they go out of their way to offer you a skill or include you. Ask questions but be careful of questions in front of the patient.

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1,223 Posts; 7,947 Profile Views

Most of the time, I absolutely love having students on the floor. A few things that I appreciated:

1.) Tell me right away that you are assigned to my patient (otherwise, I'm going to assess, give meds, and do whatever other morning care (dressings, ect) and you're going to miss it all, then I'm going to feel bad

2.) Collaborate with me. I know you have to wait on your instructor for things, but tell me if you're not going to be able to give meds until 10 or if you want to give a bath right now (maybe the pt has PT or testing or some other time-sensitive thing going on) so work with me.

3.) Stay and watch. Nurse's do lots of stuff with patients that you won't be allowed to do at first, but stay and observe. IV insertions, dressing changes, ect. If you do this, I will find cool things for you to observe- like the cardiac drain 3 rooms down or the wound vac that's being changed down the hall or even the lung sounds of my other patients so that you can hear something different.

4.) Do the above 3 with my CT/PCA/NA/CNA as well; they are a wealth of knowledge!

5.) For the love of god, tell me if something seems wrong with the patient! Do not just chart that BP of 80/40 without finding me ASAP.

Keep in mind some nurses are just grumpy, it's not personal. Sometimes we're grumpy because the rest of our assignment sucks/is unsafe/is a train wreck; so just roll with it.

Good luck!

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Been there,done that has 33 years experience as a ASN, RN.

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I didn't need to see anything.. but a student wanting to learn. Please try to relax. It is our duty to take you under our wing. Ask any questions you have, if you run into a nurse that will not help you.. notify your instructor.

PM me along the way.. if needed.

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