I am your soon-to-be instructor. Here are my golden rules to my students. Take what you like. Discard the rest. But understand why each is important. Apply them and perhaps you will make the most of our 12 short weeks together.
I am your soon-to-be instructor. Know that I love this profession and have dedicated my life to it and to my patients. I consider this profession to be a calling. I did not come to this profession for money, for prestige, or for the title. I came to it for the love of caring for people at their worse. Along the way I discovered that I love to teach the next generation this love as well, while at the same time instilling in you all the importance of taking this seriously, understanding that people live or die by your decision.
Nursing today is about much more than turning a patient and washing them (although I seriously doubt it was ever about only this, despite what the movies would have you think). Nursing is about understanding the medical and nursing diagnosis, medication recognition and administration, symptom management, pathophysiology, procedures, and most importantly how the nursing process fits into all of this. Is it a daunting task for us to teach all of this to you in 12 weeks, yet somehow we are expected too.
I ask for your help in all of this. Some things are basic. Show up on time. Come in uniform. Make sure it is washed and pressed. Look your best. Remove your piercings and cover your tattoo's. Wash your hands before and after entering a patient's room. Imagine your grandmother in the hospital and the nurse comes in with a nose ring or a tattoo. Or doesn't wash their hands. Or is unclean. Would you want that person caring for your family? Furthermore, come awake, with passion and motivation to learn. I, like you, have a personal life. However, once we come through those doors to the unit, all of that has to be put aside and we must give all we have to caring for our patients. If we don't, who will?
Furthermore, we challenge you mentally not to show you how much we know, but to stress how much you need to know. It is not enough to report a vital sign. You must be able to tell me the normal ranges, which ones are abnormal, and most importantly why. If you cannot, what good does that do your patient? It is not enough to know that a lab value is abnormal. If you cannot tell me why your post-op patient has a low hemoglobin, what good does that do your patient?
It is certainly not enough to tell me the patient has a history of diabetes. You must tell me why it is so vitally important to understand the pathophysiology of hyperglycemia (high blood sugar) and how it affects the healing process, how it affects the ability of the body to fight infection, and the most accurate way to treat it. If you cannot, your patient will suffer.
To prepare for clinical is not easy. I emphasize that it takes a long time to write a care plan, and that you think it may not be as important as studying for that exam coming up. I understand that each instructor grades your papers differently, and that it feels unfair that you must change and conform to what each instructor wants. However, what you don't understand is that nursing is an ever-changing profession. Each patient is unique, and your ability to care for them needs to change for each patient you see. Some will love you, some will loathe you. It is not personal; they are patients who need different things, much like we are as your instructors. You ability to adapt to out of control situations and dangerous scenarios will define you and your career, not your ability to complain about the amount of work you have.
Golden Rules For Students
Take what you like. Discard the rest. But understand why each is important. Apply them and perhaps you will make the most of our 12 short weeks together.
Come prepared and ready to work.
Your hygiene and appearance means everything to your patients.
If you haven't spent 8 hours on your care plan it is likely incomplete. Coordinate the care plan. Link the pathophysiology, labs, and nursing diagnosis. Show us you understand how they are all related. If you don't know, say it. but give an educated guess that shows us you are trying. I give just as much value to trying as I do to getting it correct.
If you know your patient has a foley catheter, nasogastric tube, chest tube, etc... look up and prepare for how to care for those. Print out the care from the book. Include it on your care plan. make an effort. Saying I don't know to an instructor tells us you didn't care enough to look it up.
Know the 5 rights of medication administration in and out. Be ready to tell them to me during med pass. know your medications. Write down the important information and be ready to discuss it at the pyxis, in the room, in the nursing station.
It is never personal. remember that your patients are there to get better, not provide you with an opportunity to learn. That is a gift that can quickly be taken away by your attitude.
Watch what you say in the hallway and the volume of your voice. sound carries. your patient does not care about your lunch, your day, how mean your instructor is.
If your instructor provides constructive criticism to you, do not take it personal. listen to what they are saying and improve. show them you can internalize criticism and get better.
Love your profession. if you are in it for anything except caring for patients, leave now. If you are in it for the money, leave even faster.
Love nursing. every day. take every opportunity to improve your practice and the profession. This is your shot to make a difference in a world where for many it is difficult to even go to work each day. don't sell yourself short, you are about to enter the most rewarding profession there is.
I loved the post it was spot on. I remember going for my LPN my instructors really stressed care plans, (they wrote a care plan book) I am glad they did. We had to have two careplans each week for our patients. I feel it gave me a better understanding of Care plans and the role they play in the nursing process. It also helped me land a job as a MDS Coordinator. I find however that students who have not had care plans stressed during clinicals do not appreciate their role. As for the comments about 8 hours being a lot clinicals are not supposed to be easy they are supposed to be hard and time consuming to make sure that the students have what it takes to handle the stressful situations that nurses can be thrown into.
As a clinical instructor I thoroughly enjoyed your post. In fact, I have just finished sending it to several of my colleagues, I plan to implement much of this post in my next student orientation.
Thank you for taking the time to submit this post.
To all the students that read this and think the work was too much, all my students survived their semester with me. To a person they all said that if they hadn't done the work on the care plans, they would never have been able to care for the patients. It is imperative to know your patients, both as a student, instructor, and staff. If you don't, the patient will suffer. Thanks everyone for all the kind words, I am glad some folks liked this article.
Hi there, i am a 2nd year RN student! This is my first year at uni as i completed my enrolled nursing diploma last year and received credit for first year!
Thank you for your post! I can see that you are devoted and care about your teaching and the professional development of your students that you teach!
I am trying to learn the most that i can, however i feel very nervous as i do not think i have as much skill as i would like as yet but i do know i will pick this up in time. I study so much and feel like i have not learn much because it seems that the Registered Nursing degree is so academic which i can understand, respect and appreciate. I am just a little dissapointed because i wish the stubjects i am studying were a little bit more related to nursing itself and not SO BROAD! Some of the subjects i study i can REALLY understand is what we need to know about as it is all related, but i just cant understand why they are teaching us information in certain topics which is sooo.. far from being linked to nursing when they should be teaching us information in that topic which is more relevant!
I have been so fortunate and lucky to have worked with some wonderful nurses and i thank them so much for all the knowledge and experience that have passed on to me. When they ask about my training and my course, they all say the same thing! Back in the day it was more hands on practical training! I really wish the University would provide more of this in addition to academic learning! I really want to be a good nurse and i know i will be, i am dedicated, good natured and i care! I know i need to learn and read in order to put theory into practice i just wish that the course would emphasize more on teaching nursing skills and knowledge and not make it all about writing academic essays (which most times is not directly related to nursing) and freaking out about a reference list not having a commer or dot point where it should be! LOL a little stressed here :|
But hey, ill get there in the end and i will try to learn the most that i can whilst on placement! Im just worried that i will graduate not knowing much because i lack experience.
This is wonderful!! By the end of the day i usually spend about 8 hours or MORE on my care plans. This does include all research needed. I make DETAILED pages with all sorts of research :).
I'm an upcoming nursing student this fall semester on August 30, 2010, and this post had helped me realized what i should focus on and why i wanted to take this major.
thanks for the tips!
i'll be sure to apply it when i get into the program!
and when u said "smile, the hardest part is to getting in" it made me feel alot better and at ease, bcoz i've been feeling that i might not make it until the end of the program coz i have heard how hard it is...but then i realized that it took me alot of time, effort and will just to get in one of the nursing school...i guess, i will make it until the end! hehe :)
Dear marty, I really liked your letter and was wondering if it would be okay with you if I read it out to student nurses at my uni. :) I am a nurse educator and thought that it would be a great letter for motivation and information about what is expected of them when they enter the wards.
Absolutely you can read it to them. I wrote this while working one night not realizing that so many people would enjoy it and either internalize it as students or share it with their students. I remember the day I had my students read this. It was toward the end of the semester, and they are laughed saying how they wish they knew this the first day, that it would have made the unit, and me, less scary. Thanks for the kind words!!
It was very nice to read such heart-felt writing from an instructor's perspective. I only have one gripe about it though -- care plans, but my complaint is not about how much time is deemed sufficient to spend on them.
Care plans were very much emphasized when I went through school to become LVN. But never did I see them serving much purpose as I worked in acute care and long term care facilities. There's this little tab labeled "care plan" in the charts, never getting attention from anyone except by medical records and whoever's auditing the chart and harping on us if incomplete. In other words, they do not have much practical function other than being more paperwork for the sake of paperwork. Whether in a hospital or a nursing home, nurses working in today's condition of health care field simply do not have the time to sit and produce a writing composition. Please teach us relevant skills. Help us be efficient nurses and prepare us for the reality of nursing these days, not the outdated or irrelevant nursing models.
Now, if the purpose of writing care plans is specifically to train us in critical thinking, then please forgive my impudence. However, if we're expected to believe that the plans themselves are actually important in our work, other than being yet another useless paperwork to be completed, I can't help but roll my eyes. I am extremely excited to start RN program this fall, but I dread for the vestigial parts of nursing education that will not see the light of day once we go out in real world.
Wow, care plans not used by anybody but med records or chart audits??? I've been a nurse [RN] in LTC for 10+ years and regularly reference care plans and update them as needed, which is frequently! New diagnoses, changes in condition, new interventions, resolving interventions when desired outcome is reached etc. I don't know where you work, but if care plans are truly not viewed as anything but busy paper work I'm glad I don't work there. By the way, I don't work behind a desk, all floor RN's are expected to incorporate care planning into their routine.
NURSEMOMMIE75
2 Posts
I loved the post it was spot on. I remember going for my LPN my instructors really stressed care plans, (they wrote a care plan book) I am glad they did. We had to have two careplans each week for our patients. I feel it gave me a better understanding of Care plans and the role they play in the nursing process. It also helped me land a job as a MDS Coordinator. I find however that students who have not had care plans stressed during clinicals do not appreciate their role. As for the comments about 8 hours being a lot clinicals are not supposed to be easy they are supposed to be hard and time consuming to make sure that the students have what it takes to handle the stressful situations that nurses can be thrown into.