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Do you have your clinicals in the hospital?

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by SummitRN SummitRN, BSN, RN (Member) Member Nurse

SummitRN has 5 years experience as a BSN, RN and specializes in ICU.

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So I've talked to several students at nursing schools who seem to have many or all of their clinicals at health fairs, respite care, nursing homes, doctors offices, or anywhere but an actual acute care setting.

This non-hospital-clinical thing seems like a bad idea to me for anything besides community health or nursing fundamentals!

What is it like at your school? What do you think?

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I've never heard of that. At my nursing school we go to multiple places. We go to two hospitals, and two psychiatric hospitals, as well as a health department, and I believe there are a few hospice clinical experiences as well. Before graduation, we have done: emergency department, ICU, medical/surgical, OR, pediatrics, adult and pediatric psychiatric, OB/GYN, labor and delivery, and psychiatric ER. I also believe that there are opportunities for us to go to places like cardiac ICU, telemetry, neurological floors, respiratory care departments, cardiac rehab, cancer units, hospice, the local health department, orthopedic units, and other speciality floors and units. We have a wide variety of clinical experiences, and our nursing program does a good job exposing students to different units and specialities.

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So I've talked to several students at nursing schools who seem to have many or all of their clinicals at health fairs, respite care, nursing homes, doctors offices, or anywhere but an actual acute care setting.

This non-hospital-clinical thing seems like a bad idea to me for anything besides community health or nursing fundamentals!

What is it like at your school? What do you think?

We were in the community during our first term, which I thought was a good thing. We didn't have any skills yet, so going someplace and working on one skill was really useful....so we'd work flu shot clinics and just give IM's all day, or do blood pressure screenings at a health fair, you get the idea. By the end of our first term, we then spent time in nursing homes. Many in our program were not CNA's (not required or even rewarded with application points) so, it was much less intimidating for them to approach a patient, do an assessment and provide care in the slower pace of a nursing home before hitting the hospital.

I have friends in other programs who did start at the hospital right away and they said that they really felt in the way in the beginning....putting us in the community to practice targeted skills avoided that.

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Went to hospitals for everything but the community nursing portion of the program.

I wouldn't pay a cent for a nursing school that sent me to nursing homes instead of hospitals for rotation.

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SummitRN has 5 years experience as a BSN, RN and specializes in ICU.

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Sure, doing a health fair or nursing home for your community health rotation makes sense. But some of these students were telling me that they were at the end of their first year... or halfway through their second year and had never had a clinical in a hospital!

Others did their entire pediatric rotation at respite care... essentially day care with no skills or critical thinking necessary, or a clinical setting where they were allowed ONLY TO OBSERVE.

All I could think was: "no wonder hospitals complain new grads are unprepared!"

I guess I shouldn't be surprised that most of the no-hospital students were from for-profit schools (and they seemed remarkably unconcerned), but a few were from a community college and complaining loudly that they weren't ever allowed to have real pediatric patient contact. I felt really bad for them!

Edited by SummitRN

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KristeyK specializes in Private Practice- wellness center.

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I'm in a for-profit school and we aren't part of that scenario. We did our first semester at LTC facilities. From here on out, we are in hospitals. And yes, my peds rotation next semester will be at an actual peds unit. (There aren't any stand alone peds hospitals where I live, and only two of them have peds units.) My OB rotation will be at the women's center of a hospital. (REALLY nice place to go deliver a baby...almost makes me wish I lived here when I had my boy! lol)

In my honest opinion, it speaks more to the quality of the programs that are churning out the students. Frankly, if the school I attend was like that, I would have stuck with the six semester wait list to get in at the community college. It's unconscionable to me that ANY RN or LPN program would not get their students in where they need to be in order to learn all of the skills we're expected to learn. Maybe the for-profit school I attend is the exception to the rule. I have heard NOTHING except rave reviews from Dr's and nurses I've talked to since deciding to join this program. That was enough of an endorsement for me. KWIM?

Plus, we have the opportunity to do extra things in the community, but they're just that- extra. My school is part sponsor of a HUGE health fair here, and many of us jump at the chance to work at them. We are highly encouraged to continue volunteering our services as RNs in the community once we graduate and become licensed.

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That Guy has 6 years experience as a BSN, RN, EMT-B and specializes in Emergency/Cath Lab.

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Very very few of my clinicals were in places other than the hospital.

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SummitRN has 5 years experience as a BSN, RN and specializes in ICU.

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KRISTEYRN

Great post! I think the problem in my area is that nursing schools proliferated suddenly, with new grad production up 50% over the last decade vs 15% population growth and only 2 or 3 new hospitals in that time... so all the new schools, many of which were for-profits looking to capitalize on the demand for nursing school slots, found that the available hospital placements were full. What was alarming to me was that one of the for-profit schools that I had multiple students say they had no hospital time until their final rotation of school is the for-profit with the best rep in the area.

Your school sounds awesome! Didn't you choose PMI? They have a good reputation around here for their RRT program (they have no RN program here).

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Certifiable has 5 years experience as a BSN, RN and specializes in Oncology/hematology.

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My university is on campus with the hospital. EVERYTHING we do is in the hospital, except for one project that we need to do in the community.

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I'm in Australia & all of my clinicals have been in hospitals, right from the beginning. For general med-surg placements we get allocated to different wards in different hospitals each placement. In my first and second years I went to elective orthopedic surgery, respiratory medicine, colorectal surgery, a CCU & cardiac stepdown ward, a cardiothoracic surgery ward and neurosciences for what I think you'd call med-surg placements. I went to a drug and alcohol detox unit for my mental health placement (other's went to a variety of public and private inpatient units or community mental health centres) and a special school for severely developmentally disabled kids for our introduction to children's health placement (we all went to a child care centre or special school.)

In third year we do one more advanced med-surg placement... although this year 3/4 of us are going to high acuity areas. I'm going to cardiothoracic intensive care. We also chose an elective such as women's health, community, mental health, critical care, indigenous health and go on a relevant placement (hospital or community) and a major (med-surg, paeds, mental health, aged care) and go on a relevant placement (again, hospital or or community as appropriate).

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JROregon has 5 years experience as a ASN, BSN, RN and specializes in Infusion.

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I go to a community college and all of our clinicals are in the hospital except for a 4 week rotation at a geriatric facility. The college and hospitals in the area have agreements that have been in place for a long time. I do like the idea of community care for the first term of nursing school. However, we have to be certified nursing assistance to be admitted to the nursing school so some of that patient interaction piece is already in place.

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