Extremely frustrated @ clinicals!

[miss_pitty_pat]

I am in my second semester of an ASN program. We started our first hospital clinicals a few weeks ago. Things were fine when I was in observation on other units, but when I was put on the Medical/Surgical unit to participate in patient care, everything went down hill! The nurses on the unit are SO VERY RUDE! The nurse manager actually yelled at another student in front of a patient! And the student had done nothing wrong (truly, the instructor even said she was not doing anything wrong). This manager also was very hateful with me. The nurse responsible for my first patient brushed me off, telling me to go find something else to do and she would find me when she was done with report (I was supposed to get report for the patient I was assigned to) and then walked past me, ignoring me when she was done. She wouldn't have anything to do with me the entire shift. Then today, I had the same issues, being ignored and feeling lost because I didn't know what to do. I tried to find the instructor but she must have been off the floor, couldn't find anyone to be nice to me. I told a girl I was sick and left. I just finally stopped crying. I am miserable at this clinical site. We have 9 left (2 a week) then switch to OB/Peds which I have heard the RNs are even worse! A group actually pulled out of their clinicals here on Med/Surg because the instructor refused to go back to the hospital. They transferred to another facility. I have heard there have been numerous problems with this hospital. I live in a kind of rural area, so clinical space is extremely limited, which is why I am assuming we are still here. I have heard there have been meetings betweeen the school and administration at the hospital, but nothing is being done.

I can't quit over something like this. I know that I will have to learn how to deal with people like this because they are everywhere. I have worked in Dr. offices and have been cornered and yelled at by some pretty mean docs. That I can deal with. But when I am in a setting where the RNs are supposed to be our teachers and take us under their wings, remember their own experiences, and helping us and they don't and are down right rude, I have a really hard time dealing with that! Anyone have any advice? Anyone had any similar experiences? I am at a loss. The only thing I can think to do is go in tomorrow with the attitude that it's going to be a better day and not take anymore crap! I am normally a person who can't bite her tongue, but as a student there is a line that I am afraid to cross, but I am ready to say screw that line and just tell them how it is!

[PEBBLES1]

I felt the exact same way on one of my clinicals. I hated that site. The nurses and the pca's treated us like we were slaves. Anyway, my instructor was great. He did all teaching at the bedside, so if I had any questions, I would just ask him. How I got thru it was to just stay out of their way, however, they did teach me one thing and that is, how not to treat students. One of the nurses even lied on me and said that I made a patient make up their own bed. My instructor knew that this nurse was lying because, on the date and question I was in the OR with one of my patients who had to have emergency surgery and I was gone most of the day. I know how you feel, you are not the only one.It's a shame that some nurses treat students horrible, I guess they forgot what it was like to be a student. Maybe they was born with a stethscope and a RN license around their neck. Good luck to you and hang in their.

[AOx1]

First and foremost, you should talk to your instructor. Don't ever leave the floor without permission. Although the nurses are the ones at fault, you don't want to act in a way that could jeopardize your standing.

I personally wonder if there are not alternate experiences that could be found for your group. As an instructor, this is something we face at some sites. I know another instructor who faced similar problems and created several new experiences as there was no opportunity for him to move his group due to clinical site limitations. If it were me, I would do anything I could to make it a learning experiences, even if it meant assigning students in small groups and making rounds with them, and doing other activities that can be performed independently of staff such as taking time to practice interpreting lab values, documentation, familiarize yourself with equipment such as IV pumps, etc. There are so many things you can do besides just pair one student with one nurse. I also make sure I am available on the floor at all times. I leave my phone on vibrate and students can text me if I am not visible (for example, in another room with a different student's patient).

I've also found that the more you clarify as an instructor what your expectations are for the students (ex- provide objectives, explain what students should be doing on the floor) the better your relationship with the floor. This helps them know what to anticipate. Your instructor may have already done this.

Finally, and I hate to say it, but you will face nasty people in every profession (as you've already seen in clinics). I highly recommend books such as "Difficult conversations" and "How to work with just about anyone." Try to reframe your anxiety. These nurses are NOT angry with you. They hate their jobs and are unhappy with their situation. They may even hate their lives. It is their issue. You just need to find a way to learn in a very difficult environment. Even if your instructor makes no move to fix things, you can ask him/her what to do, and offer solutions, for example "I really want to learn and get the most from this rotation, but have found it difficult. When I worked with _____RN yesterday, I tried to offer assistance, communicate assertively, and spend as much time with my patient as possible, but the nastiness continued. Can you think of a way I might ensure that I learn as much as possible? I've already (studied my labs, talked extensively with my patient, performed my assessment, etc)"

Do as much as you can independently. Talk extensively with your patient. Perform frequent assessments. Ask your instructor if you can pair with a classmate to assess each other's patient as a team and compare findings and labwork.

Ultimately, no one will care as much about your education as you should. It's your instructor's responsibility to be available and try to create a climate conducive to learning, but you should not give up. Even if you receive no help at all, make up your mind that you will learn. Look everything you don't understand up. Figure out that pathophysiology. Download Daytonite's critical thinking flowsheet and fill it out for your patients. Compare what you would expect to find with this condition to what you actually find. Determine your key interventions and discuss them with your instructor.

Good luck.

[BabyLady, BSN, RN]

Your age may have quite a bit to do with it. I have noticed that the younger nurses get picked on and the older ones...not so much.

I can handle a physician or a senior nurse just having a "moment".

However, when those moments turn into a daily attitude issue, there is nothing wrong or disrespectful, the next time they say something rude, say, "I'm here to help in any way...but it would probably be better if we kept things professional, ok?"

[miss_pitty_pat]

Download Daytonite's critical thinking flowsheet and fill it out for your patients. Compare what you would expect to find with this condition to what you actually find. Determine your key interventions and discuss them with your instructor.

Where can I find this?

Thanks for all of your advice. Our instructor is always saying you get out of clinicals what you put into it. I guess I need to be more assertive and inventive in finding things to do. The patient care techs have been really nice, but haven't really needed much help b/c they are in their routine and get things done without really thinking about someone else helping. I really do appreciate your advice. Thanks again!

[teeniebert, LPN]

Look for any post by Daytonite--she has a downloadable report sheet and a critical thinking sheet in her signature. She's also awesome. :)

[86toronado, BSN, RN]

i have had clinicals on floors where the nurses were extremely helpful, and i've also had clinicals where they couldn't be more rude, but i've always tried to remember that when it comes down to it, it's not their job to teach us. that's what our instructor is there for. the floor nurses are just coming into work, maybe at a job that they don't really like, and without any choice in the matter, they are told that they have a student covering one or more of their patients that day. how would you feel about that? if i get a nurse who likes teaching and wants to help me with things, i consider it a bonus, but really i rely on my instructor for whatever teaching i need.

[truern]

Miss pat, have you considered that maybe you're part of a self-fulfilling prophecy?? You've heard the horror stories about that facility and expect to be treated badly?? Just a thought.

I would go to clinical and do my utmost best to provide care for my patient. If the nurse won't give you report, then look at the chart and orders. Look up the labs. Look up the procedures. GET report.

The nurses are not required to teach you...that's not in *my* job description at all. I LOVE having students, though...and do my best to make sure they have great learning experiences. But you have to accept that not everybody wants to teach and, in fact, they don't have to. Your learning experience is YOUR responsibility...and your instructor's.

Go to clinical...do your best...and learn from the good AND the bad. And whatever you do, please please please don't ever leave a clinical site again.

[Cilantrophobe]

Why are students paired with nurses if the nurse has zero responsibility to that student?

[truern]

Why are students paired with nurses if the nurse has zero responsibility to that student?

IMHO, if the nurse doesn't want to take on a student they should say so. They're not doing anybody any favors by making a miserable experience for the student.

That said, nurses are not responsible for students...they're responsible for their patients. Clinical instructors are responsible for their students.

I've turned down students when I felt uncomfortable with them providing care for my patients...the ones that already knew it all, that couldn't take instruction, etc.

[Cilantrophobe]

IMHO, if the nurse doesn't want to take on a student they should say so. They're not doing anybody any favors by making a miserable experience for the student.

That said, nurses are not responsible for students...they're responsible for their patients. Clinical instructors are responsible for their students.

I've turned down students when I felt uncomfortable with them providing care for my patients...the ones that already knew it all, that couldn't take instruction, etc.

I agree that a nurse should not take on a student if they either don't want to or just don't feel comfortable with that student. I am fully aware that the nurses are for the patients and the instructors are for the students. You get a DUH for that one! :) I was just curious why the students were paired with a nurse if the nurse could potentially be of no use to the student. What's the point of that?

[truern]

I'll see that DUH and raise you two

"why the students were paired with a nurse if the nurse could potentially be of no use to the student. What's the point of that?"

Ok, I'm punchy this evening and *almost* asleep, but here goes: I agree that nurses shouldn't take students if they don't want to teach, but it's not all about what's "of use to the student". If in my providing care for my patients I can make a learning opportunity for the student that's GREAT, but my focus is on the patients.

I promise when you're out of school you'll see what I'm talking about...especially when you have students :)

I really hate that the nursing students at clinical sites thread got pulled...there were some posts in it that explained what I'm trying to say so much better.

I think it's bedtime for me...long long day at the endo office.