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Facility not allowing us patient contact

Posted

Hi all,

Long time lurker first time poster. I'm doing my half semester psyc rotation right now and after five weeks we haven't been allowed by the facility to step foot on any of their units hence no patient contact. We've all reported each week fulfilling our part, but have been placed in a classroom every week. I had talked briefly to our clinical coordinator who told me after week three that she was attempting to resolve this, but it seems wasn't able to do so. While I'm not happy about this I realized that midsemester there isn't much we can do, and was content with just riding it out. This was until our lecture professor found out, and threatened to fail all of our clinical group. I think that's a vastly unfair threat as we've done what we're supposed to do, and they've had similar problems with this facility the past two semester. Any thoughts or experiences like this?

C0SM0

Has 1 years experience.

It seems like there is a major communication issue between your clinical facility, clinical instructor, and instructor for the didactic portion. I've never heard of a clinical rotation where students aren't even so much allowed on the floor. What's the point of being at a clinical site?

If I was threatened with failing a class because of something that was completely out of my control, the least I'd be doing is getting the dean/director of nursing involved. You've paid way too much money and put in way too much effort to be failed because a clinical site wouldn't allow you on the floor of their facility. My advice is to take action now. The longer you wait, the harder it'll be.

Planning on taking action Monday Morning wanted to seek some advice first. This has been a mess from the start as they assigned us a brand new CI who had never even visited the facility before. Heck she didn't even bring her titers the first morning had to go home during lunch to get them. It was clear also from the talk that the director of nursing of facility gave that she really didn't want us around. We've now been told that we might be allowed on the unit for the last two weeks of the rotation which is what happened to the first half group, but at this point who knows. Sadly our lecture professor just really escalated this to a level that really wasn't needed.

RainMom

Has 7 years experience.

Another concern I would have is what are your state's requirements for minimum clinical hours? If that had been my program/state, sitting in a class on site doesn't count & additional days would have to be scheduled to make up the hours or we wouldn't have qualified for NCLEX. You might be finding yourself having to add extra clinical days to your semester or program at some point.

Going to look into that. Either way no one should fail over this.

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

Where the bleep is your clinical instructor while you all are being told you can't enter the unit???

Sitting there having us read from the textbook or doing case studies. She's new so I don't she has a clue how to deal with this. Our lecture professor also stated she had problems when she had a group there. Seems like for the future they need to stop sending groups there.

audreysmagic, RN

Specializes in Psych, Peds, Education, Infection Control. Has 15 years experience.

As someone who works in inpatient psych, that's just BS. Clearly this facility shouldn't be allowed to continue to host clinicals. I tried to think of all the liability reasons one might not have students on the floor, but we have those same issues at our facility, and we work around them. If one unit is too acute for us to feel safe having students there, we send them to another unit. (We're a freestanding psych hospital, for reference, so all of our floors are psych, just different populations.) Maybe they're not trusting the newness of your instructor - but again, if they've done this in the past, it's probably not the issue. And you're probably not CPI (Crisis Prevention Institute) certified, but neither are a lot of people who rotate through psych units...at my facility, we just don't allow those people to participate in security codes. Either way, I agree - no one should fail because it's beyond your control. And I'm not sure how the lecture professor thinks it's their business, specifically, unless they're a higher-up in the program - but if they are, they should be working to solve the issue. Agree with the others that you need to check in with the program director. That's a mess, and I'm sorry you're getting robbed of your proper clinical hours.

Edited by audreysmagic
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Kuriin, BSN, RN

Specializes in Emergency. Has 4 years experience.

Our inpatient psychiatric clinical instructor did not allow us into her facility. Yes. HER facility. She was the director of nursing at a prestigious psych facility in the Bay area (can you guess which one?) and none of us were allowed patient contact. It was escalated to the didactic instructor, as well as the dean, but nothing could be done.

audreysmagic, RN

Specializes in Psych, Peds, Education, Infection Control. Has 15 years experience.

Our inpatient psychiatric clinical instructor did not allow us into her facility. Yes. HER facility. She was the director of nursing at a prestigious psych facility in the Bay area (can you guess which one?) and none of us were allowed patient contact. It was escalated to the didactic instructor, as well as the dean, but nothing could be done.

I'd say I'm shocked, but...just like not all nurses are excellent nurses, not all instructors should be teaching and not all managers should have any sort of power. And you'll find some really special people working in psych... I do know of one nurse that I worked with that, let's just say, I wouldn't trust to have my back when things got rough, and I found out she teaches nursing somewhere AND she's one of the first to say she's not taking students. That still sucks, though, and I'm sorry you had that experience. Psych is DEFINITELY not for everyone, but I find a lot of students get turned off to it by a poorly-managed rotation. (Whereas I am passionate about giving students good psych clinicals because it was an excellent one that really made me excited about the specialty, and got me amped for peds/adolescent psych specifically.)

I don't understand why a school would be using a place that won't allow students on the floors as a clinical facility in the first place. For goodness' sake, take the students someplace else, someplace that will allow the students to have an actual clinical experience! Even if that means driving farther or arranging a different clinical schedule. I've taught psych in a few different schools over the years, as the lead psych faculty person who arranged the clinicals as well as serving as a clinical instructor, and, in my experience, facilities typically won't allow students to give meds or participate in codes (of course), but they have been happy to have students on the floors, participating in the milieu and spending time interacting with the clients. What's the point of going to clinical if you're not going to be able to do that? Sitting in a classroom, reading the textbook and discussing case studies, is not "clinical." Yikes!

Finding another facility isn't so easy as we have several schools who are sharing just a few facilities. I'm in a major city, but quite a number of our students are dependent on public transportation which isn't so great here so that needs to be accounted for in finding a new clinical site. As an update we've been told that for the last two weeks we will be allowed on the floor, but I won't believe it till it happens. Hopefully this is the last semester we will send people there.

NicuGal, MSN, RN

Specializes in NICU, PICU, PACU. Has 30 years experience.

It is the school's responsibility to find a suitable site. Why is the director even allowing this? I don't mean to sound harsh, but it isn't the schools responsibility to make sure people don't have transportation issues. If this is the reason they keep this place, then that is a problem also. The facility does not have to accept students unless the school is affiliated with them in some way.

What a stinky situation for all.

Finding another facility isn't so easy as we have several schools who are sharing just a few facilities. I'm in a major city, but quite a number of our students are dependent on public transportation which isn't so great here so that needs to be accounted for in finding a new clinical site. As an update we've been told that for the last two weeks we will be allowed on the floor, but I won't believe it till it happens. Hopefully this is the last semester we will send people there.

With the proliferation of nursing schools all over the country, finding specialty clinical sites has become a serious challenge in many places. At the last school in which I taught, negotiating the specialty clinical sites and schedules among all the nursing programs in the city was like some kind of international summit. However, that does not relieve the school of the responsibility to provide appropriate, suitable clinical experiences for students they enroll.

I agree with NicuGal that student transportation is not the school's concern when planning clinical rotations. When I attended nursing school a kazillion years ago, and in every nursing program I've attended or taught in since then, students were told as part of the application/enrollment process that clinicals would be held in a variety of locations around the area and it would be students' responsibility to get there, whether that was a matter of owning a car, carpooling with other students, or using public transportation. Was that not the case at your school?

This clinical site is receiving a decent amount of money from your school to be there. To not allow you on the unit and for the school to accept this should be completely unacceptable. Your school should get their money back as to me this is nothing less than stealing.

Sometimes, it is strictly observation. But you should at least be observing, not doing case studies. When I was in school, only a certain amount of hours could be used for case studies.

This clinical site is receiving a decent amount of money from your school to be there. To not allow you on the unit and for the school to accept this should be completely unacceptable.

None of the nursing programs with which I've been connected over the years have ever paid any facility to be able to use it as a clinical site. If that happens at all, it is certainly not a common occurrence, and I don't think one can assume that the OP's school is paying the psychiatric facility.

I hope they work something out and it does sound positive that we will get to go next week from the message we received. We'll see it when I believe it. Thanks everyone I will bump this thread with an update!

Generally I agree with this as we usually get to get pick between two or three sites at the start of the semester so everyone gets something that works for them. I was only bringing up the transportation issue for a midsemester switch as that could really screw quite a few people in my clinical group over. Anyhow it's sounding more positive from the message that we're supposedly getting on next week. We'll see what happens ,and I'll bump the thread with an update. Thanks everyone!