finished nursing 1 and feel cheated

llg, PhD, RN · Jan 3, 2009

It's usually a mixture. Most instructors are supervising too many students at one time to be at your side for more than a small portion of the clinical time. However, they should be there for you SOME of that clinical time and be able/willing to demonstrate at least a few skills.

I hope you expressed your concerns with your instructor on your course evaluation.

Jules A, MSN · Jan 3, 2009

I'd just take it with a grain of salt. In my experience some clinical experiences will be great and some will be disappointing. You really don't have the extra time to dwell on things you can't change. I've seen students have very different experiences on the same floor with the same instructor just by the luck of the patient draw or getting a great nurse to follow. Hang in there, focus on passing school and then the real fun starts!

puresass · Jan 3, 2009

you definitely need to get in there & take control of your learning experience. if you want to be shown how to do a head-to-toe assessment, ask your instructor to show you or ask your RN to let you watch his or her head-to-toe in the morning & explain what they're doing/looking at.

it can be disappointing if you feel like your instructor isn't showing you everything you want to see, but you also have to take responsibility for it & actively look for learning opportunities.

RNDreamer · Jan 3, 2009

Make friends with the nurses, techs, etc on the floor. With them you can learn/see/experience many things that the instructor may not have the time or opportunity to show you. Let them know that you want to be called over for anything.

In my clinical experience, we got to see alot because we got along great with the staff and with each other. If I was going to perform/watch a skill that I knew my classmate would like to see, I would call them over to watch (with the patient's permission, of course)

That Guy, BSN, RN, EMT-B · Jan 3, 2009

I did what above wrote. Make friends with the nurses on the floors and prove to them you are a capable nurse and they will more than likely be willing to help you learn. I had the nurses on the floor come get me anytime something was being done even if I was only able to watch. I witnessed so many interesting things that I will soon be able to do.

But I do feel for you, our instructor only had 5 students per day to manage and man, we got so much one on one time I felt spoiled with it.

kcochrane · Jan 4, 2009

We learned all the skills we needed in lab and then went to our facility to practice them. The instructor is supposed to watch you the first time and if you are successfull, let you do it alone the next. Although in our schools, you will ALWAYS have an instructor watch you pass meds, do IVs. But even if she/he doesn't watch you the first time, they should be able to answer questions or guide you through it if you are unsure.

But like others said, some intructors are better than others. If yours isn't good, you do need to take it into your own hands. I ditto ask the RN, LPN, other students (that you know are doing it right) and watch your videos, study your text.

Good luck! I hope you have a better experience next time.

textucker · Jan 5, 2009

you are right. Next semester starts in a week and I am going to do things different in class and in clinicals. This is going to be a great semester!!!!

cursedandblessed · Jan 5, 2009

ITA that paying attention to the nurses is sometimes much easier than getting your instructors attention. There were 9 of us, and it seemed like the two slackers got more attention than those of us who actually did our prep work, instead of sending them home for not having their med cards done, she actually let them stay and helped them out. Talk about some of our group being ticked off about it, we were livid, but we knew better than to make a ruckus. I passed meds with my nurse, did some very pretty dressing changes, got to disconnect and flush an IV, I wouldn't have gotten to do almost anything if I had waited on my instructor.

pcw6924 · Jan 5, 2009

I take it that you are speaking about a clinical placement - What a shame that you finish feeling cheated. I am studying nursing in Northern Ireland and I know there are probably many differences in the way that our nursing education is carried out compared to that in the USA. Here we spend a number of weeks in university then we spend the same length of time out in clinical placement (which may be in a hospital, nursing home, community etc). When we are assigned to a placement we are also assigned a mentor who will be a staff nurse working in the placement location but it is one student to one mentor. In addition to this, we also have a "link lecturer" who is a lecturer who will call in and visit you whilst you are on placement to make sure that you have settled, have no difficulties or concerns. Our rota will usually be the same as your mentor, you will not necessarily have every day the same but a large percentage of your rota will match your mentors.

I tend to treat all staff as a mentor as I believe I will learn something from everyone. Although a few students have had mentors who they didn't get along with or were disappointed with, I have been extremely lucky in that in my 4 different placements last year, I could not fault any of my mentors - they were all brilliant. Most of staff were very willing to answer any of my questions and very willing to show me new things and let me practice. We have a portfolio to complete and sign off as you practice various procedures and I have been lucky to have had the opportunity to practice most of them. Obviously depending on the placement, there may be some procedures that are not relevant to that placement. I have founf patients brilliant, I think they are happy to feel that they are helping in your training, so far everyone has been more than willing to let me participate.

Do you have link lecturers attached to your placements in the USA? If so, could it not be raised with them if the student feels that they are not getting the proper assistance and learning experiences?

:nuke:

TexasCowgirl24 · Jan 5, 2009

After talking to other students about their clinical experience i feel so cheated. My clinical instructor IMO didn't teach me a thing. Yes, she was there, but in body only. If you had a question she would answer your question but she didn't show you how to do anything. She would walk around and poke her head into the room and ask if you were doing okay, that was it. Several of the instructors actually SHOWED their students how to do a head toe assessment on a patient. I realize you have to have the patients permission but there were plenty of patients who would have been willing to participate. My question is... was my clinical instructor the norm or are the intructors suppose to demonstrate/hands on instructor?
textucker

You need the pts permission to do an assessment? At my school in level 1 ( 1st sem od NS) our instructor had 10 of us on the floor so she stayed busy. Ask your pts RN. Some RNs don't want to mess with you cause they think having a student = more work for them, but most nurses love having students.

Daytonite, BSN, RN · Jan 5, 2009

you are also responsible for some of your own clinical experiences keeping safety rules within mind. sometimes you have to page your instructor, being assertive, and say, "i would like you to help me with xxx." this is advice that is given to medical students (http://meded.ucsd.edu/clinicalmed/thoughts.htm) look at the first item, in particularly, because it sounds like it applies in your case:

never be afraid to ask questions. if those that you are currently working with are unreceptive, make use of other resources (e.g. house staff, students, nurses, health care technicians, staff physicians). you can learn something from anyone.
there is no substitute for being thorough in your efforts to care for patients. performing a good examination and obtaining an accurate history takes a certain amount of time, regardless of your level of experience or ability. in addition, get in the habit of checking the primary data yourself, obtaining hard copies of outside studies, mining the old records for information, re-questioning patients when the story is unclear, and in general being tenacious in your pursuit of clinically relevant material. while this dogged search for answers is not too sexy, it is the cornerstone of good care.
learn from your patients. in particular, those with chronic or unusual diseases will likely know more about their illnesses then you. find out how their diagnosis was made, therapies that have worked or failed, disease progression, reasons for frustration or gratitude with the health care system, etc. realize also that patients and their stories are frequently more interesting then the diseases that inhabit their bodies.
become involved (within reason) in all aspects of patient care. look at the x-ray, examine the sputum, talk with the radiologist, watch the echo being performed. this will allow you to learn more and gain insight into a particular illness/disease state that would not be well conveyed by simply reading the formal report. it will also give you an appreciation for tests and their limitations. caring for patients is not a spectator sport. as an active participant in the health care process (rather then simply a scribe who documents events as they occur) you will not only help deliver better medical care but will also find the process to be more rewarding and enjoyable.
follow up on patients that you care for in the er, are transferred to other services, seen by sub-specialists or discharged from the hospital. this should give you a better sense of the natural history of some disease processes and allow you to confirm (or adjust) your clinical suspicions. this is particularly relevant today as patients are shuttled through the system with great speed, affording us only snap shot views of what may be complex clinical courses.
keep your eyes open for other interesting things that might be going on elsewhere in the hospital/clinic. if there is a patient on another service with an interesting finding, go over and investigate, assuming it doesn't interfere with your other responsibilities and is ok with the patient and their providers. this will give you the opportunity to expand your internal library of what is both normal and abnormal.
pay particular attention when things don't seem to add up. chances are someone (you, the patient, the consultant) is missing something, a clue that the matter needs further investigation. challenge yourself and those around you by continually asking "why... ?"
before deciding that another provider is an "idiot" for adopting what seems an unorthodox or inappropriate clinical approach, assume that it is you that are short some important historical data. give others the benefit of the doubt until you've had an opportunity to fully explore all the relevant information. and in those instances when it becomes apparent that mismanagement has occurred, focus on communication and education rather then derision and condescension.
realize that, ultimately, you are responsible for you. the quality of care that you provide is a direct result of the time and effort that you invest in the process. the distinction between good and bad medicine is generally not a function of oversight by the patient, colleagues, or the legal system. for the most part, it's dependent on your willingness to push and police yourself.
you are not automatically endowed with the historical wisdom of a particular institution merely by walking through its doors. nor does this knowledge necessarily arrive with your white coat, degree or other advanced title. rather, this is something that's learned and earned, often on a daily basis.
every once in a while, push yourself to become an expert in something. first hand knowledge is a powerful tool, one that is available to anyone willing to take the time to read through the primary data. become informed by delving into the original literature pertaining to a particular subject. you may find that the data is robust and the rationale for a clinical approach or treatment well grounded. as frequently, i suspect you'll find instances where the data is rather shaky, and the best path not as clear as guidelines or expert opinion might suggest. [we have plenty of sticky threads on this and the nursing student assistance forum with weblinks to information where you can do just this!]