During Clinicals Are You Able To Choose The Area You Want To Practice In

leighton · Sep 21, 2009

If your clinical is a group of 10...all of you will probably go to a specific unit/hospital. For example our clinical group which consisted of 8-10 students would rotate units each semester. The first semester we had Med-Surg I so we were on a medical floor the entire semester. My second semester we had Med-Surg II so we were on a surgical floor. Then our third semester we had Mental Health and Maternal-Child...so we were on the Peds and OB floor and also a psych unit. Our fourth semester was Med-Surg III and Community Health so we were on a Cardiac floor and then we did Home Care too. But the entire semester was spent on the same floor for each class. The other clinical groups would be at the same hospital and usually same floor but different days...so there were never two clinical groups on the unit at the same time. Hope that helps you! Although every school is different! Good luck!:)

roser13, ASN, RN · Sep 21, 2009

No, you don't get to choose. And that's a good thing. I have never yet met a nurse who stuck with his/her original idea of what they wanted to specialize in.

No matter how dedicated you may be to your personal nursing goals, it is all to the best that you are exposed to any/all clinical experiences. Particularly if you have a specific area that you are not inclined to enjoy. A short exposure can only help round out your experience.

rachelgeorgina · Sep 21, 2009

I'm from Australia so I think how things are done in regard to clinical is a little bit different.

First off, our clinical placements are arranged in "blocks" that range in duration depending on the semester. In first and second semester of first year the placements are short, 1 week in the first semester, 2 in the second. In second year, there are two "blocks" per semester, 1 of 1 week and 1 of 2 weeks for two different subjects (one med-surg subject and one speciality subject e.g. mental health, children's.) In third year more time is spend in the hospital setting with placements hitting up to 8 weeks for sub-major allocations.

Our blocks are allocated firstly, according to subject. Our med-surg subjects are structured by system (e.g. Adult Nursing: Cardiovascular, Adult Nursing: GIT & Ortho, Adult Nursing: Neuro/Endocrine etc) however that doesn't mean that you'll be allocated to a ward of that speciality (because there simply aren't enough out there for all the students!) What it means is that you are allocated to a med-surg ward in a major hospital for that block and you have to try and focus some of your time there around some of the specific things you learnt to that subject (e.g. in Respiratory we looked at chest physio and if you aren't on a respiratory ward (& even if you are!) you need to hunt out a patient that might need chest physio to see if you can observe that.) For speciality subjects like mental health and childrens, you are allocated to a facility (inpatient or outpatient) that deals with that speciality. Interestingly, for children's nursing, placements are either in childcare centres or in special schools for disabled children.

In third year, we are able to choose one elective (from paeds, mental health, palliative care, community, aged care, critical care, child & family, aboriginal health etc) and one submajor (med-surg, aged care, paeds, mental health.) For these clinicals (which are longer and give the student wayyy more autonomy in terms of practice) you are allocated to a facility that deals in the specialty that you've chosen. So for paeds, that's either a major children's hospital (of which we have two), a NICU in any other major hospital or a paediatric ward in an adult hospital. For aged care, it's generally a nursing home and for mental health, it's generally an inpatient facility (often for the compulsory mental health subject there aren't enough inpatient facilities to go around and a lot of students are placed in outpatient mental health teams such as crisis and primary community care services.)

The clinical organizers attempt to arrange placements by location/postcode but obviously that isn't always possible. We aren't allowed to ask for a specific facility or shift for convenience reasons but if you have extenuating circumstances then they can attempt to make arrangements for you.

Usually there are two separate periods for each "block" to accommodate all the students in the number of placements. Generally there is one block in the early part of semester and one in the later part before exams. Half the course goes in one period and the other in the other half. Clinical groups are made up of 6-10 students who are allocated 1-3 per ward in the same hospital. Each clinical group has one facilitator though there can be up to three or four different clinical groups in the one hospital on the one shift (and then another load on the next shift!)

So, no, we can't choose our placements or facilities but we get a little bit more say when we get to third year and up until then we get a good variety of different placements to give us a feel for different areas.

elkpark · Sep 21, 2009

In the US, nurses are educated as "generalists" (that is, prepared to practice in any of the main/typical areas of nursing), and the state BONs require that school curricula include a specific number of supervised clinical hours in each of the main areas of nursing practice -- med/surg, peds, OB, psych, and some others. So, in the larger sense, no, you don't get to choose. You have to rotate through all the specialty areas. Some schools that use multiple clinical sites offer students a choice of where they would like to do different clinicals -- e.g., if one hospital is much more convenient for you than another across town, you can request the more convenient site. But, because the BONs also specify the maximum number of students per instructor in clinical, sometimes the need to balance out the clinical groups has to override some student requests (e.g., if most students request one site and no one wants to go to the other site -- some of the students are going to have to go to the other site, regardless).

Lots of schools offer a senior practicum, typically the last term before graduation, that is intended to ease the transition into practice, and students typically get to choose what area/specialty they want for that rotation.