Clinical Instructor sucks...

[FutureNurseInfo]

Hi there!

So I am in week 3 of the first semester of nursing school. Btw, it is an accelerated BSN program. So, so far I have had 2 clinicals on campus, and I will have my third one tomorrow. I am actually going to the hospital next Friday! Anyways, my issue is that our clinical instructor is non-existent.

On the first day of clinical she was late. When we finally split into stations, she was running Vital Signs. When we showed up she said she was tired so we were kicked out. The next station was Infection Control and we had to wait for an hour and a half to enter. Out of 10 hours on campus, 2 hours spent doing procedures, and 8 hours spent wasting time.

Last Friday's clinical was no better. The clinical instructor did not show up! Sixty or so students were split between the two CIs that did show up. Like the last time we pretty much spent time talking and talking and talking, without actually doing anything.

The way the two clinicals went I can only assume how tomorrow will go. My beef is this: our clinical instructor did not bother to get to know us, not once in three weeks! The only time she saw us she looked bored, yawning, running out the building.

I feel like when we do show up at the hospital, I (not sure about the others) will not feel prepared to do even basic things. Btw, I am not the only one who is annoyed by such disorganization and clinical instructor's lack of interest in her students.

What should I do?

[elkpark]

Pro Tip: Clinicals suck.

How so? My clinical experiences didn't "suck" when I was in school (diploma program, BSN-completion program, or master's); they were useful, relevant, and valuable learning experiences. I recognize it's entirely possible that some clinicals at some schools might "suck," but I don't see how a sweeping generalization can be made.

[LilyRN99]

You are just starting out so take a deep breath. I teach second quarter in a LPN program. I teach the clinical in the nursing home. Your clinical instructor knows what you are learning and practicing on real people is different. My students independently do bedbaths, vitals and head to toe assessments. I expect there to be questions and many students will say that they can't get a blood pressure, find the pedal pulse, and visualize pupil reaction. This is normal and I'm there to help them. Any other tasks, I am there with them. I know they are anxious and will often demonstrate the skill the first time and then have the students try it. I don't expect perfection. I supervise all medications given, finger sticks until I'm sure they can do it independently, and skills involving a feeding tube, etc. I am aware that people learn at different speeds and some people are more comfortable giving injections after one try and some need several attempts. Your teacher in the lab might be different than the one in the clinical site. I don't teach in the skills lab at all. I think you will be fine. Be respectful, willing to do whatever your instructor asks you to, and try not to look bored. You can always talk to patients, look at charts, or help aides or nurses. There are things you can't experience in the skill lab. I love seeing a student who finished their tasks talking with a dementia patient. Patients without dementia are often willing to tell their stories. Ask why they were in the hospital, what happened in the hospital, and why they are in the skilled nursing facility. Some people love to talk to students and nothing is better than hearing about an experience from the patients viewpoint. Of course, you won't learn everything you need to know in nursing school. You will learn so much more on the job.

[FutureNurseInfo]

You are just starting out so take a deep breath. I teach second quarter in a LPN program. I teach the clinical in the nursing home. Your clinical instructor knows what you are learning and practicing on real people is different. My students independently do bedbaths, vitals and head to toe assessments. I expect there to be questions and many students will say that they can't get a blood pressure, find the pedal pulse, and visualize pupil reaction. This is normal and I'm there to help them. Any other tasks, I am there with them. I know they are anxious and will often demonstrate the skill the first time and then have the students try it. I don't expect perfection. I supervise all medications given, finger sticks until I'm sure they can do it independently, and skills involving a feeding tube, etc. I am aware that people learn at different speeds and some people are more comfortable giving injections after one try and some need several attempts. Your teacher in the lab might be different than the one in the clinical site. I don't teach in the skills lab at all. I think you will be fine. Be respectful, willing to do whatever your instructor asks you to, and try not to look bored. You can always talk to patients, look at charts, or help aides or nurses. There are things you can't experience in the skill lab. I love seeing a student who finished their tasks talking with a dementia patient. Patients without dementia are often willing to tell their stories. Ask why they were in the hospital, what happened in the hospital, and why they are in the skilled nursing facility. Some people love to talk to students and nothing is better than hearing about an experience from the patients viewpoint. Of course, you won't learn everything you need to know in nursing school. You will learn so much more on the job.

I really appreciate your taking time to write such a comprehensive response! I do agree, that the real learning begins after graduation. As a second degree student, I guess, I expected more. But I will follow your advice to the T. My biggest fear is to actually interacting with the patients, and, even more, performing procedures on them! What would be your advice about that?

[rnhopeful82, ASN, RN]

If a group of you are sitting around waiting for her, try practicing checking vitals on each other. If you haven't QUITE learned how to check BP, etc, there are a ton of resources online. Practicing checking pulses and bp can help you with your confidence and skill for once you get onto the site. Sorry your supervisor sounds like such a poo. Good luck!

[LilyRN99]

Practice skills on family and friends. I tell my students the more times you check a BP the better you will be at it. It's easier to find pulses and see pupil response on younger healthy people than on the elderly. The more lung sounds you listen to the better you will be able to identify abnormal signs. Practice the full head to toe assessment everyday at clinical. Even if the pupils were normal yesterday check again for the practice. Ask for help. I'd rather have a student ask for help with a skill than just assume they know how. Questions also indicate to me that you are interested in learning and are taking clinical seriously. Some of my students seem to do the minimum required. How is that going to help? Look up the conditions your patients have. You can't understand your assessment findings if you don't know what the condition is. You can read care plans online to help you know what to assess and what to do for a particular condition. I like nurseslabs.com. Nursing is tough and requires dedication. You need to understand the information, not just memorize it. Writing things down helps information soak into your brain. Make flash cards, make lists, take notes, etc. When it is time for the NCLEX take a ton of practice tests.

[Leader25, ASN, BSN, RN]

If she is not showing up and you are forced to double up with another instructor or whatever it leaves you unprepared.We had this in school and when she did show up she smelled of alcohol.We wrote a letter(leaving out the alcohol part), everyone signed it we walked it to administration the head honcho, we got results.A new reliable instructor.Of course none of us were ever selected for any of those goody goody awards because as activists we were branded "troublemakers", lol. Never regretted it ,we all passed we all graduated.

[Orion81RN]

Well, the first couple weeks we are supposed to learn the basics before we practice the skills on actual patients. So, next Friday we are going to the hospital.

Ok, so this sounds like lab, not clinical. Not the same thing even if your school is calling it clinical. And in real clinical, an instructor can only have so many students. There is a cap to the number. One of the main reasons for so few nursing spots.

An instructor would not get 30 students for clinical. Let it go. This isn't real clinical.

[Orion81RN]

I would love to spend clinicals in the lab, I am sick of washing buts all day long

Use the time you are doing bed baths and diaper changes as an opportunity for building your assessment skills. Complete head to toe. Feel all the pulses, listen to as many lung sounds and hearts as you can. Check skin turgor, coloration, respiratory and cardiac effort...and think about the disease process. Put it all together.

Is the patient there for pneumonia and dehydration? Need their butt wiped? Wipe their butt, put your stethoscope to their lungs, check their mucus membranes, skin turgor... Clinical is what you make of it. Even just the butt wiping.