12 hour shifts for students AND Med. school

Published

Hi. I am in Peds this semester and we are starting 12 hour shifts for clincials. I, for one, have a hard time with that cause of meds. I have to take myself. I know some hospitals offer other shifts, but this seems to be the common standard. If I did not have to take meds and eat, 12 hours might be fine. Geeezzzz.... how do you breathe, eat, rest for a few minutes, etc. It seems like a LONG shift. I guess you just go go go. I really can't do that. :( I have mentioned this to the clinical instructors. They have not been too understanding so I'm getting a letter from my doctor explaining my situation. The last year was fine cause they offered different times for clinical and I worked it around my schedule. No problems. Not the case this semester. I hope they work with me since I have a legitimate handicap. :rolleyes:

Also... a nursing student was telling me today that in Med. school, there is no such thing as a C- and you fail. They have nothing like this for grading standards I was told today. You get a D and you are still fine. Anyone know if this is true??

Thanks!! Epona

Specializes in Emergency & Trauma/Adult ICU.

I'm sorry you are having this difficulty but I do not find your proposed solution reasonable.

Your school is required to hold a minimum number of clinical hours. Schedules are dictated by contracted clinical facilities, and most are juggling students from different schools. To meet your request, your instructor would have to be at the clinical site from before 6am until 8 or 9pm to accomodate your clinical hours.

I have never had a patient taking beta blockers who needed to "be still" for an hour after taking the med, but I accept that your case may be different. Surely you knew of this 6am start time in advance. Why could you not gradually adjust your dosing schedule, moving it say 15-30min. a day, so that you would have adapted by the time clinicals started for this term? Why can you not take the meds when you awaken at 4am? I'm picturing limited activity between 4am and 6am - whatever your morning routine entails and the drive to the clinical site?

Up Vote Up Vote ×

Hi. You all bring up some good points. Usually the clinical time has been flexible. In the past, I have done 9-3, 3-11 and so forth. I have selected these times just for this reason. This time the clinical is only offered from 6 AM-6 PM. The clinical is for about two months so I don't want to shift my meds for two months and then shift them back. The KCL I can play around with some.. I have some flexibility there, but I do not want to change the beta blocker. My system is super sensitive and I actually divide up the beta blocker doses in two and take them about ten hours apart. I do not take the "typical" dose and have taken it this way for years. I am always tachy in the morning until I take the meds and sit for about an hour, then I am fine. In-fact I had to switch the meds up when my husband and I went to Europe last year (time changes) and my heart DID NOT LIKE IT. Skipped beats and beat pretty fast since I was not on my regular meds schedule. I had to rest three times (literally site down) while we were on the trip. So taking meds really early (up to 6 hours early) is not really an option and moving around (getting dressed and ready for school, etc.) without meds is not really an option either. I did inquire a few years ago before I went to RN school about 12 hour clinicals and heard from several folks that no... there are no 12 hour clinicals.... now in the "real-world" if you chose, you can work 12 hour shifts, but other shifts are also available. I was told no 12 hour clinicals. Well I guess the times have changed. Had I known this, I may have not gone to RN school.

I do understand where the teacher is coming from and I know the "class" has certain times. I understand that. All I would do is come in at say 8 or 9, get a quick brief on what's been done, then jump in the game. I would leave at the regular time... so I would have a 10 hour clinical vs. a 12 hour. It would be SO NICE if the teacher could just say "Well Ok you have this documented condition, you can come in at 8 and I'll catch you up." OR to make up for it "You will need to demonstrate in the lab how to insert a Foley and check g-tube placement." This is what we did in clinical and I need to make sure you have mastered these skills. I don't know. Something like that. I could make it up. I am workable. The bottom line, is if the teacher worked with me for 2 lousy hours, there'd be no problem. I think the teacher is making a mountain out of a molehill here. I am willing to work with them... stay later, go to lab, whatever, but I can't switch my meds up or run around without taking them. If they don't work with me, then I have no choice but to go... I will not have had the meds and will have to be "very quiet" on the floor until it's time for my meds. If I go into an SVT then the teacher and the hospital will then have to deal with it. I do wear a medic alert tag and have a handicap tag in my car and have seen a cardiologist for over 10 years. It was my GP that refused the note.. I went to the heart doc. today and left a note with his nurse. Maybe he will give me one explaining my situation to the nursing professor... the GP wouldn't.

Oh well....Anyway, I appreciate you all listening and wish me luck!! :icon_roll

Up Vote Up Vote ×
Specializes in DOU.

If your instructor allows you to come to clinical two hours later than everyone else, what's to stop the mother of three from asking if she could come in late because she wants to get her kids off to school? Or the guy who has to work as an LPN at night so he can afford to go to nursing school during the days? Everyone would like to start at 8, and I bet most of us can think up pretty good reasons for it. I myself would like to go in late because my daughter sometimes forgets to take her anti-seizure meds when I am not home to remind her.

Up Vote Up Vote ×

Hi natania. I would gladly go in at 6 or 5 or 4 or whenever if I did not have meds to take for a heart condition. I am not trying to give them a hard time, like 'well I like to sleep in cause it feels good, or I am going to be late cause my husband likes to smoke Newports and needs me to run to the food mart to buy him a pack'...... you get my drift. This is not something to take lightly. We all have our problems, whatever they are and people SHOULD be understanding. This is not 'oh I need to take an aspirin, I have a headache.' This is I have a heart condition and have been hospitalized for episodes of SVT and irregular heart beats. Almost had heart surgery. This is no joke. I am fine when I take my meds as directed, but I have to take them as directed and on time. So I do see what you are saying and everyone has to deal with their own issues. This is an issue I have and I feel that the teacher should work with me if I am willing to work with them.

Take care!

Up Vote Up Vote ×
Specializes in Telemetry.

I don't think its in the teacher's hands to budge or not. In order to graduate you have to have a certain number of clinical hours- and if you are missing 2 hours each week over 2 months thats 16 hours. More than one whole day missed.

I think if you adjust slowly with your meds, your body will cooperate with you.

The last thing on my mind is that if this is important to you, you will figure out a way to work the schedule. It is, afterall, only two months.

Up Vote Up Vote ×
Specializes in Neuro ICU, Neuro/Trauma stepdown.

you cant just jump into a shift 2-3 hrs into it, thats not how it works in nursing. your clinicals are to prepare you for nursing in the real world, from the beginning to the end of the shift. it wouldnt be safe or smart to start your day without getting report from the previous nurse. Also, it's not fair to expect others to 'catch you up' on what's been going on both with your pts and on the unit.

i'm not surprised your school wont let you around this, that's just not typical of nursing schools. and i certainly wouldn't expect an employer to flex with you. not in this profession anyway...

one more thing...heart condition or not, it's not wise to be the one perceived to be receiving special attention. again, not in this culture...

Up Vote Up Vote ×
Specializes in Emergency & Trauma/Adult ICU.

Bottom line:

Clinical 6a - 6p + unwillingness/inability to attend clinical 6a - 6p = something's gotta give.

Up Vote Up Vote ×

My first thoughts are that you are assigned a patient to be under your care while you are in clinicals. The first couple of hours in the shift are very important... morning assessments, meds, building rapport with the assigned hospital nurse etc. You would really be missing out on a very critical part of your day. I also don't think it's fair to anyone for you to walk in two hours later than everyone and ask to be "caught up". If it were me, I would make an appt with my heart Dr. asap and have him help me reschedule my medications.

Up Vote Up Vote ×
Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.
I don't think its in the teacher's hands to budge or not. In order to graduate you have to have a certain number of clinical hours- and if you are missing 2 hours each week over 2 months thats 16 hours. More than one whole day missed.

:yeahthat:

Unless I'm mistaken, when the school sends your paperwork in to the state Board of Nursing, they have to verify that each student did "X" number of hours of clinical. If they allow you to come in two hours later, then that would not be true in your case.It might be that the school would get into a lot of trouble for doing what you're asking.

I don't think lab time can or should substitute.

I don't see many employers being this flexible with your schedule, either.

Up Vote Up Vote ×
Specializes in Geriatrics, Cardiac, ICU.

I think there is a reason why the GP won't give you the note.....

Up Vote Up Vote ×

Hi everyone. It's Epona the original poster. Well I got it sorted out. Thanks for trying to give me some good advice. The GP wrote the note, but only stated that I was a heart patient and needed meds. at certain times. Anyway, the teachers ARE GOING TO WORK WITH ME. I had to go through the disability dept. and provide them with my doctors note. They are allowing me to come in a little later, but I will be doing extra clinicals on other days. I will be doing extra clinical hours to make up for those hours on other days. So the hours will work out. I am just not coming in WAY early. The MAIN teacher of the Peds. classes said she didn't want me to switch up my meds. either and shift things around. She said that would not be in the patient's (me the student's) best interest. So I will be able to come in later and will pull extra days and hours to make-up for the missed early hours to fulfill my clinical requirement. Since my condition is considered a disability, the school recognizes this and is working with me. As a side note (I did not need it) my Cardiologist wrote a letter that stated my condition and that it was NOT in my best interest to start before 8 AM and shifting my meds. around was NOT recommended. He added this could compromise my medical condition. So I have that from my actual heart doc. as a back-up, but I will not need it. The school and the teachers are working with me and I will end up meeting the clinical hour requirements.

Like I mentioned earlier, I knew from the get-go that I was NOT working 12 hour shifts in the hospital. So I will work this out and make it through, but I am not pulling 12's when I get out. It's just not for me medically.

You all have been great! :) Thanks for listening!! Epona

Up Vote Up Vote ×

To answer your question related to medical school (I assume you're talking about MD/DO schools). There are a variety of grading schemes; some schools use letter grades while others (including the school I went to) use a system of pass/fail/honors.

From a practical standpoint, the actual letter grade you receive is kind of meaningless. Both clinicals and lecture-based courses use arbitrary cutoffs to determine if you pass or fail, so getting a C- versus a D versus a B+ is really a function of your performance in relationship to your peers, rather than an objective measure of your knowledge or ability. Clinicals are even more arbitrary, and you basically pass if your clinical course director says you passed.

I don't know how nursing is, but medicine is a very strict hierarchy. Objective assessments are somewhat lacking, and angering someone higher up on the food chain is the quickest way to find yourself failing a course.

Up Vote Up Vote ×
+ Join the Discussion