I really hate going to clinicals

sharann, BSN, RN · Dec 25, 2004

Here I am on vacation, but already dreading starting school again b/c of clinicals.
I've pinpointed a few reasons why I hate them, and I'm hoping someone here can help me out...
1) It's not so much the fear of the unknown that haunts me when I roll out of bed at 5:30 a.m., it's that I'm scared that something bad is going to happen, and the finger is going to be pointed at me.
2) One of my instructors rides the hell out of me and I don't understand why. I was warned about her from previous students. they told me that she finds one person in the group to ride, and she rides them during the whole rotation with her - which was 6 weeks for me last semester....WTH?....
I always get there before any other student so I can get organized. I never smart back, etc, etc....but, i do get VERY nervous when she comes around me that I always make a silly mistake or say something silly - nothing major at all...i.e.,
I put a blood pressure cuff on on of my patients upside down, but realized it myself. She embarassed the hell out of me. And one time I grabbed for some gloves to give an IV push and she asked me what I needed them for...."do you see any drainage coming from his IV?" Then rolled her eyes.
She once cornered me and told me that I need to be more assertive with the staff nurses because they are using me to do everything and now I've put HER behind schedule and how she may write me up. I cried when she walked away.
I was looking thru one of the charts and I guess the unit clerk was looking for it. She told me to go give it to her, while adding..."she's got your number now" WTH?
I'm going to have her for 6 more weeks next semester, and I hope she will find someone else to pick on b/c I don't know if I can take anymore. The stuff that I listed is only a few, and it's very hard to describe the condescending tone she uses and the faces she gives.
Also, in post conferance one time we were talking about the Hesi test. That is the "final" exam after 4th semester and we get 3 tries to pass it. If you don't pass by your 3rd try, she stated, "that means you are too stupid and you need to repeat 4th semester - hahaha" I thought that was very unprofessional. In my opinion, you must have something going on upstairs to make it to 4th semester. If you don't pass Hesi or state boards, you probably have some type of anxiety issue. That response was not called for at all.
She also embarasses people during post conference.
So, how do I deal with her? I was thinking of going to my doc to see if he would put me on Zyprexa or Ativan to take PRN, and I would take one before every one of her clinicals. I absolutely dread them.
Any other advice you can give will be greatly appreciated.

First off I'd like to say that I have been there before. My second semester I had a very negative experience with an instructor and dreaded each day.

Second, she sounds like a gem.

Third, some practical advice. I think that you may have unintentionally come into this rotation with preconcieved notions about this woman and her "singling" out one person to pick on. You may find that you are not the only one who feels like they are that person!

Now when she rolls her eyes at you etc.. I would ignore it. Just literally let it roll down your back. Don't try to justify things to her, just say "Ok" and do it her way(you will learn the correct way when you are out of school). Some nurses have a complex, and feel they must be superior over someone, so they pick on students..easy prey, who don't want to be kicked out.As for her being unprofessional, that's HER problem and it will bite her in the butt someday. Others will see her for what she is. If you feel she is being abusive you should of course contact higher ups in the school but it doesn't usually help(they are short staffed as well). I am sorry to hear you are feeling so stressed out by her but I would hope you don't require medication to deal with a person. Therapy might teach you some coping skills. Maybe an assertiveness management seminar is in order(these can help).

Just come as prepared as possible to clinicals, know your meds and conditions, and make friends with the staff nurses. THESE are the people who can help you learn the most if they know you are serious(and they know!) Happy holidays(from me, the token Jew in the unit, ha ah)!

VickyRN, MSN, DNP, RN · Dec 25, 2004

I am sorry you are going through this. Is there a guidance counselor on campus with whom you can communicate (in confidence) these concerns?

angelbsn · Dec 25, 2004

I am so sorry to hear you've gotten an instructor who advocates the "eating her young" school of thought. As a full-time ED nurse & part-time clinical instructor, I believe my role is to teach, not harass & belittle, as I was once a student myself. You can't learn what you truly need to know when you have an idiot constantly hounding you, & IMO, your instructor is an idiot. :uhoh3:

Go to your clinical director & file a formal complaint. You've stated she is derogatory & demeaning...have other students stated they've had difficulty with her? Have any other complaints been lodged against her? Look in your student handbook...you do have rights, & one of those rights is to be treated professionally.

Unfortunately, this is one profession where you will come across nurses who truly believe that a demeaning attitude is an effective teaching tool, & this causes undue stress, is unnecessary, & wrong. Be assertive...know your rights as a student, & advocate for yourself so you can learn to advocate for your patients. Keep written documentation of her behavior toward you & other students you have seen her treat this way, & turn this in to your director. Use your voice...you'd be suprised how powerful it can be.

One last note...don't medicate prior to clinicals unless you've been thoroughly evaluated by a competent doc & prescribed the appropriate meds. While an anti-anxiety pill may seem like a good idea now, it can cause you to think more slowly & cloud your critical judgement, & it will most likely not change this person's behavior, only dull your reaction to it. Remember why you made the decision to become a nurse, & don't let one person take that away from you.

Again, I'm sorry you're having such a difficult time, & I wish you the best...be strong. :)

angelique777 · Dec 25, 2004

Here I am on vacation, but already dreading starting school again b/c of clinicals.
I've pinpointed a few reasons why I hate them, and I'm hoping someone here can help me out...
1) It's not so much the fear of the unknown that haunts me when I roll out of bed at 5:30 a.m., it's that I'm scared that something bad is going to happen, and the finger is going to be pointed at me.
2) One of my instructors rides the hell out of me and I don't understand why. I was warned about her from previous students. they told me that she finds one person in the group to ride, and she rides them during the whole rotation with her - which was 6 weeks for me last semester....WTH?....
I always get there before any other student so I can get organized. I never smart back, etc, etc....but, i do get VERY nervous when she comes around me that I always make a silly mistake or say something silly - nothing major at all...i.e.,
I put a blood pressure cuff on on of my patients upside down, but realized it myself. She embarassed the hell out of me. And one time I grabbed for some gloves to give an IV push and she asked me what I needed them for...."do you see any drainage coming from his IV?" Then rolled her eyes.
She once cornered me and told me that I need to be more assertive with the staff nurses because they are using me to do everything and now I've put HER behind schedule and how she may write me up. I cried when she walked away.
I was looking thru one of the charts and I guess the unit clerk was looking for it. She told me to go give it to her, while adding..."she's got your number now" WTH?
I'm going to have her for 6 more weeks next semester, and I hope she will find someone else to pick on b/c I don't know if I can take anymore. The stuff that I listed is only a few, and it's very hard to describe the condescending tone she uses and the faces she gives.
Also, in post conferance one time we were talking about the Hesi test. That is the "final" exam after 4th semester and we get 3 tries to pass it. If you don't pass by your 3rd try, she stated, "that means you are too stupid and you need to repeat 4th semester - hahaha" I thought that was very unprofessional. In my opinion, you must have something going on upstairs to make it to 4th semester. If you don't pass Hesi or state boards, you probably have some type of anxiety issue. That response was not called for at all.
She also embarasses people during post conference.
So, how do I deal with her? I was thinking of going to my doc to see if he would put me on Zyprexa or Ativan to take PRN, and I would take one before every one of her clinicals. I absolutely dread them.
Any other advice you can give will be greatly appreciated.

Hi first of all Merry Christmas to you and I hope that your time off will be really good and refreshing to you with all my heart hope that is how it will be for you.

Gosh do not know how to advise you but can say that is not the way it should be and feel awful for it to be like that for you. Clinicals is the best part of everything you do cause you get to experience nursing and see clients and see how they are treated for there conditions first hand. It was a lot of my clinical experience that often helped me to answer questions sometimes even for nclex cuase I would think back on what was done for certain clients it even helped me for my interview for my current position. They grilled me on CHF and different meds and on some of the ekg you may see and well I got to see all that in clinic and often did not have to rely on just academics to remember but go back in my mind and think hey I know exactly what they did for such and such and this is about how I would handle this. So I do not want you to miss out on that for you.

I managed the stress of clinic by thinking back on every critical thing our intructors said to us. I noted in my head all there criticism and try not to do any of the stuff that they scolded other people for. I try to think about all the stuff they wanted us to do and I try to make sure I did that.

For example on instructor was very particular about head to toe assessments so I reviewed head to toe assessments before going to clinic. Made sure I always had a penlight for neuro checks ......kept a little cheat sheet on what I needed to know or what she usually asked us about and reminded my self during the rotation. I kept things like a scissor in my pocket and tape. Instructors like to see that you have the tools you need to do what you have to do. So doing wound care make sure you have everything try to anticipate what type of client you may have and be prepared to bring to the room what you need to save trips instructors like to see you know what your doing and being prepared shows anticipation of what you may expect.

For example borrow a chart make sure you always tell the unit clerk. The unit clerk should be your friend. I often found unit clerks nasty but I always ignored that aspect of them and would say good morning even if they did not say so back. I would never go far with a chart and would not take it with out letting her know first. So even though that unit clerk acted stupid towards you ignore it and treat her with a lot of sugar and let your kindness shine. In the long run that wins. Sugar beats vinegar every time.

I would go in and if I knew what patient I was going to have I would get labs and information on the patient before our class came. I kept a copy of your nursing plan so I made sure to get everything that was required of me. I learned about my clients condition so if the clinic instructor grilled me and I could tell her what my priorities where for my client. What was my plan and what changes where present what I should alert the doc about etc.Know your drugs know what labs you should being looking for. No what may be potencial problems. Know what is hanging IV wise and know about basically everything you should know about your patient and what you as a nurse can do for them while they are in your care. this is what the instructors want to see.

This usually kept me from being on the clinic instructor bad side cause I know students who they really bugged on a rotation. Again trying to listen for what your clinical instructor is looking for in her students and doing it as best you can is the best way to deal with them. Anticipating what they may ask and having answer so they will go away and not really pick on you. On the other had I usually try to look at criticism as a way of getting me to get better at a skill. it is just during rotation since we are so focused on passing that that type of attention from an instructor can be so annoying my heart goes out to you.

I really think extreme preparation is the best way to had clinical. Anticipate what is wanted from you and have it the information available when they do there rounds is the best approach. Imagine your not a student and that is really your patient and they are depending on you for there care I think that is the best you can do in that circumstance.

As a student people will try to get you to do a whole bunch of work that is not why your are there so be careful. think of how much time you have and what things have to be done by what time and get that done first. If time is left over then if you want to help another nurse you can. However be careful remember stick to what your clinic instructor wants of you since you have to answer to her and no one else. If someone ask you do something say my instructor has given me some assignments to do once I am done with them I will check back and see if I can help but I must attend to what I have to do first since we have a time limit on the unit. Of course everything in life is based on what is going on. You never want to leave someone stuck in a situation that is obvious that they need help. Get some one who is staff to help the person is another option too.

I do not know if what I wrote makes sense to you but the idea is preparation preparation preparation fulfill what is needed of you trying not to leave anything undone to leave less room for criticism even though students know of people who can find something wrong in anything or everything.

Eat a good breatfast study what needs to be done and I prayed a lot before going in to clinic too. that is just me.

I hope things change and you get to enjoy your clinic as much as I did cause it is where all the hands on is and where I think a lot of the real learning occurs. I still remember all my clients that I had and each client that I have had has taught me much about what to do in different circumstances. I find that visual more potent than all the readings I have done.

Wish you the best!

In the mean time enjoy your holidays to your fullest.

I am not one to really support using a drug to help cope. I did have to ask the doctor once to give me a sleeping pill just so I could sleep when I was really stress over one of my exams. I only asked after trying to sleep on my own for several nights and saw I need the relief despite my own dislike of the solution. However it is only a last resort solution for anxiety that has taken over. My best friend in school was making sure I was prepared.

If I would have changed anything during clinicals I would have wished I had a palm pilot then. I could carry the drug guide in the pocket and plus other downloads that would have stuff on assessment even notes for reminders even my care plan. wow that would blow your instructor away huh

You hang in there and be the best you can be that all anyone should ask of you try your best.

Luv Angela

nursemike, ASN, RN · Dec 25, 2004

I heartily agree with Angela. This is one time when you do want to let them see you sweat. My instructors have been wonderfully supportive and encouraging, but clinicals are hard. Last spring I literally felt like throwing up, at times. This past semester was better--even fun, at times--but still pretty scary. Work hard, do your best, and trust that it does get better.

I can't judge from here whether your situation merits going to higher authorities, but a less drastic alternative may be finding a more sympathetic instructor you can discuss your feelings with, confidentially. If so, I'd suggest avoiding criticism of your instructor, but focusing on what you can do about your end of the equation. If your instructor is that bad, it's probably no secret, but there may be some strategies that can help you. Then again, we've chosen a field which is notorious for its adversity, and we are almost assured of doing harder things than nursing school.

I did get a palm pilot, last year, and I recommend it. It isn't the answer to all problems, but it can be really handy.

I use my drug guide and medical dictionary a lot--a lot can change between preplanning and clinical.

Good luck, and look on the bright side: you could be a 48 yr old bachelor about to start Maternity. Ay, carumba! This is not going to be pretty.

begalli · Dec 25, 2004

Gosh, there must be one in every nursing program.

We had one as well who was very condescending and consistently picked on a few students each quarter. We complained...they new....even she knew. She said she was "preparing" us for what it would be like when we starting working with other RNs in the real world. What a bunch of crud. I was one of her chosen lucky ones for a time until I talked with other students and instructors and found out that it wasn't me, it was her. I did the best I could doing all the things necessary to be prepared for clinicals and did eventually end up rolling my eyes right back at her (behind her back; a couple of times to her face). I'm not recommending you do that, but like someone else mentioned, let it roll and let it go. She ended up being an instructor who recommended me as student nurse of the year at my school. The woman had the nerve. She knew I couldn't stand her.

My instructor and your instructor are typical bullies. Only difference between them and other bullies is that they're also nurses and nursing instructors. There's a great thread here somewhere about bullies. Maybe you can search for it and read some of the characteristics and behaviors that they exhibit and some ways to deal with being the subject of someone like this.

I know you want to be successful and do an impeccable job during your clinicals and throughout your nursing education. It's so important to you what your instructors think of you. I've been there, I know. It's an absolute shame and quite disturbing that this happens to nursing students.

Hang in there. If there's another instructor you have a good rapport with, ask to speak with her/him about it. Don't let your mind become clouded worrying about what she might do next. And meds are definitely not the answer.

Good luck raindrop, and enjoy your time off!

Mystery5 · Dec 25, 2004

I had a clinical instructer who made life difficult for me. Ironically, she was in charge of the psyche unit, and was trying to teach us all these phoney active listening skills and other silly fake empathy stuff. Meanwhile, she knew that my mother was in a coma from an aneurysm the whole semester, and begudgingly allowed me one day off for her funeral. This was in second semester. I remember her, the first day back from the funeral, riding me while I was drawing up insulin the first time, and making me cry, saying that if I couldn' handle it, maybe I wasn't cut out for nursing. I was a wreck!

Basically, I hated clinicals all the way through nrsg school because I was very nervous and I'm not a go getter type in new situations, but tend to be fearful. But I survived and I love bedside nrsg now.

After nrsg school I moved to WA state (from Calif) and this clinical instructer, who knew that she had alienated me, somehow got in touch with me and told me that her daughter was on her way down from Alaska, and could she stop by and see me? I had married a man who owned a restaurant that was featured in a very popular TV show at the time in a town that was used for filming the outdoor scenes.

So, I met this instructer's daughter, who was in the middle of getting a divorce, and for some reason the woman felt the need to open up to me about the anguish of her childhood growing up with this horrible mother, who sounded a bit like Mommie Dearest. She had been a cruel task master, obsessed with cleanliness, making her daughter clean to her obsessive standards, then reclean, at an unGodly young age, had been verbally abusive, and the daughter obviously had deep psychological problems resulting from this harsh treatment.

Anyways, a word of encouragement: You'll survive, you'll be a stronger person because of it, and you'll be a great nurse. If I could do it, then so can you?!:)

Nurse2B2005 · Dec 25, 2004

Raindrop -

I know how irritating that is. I've had one clinical instructor just like the one you mentioned. Do you go to my school? :chuckle

Funny story - this past rotation, I had an instructor that was known for the term "She can smell fear and likes to ride people that she can smell fear on." On the first day of clinical, she simply stated to us that she expects a lot from us. She also went on to say that she heard from other students that she is intimidating. Once she heard that, she said that she changed her ways, and realized that it does no good to bully people in the clinical setting. With that said, she was the greatest instructor that I had so far. Now, the clinical instructor that I had prior to that was exactly what you described, but maybe a little worse if you can imagine that. She would call us stupid to our face and always threaten to not pass us. At the end of the rotation, I went to the Deans office and explained everything that I and other students felt. In the end, the Dean told us all to write up our comments on the end of the course evaluation forms. The next class behind us started the next rotation with her and she didn't change one bit. I know she read all the comments we wrote - while the comments were not completely nasty, I am sure they hit home to some degree because they weren't exactly nice. But in the end it still didn't change anything about her behavior, it just continued. I'm guessing that the Dean spoke to her, but with the nursing shortage, the excessive amounts of people that get turned away from nursing school because there is not enough room, and with schools not having enough instructors to whip people out of nursing school, what is the best way to handle this? There isn't at this point, is what I have learned, and I just move on.

I can only offer you advice on what I have learned so far that seems to work for me.

1) I feel like vomiting every morning that I have clinicals. The nausea sets in the night before while I am working on my care plan, actually. This is common - and I try to look at it this way - I'm anxious because I care. It's human nature. If I wasn't anxious, then that means I don't care. Don't worry so much about something going wrong. (Easier said than done, I know) Make sure you partner with the RN that is ultimately in charge of the patient. Tell her everything that you will be doing, what you can do, can't do - go over all the meds - everything - ask questions - that way the RN can see that you are competent and in case your instructor asks for feedback from the RN your butt is covered. At times I feel like I am bothering the RN with mundane questions, but the RN would rather be in the loop.

2) I truly believe that there will always be an instructor that rides at least one student. Unfortunately you are her target. Trust me - you will look back on this when you graduate and giggle - especially at putting the BP cuff on upside down. On my very first clinical day ever, I used a rectal thermometer on someone orally, not knowing that the rectal thermometers were a different color. These things just happen - and I look back on that and see how far I've come.

As for having gloves on with an IV push - I wear gloves for everything. Even though the IV is patent, you still never know if the patient is going to all of a sudden start vomiting, or just becomes agitated and pulls the IV out and you are standing there without gloves on, or turns the other way and there is poop, etc. The instructors from our school learned the old school way back when they hardly wore gloves for anything . . .before HIV was an issue. They still forget to put gloves on sometimes when they are with us. Now they teach us to always wear them.

As for putting your instructor behind schedule, I've found that what works for me is a timeline of what I am going to do that day, broken down hour by hour. That way, if I know that my instructor is going to meet with me at 10:00 for a med push, then I literally start getting ready at 9:00. I make sure the med is there, the supplies are where I know they are at, drug interactions, safe dosages, etc. That way, my instructor knows that I tried to be proactive and not waste a bunch of her time as well.

In the end - this will just make you stronger. I know it seems tough but you will get through it. She keeps you on your toes, and trust me, even though it sucks, it will keep you on your toes when you don't have to have her anymore. You will look back on this and laugh. When I think back to my nasty instructor, I'm glad that I don't have her anymore - but then at the same time, it makes me really value the instructors that do go out of the way to help you learn.

Best of luck to you and PM me if you ever need to vent. Nursing school is tough. The past year and a half have been humiliating at times, but we all get through it when we want something bad enough. Take it one day at a time, and especially enjoy your time off from school right now!

Nurse2B2005

UM Review RN, ASN, RN · Dec 25, 2004

What fantastic advice! I truly had a hard time deciding which post was the best, but having been there and done that, I think this one hits pretty accurately at the crux of the problem.

I had an instructor who was new, nervous, and overwhelmed. It didn't help me at all that I blurted this fact out to her in our first pre-conference. In the end when she tried to get me kicked out of the program, I really got so ticked off that I was determined to stand up to her. I did, too. I told her that I might not be the world's greatest student, and I had done some things wrong, but that was what being a student was all about--we were supposed to be learning this stuff, and learning new things meant that you didn't necessarily get it right the first time. I added that her teaching methods didn't create a good learning environment either, because I was such a nervous wreck in her clinical, I couldn't do anything right. I finished with something like, I'm paying very good money for this education and I expect a teacher, not a judge, when I'm at clinical.

Well, then I just shut up and let the Director and the Instructor ramble on, but at least I know I gave them something to think about. Most likely I passed on the strength of my Theory classes, which I aced. But she had some girls from that clinical come out of her final conference upset and crying because in her opinion, they wouldn't make good nurses. Which is what she was trying to tell me.

All I can say is, if ever there was a time in your life to tune a message out, this would have to be it.

Tune her out, dig your heels in, and carry on. Because she is WRONG.

My instructor and your instructor are typical bullies. Only difference between them and other bullies is that they're also nurses and nursing instructors. There's a great thread here somewhere about bullies. Maybe you can search for it and read some of the characteristics and behaviors that they exhibit and some ways to deal with being the subject of someone like this.
I know you want to be successful and do an impeccable job during your clinicals and throughout your nursing education. It's so important to you what your instructors think of you. I've been there, I know. It's an absolute shame and quite disturbing that this happens to nursing students.
Hang in there. If there's another instructor you have a good rapport with, ask to speak with her/him about it. Don't let your mind become clouded worrying about what she might do next. And meds are definitely not the answer.

Soleilpie · Dec 25, 2004

What a terrible situation to be in! People who act like your instructor usually have insecurities that they cover up by belittling others. Unfortunately, she's in a position of power and this makes it worse than working with peers who may act the same way. Peers don't usually give you grades or promotions. At any rate, this instructor should not be teaching. She is sabotaging a program that should be producing as many CONFIDENT and competent nurses as possible to enter a profession that is in desperate need! I could not allow something like this to continue. Now I know some here feel it's better not to confront this situation because it may end up with no change. However, I disagree. I would not assume that your school will be the same way. Are there other students who would be willing to take a stand with you? Some people are more willing to listen when more than one person is having the same problem. I would definitely document every negative encounter with her. If you're uncomfortable pursuing this while in class for fear of it affecting your grade, you might even consider doing it after your grade is posted. By trying to fix this problem you'll not only be an advocate for yourself but will be one for future nursing students as well. How can anyone be an advocate for their patients, if they're not willing to be an advocate for themselves? :icon_wink

Justmeandmycat · Dec 25, 2004

Here I am on vacation, but already dreading starting school again b/c of clinicals.
I'm sorry. You've met the bully you're not even out of school yet.
The problem is not you, it's her. This is the type of person that likes to devalue students in the guise of "instructing" them so she can up her own ego. She's not trying to instruct you in other words, she is trying to demean and probably doesn't even care that there is a difference. I'm sure it has been brought to her attention before. But because she has power, she won't change unless you go above her and that is very tricky business. Trust me, the director of your nursing program already knows about her because she has pulled this before. The director is probably just tolerating her for some reason, too.
At any rate, the best you can do is to prepare as much as you can. Don't even bother trying small talk with her because she'll use it as an opportunity to figure out something you may not know yet and slam you with it. Skirt a wide path and watch what she picks on the others for and learn indirectly from that. Just stay pleasant. Be present but don't draw attention to yourself. If you see her ramping up on someone, and you will, stay busy with your own corner of the world. People like this love an audience. Don't even be part of that.
You don't have to like her or hate her. You just have to interact with her. She's a thing. An annoyance. An irritation you just have to recognize that is there until you become a nurse. And when you are thru with school, you will recognize this personality a mile away when you start your professional life.
Also, don't let on she is scaring you. Puke later if you have to but put up a force field between you and her. Being scare just gives her more energy. If she doesn't get the reaction she is looking for, she'll move on to a weaker student.
Last but not least, cover your ***!!! Your instructor is probably an expert at covering hers. Once I watched my instructor try to wiggle out of something. These were her techniques: she covered her ***, cast blame and innuendo on pretty much everyone else that was in the area, and last but not least, even inferred that it was partly the patient's fault. These are the three rules of survival for these types. You will see it over and over again in the future. Just be aware of it.
Good luck. You've got a brain in your head of you wouldn't have gotten this far. You'll get through it and you'll already be politcally savvy by the time you get out.