Need Advice on Clinical Instructor

Carpediem1012, BSN, RN · Sep 20, 2014

I don't know your situation, but FWIW, maybe this is actually a positive. I find all my clinical instructors spend less time with me than some other students. They ask me how it's going and expect me to come to them with questions because, I believe, they trust my skills and judgement. There are various levels of competency and confidence within every clinical group. I find instructors do spend the majority of their time with students who require a little more support. I know you are just beginning your nursing experience, but sooner than you think, you will be expected to "fly" on your own. Instructors do not leave to you your own devices if they think you are dangerous.

Don't be afraid to ask your instructor for some time if you are able to attempt a new procedure, or are unsure in any way. But if things are going well, go with it :)

Everline · Sep 20, 2014

I agree with the pp. After we had check-offs in lab, with my past clinical instructors, they hovered over the ones they didn't trust could do the work in the hospital. If they were confident that you knew what you were doing, they left you alone. I'm not talking for med passes and invasive procedures, as we had to do those in the presence of our instructors. But when it came to basic care, it was a good sign if our clinic instructor let us do most of our work without interference. She may be watching more than you are realizing and also talking to the nurse about how you are doing. Consider that she thinks your work is adequate, especially if she has told you, "good job". There may be other people in your clinical group who she feels the need to supervise more closely.

The question is, how do you feel? Are you confident that you are doing the skills well? If you have particular questions or want her to watch you do something, then ask. But be careful what you wish for, lol...

hardworkinmom · Sep 20, 2014

Thanks for the advice, I have looked at this whole situation another way, I feel confident in what I've learned so far and if I have questions I don't hesitate to ask a tech, or the nurse that is assigned to my patient, both have been very helpful. I guess I want some type of feedback when actually doing a skill, I will communicate that to her this week.

rob4546, ADN, BSN, MSN · Sep 20, 2014

Agree with the previous posters, this is a positive. I had a similar situation early in my nursing school experience but I did go to the instructor and ask why. She said she had watched me in early interactions with the patients and skills and was confident in my abilities. She also said that between the staff and patient responses, she always knew what was occurring.

The clinical instructor had a lot on her plate and I knew she was not able to watch everything herself. From time to time she would show me something new or watch an particular skill, but overall I found she spent time with students that were struggling. From your description you fit the description of a competent student. Relax it is all good.

mrsboots87 · Sep 21, 2014

I think you are looking into this too much and making a big deal out of nothing. If your clinical instructor thought you werent competent enough to practice your basic skills, she would be on you like white on rice. I only see my instructor when I call her up to be checked off on something she hasnt seen me do yet, or to pass meds. (I am now independent with a nurse for meds yay!). She does circulate all the floors and I see her in passing. She does this so that we have to reach out to her for help instead of her having to find us all day to ask if we need help. We are adults and should be able to call for our instructors when we need them. There are a few students who take up a lot of her time and call her to their floor constantly. But I do notice that my instructor checks in with my nurse periodically. I assume this is to check on me and see how I;m doing. I get good marks for my clinical eval even though I have minimal contact with my instructor. I would like to think that since you instructor is not all over you, it is because she thinks you are doing well enough and maybe some other students in your group are just more needy than you. Since you ask your nurse and the aids when you have questions it means you are using your resources instead of texting or calling every 10 mins. If you are truly concerned, then at your next clinical, tell your instructor you want a performance evaluation conversation just to make sure you are on the right track. If you search the threads on this site, you will get countless examples of what clinical instructors do to students they dont like, and ignoring them is never one of them. Relax a bit. Enjoy learning the basics. When you get to block 2 and get into heavier concepts and harder skills, I'm sure you will see more of your instructor. And if you truly wold feel better with a little more monitoring from your instructor then just let them know. They may think you feel comfortable by yourself and are leaving you be to learn with your nurse and the aids.

akulahawkRN, ADN, RN, EMT-P · Sep 21, 2014

Like the others, I would have to say that chances are your clinical instructor is probably not having to worry too much about you. When I was in school, I was the "lucky recipient" of both types of attention. There were times when I did not do so well and I received a lot of attention and then there were times that I was doing fantastic and I rarely saw my CI at all. I know that even when I wasn't being directly visited, my CI's were going over my charting and checking in with the nurses I worked with.

Truly you do NOT want to be the center of your CI's attention unless it's for a procedure or task that must be observed by a school employee.

I would echo some of the above comments that suggest you should privately have a conference with your Clinical Instructor about your performance, in particular, where you are versus where the CI thinks you should be at this point in your education. If you get poor reviews or great reviews, keep them to yourself. How you're doing relative to your classmates is not really any major concern. What matters is how you're doing relative to where you should be, performance-wise.

I had a CI that probably didn't like me much... and she was tough! Though I ended up failing that semester, I actually don't care that she didn't seem to like me much, but I did learn a LOT from her and ultimately that was ended up helping me get through the next few semesters without even a hint of trouble!

Sometime the toughest CI's don't "like" you because they need to be tough on you because they know that you're the next generation that will ultimately replace them at the bedside.

Esme12, ASN, BSN, RN · Sep 21, 2014

Thanks for the advice, I have looked at this whole situation another way, I feel confident in what I've learned so far and if I have questions I don't hesitate to ask a tech, or the nurse that is assigned to my patient, both have been very helpful. I guess I want some type of feedback when actually doing a skill, I will communicate that to her this week.

I think this is reflective that she has confidence that you are competent in your skills so far and can fly more independently.

Yesterday when I was taking my patients soiled linens out of the room she was outside the door but didn't come in.

Her lurking outside your door is observing you at work. She didn't come in because you were flying on your own.

I'd look at it as a good thing...trust me if she felt you were not doing well...she'd tell you.

RunBabyRN · Sep 21, 2014

Thanks for the advice, I have looked at this whole situation another way, I feel confident in what I've learned so far and if I have questions I don't hesitate to ask a tech, or the nurse that is assigned to my patient, both have been very helpful. I guess I want some type of feedback when actually doing a skill, I will communicate that to her this week.

I think this is exactly why she's letting you work on your own. Once an instructor knows you'll ask for help when you need it and can handle being on your own, they'll shift their focus more on the students that need their hands held. I rarely saw my instructor my final semester of med/surg, because she knew I had it (my classmates had 2 patients when I had four). Tell your instructor if you need something from her. Sometimes they get so caught up in trying to grease the squeaky wheels that they forget about the ones that appear to be humming along nicely. :) When a student either won't do ANYTHING without someone there, or tends to do too much or "fake it til you make it" in a dangerous way, that's when instructors tend to be over your shoulder more. If you've shown you can handle yourself but know your limitations, it's likely she trusts your judgment.

phoenoryker · Sep 21, 2014

It is your clinical experience, so take control of the situation. Ask your instructor directly or indirectly, either way you will know where you stand. Sounds like you are doing all the right things, confirm it. Seek out constructive feedback from people, embrace the advice and grow. We are all individuals, and people are not alike. It's funny really, we are in a field that acknowledges and accepts difference, we think to be effective in uncertainty, but are we forgetting to carry these qualities into our peer relationships? From your words, it seems as if you are a person who enjoys affirmation. I am sure your instructor recognizes this, perhaps she is pushing you out of your comfort zone a little bit. Maybe there is method to the madness.

Mandylpn · Sep 22, 2014

I had a similar instructor who totally ignored me until the day she called me after class to say I was getting written up. She was never on the floor at clinicals so how could she know what I was doing and if it was wrong? She would vanish if you wanted to do a procedure to get checked off saying she did not have "time". not sure if yours is at the point that she dislikes you, just what others have said it sounds like she has some confidence in you to do the basics. I still would seek her out however, as she is there to "teach" just hang in there.

SeattleJess · Sep 22, 2014

Great comments previously. Your actions are your instructor's responsibility; she's not going to cut you loose to reflect poorly on her.

Also, perhaps your instructor is seeing/hearing/knowing more than you know. When I did my CNA clinicals, I was amazed at the feedback my instructor gave me at the end of my time with her. I thought I was invisible but she was watching me from the end of the hall, checking about me with aids and nurses and otherwise on top of her game.