Published Jul 24, 2005
I have been teaching for a long time, but always first year students, both in BSN and ADN programs. I just finished teaching my first semester of senior leadership. Student evaluations said that this felt like a regular med-surg clinical to them and not what they expected from a leadership course. What tips can you give me to make this a leadership course? Thanks!
What did you think you had them do in clinicals that put them in a leadership role? (Need more info before I give my opinion) :)
Since we start clinical an hour after the unit change of shift, I give the students their assignments and they go to the staff to get report individually. Although they have their own assignments of 2 to 4 patients, they work in a team of 4 students, with one student as charge nurse. The charge nurse doesn't have an assignment. This student helps other students with decision-making, will help with care if needed, makes up lunch schedule, checks charts, calls pharmacy, etc. The RNs work closely with the students. I also assign students to "cover" for LPNs. Many believe that working with an LPN just entails giving their IV meds, so we work on teambuildin" and delegating. I also have them work on a report sheet that works for them so they can prioritize and manage care. I have them attend interdisciplinary rounds on their patients, too.
I have an associate degree and when we did our "managment clinical" we had something very similar to what you are talking about.
Each week a different student was "charge nurse" (say clinicals were TWT), sometime monday afternoon the "charge nurse" would go to the clinical site and make assignments for the next day, later that evening the other 2-3 students in that group would go the site to do their pre-planning for their patients (Dx, Hx, medications, etc.); he/she also assigned when breaks and lunches would be taken and made sure that each "nurse" took his/her breaks by watching his/her patients while gone. (This was for 8hr clinical days and we were their at both changes of shift). Don't know if any of this helps.
Sounds like I'm on the right track, but students still seem dissatisified with the leadership portion of the clinical. Many of them get very incensed when they find out that they can't delegate bed baths to aides and must do the baths themselves. First, baths are already assigned to aides before we get there. If a student is lucky, his/hers may have been done. Second, the staff feel that a student with only 2-4 patients should be able to handle baths, too. Somehow, the focus sometimes seems to be on a.m. care rather than leadership.
Students also feel that they should be able to give meds independently since they are graduating. I feel that no matter what they've done previously, I need to evaluate their med admin and make my own judgements. I am very strict and safety conscious and many resent, for instance, that even on the third time in the room to give meds I still make them take the MAR in and check the ID band.
I also have many alternate leadersip experiences, such as shadowing a clinical manager, case manager, interdisciplinary team member, staff development nurse.
llg, PhD, RN
Perhaps the students need to get a better understanding of the different levels of leadership at the beginning of the course. It sounds as if you had very appropriate content for the "1st level of leadership" that a staff nurse typically needs -- but that maybe the students were expecting content targeted towards a higher level of leadership (such as would be appropriate for a shift coordinator or head nurse.)
In other words ... the issue might not be the course content itself, but rather the fact that it did not match the students' expectations of the course content. They may have thought that they were taking a class that would teach them "how to be a nurse manager" and instead, got a course that focused on "how to handle the charge nurse responsibilities that the average staff nurse has on a typical day."
I would recommend first clarifying the purpose and objectives of the course before going any further. Once everybody understands (and is in agreement on) what the course is supposed to be about, then and only then will any evaluation data be valid.
Could that be the issue?
Thanks, llg. The syllabus states that the clinical portion of the course focuses on the leadership aspects of the team leader in the care of a group of patients. While the course content covers a much wider range of leadership, the definition of a leader in clinical is stated in the syllabus and discussed during orientation.
(I'm not an teacher, but I just graduated May '04)
I think it sounds like the students are giving you a hard time b/c you are new at this and at least some of them have a "senior"/I'm a nurse complex.
They need to suck it up and do the baths (all nursing school students in my area do total patient care including baths). And they need to be reminded that they are not RN's yet (=can't pass meds by yourself b/c they don't have a license) and your license is the one on the line when you work w/students.
You can also ask the nurses at the clinical site if there are more things the students can be doing while there.
Keep your chin up, sounds like you're doing fine. :)
I agree that the senior students should do the baths, but it seems in a senior leadership clinical the emphasis should be on leadership. What about having them "shadow" a nurse manager/administrator/director? The literature is very clear about the shortage not only of nurses/educators, but of administrators. I think (my opinion) that if the students are going to get an accurate view of leadership and all of the roles that entails, they need to spend time with people that are in that position.
I am new to education, not to nursing, but graduated with MSN in nursing education and administration. Good discussion.
Hi iteach, I don't teach the RN program but I do teach the LPN program. Its a one year program and what I do is teach a leadersip class of the different leadership styles and have role play and they get the point. My boss and I have the students one at a time do a transition rotation at a nursing home where each student gets two times to be the leader or charge nurse and the med nurse for ten patients. This happens the month before they graduate. The leader gets the assignment and report from the real charge nurse of the facility and gives it to the students and picks their assignment and they are expected to do the baths and leader can help if needed. I am very firm about certain things and that is one of them. The students know they best respect the leader and med nurse. Just stay focused and don't let them get the best of you. I had a rough first year but then the next two were great. Good luck shull
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