New Clinical Instructor Looking for Advice on Planning out the Day

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Hello,

I will be a new clinical instructor for 8 students on a neuro advanced unit next month. My background is cardiac ICU, precepting new grass, and 8 years of PCT experience. I am very excited for this new role, but a bit overwhelmed on trying to develop a game plan of planning out the day and making it a good experience for the student as we are only getting 7 12hr shifts together. This will be there last semester of clinical before they do their preceptorship before graduating. I was hoping someone could share kind of a "schedule" of how you plan your day and direct the students. I have to be present for all med passes, so if you could share how you manage that process or how many you let pass meds each week that would be great. Also curious of how many patients you have them pick up and how that progresses over the next few weeks? We are not suppose to have them follow the primary nurse. Any advice you have I would greatly appreciate,  thanks!

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Specializes in Geriatrics, Transplant, Education.

Hi!

I've been clinical instructing for 5 years and it can really be a learning curve! Is this an advanced med surg type class? If they are about to hit preceptorship, they should be pretty solid in their assessment skills. I focus a lot on critical thinking in my clinicals and ensuring I am talking with students and questioning them throughout the day. I'd probably give them 2 patients (or maybe just 1 the first day so you can feel them out). When I've done 12s recently (with limited in person hours d/t COVID) I have had my med surg 1 students take one patient in the morning and then usually an admission or pick up another patient in the afternoon. I give them clear instructions on what they are expected to do/document. Don't bite off more than you can chew with med passes! I typically do 2 students per day to pass ALL meds on their pt. However, with less in person time during COVID, I focused on more challenging med pass skills like injections, IVs and less on POs. I don't have mine follow the primary nurse around either--they need to do, not observe. 

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Specializes in oncology.

I wish I had connected with you all years ago. After the first medical LTC course, I had all 10 students give medications to each of their patients. I just met a barrier from the staff who would not check my notes regarding who gave meds. Prior to the pixis I put post it notes on each patients med drawer. Afterwards I put post it notes on the pixis.

One hospital I advoided pressed the instructor had to attend all skills, Foley, IV starts in addition to medication. My main hospital allowed the staff to assist students with some skills other than medications. I live in a small city, have taught here in BSN and ASN programs for 30 + and knew just about all the nurses. I felt more comfortable with the guidance and skill performance with the nurses I knew. 

The ugly truth is I started 0900 med passes at 8:15 and finished at 11:15. I always had looked at the meds prior and knew who to start with. My fellow faculty had an almost indentical time frame for 0900 meds.

What type of school are you going to work for...how many clinical experience days (12 hours) versus less?

How acute are the patients? How many IV PBs, how complicated is the computer system (mine was meditech which asks another question for each button you push and my clinical was the first meditech system for them.) A thousand questions for pills especially pain pills.

How familiar are they with the pyxis and computer program? It all takes time! I subbed for courses where the student was going to graduate and marveled how much easier it was!

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11 minutes ago, londonflo said:

I wish I had connected with you all years ago. After the first medical LTC course, I had all 10 students give medications to each of their patients. I just met a barrier from the staff who would not check my notes regarding who gave meds. Prior to the pixis I put post it notes on each patients med drawer. Afterwards I put post it notes on the pixis.

One hospital I advoided pressed the instructor had to attend all skills, Foley, IV starts in addition to medication. My main hospital allowed the staff to assist students with some skills other than medications. I live in a small city, have taught here in BSN and ASN programs for 30 + and knew just about all the nurses. I felt more comfortable with the guidance and skill performance with the nurses I knew. 

The ugly truth is I started 0900 med passes at 8:15 and finished at 11:15. I always had looked at the meds prior and knew who to start with. My fellow faculty had an almost indentical time frame for 0900 meds.

What type of school are you going to work for...how many clinical experience days (12 hours) versus less?

How acute are the patients? How many IV PBs, how complicated is the computer system (mine was meditech which asks another question for each button you push and my clinical was the first meditech system for them.) A thousand questions for pills especially pain pills.

How familiar are they with the pyxis and computer program? It all takes time! I subbed for courses where the student was going to graduate and marveled how much easier it was!

We will be on an neuro advanced care unit, nurses usually have around 4 patients. Usually a mix with neuro and medical population, so I'm sure they will get plenty of experience with IVPB, etc. Luckily, about every hospital in our region uses Epic and everything is pretty straight forward as far as pyxis goes.

1
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3 hours ago, NurseKatie08 said:

Hi!

I've been clinical instructing for 5 years and it can really be a learning curve! Is this an advanced med surg type class? If they are about to hit preceptorship, they should be pretty solid in their assessment skills. I focus a lot on critical thinking in my clinicals and ensuring I am talking with students and questioning them throughout the day. I'd probably give them 2 patients (or maybe just 1 the first day so you can feel them out). When I've done 12s recently (with limited in person hours d/t COVID) I have had my med surg 1 students take one patient in the morning and then usually an admission or pick up another patient in the afternoon. I give them clear instructions on what they are expected to do/document. Don't bite off more than you can chew with med passes! I typically do 2 students per day to pass ALL meds on their pt. However, with less in person time during COVID, I focused on more challenging med pass skills like injections, IVs and less on POs. I don't have mine follow the primary nurse around either--they need to do, not observe. 

Yes we will be on an advanced care neuro unit, stepdown from neuro ICU, also mixed with the regular advanced medical needs population. Do you typically go in early to make assignments and touch base with the nurses? We will be doing 12 hours shifts. I like the idea of focusing on the IV meds now that they are near the end. I've thought about making maybe a mini cheat sheet of my expectations, such as they need to do charting according the units standards, performing all patient care, being able to explain the reasoning behind all meds prescribed even if they are not passing meds that day, critical thinking questions, etc. Not to overwhelm them, but guide them? I'm super type A so I may be going a bit overboard, but figuring out how to direct 8 people and give them the best experience is a lot.

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Specializes in oncology.
35 minutes ago, missjessicag said:

Do you typically go in early to make assignments and touch base with the nurses?

Our students started at 0630 and I was there at 0530 making assignments. I always talked to the night nurses. You have your MSN education?

Oe thing I would suggest is putting a definate deadline for their completion of assessments and other things that may be unique to the unit.

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