knittwhit

I am making the leap from adjunct clinical instructor to full time clinical lab instructor. The position became available unexpectedly and I will be jumping in without the benefit of the former instructor being available as a resource. I am looking for any/all advice on resources to help me make the transition. I do have a colleague at another facility who can help mentor me. I know there is one other nurse in the department who runs the simulations. I will be assisting her with those, but as for the skills labs, they are mine. I will also be responsible for conducting open lab and some remedial work. I am confident in my skills and am good at time management and self direction so I'm not so worried about those aspects. It just feels a bit like I am jumping in feet first without dipping my toe in a bit more. I will be meeting one more time with the dean before I formally accept the position. Thoughts on questions I should be asking?

You could contact the continuing education or staff development department from a hospital you are interested in. They could help set you up. Good luck, and remember what you see in a day or so, is far from what the career can offer.

i can't claim authorship. i found the original information on one of the boards here. i print on both sides of a 4x6 index card then can lay them out 3 to a standard sheet, laminate them then trim them. the students love them, and i love sneaking up on them and see them using them. you should be able to just copy and paste the information below to a word document. to use the 4x6 card you need to go to the page set up and choose a6 as your paper size. i have also done it in two columns on a standard 8/5x11 then folded, trimmed to the pocket card size. hope this as helpful to you and your students as it has been for us. i am using it with my third group and really feel it enhances their skill development. side 1: head to toe assessment loc (alert/lethargic/non-responsive) orientation (to person, place and time) neuro check, if applicable skin-color (pale/ pink/ruddy) temp (cool/cold/warm/hot) texture (dry/diaphoretic) *any o2, ng tubes would go here apical-rate rhythm (regular/irregular or normal/abnormal) intensity(loud/distant) respirations-rate effort (easy/non-labored) deepth (deep/shallow/blowing) *chest tubes would go here upper extremities- if iv present, note the solution, the rate and the site. note the site for warmth, redness,edema etc. abdomen-look (round/flat) listen (boso present x 4 quads?rhythm of boso-normal/hyper/hypoactive and the intensity-high/low-pitched) feel (soft/firm/hard) side 2: *any peg, pej, etc. tubes would go here. bowel and bladder- voiding (color, clarity, amount) postop flatus? foley? (patent, note drainage system) ostomy? (note stoma) *this would include any suprapubic caths,drains,etc. lower extremities- homan's sign (negative/positive) pedal pulses (+1=weak/faint, +2 palpitable, +3 bonding) capillary refill (brisk/sluggish-how long if >3 seconds) **put any dressings or wounds in the order they came. for example, a forearm dressing would go with the upper extremities. a cast would include a circ check with the corresponding area. edema include pitting (and the deepth) or nonpitting at the correspodning area.

I agree, I worked on an adolescent unit that had a successful suicide. It was devastating to staff to say the least. Our manager brought in the hospital's employee assistance program (EAP) professionals to help us deal with the loss and the impact it had on the staff overall. It was extremely beneficial. You might want to check if something like that is available to you. People outside our specialty often don't realize how difficult it is, expecially when you work with children who are so ill. Best wishes and Blessings to all of you

This is related but a little off topic. Our new manager wants us to be like "the other nursing units" which of course as a 22 bed, mixed CD and general psych unit, it is not. She is not in favor of a taped report for all oncoming staff to listen to (we can ask questions of the outgoing shift after we have listened to the tape) she wants live nurse to nurse report. That leaves out the psych counselors that are working in the milieu. Our feeling is that it is in the best interest of maintaining the therapeutic milieu for all staff to know what is going on with all the patients as it does impact care. I'm just wondering how other units are doing it and is there a format they are using to help keep the report time manageable, as report has become too long in attempt to cover all the "juicy bits" she insists we are missing. Thanks in advance:)

I absolutely agree with you. I teach freshman fundamentals. One of the first things we talk about before going into the clinical setting is beginning the assessment as soon as you walk into the room. I give my students a laminated pocket card the first day of clinical to help them remember the things they should be looking for. In our clinical conferences we talk about any questions they had or interesting findings. I want this process to become as automatic to them as breathing, it will make them better nurses.

I am currently supervising my students with IV push meds. Our policy is that the student can only give IV push under the direct supervision of the instructor. They have had to demonstrate competencies in the lab prior to the clinical setting and must calculate dosage/push rate and give indications/side effects etc. before we administer. The reality is this route is becoming the standard and these students are going to be expected to have these competencies when they enter the workforce. The more we reinforce good practice now, the safer and more confident they will be when we are not there walking them through the process.

Thanks for the advise BigBad. So that is what they really think of us...LOL This is my first year teaching. I started with clinical lab in an ADN program 2 weeks ago. We have one more lab before we hit the floor. It is interesting getting to know each student. I can see who my leaders are already. I have a couple who are going to need a bit of encouragement and sometimes a little push. I'll keep an eye on this board for more advise. I have a mentor at the college and a resource contact at the hospital, both have been very supportive.

My name is Barb. I completed my MSN with specialization in healthcare and nursing education last November through the University of Phoenix. I will be starting as an adjunct clinical instructor, teaching fundamentals with the freshmen, with a local community college in September. I am looking forward to moving forward on this newest journey in my nursing career. My specialty area is psychiatric nursing, which I will be teaching in the spring. Just skimming this forum, it looks like it will be a good resource and place to ask questions.

I am curious as to how others are handling change of shift patient handoff. Up until recently we have used a taped report by the charge nurse to convey information to all members of the oncoming shift. In order to meet JCAHO and CMS standards however we have recently begun doing a live report with each member of the outgoing shift reporting to the oncoming shift. The result is much redundant information and report taking far longer than the allotted 30 minutes. We are a 22 be inpatient unit with a milieu therapy model, therefore it is imperative that all members of the oncoming shift hear report on all patients. We have both RN and non-nursing staff. One dilema is making sure that pertinent medical information (labs, meds, VS etc) are accurately reported on the patients of the non-nurses without repeating information. Any and all feedback/suggestions are welcome. We have been told we have to make this work. Right now it is generating a lot of confusion and anger.

Oldibutgoodie, hang in there. When you get to the end you will see how it all comes together. The information you are learning is all part of the skill set you will need as an advanced practice nurse. The courses will enhance your critical thinking and broaden your world view. Good luck. I got dinged a few times for APA errors, when protesting to my professor she told me the APA is the frosting on the cake, if the cake doesn't look attractive people won't want to eat it. It is about consistency and precision. If you took the time and put in the effort to turn in a theory based paper, but spelling, grammar and formatting errors left it unreadable, what good is it. As an advanced practice nurse you may decide to publish, APA is the format you need for submission, otherwise they won't even look at it.

I have been in psych nursing for over 25 years, the time has flown by. I agree, follow your bliss, you won't regret it!! I agree with the previous poster, there are so many opportunities and different areas of psych.

Accessability was the key factor for me. The closest masters course for nursing education in my state was over an hour away and they would only accept full time students. Since going to school full time and not working was not an option, I put off returning to school for several years. UOP has opened doors that would not otherwise have been opened unless I had relocated, which was something we had no interest in doing. I think each person considering UOP needs to look at their life situation and carefully weigh the pros and cons. Sure the expense was a consideration, but the other pros offered by the online format far outweigh it. I have no regrets for choosing the path I did.

I heartily disagree with you. I am about to finish my MSN in Nursing and Healthcare education. This was my second time in a masters level program, the first being a traditional land based program. The level of interaction between myself, my classmates and instructors was much more intense than in the land based, lecture based program. The online format is very learner centered and requires much discipline, you get out what you put in. The objectives of the courses are in line with competencies spelled out by NLN, ANCC and CCNE the main accrediting agencies for nursing education. The level of participation expected between class mates and in the learning teams fosters learning in a manner which goes beyond memorization of facts. Having to apply the principles spelled out in the objectives, to real world scenarios leads to a much deeper level of learning. The program is clearly geared toward learning at the deeper levels of Bloom's taxonomy and the development of critical thinking skills. I suspect that those disenchanted with the program thought that because it was online and because it is accelerated, that would mean it would be easy and abreviated. NOT the case. It was a lot of hard work and more time consumptive than I originally thought it would be, but I have absolutely no regrets with the outcome. I feel I have received a very high quality education. The experience has been overall a positive one and as I consider pursuing a PhD, I am looking at other programs that will allow me to complete the majority of the program in an online format. If Phoenix expands their program to include a PhD in nursing education, hands down, no question, it would be at the top of my list.

I am an MSN student working on my capstone project which involves exploring the role of the nurse educator in a variety of settings. I tried posting my survey here yesterday but cannot due to board rules. I ask for a moment of your time to go to the following link, complete the survey and send it back by private message. Thank you in advance! https://allnurses.com/forums/f17/nurse-educator-role-survey-258461.html