Schools misrepresenting clinical site locations

Editorial Team / Admin · Oct 29, 2016

Quite frankly, its embarrassing and a slap in the face to the 3 yearsof hard work I put into my education to get into this program.

What, exactly, is embarrassing and a slap in the face about being exposed to environments other than a hospital? Nurses are involved in care outside of hospitals; in fact, it is likely the wave of the future for more and more care to be moved out of the hospital and into other settings. I'm sure that somewhere in all of the paperwork you received from the school it included that clinical sites could change. Contracts end, are renegotiated, started somewhere else.

LPNtoRNin2016OH, LPN · Oct 29, 2016

I think your misunderstanding my post. I am in an accelerated program, its three semesters. this is my ONE and only med-surg clinical/hospital experience. I did a peds rotation/psych rotation, this is our big all encompassing med-sure/acute care rotation. I currently work in a transitional care unit so yes I am aware that nurses work in all kinds of enviroments. But generally, LPNs go back for the RN to gain access to a hospital so I think its logical to assume your one acute care exposure would be, well, in a hospital. And yes, I was told you needed to be flexible about clinical sites, which I am, but I do feel its misrepresentation to have every single site listed you go to but then happen to leave out a nursing home site and then use it as your big clinical experience.

verene, MSN · Oct 29, 2016

Nursing schools are constantly in negotiations with clinical sites. Just because a program was able to go to a specific site in past years, doesn't automatically mean they are able to go again. Sometimes a new location becomes approved to send students to. I would guess that the list you received was a list of past sites the school has been to for informational purposes only. Not a contract that those are the end-all-be-all list of placements they would be sending students to in the future.

I am also in an accelerated program, and at least one quarter will be spent in a non-acute care setting (usually community clinic, dept of health home health team, or prison). If I went to my school's traditional program I would spend at least 2 quarters specifically in a skilled nursing or other LTC setting. I don't think spending 1 quarter in a non-acute care setting will destroy your chances of finding employment in the future. Also does your program allow you to rank your placement choices? If you feel super strongly about not spending a rotation in a skilled nursing facility, then put it does as your last choice for placement.

caliotter3 · Oct 29, 2016

I used to follow the site of WGU when the program first started up in my state. The listed clinical sites, (when they even mentioned the clinical sites), changed almost every time I went online. I was aware that if I went with that program, I would be attending clinical where I could get a placement. Something like "beggars can't be choosers". However, I totally get where you are coming from and see how a person could easily have been led down the wrong path. At some point, I would make my disappointment known to the school administration, after graduation and licensing, but make certain that you can find no warning anywhere that points out that clinical sites could not be guaranteed to each student. Almost all entities always have their caveats published somewhere to preclude people presenting legitimate complaints.

Kabuto_ · Oct 30, 2016

Nursing schools are constantly in negotiations with clinical sites. Just because a program was able to go to a specific site in past years, doesn't automatically mean they are able to go again. Sometimes a new location becomes approved to send students to. I would guess that the list you received was a list of past sites the school has been to for informational purposes only. Not a contract that those are the end-all-be-all list of placements they would be sending students to in the future.
I am also in an accelerated program, and at least one quarter will be spent in a non-acute care setting (usually community clinic, dept of health home health team, or prison). If I went to my school's traditional program I would spend at least 2 quarters specifically in a skilled nursing or other LTC setting. I don't think spending 1 quarter in a non-acute care setting will destroy your chances of finding employment in the future. Also does your program allow you to rank your placement choices? If you feel super strongly about not spending a rotation in a skilled nursing facility, then put it does as your last choice for placement.

Is there any employment related benefit of having placements in the community setting? It's unfortunate and I may look into transferring to another school downtown if my school selects placements in a preschool again. Community placements might be beneficial to others but I already have experience in community and social services and a degree. Jobs are becoming increasingly difficult to get for new RN Grads, why make it more difficult by wasting our time?

verene, MSN · Oct 30, 2016

Is there any employment related benefit of having placements in the community setting? It's unfortunate and I may look into transferring to another school downtown if my school selects placements in a preschool again. Community placements might be beneficial to others but I already have experience in community and social services and a degree. Jobs are becoming increasingly difficult to get for new RN Grads, why make it more difficult by wasting our time?

Yes, actually, community placements do help us get jobs. In my city there is no shortage of new grads and experienced nurses ready and willing to fill acute care jobs. The shortage of jobs is in the less desirable and non-traditional roles. Our program saw that by teaching students only how to function in the acute care setting they were providing a diservice to both the community the school serves and to the students who may find their first job in LTC or community-based settings.

The intention behind community placements is to expose students to areas of nursing they may not have considered as well as provide us with a broad skill set that will be useful both in and out of acute care settings. It also helps our school build long-standing ties with the broader community our health care system serves (university has a teaching hospital and numerous clinics in the area) which is more visibility for our graduates. While many new grads DO end up in acute care (usually via residency programs), not all will find positions, or even want to work in the hospital environment. However jobs are plentiful in the broader community (and many pay surprisingly well).

It seems to be working - most of our graduates find jobs very quickly post (and even pre) graduation. My mentor in the year ahead of me had a position lined up with the county health department before she graduated and she loves what she is doing! Several other recent grads I spoke with had a selection of job offers to chose from with in a month or 2 of graduation (depending on how quickly they started looking).

pmabraham, BSN, RN · Oct 30, 2016

And could this affect my hiring potential after graduation?

Absolutely yes. If you grow through it, it will show future employers you had clinicals in various settings for which you (hopefully) excelled. And if you do your homework, the typical recommendation is to avoid putting clinical sites on a resume unless you can directly show a correlation between skills and nursing judgement tied to the position for which you are applying.

Now, a question I would recommend you ask yourself and process through is are you going into nursing for the big names, the money, etc. or are you passionate about helping patients who are in need without regard to their personal position, circumstances, income, and current life choices?

applesxoranges, BSN, RN · Oct 30, 2016

Unfortunately, it can be hard to place students for their capstone because every program wants to place their students 1:1. In my hospital alone there is hardly enough full-time nurses who meet the state requirements for the preceptor to place students. That is before you filter the people who should not precept students for a variety of reasons (personality, skills, scatterbrained, etc).

Also, in my school they mixed the LPN to RN program with the traditional RN program so I don't know who was who. Those who worked were generally placed somewhere. With my coworkers in different programs, some of them actually went to the department they worked in although our school had rules against that.

We had people go to prisons, schools, doctor offices, and even nursing homes. Nurses work in a variety of settings. Not every nurse will work in the hospital. A lot of my classmates started out in non-traditional roles like prison, nursing homes, etc.

applesxoranges, BSN, RN · Oct 30, 2016

Unfortunately, it can be hard to place students for their capstone because every program wants to place their students 1:1. In my hospital alone there is hardly enough full-time nurses who meet the state requirements for the preceptor to place students. That is before you filter the people who should not precept students for a variety of reasons (personality, skills, scatterbrained, etc).

Also, in my school they mixed the LPN to RN program with the traditional RN program so I don't know who was who. Those who worked were generally placed somewhere. With my coworkers in different programs, some of them actually went to the department they worked in although our school had rules against that.

We had people go to prisons, schools, doctor offices, and even nursing homes. Nurses work in a variety of settings. Not every nurse will work in the hospital. A lot of my classmates started out in non-traditional roles like prison, nursing homes, etc.

araleman · Oct 31, 2016

I would like to clarify a few items and then make a comment.

1. All BSN programs have a community health clinical to prepare nurses for work in the community, in such jobs as public health, school health, occupational health, etc. The community health clinical also educates future acute care nurses about public health theory, issues of health in the community, and local community health resources for refer of hospitalized patients. This knowledge is, in my opinion, fundamental to have for excellent nursing practice.

2. I know that in many communities, acute care hospitals are no longer hiring ADN nurses and even refusing to house their clinicals in favor of the BSN student.

3. The author does not state if she is in a BSN program, but this is irrelevant to her issue. All students should have the same experience. If there are not enough acute care clinical slots, students should rotate from sub-acute to acute within the semester. This option seems the fairest.

LPNtoRNin2016OH, LPN · Oct 31, 2016

I would like to clarify a few items and then make a comment.
1. All BSN programs have a community health clinical to prepare nurses for work in the community, in such jobs as public health, school health, occupational health, etc. The community health clinical also educates future acute care nurses about public health theory, issues of health in the community, and local community health resources for refer of hospitalized patients. This knowledge is, in my opinion, fundamental to have for excellent nursing practice.
2. I know that in many communities, acute care hospitals are no longer hiring ADN nurses and even refusing to house their clinicals in favor of the BSN student.
3. The author does not state if she is in a BSN program, but this is irrelevant to her issue. All students should have the same experience. If there are not enough acute care clinical slots, students should rotate from sub-acute to acute within the semester. This option seems the fairest.

Thank you!! I am in an associates program but its designed to be 1+1. We (as in LPN-RN students) do all of our bachelor pre-reqs while completing the associates program. Once we graduate with our associates we then have 9 months left online for our BSN. So while its not technically a BSN program its designed so that you end up with one quickly after graduating with your associates. Hospitals in my area do still hire associate grads w/ the condition you obtain BSN in 5 years. We have a lot of hospitals in my area for a medium sized city so it works in our benefit at times but we also have a lot of nursing programs which is obviously impacting the clinical issue. I just want the same experience that other students in our school are getting and the experience I paid to have because I did specifically ask the question will our clinical be in hospitals and I got a resounding yes but the hospital sites will vary, not the setting.

And yes (and this is not directed at any one person) again, I know nurses do not just work in hospitals. I have been a LPN for 8 years and have worked in occ health, LTC, family practice, etc etc. But I wanted exposure to the hospital IN school so I could get an idea if I want to work in one or not. Plus many nurses in my area are leaving the bedside to become an NP or something of that nature so many of the jobs open for new grads are staff floor nurses so it's likely that's where I end up if I do not stay in the field I am in now.