Senior Clinical Ideas

Oh'Ello, BSN, RN · Jul 28, 2014

I'm not an educator... I'm a recent graduate. One of my senior instructors made up (probably from old patients) complicated med passes for us to try to sort out. Brief patient HPI vitals etc.. and a whole list of 8, 9, 10 and 12 o'clock meds. The IV medication part was wonderful. She would give us lists of meds that the patient needed that were incompatible, high-priority, contraindicated.....with different types of IV access... and we had to use the various resources available to us (micromedex, hospital policy, orders, Trissels) to try to figure out how we were going to give all of these meds to a patient while managing conflicting priorities.

Initially she gave us the full post conference to work on them and we'd discuss and work together. But each week she would slash the amount of time we had to figure them out, and start adding on more assignments.

It was actually fun! we all looked forward to doing it and it was incredibly valuable. Once she started slashing the time, it was really eye opening and sort of helped transition us from the complete non-reality of passing meds with an instructor to... "Oh crap.... I'm going to have to do this for 4 people on my own here soon."

We were never graded on our results, unless someone was doing horribly and needed to really ramp up their skills in organization.

Hope this helps!

llg, PhD, RN · Jul 28, 2014

I really like the previous poster's suggestion -- scenarios with priorities to figure out, etc. You could also do "unfolding case studies" that would start with a situation description and then evolve as the students discuss and choose actions to take (critical thinking skills).

On a completely different track ... you could discuss career issues. I find a lot of schools do little on that topic. For example, you could interview the managers of the units where you are working and ask them to give you a list of the things she looks for when she is hiring ... or the educators could tell you about the common challenges new grads face on their unit. Such a topic would help the students prepare for actually working on such a unit after graduation -- and might be a refreshing change of pace every once in a while.

KBICU · Jul 28, 2014

This is an awesome idea. Thank you!!! :)

Nonyvole, BSN, RN · Jul 29, 2014

Something that I loved was that my clinical instructor had us present on a patient, and back up things like our nursing diagnosis with current literature. No textbooks allowed. And then we were asked to also present an intervention that we had seen that had made us go "huh?" in either a good or bad way - and find information in the current literature to either back up or disprove our reaction.

We also played games. Two teams, one person up from each team. The professor asked a question, and the first person to slap the table had the first chance to answer. We were allowed to consult with our team. If the answer was wrong, it was bounced to the other team.

And to carry on from the career discussions - have a day to talk resumes. The resume advice from my school was amazingly wrong, and it took talking to a current nurse manager and hiring manager to finally get my resume into such a shape that people would actually look at it. Same with cover letters. Should the students be preparing them, or are they generally ignored if they're coming from new grads?

KBICU · Jul 30, 2014

Hi Nonyvole,

Thanks for the game idea! That sounds fun and won't put everyone to sleep. I will definitely give it a try!