New Clinical Educator

How can I keep it fun?

"Fun" isn't what I imagine when attending clinical as a nursing student. Lots of skills, but be open to lots of questions and performing the see one, do one, and teach one method for those skills.

What can we do if we are not welcome on a floor (example: low census), but we can still in be in the hospital?

I've never experienced this throughout my career. I would recommend asking the instructors for content and allowing students to spend the time studying and asking you questions about content.

What did you do for first Med/Surg clinical rotation?

Wounds, wounds, wounds, WOUNDS!

As a current nursing student, I think it's important to have a structured pre- and post-conference. I've had them where we each present our patient and I've had them where the instructor gives a specific assignment, like Student A will do an SBAR handoff report to Student B and Student B will try to identify any gaps in the report. Both worked well. One particular instructor worked in the ICU at a prestigious university hospital where patients were transferred in with mystifying symptoms. She would ask us to figure out what kinds of tests we would order to properly diagnose a patient. She was a masterful storyteller as well and her ICU stories, besides being fascinating, always included some kind of nursing lesson or kudos to nurses. Be organized. One instructor kept a spreadsheet detailing our patients, care plan interventions, and specific skills we got to practice so that when she wrote our evals she could refer back to it. Advocate for your students--if a patient is going to cath lab, can your student go too? Patient needs a Foley--can your student do it (if checked off, of course)?

Be positive, encouraging and don't make your students feel like idiots--we are already beating ourselves up pretty regularly!

I taught clinicals for a semester while in grad school. Hope these help you:

1. Realize you can't do everything. I had to watch each student pass meds and assess a patient at least once in the term. I felt like I needed to be there everytime each student passed a med, which is impossible. I know you said they can't pass meds just yet. Will they be able to later in the semester? I had to trust the nurses on the floor and explain to them what I was looking for when the student passed meds.

2. Talk to to the charge nurse when making out assignments. I did this to see which patients would provide good learning opportunities, which may not want students (we had student 3 days/week and mine were day 3 - some patients were done with students by that time!), etc.

3. Know what your access to the EMR is versus the students' access. We had differing views and it was frustrating. Are you teaching in a facility where you already work? If you are, be careful not to use your employee access while instructing. They explained to me that it was a HIPAA issue since I was an employee of the university and not the hospital at that point.

4. Volunteer for anything! I told the nurses on my unit to let us know if there was anything going on - foleys, dressings, blood sugars, procedures, therapy, etc. My students loved getting involved, even if it was only watching a procedure.

5. Be prepared for going back to the basics! I struggled initially when they would ask questions (ex. Why does x med cause y reaction?). I had been a nurse for years and that information had become so ingrained that I had to stop and think about why I did what I did. (Even though I wanted to say "because that's they way it is"). Your students are at the conscious incompetence level - they know they don't know the information. You are likely at the unconscious competence level where you can do something without thinking about it. Along with that, I tried not to ask questions while they were performing a task. I was taught that beginners have difficulty crossing learning domains (cognitive, psychomotor, and affective). I would ask questions before going into/upon leaving the room and let them focus on the task/patient when in the room.

6. For post clinicals, we took part of the time to debrief. We also talked about labs, tests, etc. to help students understand better how everything was connected. MyAimIsTrue suggested SBAR which is another great idea. A co-worker arranged for the students to tour the lab, central supply, and pharmacy, which I felt was helpful for them to understand why it takes a while for a certain lab to come back/med to come up or why the central supply people may not understand which foley supply you are talking about when you call them.

7. Be prepared for the time it will take to grade the paperwork and do evals. I loved teaching but the time commitment was too much when combined with school and work. I would love to get back into it at some point in the future.

Have a great time!

I have been teaching in an LPN program for the past seven years and absolutely love it. I teach classroom and clinicals. One thing I suggest since they aren't at med pass yet is to focus on physical assessment, start correlating meds with dz process, communication (some days I have everyone give me a shift report in post conference). I'm not sure how many students you have in your clinical group, but I try to have a max of 6 students actually on floor with me at a time. The others are outposted within facility and/or other facilities to shadow. You definitely have to be patient and you will see the needs of your students and that will help you do what needs to be done. It's a hard job, but I have learned so much from my students and a lot of about myself. I have a lot of things that I have just come up with to incorporate learning and a little fun. Good luck and welcome aboard!!

I've been teaching clinical for an LPN program for 3 years. I found that students definitely need structure or they act like lost sheep. Depending on the units they were on and how they flowed, I would make up assignments for them to do to guide their learning. It also depends on whether or not they have access to the EMAR. I've done chart review assignments, short essay assignments if they were on an observation unit like surgery, and of course care plans. I also like to start preparing for NCLEX early and would sometimes spend post-conference doing NCLEX activities and discussions. Depending on the unit or facility and what supplies are available, sometimes I would do a short lab regarding IV fluids or wound care during post-conference as well. I've also given them projects to work on throughout the rotation, like giving a presentation during the last week about a topic they spent the rotation researching. Giving them assignments also helps with their clinical evaluations considering you can't always have your eyes on everyone at all times. Sometimes I based their clinical evaluation for that week solely on the quality of their assignments and feedback from staff.