Tips for Making Your Clinical Day Better

suboyer · Mar 11, 2006

Calling all clinical instructors:
Please list your secrets/ tips for better organization on the clinical floor. What are your proven methods for making the clinical day run smoother? Thanks in advance :)

Some of the details of what worked for me included:

- attending a staff meeting prior to bringing students on the unit, and discussing the plans, expectations, and limitiations

- asking staff to let me know if they did not want to work with students (none refused the role!)

- starting with VERY basic assignment/expectations like communication skills. (A couple of my students were terribly anxious about simply conversing with patients, so that became our starting point)

- if asking staff to help you select patients - make sure that they look at whether the total assignment is realistic for you to manage/supervise (they often recommend the most challenging patients - to provide that complex experience for the student, without considering what that workload is for you!)

- team assigning students - partner the more capable with less proficient students within an assignment so that they can learn from each other, practice team leading, and work on collaborative skills

Teaching nursing students was a wonderful, fun, challenging role and I highly recommend it!

Have fun!

VickyRN, MSN, DNP, RN · Jul 3, 2006

First suggestion: before you begin, investigate the floor in which you will be having the clinical. It is our responsibility as nurse educators to facilitate our students' education (in other words, we partner together with our students for their learning). It is our responsibility to create the best environment possible for learning. I would advise you to meet with the unit manager and informally chat with some of the nurses just to get a "feel" for the floor. Attend one of their unit meetings or change of shift report meetings, just to help them get to know you better and to be comfortable with you. This little bit of "PR" work up front can earn tremendous dividends later. You may want to "shadow" on the unit for 6-8 hours; this will help you become familiar with supplies, policy and procedures, medication delivery systems, IV pumps, charting, doctors, etc.

75% of the difficulty we have had with clinicals at our school have been because of unsupportive/ outright hostile clinical environments (actually, it was just one hospital :uhoh21: ). The vast majority of clinical sites, I am happy to say, are very supportive of students and clinical instructors. If you do, indeed, encounter a problem with one of the nurses (or nursing assistants, etc.) on the floor, don't just ignore the problem, but address it at the point of conflict in a professional manner. Go up the chain of command if you need to, until the problem is resolved to your satisfaction. Strive to have constant good communication with the patients' nurses and the unit manager. That good rapport on a unit is worth its weight in gold, but sometimes takes a lot of work.

Always treat your students with dignity and respect. Strive always to be fair. I hate intimidation--it makes for poor learning. We certainly cannot be personal friends with our students or cross professional boundaries by being "buddies," but we should always be encouraging and let the students know that we desire their success. There is a right way and a wrong way to correct a student. When you have to correct a student, (if at all possible) never do so in front of the patient, staff, or other students. Do so in a private area, as soon after the incident as possible. Start out with a positive statement, then gently bring correction. For instance I stated this to a beginning nursing student, "Your patient care is excellent and I can tell you really care about your patient, however, I am a little concerned about your saying to the patient 'You are going to be my guinea pig today.'" (This actually happened!!! :eek: ) One thing that can never be compromised are any issues concerning patient safety. This requires immediate intervention. Also, I do not tolerate an "I do-not care" attitude, sloppiness, being late for no valid reason, being unprepared, or treating the staff/ patients rudely.

There is a big difference, of course, between the performance of beginning students and senior students. The expectations of senior students will be much higher. If you have any questions about student performance (i.e., what they should already know at this level, doubts about them being "where they should be to graduate," etc., etc.)--address your concerns to the director of the school of nursing. Always maintain a united front with the faculty at your school. Say only positive things about the school of nursing to the floor nurses or to your students. Also, never say negative things about your host facility to the students. If a nurse behaved in a perceived unprofessional manner, allow the students to discuss the situation in confidence during post-conference, but only for the purpose of learning. Never allow a student to "downtalk" another faculty member in your presence, and do not be drawn into those type of conversations. Simply state, "if you have a problem with so-and-so, you need to talk to him/her about it." End of conversation.

It is a good idea to have a "quick" pre-conference before the students go out on the floor, to go over patient assignments. You can also quiz the students as to which of the patients has the top acuity, etc. Have reasonable expectations. Make your expectations crystal clear and stick to them. Be consistent and objective, and follow the facility's and your school of nursing's protocols and guidelines. It's nice to have a post-conference after the student shift is finished for the students to debrief and discuss patient concerns and valuable knowledge and insight that they have gained. You can also question them about patient diagnoses and other pertinent matters: "What does congestive heart failure mean in your own words? How has this affected your patient? Why is such-and-such in the patient plan of care?" Try to inspire enthusiasm and critical thinking in your students.

One last thing, if you do encounter an unsafe or unprepared student (which is a generally rare occurrence), patient safety is always number one and can never be compromised. Always make sure you document, document, document well on the student's competency form.

puggymae · Aug 13, 2006

Have objectives for the day - start simple and move to more complex as the rotation progresses.

Set deadlines - or you will be there at midnight while some of them mosey along.

Separate co-dependent students - they may find security clinging together but one of them is usually doing all the work/thinking/organizing and the other is just hanging on for dear life.

The most important? Set high expectations - people work at the level of expectation you set for them. I tell the students right up front what I expect from them and what they can expect from me - and I often ask what they expect from me - you would be suprised what they want/need.

dikay · Jan 19, 2007

Does anyone have any resources for keeping track of student experiences during clinical. I have been teaching clinicals for about 5 years, took a year off and just started again. I just remember at the end of the clinical evening, it was hard to remember who had done what. The other question I have is does anyone have some expamples of ancedotal notes that are written on student evaluations. It is sometimes hard to come up with good and constructive comments. Thank you.

zsuzan · Jan 19, 2007

Hi,

I create a grid at the start of a rotation.I teach peds. so I need to keep track of age groups that students work with. The same could be for any focus that you have. Columns include: Name of student & absences if any; written work & pull out experiences; one col for each age group (I include date, pt. age & diagnosis); IV/IM/SC meds;PO; Nebs. with info on O2 sat, MDI's etc; Topicals;Disch teach & forms; & the last col. is for anything else e.g. # of pts.for the day, other treatment modalities, good & bad actions for the day, comments from staff, other documentation for the unit, referrals, etc. This really keeps me organized as I have a quick visual for making the assignment as well as keeping track of what each student has done. I hope this helps.

ZS

cholli · Jan 20, 2007

Our students turn in a care schedule to the instructor at clinical preconference (part of a 3 part form). I keep the stack in my pocket and write notes about each student as we interact through the day/shift. After postconference, I always take a few minutes to go through the stack and add any other comments/observations. Then when it is time for conferencing, I have lots of data at my fingertips. I also review weekly for trends and counsel individual students prn- ie prep for med pass, communication skills etc.

This quarter, I am refining this to a kind of data base form I developed with the things I want to keep track of and there will be a form for each student- I guess I might keep it in my briefcase and transfer the info from my notes on the care schedules at the end of the shift.

As far as evaluation notes- At our college, we have word documents that summarize the clinical objectives and then the instructor caninsert comments whenever they want.

dikay · Jan 21, 2007

Thank you for the good suggestions. I used to keep track of the students on my clipboard, but as we got busy through the evening, I wouldn't have time to write each thought down. As an Instructor, we have weekly mini-evaluations of the students. Thanks again.

RN28MD · Apr 25, 2007

Hello everyone,

I am not sure where to post this as I am new to this forum. I have always loved to teach and was wondering how can I become a clinical instructor. DO I need to be certified or need X amount of years of experience or need my Masters or more. Can some one direct me. I have my BSN and have done nursing for about maybe 2yrs. Any suggestions would be appreciated. Thank you.

shull · Jun 19, 2007

Hi I have to agree with many of the writers today. We have a folder that each of us have, more like a binder with rings. We have evaluations made out for each clinical day for the rotation we are on. We can fill them in as we go or at the end of the night. I have a print out of the assignments and I write the meds, injections etc on each one for the students as my own when we are getting report and I can use them later if I don't have time right then. We also made up a great form with all of the things we expect to be done in clinical and we put a date next to it when they do that procedure so we can keep track. So far we have had no major problems with staff and facilities. My boss and I have worked at the places where we go so we are familiar with the equipment or policies. For the person that asked about the degree needed to teach, it depends on the state and the program, RN program needs a MSN and LPN a BSN for the instructor. But check your state board of nursing. Sally:lol2:

Lisa CCU RN, RN · Jun 19, 2007

These are great suggestions. I want to be a clinical instructor, but not until I get some experience and know what the heck I'm talking about!

VickyRN, MSN, DNP, RN · Jul 22, 2007

the clinical evaluation process- are your students "at risk for failure?"

the clinical evaluation process for nursing faculty faces many difficult challenges today. student performances are often viewed subjectively by faculty members, as the grading criteria and evaluation tools may not sufficiently assist them in accurate findings. in addition, students today face an array of barriers that may indeed place them "at risk for failure" within the clinical setting.

students face many barriers that faculty may not recognize as problems in clinical today. whether the student is traditional or non-traditional in age, the student may exhibit one or more of the following barriers which impact their ability to succeed clinically, including: role strain, stress and anxiety, employment during school, family issues, low self-esteem, and lack of support systems. faculty members need to recognize that students exhibiting one or more of these characteristics are at risk for clinical failure....

http://emarketing.delmarlearning.com/nursing/nursing_july07_feature_art.asp