Tips for really strict clinical instructor?

[Kiki<3]

Hi all, so today has been a particularly awful day. I am a second-semester nursing student in an accelerated program so I am in school all this summer.

This semester I have my Medsurge clinical at the veterans hospital and for some reason, it seems that all the instructors there are particularly strict. My CI is new, we are are her first group however, she trained under another VA clinical instructor who is also known for being tough.

Coming from a different hospital with a particularly nice CI for foundations who was not as strict on paperwork, I am shocked by the high expectations of my CI and what little time she expects me to have it all together and be proficient. I'm only now really understanding what she expects of us, and how nothing is going to be the same or similar to my previous clinical experience. However, I have only just learned all of this because she pulled me aside and with another instructor before clinical went over what was wrong with my paperwork. Then, she sent me home saying she didn't think my care plan was efficient enough to take care of my patient today.

I was so livid, this is only 2nd clinical day, but 1st clinical with medications. In my prior semester I'd never done preplanning the night before, just 45 min before the tradeoff. I'd never done med cards either. I honestly feel like it was a very harsh judgement to place on me considering my prior experience, but it's very hard to explain that since everyone in my group comes from different instructors (some of whom, also had higher expectations thus making those student's transition to our current instructor's expectations a lot easier). I feel like I have been placed at a disadvantage due to my school not having a set standard of expecations for each clinical group so we all end up with different baselines.

In the meeting I tried to explain myself, but it really seemed pointless because I still didn't have what was needed for that clincal day. I also felt intimidated by the other CI that my CI brought in with her. She was very stern with me, and I felt like she maybe had the impression that I was just lazy rather than misguided. It was so bad. I feel like such an idiot because I haven't grasped things as quickly as the others in my group.

Any tips for dealing with really strict instructors?

[NewMurse1014]

I would say just step up your game and prepare more at home before your clinical days. Now that you know the new CI is strict and recognize your disadvantage, it's better to start working on it early than failing the clinical later. Review the common meds at your facility, practice writing care plans for common pt populations, go over unfamiliar skills/equipments, etc. Prove to her that you're as capable as your classmates. Good luck!

[Ginger's Mom, MSN, RN]

If she spelled out the expectations and you did not fulfill them shame on you. How were you going to give medications if you did not look them up and were prepared. Your CI can not do everything for you. If the expectations were not spelled out for you either verbally or in a written document, I would speak to the school since the that would be unfair to you.

You are not in Nursing Fundamentals any more you do need to step up your game. It sounds like your first CI did no favors to you by

preparing you for this semester. Sounds like the CI did the right thing speaking to you privately. Next time you will be prepared I guarentee it.

[sirI, MSN, APRN, NP]

Thread moved to General Nursing Student forum.

[roser13, ASN, RN]

Sounds like nursing school!

Seriously, everything you described sounds completely appropriate. Your CI does not have time to wait for everyone to find their way around the paperwork at their own pace. Everyone needs to get up to speed NOW. Perhaps the real issue here is that your "particularly nice" CI last semester did not adequately prepare you.

Med/Surg clinicals traditionally require a ton of preparation in advance. Some clinical students actually have to go to the floor the night before and research their patients.

You have 2 choices here. You can continue to be livid and offended and be behind from day 1, or you can throw any pre-conceived notions of Med/Surg clinicals out the window and make every effort to meet expectations. If you're behind your classmates, figure out what you need to do to catch up. Then do it.

And PLEASE do not come back here and blast all of us who took the time to give you some very good advice, just because it's not the "tip" you were looking for. We are all saying essentially the same thing, because it's so obvious to all of us what the real issue is.

[Jensmom7, BSN, RN]

Remember, it isn't your CI's responsibility to adapt to you, it's YOUR responsibility to adapt to HER. She honestly doesn't give a furry rodent's posterior what your previous CI did or didn't require for clinical preparation.

You're in an accelerated program, which means they don't have the time to be gentle and patient while you adjust to a different teaching style. Actually, even in a regular program, "That's not how my other CI did it" is going to get you some serious stink-eye, if not an "invitation" to discuss it further with your instructor.

I find it interesting that you are "shocked" by an instructors high expectations. If it wasn't spelled out for you in the syllabus what you would need to prep for, then it was your responsibility as an adult to find out.

Your CI apparently saw something in your responses that rang a warning bell in her mind. You came in unprepared, did not take the initiative to find out what was expected before you showed up for clinical, and seem to be blaming everyone but yourself for your deficiency.

This can be a positive experience for you. Be proactive, find out what is expected before you have to be at clinical (you never prepared until 45 minutes before you started? Knowing you would be dealing with meds, you didn't think making med cards was necessary?)

Before you let this hurt your feelings too, yes, I'm a COB. Yes, I do remember some terrifying instructors, one especially who told us that if there was *one* wrinkle in a sheet and the patient developed a wound, our butt would be in a sling [emoji33][emoji33][emoji33]. Yes, sometimes the instructors were critical. That was the time to apologize, and then go fix whatever they deemed unacceptable.

Learning how to deal with various personalities in school will help you in the real world of nursing, where you don't get a trophy for just showing up, you WILL make mistakes, and your preceptor WILL be praying that you don't kill someone before the end of the shift.

[Kiki<3]

Oops wrong comment!

[Kiki<3]

What is a COB?

[akulahawkRN, ADN, RN, EMT-P]

Like the others have said, that's Nursing School for you. Hopefully your CI spelled out her expectations for you at the first meeting. If she did, then you're clearly the one at fault here. Clinicals (especially early on) require much preparation by you so that you can get the most out of the experience. In my program, our clinical days were Thursday and Friday. We also had around 4 hours on Wednesday to do clinical prep. That meant we would have to go to the hospital, confer with staff there to figure out which patients were most likely to still be there in 2 days and were appropriate for our level, then we'd gather a LOT of information about our patients and take that home to assemble into our care plan. That included looking up medications that we were likely to give as well as being generally familiar with the other medications that the patient takes.

Once I'd picked my patients, I ended up taking about an hour per patient gathering up all that data and then I'd have at least another 2-3 hours at home - per patient - completing the care plan. Yes, that's a LOT of work!

What generally helped was that they gave us care plan templates so we had something to go by in terms of what to gather and what to expand upon.

My tip for you, as with the others above, is that you need to step up your game. You're in 2nd semester, and as such, you're expected to be proficient in 1st semester stuff. If that includes giving certain meds, then you must be ready to give those meds. You will also very likely be observed during medication administration for other meds that weren't a part of 1st semester. Be ready to administer those meds too. In 2nd semester, you can't just show up 45 minutes prior to the start of clinicals, get report and do your "research" on your patients like you (apparently) did during 1st semester. You just can't. You don't know enough yet to be able to do that. I would expect that of a 4th semester student that's basically finished with the program. I'm and ER nurse now and I haven't been really near any MedSurg patients in close to 2 years. I still can just get report and get to work on those patients but I will NOT be efficient at it because I've specialized. My last MedSurg patient was back when I was still in Nursing School, but I do remember the basics of being a MedSurg nurse. It's seriously going to take you quite a while before you're at the point where you can just take report and go and a HUGE part of that process is doing those infernal Nursing Care Plans. I truly, to this day, despise them most immensely but I also appreciate them for what they do for you.

[roser13, ASN, RN]

What is a COB?

Crusty Old Bat. One of the nicer names that some of us get called when we answer questions realistically. We also are NETY - Nurses (who) Eat Their Young.

[pixierose, BSN, RN]

Listen to these ladies: their advice is gold.

I'm a nursing student. Take my word for it: not preplanning the night before isn't the norm. No matter how "nice" your former CI was, she doesn't sound like she did you any favors. Yes, it can royally suck to preplan the night before (hell, I've preplanned the week before), but it's what makes it part of the learning process. Med cards, pathophysiology of your patients, etc etc ... you can't "wing it."

Take a deep breath, do your med cards et al, come prepared and kick some butt. You can do this.

[BittyBabyGrower, MSN, RN]

Make sure you are prepared! Back in the day at my diploma

school, this is how it was. You better know that patient inside out, meds, diagnosis, care plan done. It's going to be rough, but you will learn! And ifnyou aren't understanding something or not sure ask! It sounds like there will

be nothing more this lady hates than if you are unprepared. And if you don't know something say "I don't know the answer to that, but I will look it up and have it for post conference".

Being ng in an accelerated program is hard, so get your nose to the grindstone, don't make excuses and show them you can do this.