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?

[elkpark]

Any tips for dealing with really strict instructors?

Yes -- meet or exceed her/his expectations.

[akulahawkRN, ADN, RN, EMT-P]

You are going to be better in the end for having this instructor. My Med-surg 1 clinical instructor was very strict and had very high expectations. I went into clinical intimidated by what I heard about her but ended up absolutely loving her! I had a breeze in med-surg 2 and frequently got 100's on assignments because my previous instructor was so strict. I'd literally spend hours on my careplans and once I completed all the required ones she had us write out SBAR notes that she was also very strict about. I learned so much with her. Good luck![/quote']

I had a couple of very tough instructors in school, one of whom failed me from the program. While I don't have a whole lot of respect for that particular instructor in regards to her actual teaching ability at the time, she was very knowledgeable and incredibly tough and had extremely high standards. The standard she maintained is what ultimately allowed me to do very, very well in clinicals after I was allowed to return to the program.

[AngelKissed857, BSN, RN]

I'm going into 2nd year, have had awesome clinical instructors, and one really crappy one (IMHO). The awesome ones set clear expectations and we're consistent in their requirements, the crappy one didn't and wasn't. For my pre-labs I plan on 6-8 hrs. That's on top of the 5 hrs of lectures that day, on top of the 1-2 hrs at the hospital getting my info. Our pre-labs consist of 2 patho-physio for that pt, a teaching plan, all meds with classification, action, pharmcology, and action, side effects, nursing implications for THAT pt, the data base work all pertinent pt data, labs with how each is important to THIS pt, and nursing implications. All typed, no typos or errors. If I'm super lucky (said with tongue in cheek), I'll be picked to either do a cade presentation at lunch, or to pass meds, which means I'll be quizzed on all of the above. It ain't fun, but I get the importance of it. Think of it this way, if you manage to harm a pt. it's on your clinical instructors license too.

[Jensmom7, BSN, RN]

Think of it this way, if you manage to harm a pt. it's on your clinical instructors license too.

Are they still teaching that in school?? Because it isn't really true:

Every BON and faq site I checked said the same thing. This is from the Iowa BON site.

"Nursing faculty frequently talk about students practicing under a nursing instructor's license. This is an inaccurate statement because the only person who works on a nurse's license is the person named on the license.

Nursing Practice Acts include statutory language that specifies what are called exemptions or exceptions to the requirement for a nursing license. Typically, practicing nursing as a student who is enrolled in an approved nursing program is one of the exempted (or excepted) practices. The nursing student is accountable for his or her nursing actions and behaviors to patients, the instructor, the facility and the nursing program.

The accountability for nursing instructors is for their decisions and actions as an instructor. For example, the instructor is accountable for the selection of patients for the nursing students' assignments. The instructor is expected to support studies preparing for the clinical experience and to monitor students' clinical performance. Most critically, the instructor must intervene if necessary for ther protection of the patients when situations are beyond the abilities of the students. Instructors must identify "teaching moments" as well as assess and evaluate the students' clinical performance.

The broader accountability reflects the education, experience and role of the instructor, who is accountable to the patient, the student, the facility, the nursing program and the professional licensing board."

[pmabraham, BSN, RN]

The accountability for nursing instructors is for their decisions and actions as an instructor. For example, the instructor is accountable for the selection of patients for the nursing students' assignments.

What is meant by held accountable? I.e. what actions can take place?

[BeachsideRN, ASN]

I had a similar experience. My first semester clinical was kind of a joke. We didn't really do anything in clinical. So when second semester rolled around I stepped up my game. I made sure I looked up everything that pertained to my patient and did exactly what my instructor expected me to do.

[BeachsideRN, ASN]

I'm going into 2nd year, have had awesome clinical instructors, and one really crappy one (IMHO). The awesome ones set clear expectations and we're consistent in their requirements, the crappy one didn't and wasn't. For my pre-labs I plan on 6-8 hrs. That's on top of the 5 hrs of lectures that day, on top of the 1-2 hrs at the hospital getting my info. Our pre-labs consist of 2 patho-physio for that pt, a teaching plan, all meds with classification, action, pharmcology, and action, side effects, nursing implications for THAT pt, the data base work all pertinent pt data, labs with how each is important to THIS pt, and nursing implications. All typed, no typos or errors. If I'm super lucky (said with tongue in cheek), I'll be picked to either do a cade presentation at lunch, or to pass meds, which means I'll be quizzed on all of the above. It ain't fun, but I get the importance of it. Think of it this way, if you manage to harm a pt. it's on your clinical instructors license too.

Definitely not true and our clinical (and theory) instructors let us know that from day 1. Patient harm falls on you and your future license.

[windsurfer8, BSN, RN]

High expectations. Love them. Embrace them. If you feel like an "idiot" there isn't anyone else can do to fix that. You choose to view yourself however you want. I am a believer that iron sharpens iron. That being pushed to limits and beyond makes a person stronger. I have screwed up my fair share of stuff but NEVER would I quit anything and never would I feel sorry for myself. When stuff gets crazy and busy and nuts I actually love it. I have been ripped by docs and other nurses. I take it and I keep moving forward. 10 years later I feel like a dang good RN who can handle anything. The KEY for me was owning my mistakes and NEVER placing blame on others. Good luck.

[WheresMyPen]

My way of dealing with strict instructors: do everything they say, learn everything you can. Even if they are targeting or being unfair (it does happen), just keep the mindset in clinical that you must listen to them. Take more time to prep. You can never be too prepared. This is the learning experience that is gonna shape you to get the advantages and learning that you didn't get before. I had a professor who I did not like at first. She had a very strict and hard attitude to deal with. And it felt demeaning and irritating to deal with at first. But I just took in everything and the more I listened the better I did and I started to understand why she was so strict. It's better to be slapped on the wrist and sent home in clinical than it is on the job! So just do what you're told and you'll make it through. Absorb info no matter how it's presented. Take everything you can from the experience and use it to your benefit. Good luck!

[BuckyBadgerRN, ASN, RN]

This!!! Step up your game and pay attention to this CI. I'm sure you will learn more during this clinical rotation than all your others combined

You are going to be better in the end for having this instructor. My Med-surg 1 clinical instructor was very strict and had very high expectations. I went into clinical intimidated by what I heard about her but ended up absolutely loving her! I had a breeze in med-surg 2 and frequently got 100's on assignments because my previous instructor was so strict. I'd literally spend hours on my careplans and once I completed all the required ones she had us write out SBAR notes that she was also very strict about. I learned so much with her. Good luck![/quote']

[AngelKissed857, BSN, RN]

Thanks for that info! Yes, they do teach this, also that the licenses of the nurses who are assigned the pts. are also on the line for our actions. I appreciate this clarification. I'll be looking it up on the CA BRN. Not that it changes anything, lol, but it'll be that little nugget in the back of my mind calling BS, as I smile sweetly and do exactly what I'm told to do....

[BuckyBadgerRN, ASN, RN]

No no no!! Stop saying and believing this!!! The CI's license is not "at risk" by the action of a student!! It's not like she's sharing her license with students during clinical studies. I really hope your CI isn't telling you this false information.

I'm going into 2nd year, have had awesome clinical instructors, and one really crappy one (IMHO). The awesome ones set clear expectations and we're consistent in their requirements, the crappy one didn't and wasn't. For my pre-labs I plan on 6-8 hrs. That's on top of the 5 hrs of lectures that day, on top of the 1-2 hrs at the hospital getting my info. Our pre-labs consist of 2 patho-physio for that pt, a teaching plan, all meds with classification, action, pharmcology, and action, side effects, nursing implications for THAT pt, the data base work all pertinent pt data, labs with how each is important to THIS pt, and nursing implications. All typed, no typos or errors. If I'm super lucky (said with tongue in cheek), I'll be picked to either do a cade presentation at lunch, or to pass meds, which means I'll be quizzed on all of the above. It ain't fun, but I get the importance of it. Think of it this way, if you manage to harm a pt. it's on your clinical instructors license too.