Wow! Time is really flying by! Sometimes, I feel like a boat without a sail! My teaching practicum has been really keeping me busy, but I am learning so much in the process. We had to send a student home today from clinical for sleeping on the unit! She was upset and could not understand why she was receiving a clinical failure for the day. She could not grasp the idea that sleeping during the clinical day was totally unacceptable. This group of students are getting close to graduating. That is not the kind of nurse that I would want to take care of my children or any of my loved ones.
I feel that there is a need for closer monitoring of students in the clinical settings. I was really surprised to find that a large majority of the students could not even perform a basic assessment at a satisfactory level. Educators are at a disadvantage in the clinical setting quite often. Most of the clinical placements are spread out over the hospital, and it makes it very hard to spend quality time with each of the students. There has to be a solution to this problem! Maybe we are the answer!
6 comments:
Kim,
Your post echoes my thoughts and concerns with nursing students in the hospita. It seems really difficult for clinical instructors and as we know often the students are spread all over the hospital. It's a challenge to meet the needs of the school, hospital and student. And it's very sad to think that students are not capable to perform basic assessment skills prior to graduating. Your semester seems to be giving you an eye-opening experience of what's happening, fustrations that occur and the need to improve clinical rotations for the student, school and hosptial.
Hi Kim…… there are few clinical instructors for the many nursing students. I was a part of a project called the WINNER program…I think you know of this because the students also came to TCH. They attended school at TWU, U of H and several community colleges. The number one concern we heard from the students is that they felt their clinical instructor did not have time to teach them. The WINNER program was a trail and learn project. Nurses were used as actual clinical instructors. 95% of students loved this. It allowed more one to one time for students. Student felt as if they leaned and were allowed to do so many more tasks that they had never done in the past, and because students followed nurses’ schedule, there were a limited amount of students on the unit at any given time. It always sad when you find students just hanging out, sleeping, making personal calls e.t.c… It is a reflection on everyone.
Stella, I attended a "debriefing" of sorts for the Winner program at UT. What a neat concept. Actually, this is how I was trained in my native country (Germany). Thw student nurses had designated preceptors on each unit and we worked along side the RN's for the whole shift for weeks at a time. We learned the routine, and had real life hands on experiences. The class room instructions made more sense and the knowledge learned was demonstarted in the clinical setting. Our instructors often were hospital practicing physicians who made sure we were present when there was something cool to see and learn.
The Winner program was deemed a succes by students and the specuially trained preceprtors as well. Unit based preceptors are also a good solution to the problem of faculty shortage.
Kim, I have encountered similar flabbergasting situations in daily practice. a few nurses at our facility were recently fired for sleeping on the job and felt wronged by the manager and the hospital. Nurses make mistakes and do not see how this is a safety issue if the patient was not harmed. Have we coddled and spoiled the upcoming generation to a point were they do not feel any responsibilty for their actions?? Or did we fail to instill values such as a reasonable work ethic??
Wow. It is sad to hear that what experts are saying about some of the younger generations' lack of self-accountability and responsibility is true.
Pairing nurses and students is a great way to improve students' clinical experiences. There are two primary problems that I have encountered with this: lack of regard for this from those who make unit assignments (i.e. busy nurses who can't deal with students) and potential for anti-productive role modeling. The best clinical I ever taught was one at which I had previously been the director of education. I knew which nurses to use and which to avoid.
I often became something akin to a secondary charge nurse in some of these circumstances, which was quite interesting but extremely functional. The charge nurse would communicate skills that needed to be done to a designated and rotated "student charge nurse" who would then assign these skills to various students who needed practice with these skills. I oversaw it all and made decisions about supervision. It worked nicely, but the reason that it did was because the nursing staff knew me and trusted me.
I think that the potential for some of the half-time nurse/nurse educator positions lies most significantly in approaches such as these. A clinical education model of this sort might make a good pro-project or dissertation for someone who's interested. I'm available as always for consult. :)
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