Most nurses experience working with student nurses at some point in their careers. With the high demand for nurses, many student nurses are needed. The excellent news is admission to nursing schools is as high as possible. But, the practicum or clinical experiences is a vital part of the education of nursing students. The pandemic and nursing shortage have challenged the placement of the students in the clinical setting. Simulation is growing as an option for learning and is helpful. However, much of the critical thinking, prioritization, and problem-solving skills develop during the clinical experiences. Making this a time of optimal learning is vital for clinical faculty but also for the nurses involved in the education process. As a previous clinical instructor, I will share thoughts about collaborating with instructors, students, and nurses to make the clinical a productive time.
Nurses usually remember their clinical experiences. Some may have fond memories, but others experience anxiety, fear, challenge, or embarrassment. Others may report some of their clinical lacked stimulation or were boring. There are ups and downs in the clinical setting. Each day is different for the students with progressive complexity in experience and responsibilities. Making the experience one of learning is the responsibility of the student and instructor. But, the nursing staff also has a degree of responsibility for student learning.
Productive clinical learning begins with planning. The instructor should discuss the experience with the nursing director or unit manager, who shares the planned clinical experiences with the staff. Instructors should provide the team with a syllabus and learning objectives. Also, include the dates and times of the clinical experiences. Making a note or poster outlining the students’ responsibilities for the course helps. I found that the more information I could provide to the unit’s staff ahead of the clinical, the better for myself and the students.
Hopefully, staff nurses learn upon hire about their participation with nursing students. They interact with students with random day-to-day assignments. Sometimes, a student may be paired with the nurse as a preceptor for several days or hours. The preceptor assignment is best when it is voluntary rather than assigned. A precepting nurse will benefit from an orientation to the role and learning objectives for the student experience. Reaching out to the instructor helps ensure the preceptor’s role is understood.
Caring for patients in today’s healthcare setting is challenging for the nursing staff. Adding a student nurse to the responsibility can be overwhelming. There must be a balance between what the student is allowed to do and what the nurse must do. Clinical agencies often set limitations on the role of the student nurse. These limitations must be made clear to all parties. Although student nurses bear equal legal responsibility for care provided, they often aren’t prepared for some skills and for caring for high-acuity and unstable patients. The nurse and instructor must ensure the role of the student is safe for both the student and the patient.
When starting the day, talk to the assigned student. Ensure the student has a plan for the day. Provide input and direction to ensure the student understands the care needed. Who is providing physical care? Who is passing medications for the day? Discuss with the instructor your role in working with the student and what skills you require the student to perform with the instructor’s guidance.
Throughout the day, ask students questions: What are the care priorities? What assessments were made? Does anything stand out as abnormal? Make your assessments to determine the student isn’t missing anything. When students don’t know the answers to your questions, please direct them to look up needed information. Providing students answers and rationale to your questions is also acceptable, especially when they need to learn procedural or prioritization skills. The nursing instructor asks students questions, but the staff nurse should feel comfortable helping the student learn. Don’t be afraid to voice concerns to the instructor also.
When busy or becoming overwhelmed with urgent patient care duties, let the student know so they can ensure the instructor is updated and will help the student as needed. The instructor is working to oversee the care provided by all the students in the group. But, if an individual student needs help, the instructor must allocate time for them.
Making the clinical practicum a positive experience is essential for the success of nursing students. Collaboration between the staff nurse, students, and the clinical instructor requires communication and patience. Safe patient care relies on teamwork. Ensuring our new nurses receive the experiences they need is a priority in nursing today.
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