Many of my nursing student clients have asked for a new perspective on the way that they receive helpful tips and strategies for success. With great thought, I’ve decided to try something new. I believe it could be fun and engaging for nursing students and new graduate nurses to use the comments section of each monthly post as a discussion board to answer common questions that nursing students have posed. I have asked nursing students on social media, as well as in-person to provide some of their most common questions, and these will be the focus of each monthly Q&A post. I strongly recommend that you contribute to the discussion by sharing ideas, tips and strategies that you may have found to be helpful. If you have not dealt with the particular situation in question, feel free to provide support and validation so that we can show our nursing students the camaraderie and teamwork that is so essential for successful nursing practice!
For the month of June, we are going to focus on tips and strategies for managing a situation where a clinical instructor may have made you feel intimidated, embarrassed or incompetent. Here are three nursing student questions revolving around this topic:
Questions
Second Semester Nursing Student – “My med-surg clinical instructor makes me very nervous. She consistently tells me and others in our group that we are going to fail. How do you recommend that I approach her to tell her that her statements are distracting and inappropriate?”
The Nurse Speak Advice – First, let me say that you are not alone. I experienced something very similar during my outpatient pediatrics clinical in nursing school. On this particular day, we were challenged to administer vaccines to infants and toddlers. During pre-conference, the instructor told our clinical group that more than half of us were going to fail today, and that we’d have to repeat an entire semester of nursing school. After my classmates and I looked at one another in disbelief for a few seconds, I asked for clarification. She immediately became upset, raised the volume and pitch of her voice and said “Well, now I know who I am going to fail first!” Everyone’s eyes grew big, and heads began shaking in continued disbelief. I remained silent and thought carefully about how I should respond.
Once we were in the patient care area, I asked my instructor if I could speak with her in private and I told her how I felt. I made sure to let her know that her statement was hurtful and that it added a lot of unnecessary stress and tension to an already stressful learning environment. I told her that I was afraid of making a mistake, or worse – causing patient harm – because I was focusing on her and not on the assignment. Although she appeared insincere in her apology and explanation of “just making sure that we were taking this assignment seriously”, she did however back off of saying that we were going to fail. In the end, she turned out to be an excellent instructor that offered the guidance and insight that we nursing students desperately needed.
So in a nutshell, my advice would be to just be honest and professional in your response. If you need further resolve, make sure you contact the clinical coordinator at your school right away and provide them with a clear and objective description of events so that they may help you resolve the issue.
Fundamentals Nursing Student – “Every time I am doing a head-to-toe assessment on a patient, my instructor comes into the room and tells me that I am doing the assessment wrong in front of the patient. Although I ask for feedback to identify where I am making mistakes, she only laughs and walks out of the room. This has happened three times, and I am afraid that I’m going to fail clinical. Can you give any advice on what I should do?”
The Nurse Speak Advice – Similarly to the advice given for the situation listed above, I would be honest and professional in your response to her feedback. Seeking clarification is the first step in finding resolve, however you must let her know how you are feeling as well. When in doubt, focus on patient safety! I recommend asking to speak with her early in the day prior to the start of your assignment and let her know that you want to know how you can improve so that you do not miss anything essential to patient safety and the management of your patient’s care. Nursing instructors are usually very impressed when their students show signs of patient advocacy. If this does not seem to open up the communication channels with your instructor, you should reach out to a professor at your school to ask for guidance and clarification.
Third Semester Nursing Student – “I overheard my instructor telling one of the hospital staff nurses that she thinks I am stupid and she is going to try to fail me. I want to talk to my instructor about what I heard to see if I can better understand how I can improve, but I am concerned she will retaliate. How should I handle this? Should I just lay low and ignore it, or should I say something? I need help!”
The Nurse Speak Advice – First, I want to apologize that you had to experience this. Educators should NEVER call one of their students “stupid”. This behavior is unacceptable and should not be tolerated in any setting, especially in a learning environment. This behavior is a prime example of nurse bullying, and she needs to be reported to your school professors immediately. Be objective in your descriptions, and let the school know of your concerns regarding retaliation. Schools generally do well with handling these kind of formal complaints, so be sure to follow all of the appropriate grievance reporting policies so that this issues gets resolved ASAP.
It is with great hope that these monthly Nursing Student Q&A Blog Series will provide you with valuable advice that help you meeting your academic goals! Please add to this discussion via the comments section below and by sharing this post on Facebook and Twitter!
Best Wishes,
-Damion
Please leave a comment here so that you can help the nursing students above develop strategies for success!
This is a great idea. Thanks for sharing a Q and A. I had similar experiences in clinicals, I was bashed in front of the group about my care plan by the instructor. I misheard the assignment and didn’t provide a thorough care plan. He could have pulled me aside to discuss it alone. I started having anxiety going to clinicals and was afraid he would fail me. He would be nice one minute and then yell at us the next. I don’t know if that’s a normal technique, but it does add additional stressors to the already stressed environment. I understand that the clinical is to be taken seriously because we are working with sick patients but having that additional fear was stressful. It took me a while to get acclimated to the nurse life, but I still hate confrontation with others. Thanks!
Thank you Evelyn for your positive feedback and for sharing your experiences. Let me ask you this – How did you handle the situation thereafter? What tips or suggestions could you give to a nursing student in a similar situation?
In response to your statement: “He would be nice one minute and then yell at us the next. I don’t know if that’s a normal technique, but it does add additional stressor to an already stressed environment.” – THIS IS NOT A NORMAL TEACHING TECHNIQUE, and in my professional opinion, it is extremely inappropriate and demonstrates unsafe practice. Nurses take an oath to uphold the highest standards for patient safety at all times. When a nursing instructor adds additional stress by yelling at their students, or by demonstrating aggressive and intimidating behaviors, they are placing the patients in harms way.
Nursing instructors should facilitate an environment of learning that includes building student confidence through clinical assessments and assignments. Our focus is to challenge our students in applying theory into practice. We should also expect for the students to make mistakes and have plans to improve student performance readily available when mistakes do happen. In the short six years that I have been teaching nursing students, I have NEVER once yelled at a student. I feel by that by using closed loop communication techniques “Stephanie, you will go and perform a head to toe assessment and then document your findings in the patient’s EHR, and when you are done, come get me to check your documentation.” Ask for REPEATED instructions – “Mr. Jenkins, I will go perform a head to toe assessment on the patient, document my findings in the patient’s EHR, and then come find you when I am ready for you to check my work.”
This is a very effective technique that prevents 100% of miscommunications. If a student does not follow instructions after this closed loop communication technique, this will result in a private discussion to review expectations – not yelling at them.
Thanks again Evelyn for your positive feedback and for adding to this discussion!
Hi Damion. I believe I did talk to him alone after the group meeting that I did not appreciate being called out in front of everyone and would work on the care plan as I honestly misinterpreted his directions. The care plan wasn’t as detailed as he wanted so I did update it for his approval. So, if this were to happen to another student, I will recommend staying calm and then speaking with the instructor privately about what happened that made you uncomfortable/embarrassed and what you can do to learn from this mistake/scenario. Communication will always be most effective, otherwise the instructor will not know what he did wrong or right if there is no feedback from the students. I know it can be scary to confront/speak with an instructor but they should be willing to hear you out and understand where you are coming from. They should not make you feel incompetent or embarrassed, as they are supposed to guide and show you appropriate behaviors and skills. That is a good idea, that you make sure your students understand the tasks given to them by having them repeat the tasks. It is similar to what we do with our patients or students, to make sure they understand the plan of care, concept or skill at hand. If there was any misunderstanding, it can be corrected before the patient or student thinking they heard something else.
Thank you very much Evelyn for sharing these details on how you handled the situation. I am certain this information will be helpful to others who may face similar circumstances!
Best,
Damion