Friday, November 6, 2009

brainstorming to battle hindrances

Yesterday we spent some down time during clinicals talking to our clinical instructor about other possible clinical opportunities. Our program is very limited in the opportunities we have. First semester we do nothing clinically speaking, other than lab learning. Second semester we spend 6 weeks (maybe it's 8 weeks, dont quite remember), at a long-term care facility. Third semester we do med/surg/ortho/tele, OB/newborn, and we're supposed to do an observation-only Peds rotation at a local practice. Because of H1N1, those of us that are supposed to be going during the latter part of this semester have been prohibited from going. There is also a time period during this semester where each group has been "orphaned". We do not have enough clinical instructors in our local, small community hospital, and there are no contracts out for any of the larger hospitals or medical centers in the region. (Let's not forget I live in the DC/Northern VA region where there is a plethora of all that is medical.)

The other two community college's programs go to vast medical centers for their clinical experiences, and oh, you might have heard me mention in the past one of those programs is also sharing our local, small community hospital. It's not an extremely large group invading our territory; however, their instructor has asked one of our two instructors if they can take the one floor that one of our groups was supposed to have! From what I heard our instructor (our group wasn't with her at this point in time) conceded!!!!

I digress; so when we're orphaned, we go to other clinical experiences, which are usually observation-only or very limited hands-on experiences. They've been overall wonderful opportunities. Most everyone's enjoyed going to interventional radiology, the infusion center, wound care center, a local same day surgery center, staff development, ICU, (no, we don't get that as a regular rotation), etc. It's usually only been one day here or there.

In our bigger rotations (med/surg/ortho/tele, OB/newborn) we are only given one patient at a time. For instance, my patient yesterday was admitted with a GI bleed with anemia. He was completely independent, so all I did was vital signs, get his cup of ice chips (he was NPO as they were waiting on GI to get in to consult, and send him down for a procedure--didn't happen on my time), straighten up his bed (he'd been admitted the night before), and do his assessment, I&O and flow chart.

We're talking lots of down time. We bent our instructor's ear something fierce, because we want better opportunities next semester, and for future students. The program is being overhauled and this is a major need. Our instructor had spent some time earlier in the morning talking with the other program's instructor (OPI). The OPI informed our instructor of all the things they do clinically and that by their third semester they're taking on at least 2 patients.

Our mental health rotation is incorporated in as part of our LTC rotation because we work with patient's with dementia. We do have a mental health facility within 40 minutes--which in this area 40 minutes is nothing. All 5+1 (we had an orphan for the day) of us sitting there voiced that we would be willing to drive to other locations, at a distance, to be given better learning opportunities.

Bottom line is we want to feel somewhat comfortable when we're interviewing for our first nursing jobs that we we'll be a little more comfortable taking on our responsibilities. We know that we'll be oriented to the facility. We know that you really don't have your true nursing groove until you've been at it for at least 6 months. We just want the same opportunities as others.

I'm wondering: what clinical opportunities were you or are you being given as a student nurse?