Nursing Faculty orientation on a medical unit

1 Veteran nurses:

I need some input from those of you who are in management or who have been around awhile. I am nursing faculty in a baccalaureate program at a small private college. My background is Community Health, outpatient, ambulatory settings, and patient education. When I was hired into this position, I made it clear that I had not worked in med-surg for 15 years. I have been in this position for 3.5 years and the dept head continually puts me in to teach senior students on a very busy medical unit every spring. I have voiced concerns about being required to work in an area where I feel uncomfortable, but have been told to "just go work on the unit for 40-60 hours and you'll be fine." I feel that this attitude just perpetuates the "a nurse is a nurse is a nurse" refrain.

Well, I am so uncomfortable that I am starting to push back. I feel like it is unsafe for me to guide students in this environment and I feel that this practice is endangering my license. The dept head has told me that since we are so small (7 full time and 1 part time faculty) we need to be able to double up on the clinicals that we teach. I am considering leaving nursing education because of being put into an untenable situation like this.

What are your thoughts? How long would a nurse like me require to orient to your unit? Is 5- 12 hr shifts or 8- 8 hour shifts enough?

Thanks for your input.

Sassysmart 66
I don't think it matters who returns a post to you. In fact I would encourage lurking students to reply. You have to decide if you want to keep your job or not. Your students will sense that you do not have what it takes as soon as you get on the floor if you are not "all in." On top of that, the floor nurses will treat you and your students like trash as soon as they see you need instruction from them other than where are the supplies, and when is report. You must be there for all things needed by your students - procedures/medpass/charting. This will be expected of you, and you will be held responsible for your own practice as well as your students practice.Do not let yourself and your students down. You should have been working somewhere medsurg even per diem as soon as you even thought this might have been a possibility. If you are that unsure of your nursing ability you need to seriously think of leaving your job.

I think it is totally wrong to send faculty members to teach clinical in specialties in which they are not competent. I would not want to be such a faculty member.

I agree. If a school doesn't understand that a nurse isn't a nurse isn't a nurse, how the heck are we supposed to make the hospitals and the public understand? Stand your ground or get out. there are a lot of jobs for experienced nursing educators out there.

I would say in the long term get a part time job on the floor. That would take care of the problem.

I have been a clinical instructor for a year now... I was asked to have a group of accelerated BSN students over the summer for their "acute/complex" course clinicals... I was told that we would be on a monitored general medicine unit... I have no RN experience in telemetry, but during nursing school I worked as a nurse tech and cross-trained monitor tech for 3 years... The department chair and I figured that this would be a good fit compared to the other available units since these weren't true "cardiac patients"... Well...When I went to the hospital for faculty orientation, I was told that this unit was not taking students because of staff problems... Instead, I was told that my students and I would be on a CT surgery unit... First of all, I am limited to medical/surgical and oncology RN experience... Second of all, chest tubes make me anxious!!! My department chair was aware but really needed my help for the summer... I was able to orient for a total of 16 hours on the unit, but that didn't make a difference...I explained to the students on the first day that my area of expertise was oncology but we would all try to learn as much as possible together... It wasn't too bad... Only one student reported me to the dean because she felt that I was unqualified to be teaching... The dean was very appreciative for my tolerance of the situation...

op: your situation is ridiculous!!! your school should hire nurses who work on that floor or a similar floor to teach clinicals on that floor. it is not necessary to hire them as full time faculty. inform your director that if this situation does not find a better solution, you will be leaving.

I am a nursing student in my first semester of my adn program. I must say that I would feel completely duped to be taught a specific area of nursing that my instructor isnt comfortable with. The instructor is someone I feel should know that specialty like the back of their hand before passing it along to future nurses that "this is how its done". This is a very dangerous scenario. These students are looking up to you to help them make the best nurses out of themselves that they can be. I am sure you are wonderful at the other aspects of nursing you are familiar with but they cannot expect you to be a jack of all trades. I respect and applaud that you have the right mind to speak up to your fellow faculty, but it is still unsafe. I am unsure of a solution to your problem but I do wish you the best of luck with what you decide on.

unfortunately this is not uncommon these days.... there is not enough faculty..... I taught my daughter OB.... she had instructors who said " I do not know this stuff"..... an up an coming 4 yr program in roch ny.....

OP- they've been putting you on this unit every year, for 3 years, and you haven't educated yourself so that you are knowledgeable and comfortable in that time? After 3 years the issue isn't so much their poor judgement in making assignments, but it's you not taking the initiative and addressing your own learning. Isn't that what your students are encouraged to do? Life is constant learning and even if you weren't comfortable at first it's high time you became accountable for your own practice.

This is unacceptable.OP, in the short term I applaud your plan to work out a specific orientation to the unit by actually working it for a set number of shifts. I would propose this to your dean immediately and offer to do whatever administrative legwork is necessary to set it up.In the long term ... I would be having conversations with the dean regarding whether or not the program is actively hiring to round out the experience and expertise of the factulty. If not, and the long term plan is to continue to "wing it" ... then you'll have to decide if this is the job for you.I don't see this as a reason to leave nursing education altogether though -- full-time faculty and facility-based in house educators are needed desperately!

Quote from canoeheadOP- they've been putting you on this unit every year, for 3 years, and you haven't educated yourself so that you are knowledgeable and comfortable in that time? After 3 years the issue isn't so much their poor judgement in making assignments, but it's you not taking the initiative and addressing your own learning. Isn't that what your students are encouraged to do? Life is constant learning and even if you weren't comfortable at first it's high time you became accountable for your own practice.

I have a limited exposure to nursing, but I'm a second degree nursing student right now. I chime in here having been a high school science teacher (different), a paramedic (different), a EMT preceptor (different), and a police officer (most of my career experience) where I often had new people riding with me and had to train them and/or keep them safe. Yeah, obviously, I like different things...don't judge. First, I think all students can perceive when a teacher is talking about something he or she doesn't know much about. Sure, you can read from a book or teach what's in the book, but when you get that question that you can't answer your body language and voice tone changes. It's obvious, I think particularly to girls, that you don't know what you're familiar with. All teachers, at some point, have to teach something from which they have very little knowledge or experience to draw. It is indeed uncomfortable. With nursing particularly being as broad of a field as it is I think it'd understandable to admit to students that you have little experience with or knowledge in a particular area. I happen to hate it when teachers and trainers feign confidence in a subject. Second, being uncomfortable in your job is pretty common, but the degree of liability that comes with whatever is making you uncomfortable makes it all the worse. I largely decided to quit my last job and go back to school due to internal problems within the agency for which I worked. I was in a supervisory position and became "the whistleblower" thus turning in my supervisor for misconduct. I'd do it again, but after doing that eight months of misery passed before my last day arrived last summer. I understand going to work everyday not knowing what you're going to be up against. Granted, this scenario is a bit different than your's, OP, but I understand the emotions. You can indeed move on to better or equal things if you so desire. Others have suggested ways for you to gain familiarity with what is less known to you, and I can't provide such suggestions because I'm obviously neither a nurse or nursing instructor. I'm just here to say that sometimes you have to push back in order to stay out of more trouble, and sometimes you eventually have to walk away like I did.