Inside the Mind of Your Nursing Clinical Instructor: What They Actually Care About
Mastering Clinical Rotations: Key Tips for Nursing Students
This blog post is all about clinical – a major milestone in your journey toward becoming a nurse. Whether you’re about to start your first clinical or are a few rotations in, clinicals are an essential part of nursing school, offering us the chance to apply what we’ve learned in the classroom in real-world healthcare settings. But, as many of you have already learned or will soon find out, clinical is one of those experiences where the more effort you put in, the more you get out. So, let’s dive in!
Feeling Nervous? You’re Not Alone
First, I want to acknowledge that clinical can feel overwhelming, especially for those just starting out. It’s normal to feel nervous, inadequate, out of place, or even a little scared. Whether you're new to healthcare or just new to the pace and environment of clinical, these feelings are a natural part of the learning process. Every nurse, including myself, has been in your shoes.
The good news? It gets better! One piece of advice I always give my students is to jump in headfirst. I know that sounds easier said than done, but the more you immerse yourself in clinical, the more comfortable you will become. When you dive in, you'll learn so much faster than if you shy away from the action.
What Instructors Really Want to See
As a clinical instructor myself, I’ve seen it all. I teach first-year nursing students, and after a few weeks in the lab, we hit the hospital floor. Let me give you some insight into what we, as instructors, are looking for in students during clinical rotations.
Professionalism
This might seem like an obvious one, but let me tell you, professionalism is something that many students struggle with. We, as instructors, want to see that you’re treating clinical like a real job. Think of clinical as a trial run before you become a nurse in the real world.
Even though the clinical portion of nursing school is usually pass/fail, it's still important to take it seriously. Trust me, treating this experience like it’s “just a pass/fail” can hold you back in ways you might not even realize. Nurses take a lot of pride in their profession, and we expect the same from our students.
Punctuality: A Critical Element of Professionalism
Let’s start with the basics: arrive on time. Yes, I’m talking about being punctual. In nursing, punctuality is non-negotiable, and it starts during clinical. Being on time isn’t just about being there physically; it’s about being mentally prepared and ready to take on the day.
Let me give you an example: I run a clinical group that meets at 6:30 am in a family waiting area at the hospital. My students should aim to be on the unit by 6:20 am. That gives them enough time to drop off their bags, grab their clinical supplies (stethoscope, watch, pens, paperwork), and make it to the pre-conference.
Now, let’s backtrack for planning purposes. It’s about a 15-minute walk from the parking lot to the unit, so I recommend students plan to park at 6:05 am, leaving enough time for a potential shuttle ride or walking time. You also need to factor in a buffer for traffic, especially on those first few days when you’re still getting to know the route. If my students had roughly a 30 minute commute, they should plan to be out the door at 5:25 am to ensure they arrive to preconference by 6:30am.
Professionalism starts with being punctual. So, make it a priority from day one!
Be Prepared: Clinical Supplies
Being prepared means having everything you need for the shift. I highly recommend designating a bag specifically for clinicals. This bag should include your stethoscope, pens, badge, watch, and any clinical paperwork that might be required for your shift.
Take it a step further: if you’re expected to complete a head-to-toe assessment for every shift, at the beginning of your clinical rotation, print out enough copies of the assessment sheet for every clinical day. This way, you’re always ready to go, and you’ll save yourself time on early mornings when you’re rushing out the door.
Professional Behavior: How You Act Matters
Professionalism isn’t just about being punctual and prepared. It’s also about your actions throughout the day. Here’s where things can get a little tricky. It’s easy to get caught up in the social atmosphere with your fellow students, but remember: clinical is not the time to hang out in the breakroom gossiping or hiding in the utility closet.
Yes, instructors notice when you’re not engaged. We also notice when you're constantly on your phone. We get it – phones are a vital part of life, and yes, you might need to look up something nursing-related during the shift. But if you're caught sitting around on your phone while leaning against a wall or in the breakroom, staff will assume you’re texting, scrolling social media, or doing something else unrelated to patient care.
Instead, familiarize yourself with the resources available on the hospital computers. Most hospitals have apps like Elsevier or Lexicomp built into their electronic medical records systems. Use these to look up drugs, nursing procedures, and protocols. Staff and instructors appreciate it when students use these resources and stay engaged in clinical tasks.
Collaborating with Staff
Now, let’s talk about how to engage with staff – and yes, this is just as important as working with patients. Every clinical rotation will be different, but one thing remains constant: building relationships with the staff and primary nurses is key to getting the most out of your experience.
Introduce yourself early. When you’re assigned a patient, connect with the primary nurse and tech to let them know what you’re doing for the day and where you can help. A simple introduction like:
“Hi, I’m Caroline, a nursing student for day shift. I believe you’re the primary nurse for the patient I’ve been assigned today. I’ll be performing assessments, passing meds, and assisting with ADLs. If you need help with anything, I’m happy to pitch in!”
That approach not only sets clear expectations but also shows that you’re actively engaged and ready to learn.
What to Do When You’re Not Sure What to Do
Let’s face it: there will be times when you’re just not sure what to do. You’ve completed your assessments, and your patient seems stable. You don’t want to just sit there, twiddling your thumbs. Here are a few suggestions for how to stay engaged when you’re unsure about what to do next.
Dive Deep into Your Patient’s Chart: Review your patient’s medical history, lab results, vital signs, and imaging. This is your chance to see trends and patterns. Ask yourself: What’s going on with this patient? What are their most pressing needs?
Get to Know the Equipment: Spend some time familiarizing yourself with the hospital’s equipment and supplies. Check out the supply closet and get to know where things are stored. This will make you much more comfortable when you need to grab something quickly.
Answer Call Bells: If there’s a call bell ringing for a patient, take the time to answer it. You might be asked to provide a blanket, help with repositioning, or assist with something minor. It shows you’re willing to help and keeps you involved.
Round on Patients: Even if the patient isn’t yours, consider rounding on them. Ask if they need anything and check on their comfort. It’s an excellent way to practice patient-centered care and learn more about the unit’s routines.
Check in with Staff and Peers: Ask the techs and nurses if they need help with anything. Maybe they need an extra hand for a procedure or to assist with repositioning a patient. Collaborating with your peers and the unit staff shows you’re engaged and willing to help.
Developing Critical Thinking Skills
Finally, I want to touch on critical thinking. One of the most important skills you'll start to develop during clinical is the ability to think critically about patient care. As nursing students, it’s essential that we assess and analyze the information presented to us and use that to inform our decisions.
Let’s review some questions that you can ask yourself to help develop your critical thinking skills.
Let’s begin with understanding the situation.
Ask yourself the following:
What is the patient's primary concern or diagnosis?
What are the key signs and symptoms the patient is presenting with?
How do these symptoms correlate with the patient's history?
What additional information or assessments do I need to gather to fully understand the patient's condition?
Next let’s ask these questions that will allow us to analyze data and patient findings in a way to help us critically think.
Ask yourself the following:
What does the latest assessment tell me about the patients condition?
What labs, tests, diagnostic results should I review and how do they influence the plan of care for this patient?
Let’s also take a moment to explore options and interventions for our patient.
Ask yourself the following:
What are the possible interventions for this patients condition?
What are the benefits and risks for each option?
Is there evidence to support the intervention I am considering?
What are the potential outcomes of my chosen intervention?
How can I anticipate complications or adverse effects from the treatment or intervention?
Have all other less invasive options been attempted before moving forward with this intervention?
What would happen if I did not perform the intervention?
As you ask these questions, you’ll start to hone your critical thinking skills, which are essential in nursing. The more you practice asking these questions, the better prepared you'll be to handle complex situations down the line.
Wrapping It Up
To sum up this blog post: your clinical instructor is looking for professionalism, engagement, and critical thinking skills. They want you to arrive on time, be prepared, and stay engaged throughout the shift. They want to see you collaborate with staff, communicate effectively, and most importantly, learn.
Remember, clinical is a learning experience. You're not expected to know everything or perform every task flawlessly right away. But the more you engage with the staff, patients, and the tasks at hand, the more you’ll learn, and who knows – it could even lead to a future job opportunity!
I hope this episode has given you some insight into what clinical instructors are really looking for and that it helps ease some of your anxieties. Don’t forget – you’ve got this!
One hand is for me, and the other for you. See you next time!
Caroline
PS Want more on this topic? Listen to Life After Nursing School Podcast Episode 5