November 24, 2008, 12:53 am

Nursing Clinicals: All-for-One?

A high school class tours a local hospital in the 60’s.

Future Nurses of America, you might say.

The girl in the middle has an expression that just cracks me up!

It’s like she thinks the patient is about ready to explode!

I had that same expression the entire time I was in nursing school.


But that does give me an idea…

We need to start a Future Nurses of America organization starting at the jr. high school level.

I wonder how you start something like that.

Well, well – a quick Google search shows that something akin to this already exists!

So much for my original idea!

(Photo credit: Life Magazine, 1966, Photographer: Leonard Mccombe)


I’m wondering if I am out of touch of nursing education.

Back in the day, when we did our clinicals, we did them at different facilities. I had experiences in the county hospital, a free standing psychiatric facility, a medical center, a couple of community hospitals and a local hospital run by an HMO.

I learned a lot from experiencing different facilities. For one, I knew I sure as heck was not going to work in a county facility. No siree! I discovered I had an affinity for psych nursing and that there was no way in hades that I’d ever work for an HMO.

The point? I had been exposed to different systems, different ways of nursing, different types of patients and different attitudes along the way. Props to Ohlone College – I am the product of a great program that is still going strong.


There is a local hospital that works with nursing students in a BSN program. The students get all their clinical experiences at this one hospital.

Now granted, it’s a decent hospital. It has a psych unit, an ICU, a medical floor, a telemetry floor and a maternity unit. The staff nurses act as adjunct faculty for the clinical students.

Many of the students are hired by this hospital after graduation.

But are they really getting a well-rounded nursing education?

Isn’t it important to experience different types of nursing, different types of facilities, different philosophies, different attitudes, different corporate cultures, different equipment, different ways of performing nursing functions?

Isn’t the ability to adapt something that should be ingrained in a nursing education?


I do think it great that hospitals are willing to partner with universities in educating nurses.

I also think it is a great idea to have staff acting as adjunct faculty for the nursing students; who better to teach than someone who is actually walking the walk.

But I can’t help but think that nursing students are missing out of many learning opportunities by not experiencing nursing at a county hospital, a major medical center (and lord, do we have a TON of those here), a psychiatric facility that has both locked and open units, and a number of community hospitals.

I wonder if the nurses who are hired at other facilities have more “reality shock” than those who stay at the hospital where they did their clinical rotations.


I know this was done under the diploma programs; one hospital for all clinical education. But I submit that nursing is more complex now than it was just 25-30 years ago and one clinical facility does not fit all.

The bottom line? It is expedient for a hospital to partner with a university in this fashion because, essentially, they are educating their future staff.

I wonder if they are really doing the nursing students any favors by limiting their exposure to different clinical situations.

Am I totally off the wall here? If so, please tell me.

Like I said, I may be out of touch with nursing education as it is practiced today and would like to know, especially from the newer RNs, what you thought about your clinical education.

What would you have changed?

November 19, 2008, 3:58 pm

See Nurse. Nurse is Busy. Busy Nurse!

I never studied in my uniform.

I certainly never studied in my cap. But hey! I have it right here in the closet! I could wear it around the house!

You think I’m kidding, don’t you?

I just realized that the green and gold on the cap match my Notre Dame jammies!

Not that I would wear those things together.

Or anything.

When I study I’m sprawled out on the floor with texts and articles and computer and diet Pepsi and notebooks and my headphones on playing ocean sounds to help me focus.

As much as I love studying, I’d rather blog!


In 1963-64 I was in the first grade. I loved to read.

These were my textbooks and I was so proud to “graduate” to the next color in the series!

I surmised that by the time I made it to college, I would be reading books that were much more difficult.

One would hope, anyway.

My suspicions were correct. When I began my nursing education, the textbooks could have been written in Greek, for all I knew. The concepts were complex, Sr. Roy’s nursing theory could cause semi-permanent strabismus, and I discovered that trying to study nursing theory in-between acts at a Day on the Green concert while drinking screwdrivers was not conducive to retention.

But I managed to absorb the material and I graduated (obviously).


Then I decide it is time to finally get my BSN.

Three decades had passed since I laid eyes on a nursing textbook.

Oh, I would read journals of course. And take continuing education classes.

I even took a full year of art history, two years of piano/music theory, a semester of paralegal studies and a semester of literature during that time.

I was challenged in all these areas, but I loved it.

Hamlet rocks, by the way.


So I begin my baccalaureate education in nursing. Heavy topics. Theory. Leadership. Public health.

Only I find myself wondering if there is something wrong with me, because with all due respect to Mickey Mouse, I have invoked his name on numerous occasions as I try to describe my texts.

I’m in a university. I’m taking upper division nursing courses.

Yet my textbooks read like they should be entitled “My Little Nursing Story Book”. Seriously, are these things written at the eighth-grade level?

In case it isn’t totally apparent, I am no genius, but I’ve read Cherry Ames novels that were more challenging.

Aren’t these texts written for professional nurses? Why are they “speaking” to me like I don’t know the nursing process from a hole in the ground?


Then I figured it out.

These texts aren’t for nurses who have returned to school for a higher degree. They are written as basic texts to be taught in basic nursing courses to students who are just learning the profession.

This presents a rather interesting conundrum. As nurses flock en masse to RN-to-BSN programs, there will be a need for nursing texts that are aimed at experienced, professional nurses who have a baseline knowledge backed by years (decades!) of experience.

Do these texts exist? I haven’t seen them. Does anyone even realize there is a need for a tailored, advanced approach to those of us who already have “RN” after our names?


Let me give you one example of what I am talking about. This is a partial first sentence of an actual text, from the chapter I am now assigned to read. The topic is home health.

  • “The purposes of home health services are to provide nursing care to individuals and their families in their homes…”


That totally floors me!

I thought home health nurses were supposed to play checkers with the patients and let them win.

And then I can’t figure out why I have trouble taking the rest of the text seriously.

A basic nursing text is not appropriate for nurses advancing their education.


See Kim. See Kim read. Hear Kim sigh.

No wonder I’d rather blog.

November 18, 2008, 2:40 pm

Grand Rounds Does the iPod Shuffle!

Oh my goodness!

I don’t know what is worse!

That fact that these are actually made

Or the fact that I actually want one!

One can never have too many places to play one’s iPod and Dr. Deb brings us an iPod themed Grand Rounds this week!


I wonder what songs you would play during the functions associated with the location of this player?

“Goin’ Down” by Bruce Springsteen?

“Wake Me Up Before You Go-Go” by Wham?

“You Keep Me Hanging On” by the Supremes?

“Stand Back” by Stevie Nicks?

“Passenger Seat” by SheDaisy?

“Smooth” by Rob Thomas and Santana?

“It Don’t Come Easy” by Ringo Starr?

“Can’t Fight This Feelin'” by REO Speedwagon?

“I Want to Break Free” by Queen?

“Push” by Matchbox Twenty?


Okay, I’ll stop, but I got a million of ’em!

I’ll be here all week and don’t forget to tip your waitress!


Oh, and while we are talking about “output”, why not send some blogging “output” to RehabRN for inclusion into the next Change of Shift! You can send submissions via blog carnival or to “hotelrehab at nyms dot net”.

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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