False. Some of you are transitioning from practice as expert staff nurses. Others are tenured professors, academic experts who need additional guidance in supervising students and in grasping the many facets of clinical instruction. Whatever your background, the first item for a clinical instructor to remember is that you will have to supervise clinical experiences with student nurses. The students you will encounter, whether in 2- or 4-year programs, are novice learners. Learning to refrain from performing any nursing skill or procedure for the student learner will be a major challenge. If the student is having a problem performing a basic clean dressing change on a wound, for example, you may be tempted to take over and complete the procedure. Resist taking over! Many seasoned clinical instructors will tell you, “Think more like a teacher and less like a nurse!” Your own professional goals of clinical competence should be tempered. Keep in mind that your role in the clinical setting is to enhance student learning by supervising (and not performing) skills. This involves using teaching and learning strategies to enable the student to perform the clinical skill with knowledge and eventual competence.

An effective clinical instructor uses these strategies, such as “questioning,” “role-playing,” and “interactive discussion,” to improve students’ thinking and problem-solving skills. This is not an easy task. Being a good teacher requires much practice and learning.

True. Many nurses become clinical instructors after realizing that they already have been contributing to advancing academic goals by assisting student nurses who have clinical rotations on their floor. Or some nurses may serve as “preceptors.” Many schools have academic partnerships with hospitals, and the hospital nurses serve as preceptors who work side by side with student nurses. A student nurse may follow a preceptor’s shift hours. This student–preceptor relationship is usually offered in independent course work, part of a scholars program, or embedded into a clinical practicum close to graduation. Many times, these preceptors offer to teach students because they themselves are taking graduate classes or hope to work in academia one day. Graduate education is the general preparation requirement for employment in most programs. However, state boards of nursing, school standards, and professional organizations can influence academic preparation requirements for employment (Penn, Dodge-Wilson, & Rosseter, 2008). Whether you are a part-time or full-time clinical instructor, you are contributing to a profession that is in great need of successful instructors who can teach students how to effectively care for their patients.

False. If you go into clinical teaching thinking that you can be “friends” with your students, then your tenure in this role will be short. As a result of the combined objective and subjective nature of clinical instruction and evaluation, friendships with your students can lead to difficult situations, particularly during evaluation periods. Remember that each school’s curriculum establishes many clinical objectives. If you share outside activities with students, you will expend energy that should be focused elsewhere—energy that should be used to enhance your students’ clinical competence and help them meet clinical objectives. In the unfortunate event that you may have to discipline or correct a student under your tutelage, it will be more difficult if you have not maintained the “boundary of teacher : student.” Keep personal information about yourself to a minimum.

False. Face it, we all want to be liked as teachers. However, stay away from focusing on whether students “like” or “dislike” you. Clinical instructors may be so focused on this that they forget the main goals and objectives of the course they are teaching. You should focus primarily on the clinical objectives for your students and place less emphasis on whether students like, or even appreciate, your efforts. Don’t get stuck on a student who dislikes you and is not as friendly or “warm” as your other students. This may be upsetting and cause emotional stress and worry that can affect your teaching and attitude toward your clinical group. Wouldn’t you rather be the teacher who instills a memorable learning experience? Focus instead on the “aha” moments of your students—moments when your clinical thinking questions led to further student inquiry and successful application of concepts. Once you experience these moments, you will be hooked on teaching. Feelings of accomplishment is positive energy and much better for your emotional happiness then worrying about being “liked” or “disliked.”

False. Staff personnel, nurses, and aides are familiar with required routines at their clinical agencies and are knowledgeable about their work. Although they are not happy about changes in policy or procedures, they will adapt in time. Thus, they will eventually accept you and your students and be willing to alter their routines a bit. However, they will not be receptive to verbal direction or recommendations from a clinical instructor. If you want to communicate with the staff, ask the nurse manager for the proper procedure.

If, however, a staff member “corrects” you or a conflict develops, try to resolve the issue professionally. Although staff nurses also model professional behavior, you are the daily role model for your students. Remember this when you observe a procedure that is being done incorrectly and you want to provide input based on your practice experience. Recall that you are first a teacher and second a nurse. For those new to the clinical instructor role, this is one of the hardest lessons to learn.

Your major goal as a clinical instructor is to teach your students. You are not there to teach the nurses or ancillary staff! If you do so, your energy is being misdirected. Instead, direct all your energy to your students. You need some degree of humility. Your goal is to facilitate communication among staff and students, so steer clear of any conflicts. Rather, focus on teaching and preparing your students for success in the practice arena.

True. It is often a prudent practice to go for a “trial run” before you drive to an unfamiliar spot. For example, many people drive to the location of a job interview a day or two in advance to make sure that they know of any detours or potential problems on the route. Similarly, it is vital for any instructor, whether new or familiar with the hospital unit, to visit the unit before the first clinical orientation day with the students. Call the nurse manager and arrange to visit for at least half a day. The nurse manager may meet with you for a brief period, during which you should be prepared to explain the clinical objectives of the course and provide the names of the students with the assigned clinical hours for the term or semester. Also be prepared to ask questions. It is his or her “turf!” You are a guest! Remember that!

You may want to go through a “full shift” with a willing, veteran nurse, thereby becoming familiar with the “culture” and routines of the unit. The bonus is clear: You will have an experienced nurse ally waiting for you when you return with your students.

False. Remember that the staff nurse is ultimately responsible for the patients, not you! You need to know times of medications, safety information like “code status,” NPO (nothing by mouth) status, necessary lab specimens, general diagnoses, and precautions, such as isolation standards. You cannot know all there is to know about the 10 or more patients being seen by the seven or eight students in your group.

Encourage your students to assume the responsibility for learning about their patients. It is the student who needs to feel the “pressure” of the obligation to thoroughly read the nursing documentation forms and to check with the primary nurse about the patient. Your job is to foster and encourage the student to gather the patient information and remember it throughout the clinical day.

False. You will be setting yourself up for failure and frustration very quickly if you try to practice this philosophy. Although you will need to supervise most medication administration, intravenous medication responsibilities, and new procedures (e.g., insertion of a urinary Foley catheter, insertion of a nasogastric tube, changing of a sterile dressing), you cannot be everywhere all of the time.

In fact, depending on your schedule, you may sometimes allow the staff nurse to supervise your student in putting in a urinary Foley catheter or changing a sterile dressing. For example, you may be supervising one student’s administration of intravenous medications when you are notified that another student needs to insert a urinary catheter immediately. If you have established a rapport with the primary nurse, whom you believe to be trustworthy and professional, and he or she offers to supervise your student, allow it to happen. You need to trust the staff nurses while broadening your students’ experiences.

False. You may very likely earn less money initially than your graduating seniors do. This is not a lucrative field, except in the area of satisfaction. As we mentioned earlier, when one of your students has that “aha” moment, it will be worth the pay cut. Remember also that you will be working an academic year, with academic appointments for possibly 8 or 10 months. You will have opportunities to teach in the summer and develop new courses, which can boost your finances and your self-esteem. You may also be offered to teach in the classroom or help out in the lab. If you choose to seek a tenure-track full-time appointment, your salary will increase incrementally and possibly more quickly. If you work in an academic institution that has union representation for its professors, this is more likely to be true.

Many opportunities exist to increase your income. You can publish, work as a staff nurse during periods off, consult, and work part time for one clinical rotation in a different nursing school. All of these expand your horizons. This is an important judgment call for you.

False. Sad to say, this is not always the case. Some students will have other life issues that interfere with their ability to devote the time and energy needed to a clinical nursing rotation. Others may not have realized what “nursing” really encompasses and may stay in the major just to graduate and get a job. These students, however, will be in the minority. You will receive satisfaction from the wonderful students who truly are motivated to learn and who will work extremely hard under your guidance. They are the future nurses of whom you will be proud and who will make teaching worthwhile for you. There is no greater satisfaction than to realize that your former students are surpassing you in knowledge—that they have become nurses whom you would want to care for you and for your family.

False. The majority of nursing programs have simulation experiences integrated for all levels of the student learner. Associate and baccalaureate degree programs are using simulation in nursing schools to supplement clinical experiences and to apply didactic instruction just like the traditional clinical experiences. Simulation scenarios are being mapped to course, lab, and clinical objectives of most nursing programs. Clinical faculty will be exposed to this teaching strategy, and thus they will need to understand this very important instructional method. See Chapter 21 for further explanation of simulation experiences in clinical education.