The challenges nurses face today highlight how important it is for nursing school graduates to feel competent and adequately prepared for the healthcare environment. Clinical placements give nursing practitioner (NP) students an opportunity to acquire in-depth patient management experience. During this period, students gain indispensable knowledge about diagnosing, treating and managing patients. This prepares them for success in the classroom as well as in their professional career.

Here is a look at everything you need to know about clinical placements.

What is a clinical placement?

Most healthcare study programs feature clinical placements. They are a vital part of any NP program as they allow students to transfer the theory they’ve learned in classrooms to practice building their clinical hands-on skills.

Clinical placements provide supervised and structured environments for NP students to acquire the necessary clinical skills and confidence to be primary care providers. This training environment also helps students gain a better understanding of the different areas of practice. NP students also get to apply what they learn in clinical placements to their coursework.

How does the clinical placement process work?

Clinical placements are a part of a degree program, so students are assessed based on their performance in these placements. Clinical hours feature in all nursing programs, with most of them requiring 400 hours or more. Some educational institutions employ clinical placement specialists. Their role is to ensure NP students identify clinical sites and preceptors that are appropriate for their specific study program.

Placements might sound hectic and cumbersome, especially for non-nurses who want to enroll in nursing as a second career. However, some programs, like Elmhurst ABSN (Accelerated Bachelor of Science in Nursing), help students manage clinical placements to ensure they are in line with national and university guidelines. They do the heavy lifting and secure quality placement sites for their students.

Before the placements begin, nursing students may need to pass some physical exams, background checks, and other set clearance requirements. It’s always good to have a checklist with details like clinical tools needed, dress code, and professional expectations to prepare for clinical rotations.

NP students work under preceptors who are licensed RNs (registered nurses) and should be prepared for clinical work shifts that are as long as 12 hours. Experienced nurses will be available to coach students throughout the process.

It’s also important to have an understanding of your scope of practice during the clinical rotations. This enables you and your mentors to have a common understanding of your clinical skill level, knowledge, and capabilities. It also helps stipulate the duties that you can and cannot perform legally.

How to make the most of clinical placements

Here are some tips for getting the most out of these valuable placements.

Prepare for your placement

Set yourself up for success before you begin your clinical placement. Introduce yourself before you show up for clinical rotations. You should be assigned a contact person; be sure to use them to your advantage. Send an email in advance and introduce yourself to the preceptor. You can also visit the clinical placement and introduce yourself in person. It’s important to make a great first impression and familiarize yourself with the new environment.

Research the appearance code of the facility in terms of your uniform and appearance. As you prepare, practice assessments on the people around you to gain the confidence you’ll need when communicating about a patient’s condition. On the actual placement day, show up at least 15 minutes earlier than your start time.

Build a self-directed learning approach

To maximize clinical placements, self-directed learning is vital. You can’t possibly know everything, but you can identify the learning methods that work best for you. Whether it is textbooks, bite-sized summaries, or websites, run with whatever works to give you basic knowledge while in wards and clinics. Take initiative and go beyond the scope of your placement. You can shadow other healthcare professionals in other wards, including doctors and physiotherapists, so don’t limit yourself.

Have a support system

Your fellow students play a role in providing support through your clinical placement experience. Find out if your placement organizes get-togethers for students to meet, share experiences and let off steam. If they don’t, you can volunteer to organize one. Make an effort to get to know senior students as they were in your shoes not long ago. They can advise you and reassure you when you feel discouraged. It’s important to create an environment that offers mutual support, so offer someone a listening ear and be their support system.

Take care of your mental health

Nursing school is stressful on its own, and the clinical placement experience only adds to it. You must make your mental health a priority, even with a packed schedule. Bubble baths and face masks can only do so much. You need to incorporate meditation, stretches, and deep breathing as well as these tips to prevent nurse burnout. Make time to take care of your physical and mental health.

The importance of clinical placement for nursing students

Clinical rotations are the key to gaining practical skills such as care coordination, assessment skills, patient advocacy, communication skills, empathy, critical thinking, problem-solving, and so much more. Here are some lessons and skills that NPs can look forward to developing during clinical placements.

In-depth knowledge of medical conditions

It’s always important to carry a notepad from the first day of your clinical rotations to the last. This comes in handy when you need to record medications or chronic medical conditions to study later. Doing some research will deepen your understanding of medical conditions and the associated treatments.

With a notepad, you’ll also be able to jot down any pending questions regarding policies or procedures that you’re not able to ask due to confidentiality, time constraints or other reasons. At a more appropriate time, you can seek clarification from your mentors.

Professionalism

There is no better place to learn about professionalism than being in the field. Dress appropriately by following the dress code and ensuring you have your student identification badge at all times. This helps the staff and supervisors to know you and can also be useful for patients.

Communication skills

During clinical rotations, it’s important to be honest and open with supervisors and patients about your knowledge and limitations and to seek guidance when the need arises. Patients and supervisors know you’re learning, so they will be understanding if you want to take your time with non-urgent tasks. It is important to explain to patients that you don’t have answers to specific questions but will get clarification from your supervisors and then provide feedback to patients.

You will learn that nurses have to ask respectful questions and listen to their patients attentively to make accurate assessments. Communication is an important skill, as all other healthcare staff relies on nurses’ information to make decisions. Effective communication signals empathy, sincerity and confidence to patients and their families.

Patient-centered care

Clinical rotations teach you how to listen, talk and spend time with patients. This helps you get a better understanding of their condition and what they’re going through. With this knowledge, you can get a clear picture of their specific healthcare needs and capabilities while creating a rapport with them. This will help you know how to provide patient-centered care in the future.

Solving challenging situations

Clinical rotations expose you to mentally and physically challenging situations. For example, you may have to handle a patient with mental health issues such as delirium when they’re aggressive and confused. It’s quite challenging if you have no prior experience dealing with this particular health condition. You’ll learn the importance of seeking help and guidance from experienced staff. You can also study patient body behavior to better understand different conditions.

Learn from interdisciplinary healthcare teams

Clinical placements give students a chance to speak with other healthcare professionals who work with the patients NPs see. It may be doctors, pharmacists, physiotherapists, or other specialists. Familiarize yourself with various healthcare roles and functions to see how the different teams collaborate and work together to care for patients.

Ask for feedback

As a nursing student, you need to know your progress in learning and personal development. You can regularly seek feedback from your supervisors and mentors to identify the areas in which you’re doing exceptionally well and those that need improvement. Be open to seeking clarification and asking questions to address the areas that need improvement. Receive both positive and constructive feedback with gratitude as they contribute to improving patient care delivery and give you better outcomes.

Teamwork and support

The goal of any nursing student is to provide patient-centered care to patients and their families while learning from their supervisors and other staff members. You get to see what supporting each other in the workplace means. You’ll experience clinical placements with other students and will be expected to offer them help whenever you can.

You’ll learn how to work well with others, including interdisciplinary teams. Learn how to accept team decisions, resolve conflicts, and communicate with team members. Try making a positive difference in other people’s lives, including fellow students and staff.

Stress management

If this is your first time doing clinical rotations and having 12-hour shifts, you’ll quickly learn that the healthcare environment is fast-paced with high stakes. This can lead to stress, burnout, and feeling overwhelmed. Stress will put patients at risk as you tend to lose focus at work, increasing the likelihood of making clinical mistakes. To mitigate this, set realistic daily work goals to limit work-related pressure.

To effectively manage stress, set time to distance yourself from the stressful work environment. Create calming environments during your personal time by practicing meditation or yoga, listening to music, and exercising. Remember to eat a healthy, balanced diet and hydrate often.

Challenges associated with placements

RNs at clinical placement sites are expected to be supportive, nurture independence, and be non-judgmental, welcoming, and warm. Professional nurses should openly welcome students, teach them where they lack capacity and ensure they reach their educational goals. They should nurture students by challenging them, asking questions related to patient care, pushing them to find answers on their own, diagnosing and giving the correct treatment under supervision. This encourages learning and strengthens students’ clinical skills.

However, sometimes clinical placement sites have a shortage of staff, putting RNs under heavy workloads. They may be frustrated and start to view students as additional work and not provide the right level of assistance.

Here are some other challenges associated with placements:

• Resistance from the nurses paired to teach and supervise students
• Nursing units reject students as they fail to understand the contribution of nursing students to clinical agencies.
• Lack of guidance or support from clinical instructors
• Having large clinical placement groups makes it difficult for students to access clinical instructors.
• Some students have to travel long distances to access placements.
• Some placements are of poor quality and don’t facilitate adequate learning and practice opportunities for students.
• There is no consistency between schools regarding the scope of practice and implementation of clinical education best practices for nursing students
• Negative clinical rotation experiences may leave students feeling incompetent, stressed and inadequately prepared to join the nursing workforce
• Patients may show a lack of trust and confidence in nursing students and prefer dealing with professional nurses during a consultation

Ways to facilitate better learning for students in clinical placements

• Create a process where students get to evaluate their performance and co-sign the final evaluations with clinical instructors.
• Have a clinical instructor and preceptor training program.
• Thoroughly evaluate the placement setting to ensure they can take on nursing students and have a learning environment based on university and national guidelines.
• Nursing staff and clinical agencies need to be taught the contribution and value of nursing students’ practical experiences.
• Ensure that standards regarding nursing students’ practical setting and scope of practice are adhered to, regardless of where they get their education or do their practice.
• Ensure students receive strong support from the faculty during placement and create safe spaces to bring up issues regarding clinical placements .
• Provide recommendation programs for students who are struggling in clinical settings to facilitate learning and improve their competency so they can pass clinical rotations.

Factors that contribute to resilience in nursing students

In nursing, some decisions can mean the difference between life and death. As a result, healthcare workers have to develop considerable resilience. Nursing students also have to build resilience to help them cope with setbacks and ensure the challenges they face are not reflected in patient care. They must learn how to adapt to the ever-changing healthcare environment while monitoring their mental state.

Here is a look at some factors that have contributed to nursing students building resilience.

Passion for nursing

A study carried out on nursing students’ experiences in clinical placements revealed that the participants bounced back from the challenges they faced in clinical rotations because they have a passion for the nursing profession. They take pride in their work knowing they’re making a difference in people’s lives. Feeling like they are giving back to the community kept them moving, and many also stated that they were encouraged by the gratitude the patients showed them. Passion for the job is important if you want to have a successful nursing career.

Personal strength and determination

Others in the study stated that they continued despite the challenges because they were determined to acquire skills, knowledge and experience to succeed in the nursing profession. Determination to be an RN kept them going.

Negative experiences are common for almost every nursing student, but the challenges should be used to strengthen your resolve and make improvements. Additionally, being held accountable for the responsibilities and obligations one is given during clinical rotations should motivate students to keep pushing and learning.

Support

Having support from peers, faculty, friends and family members is encouraging enough for many students to keep going regardless of the challenges encountered. Strive to maintain a positive relationship with the staff and other nursing students. A good working relationship helps students cope in a high-pressure environment and creates a safe environment where one can seek guidance and ask questions.