Starting clinical rotations can be an exciting and nerve-wracking time. You are juggling learning safe medication administration, tackling time management, and being ready for on-the-spot questions. How are you supposed to manage when an extra hurdle happens to be that you are not on the best of terms with your clinical instructor?
Don’t Take it Personally
It goes without saying that nursing can be stressful. Your shift is already full of around the clock assessments, endless charting, and a possible code blue at any moment. Add a student by your side to the mix, and there can be some understandably heightened emotions. Being on the receiving end of those feelings, you may sense some pushback and perceive it as you not being welcome. However, it is likely that you are not the first student that this nurse has precepted, and the pushback does not necessarily reflect the type of student you are. Your immediate thought might be: what am I doing wrong? Or, am I even qualified for this job? The first step in dealing with a difficult clinical instructor is accepting that you are there to learn and not to see yourself as a burden.
Accept the fact that there are many instructor personality types you will encounter: warm, bossy, intense, arrogant, and even distant. This acceptance will help to ease you into the type of experience you could have during that rotation. Gaining insight into how your instructor interacts with others will allow you to plan a key way to potentially ease the tension: communication.
Communication is Key
Working alongside and learning from someone who has a personality that conflicts with yours often means you need to understand their style of communication and respond in a manner that is both productive and effective. The four most common types of communication used are aggressive, passive-aggressive, assertive, and passive. In the clinical setting, you will commonly encounter three of these: aggressive, assertive, and passive-aggressive.
The aggressive communicator
The aggressive communicator tends to be controlling, honest in an inappropriate manner, attacking at another’s expense, and expressive. You might find this instructor demanding, and perhaps they belittle you in front of others, which can be difficult as you are a student and arguing and sulking are not an option. However, because of their tendency toward conflict, a good strategy is to remain cooperative, honest, and direct.
Hone in on being a good listener and remain neutral.
For example, if they are demeaning toward you for asking for help with a hard stick IV, you could respond with, “I appreciate your help and insight. I plan on practicing this skill before our next shift together.” Of course, if the nurse crosses boundaries, such as using inappropriate language toward you, it is important to notify a professor and ensure the appropriate steps are taken.
The assertive communicator
The assertive communicator often conveys a sense of power, is appropriately honest and direct, and is confident in their own skills. The silver lining with the assertive type is that although they can be intimidating to a student nurse, a sense of respect is often all that is needed to open up communication a little more. These preceptors are usually nurses with 30 years of experience, and they want to make sure that new nurses coming in are ready and equipped for this career. They might throw you an on the spot question about medication dosages or policies, but they mean well.
A strategy for working with the assertive type is to always be ready for your shifts and to go the extra mile in preparation.
Read up on a diagnosis previously seen, or practice assessment skills often utilized on that particular unit. New nurses often feel intimidated by their preceptors. However, showing a sense of appreciation by being prepared, which honors the time they are taking to train you, goes a long way.
The passive-aggressive communicator
The passive-aggressive communicator tends to be sarcastic, uses silent treatment, and is quick to blame others. You might hear them say, “I don’t know, you can figure it out,” or they might not include you during important parts of the shift that could be beneficial to you as a student.
For this manner of communication, it helps to try to get personal.
You overhear that they don’t like answering the call-light of a particular patient, so you take the initiative to do it without being asked. Bring a sense of humor and try to find any points where you have a connection, whether it be nursing, family, hobbies, or food. If you feel like you are being ignored, offer to do an independent task that can make their shift a little easier. This initiative will show them you are motivated to learn and can lead them to appreciate your help as their trust develops.
Making the Best of it & Remembering Your Why
Ultimately, clinicals are a time for you to grow in your skills and to see where your passions are within the field of nursing. One clinical instructor should not discourage you from enjoying PACU or the Emergency Department. If you tried to mend and establish a healthy working relationship with your instructor but had no success, find your allies on the unit in other nurses. They might be aware of the temperament of your clinical instructor and offer to help you. Going in and introducing yourself to other clinical staff will help open doors for opportunities on the unit that might not have been available with just one preceptor. When other staff are aware there is an eager student nurse there with them that shift, they are more likely to include you in that exciting bedside procedure or ask you to start an IV for them. These opportunities will not only keep you busy, but will show your drive to others on the unit and to your preceptor as well.
Clinicals are one step of many in your nursing school journey.
When discouraged or upset with an instructor, shift your focus to what motivated you to become a nurse. That original drive helps you focus on your end goal and helps give you a much needed push. Try your best to meet them on a personal level, and always show respect, but don’t let them stress you out or undermine your abilities. Focus on what you can contribute to the clinical team, which can set you up for a very bright career path.
Melissa Mustafa, MSN, FNP-C
Melissa is a Family Nurse Practitioner from Southern California who currently works in both Pediatric Urgent Care and Wound Care specialty settings. In her free time, she enjoys taking trips to National Parks and finding new coffee shops with her husband and Australian Shepherd Luna.