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It is important
to tell the student when they have completed an activity in a
well organized, well though out manner. But it is also important
to correct the actions of the student or their thought processes
if they are incorrect. A good way to approach this is in the “sandwich
is tell the student something they did well, then where the
corrections need to be made and then end with a positive statement.
“I thought that your approach to that patient went well. Your history was very good and complete. However, your differentials were very limited- you need to think of all the possibilities and not just the obvious. I think that this skill will improve as you go along so just keep your mind open to the possibilities.”
The best way to deal with this type of student
is to lay down some boundaries such as: “I have some suggestions
for you that I think will improve your practice. I want you to
listen to them all before you respond.” If you feel that
you cannot communicate with the student this would be a good
time to talk with the student’s faculty on suggestions
in dealing with the student.
If there is ever a time
that you feel that safe patient practice is not occurring between
the student and the patient you should notify the faculty immediately.
If your suggestions are being ignored but patient safety is not
being compromised then discuss this with the student at the next
In many classes the clinical component is pass/fail. In others the preceptor’s evaluation comprises only a small portion of the grade. That being said though, it is important that you give the student honest feedback on the clinical performance and that you score the evaluation appropriately. Most faculty do not believe that all students perform at the top level of the evaluation scale and when they receive evaluations stating such they question the accuracy. So it is far better to score the evaluation appropriately and then tell the student where they can improve.
As you precept the student, avoid giving them the answers that
you think are right. Ask open ended questions such as “What
do you think is going on here?” and “How do you think
this needs to be treated?” After they have given you their
thoughts then you can agree or suggest new ways to deal with
the issues. Make sure that you ask them for their plans first.
This is not easy nor do the faculty expect the student to be “competent” by the end of one rotation with you. Ways that you can help the student though is to allow the student to spend a little extra time with some of those patients that are of a different culture. You may want to pose some questions to the student that they can discuss with the patient to understand their culture. It is always appropriate to refer the student to the literature to read about a particular culture and their customs. The more cultures that the student can be exposed to promotes learning.
Honesty with the student is always the best policy. If you do not know about a professional issue refer the student to one of the professional organization websites such as the AANP or the state nurses’ association. But when a student asks such a question it generally means that they respect what you have to say as a professional and they look to you as a mentor. They see you as a professional nurse in a career that they want to be in as well.
At every opportunity discuss the diversity with the student. Whether it is the billing and the limitations that you have in providing care or it is because of SES or ethnicity, discuss the issues with the student. For many students this may be the first time that they are caring for someone very unlike themselves. Allow them time to discuss their thoughts on the diversity and think through their responses to these issues.
When a student is asked what decision they have made about a treatment plan, ask at that time “What did you based you decision on?” If they are unable to verbalize that refer them to a book or a web resource in EBP. OR discuss with them the evidence of why you have chosen the particular treatment or management decision. Think aloud with the student. Allow them to listen to you tell them how you came to the decision that you are implementing.