Educator Discourse 4
For the nursing student, clinical rotations are a vital part of their nursing education. Hands-on experience is gained and clinical judgment is developed in the clinical setting. The patient/student interaction that occurs within the clinical setting will be indispensible to the new nurse as he/she enters into the nursing workforce upon graduation. As Niederhauser, Schoessler, Gubrud-Howe, Magnussen, & Codier (2012) and Komprood (2013) describe, gaining clinical sites for nursing students to have these real world experiences is difficult as the sites are limited in number. The instructor-to-student ratio and time restraints of 4-8 hour rotation times also restricts learning (Niederhauser, Schoessler, Gubrud-Howe, Magnussen, & Codier, 2012). These factors present an issue, as clinical rotations comprise a great deal of the learning experience outside of the traditional classroom setting for the nursing student. Innovative changes in nursing education must take place in order to overcome the barriers to clinical learning.
On the Inpatient Hematology-Oncology Unit, medical-surgical clinical rotations for undergraduate nursing students take place. As it is not feasible for schools of nursing to have a course dedicated to oncology nursing, issues related to care of the patient with an oncologic diagnosis is handled within medical-surgical and critical care courses (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009; Lockhart et al., 2013; Komprood, 2013). However, it is imperative that students are exposed to oncologic clinical experiences. Nursing students will be exposed to patients with such things as myelosuppression, mucositis, tumor lysis, and neutropenia (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009). These experiences are most commonly found in the oncology patient population and students will have the greatest opportunity of seeing these things occur in their oncology clinical rotations even though they will most likely encounter oncology patients in all areas of health care (Komprood, 2013; Lockhart et al., 2013). Students will also be exposed to patients across the disease spectrum (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009; Lockhart et al., 2013). Patients will be seen at diagnosis, during treatment, at end-of-life, and into survivorship (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009). Nursing students often are not exposed to end-of-life issues until they reach their oncology clinical rotation and see it first hand.
With the number of patients being newly diagnosed with an oncologic disease only projected to increase, it is important that students are exposed to this patient population and the problems that can occur as a result of the diseases and the disease processes (Lockhart et al., 2013; Hwang, 2013; Komprood, 2013). As the increase in the number of patients occurs, the number of oncology nurses needed will also rise (Komprood, 2013; Lockhart et al., 2013). Nursing students need to be accultured to oncology nursing and its many facets (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009; Lockhart et al., 2013; Komprood, 2013). Many studies have been done to show that interest in nursing students to pursue a career in oncology nursing was piqued after having been exposed to oncology nursing in the curricula (Komprood, 2013). It is recommended that minimally, students be exposed in the clinical setting to oncology patients, their comorbidities, and modalities of treatment in order that they might have a generalized view of oncology practices to take with them into their own clinical practice upon graduation.
In the clinical setting there are several teaching strategies that can be utilized in order to gain students attention and encourage active learning. One such teaching strategy is titled Pass the Problem (Herrman, 2016). In post conference, students are asked to write out on a piece of paper their assigned patient’s name, age, sex, primary medical diagnosis, pertinent background information, and the primary nursing diagnosis (Herrman, 2016). This paper is then passed from student to student. Each student is to look at the information presented, write down another nursing diagnosis and patient goal, and then pass it along to the next student who does the same until that piece of paper returns to the original student (Herrman, 2016). Each student will then have the outline of a care plan for his or her assigned patient.
Another teaching strategy that could be used for clinical instruction of students in the oncology setting would be Field Trips (Herrman, 2016). Implementing Field Trips in the curriculum allows the students to have alternate experiences that compliment their clinical learning (Herrman, 2016). Students can embark on these Field Trips in groups or individually. Alternate sites can include infusion center, oncology clinic, the breast center, radiation oncology, palliative care unit, bone marrow transplant unit, or the apheresis lab. This allows the student to have a holistic oncology clinical experience. A write-up after the experience should be encouraged, as this will allow the instructor to gauge the students learning from the alternate site experience.
With limited clinical sites and limited faculty to take students into the clinical setting there is a great need for nurses to pick up the torch and run. Nursing today demands well rounded nurses and varied experiences in the clinical setting will allow this. For a new nurse to be prepared to enter the workforce, various environments must be utilized and skills gained in the undergraduate educational setting.
On the Inpatient Hematology-Oncology Unit, medical-surgical clinical rotations for undergraduate nursing students take place. As it is not feasible for schools of nursing to have a course dedicated to oncology nursing, issues related to care of the patient with an oncologic diagnosis is handled within medical-surgical and critical care courses (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009; Lockhart et al., 2013; Komprood, 2013). However, it is imperative that students are exposed to oncologic clinical experiences. Nursing students will be exposed to patients with such things as myelosuppression, mucositis, tumor lysis, and neutropenia (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009). These experiences are most commonly found in the oncology patient population and students will have the greatest opportunity of seeing these things occur in their oncology clinical rotations even though they will most likely encounter oncology patients in all areas of health care (Komprood, 2013; Lockhart et al., 2013). Students will also be exposed to patients across the disease spectrum (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009; Lockhart et al., 2013). Patients will be seen at diagnosis, during treatment, at end-of-life, and into survivorship (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009). Nursing students often are not exposed to end-of-life issues until they reach their oncology clinical rotation and see it first hand.
With the number of patients being newly diagnosed with an oncologic disease only projected to increase, it is important that students are exposed to this patient population and the problems that can occur as a result of the diseases and the disease processes (Lockhart et al., 2013; Hwang, 2013; Komprood, 2013). As the increase in the number of patients occurs, the number of oncology nurses needed will also rise (Komprood, 2013; Lockhart et al., 2013). Nursing students need to be accultured to oncology nursing and its many facets (Erickson, DeGennaro, Goeke, Cohen, & Thomas, 2009; Lockhart et al., 2013; Komprood, 2013). Many studies have been done to show that interest in nursing students to pursue a career in oncology nursing was piqued after having been exposed to oncology nursing in the curricula (Komprood, 2013). It is recommended that minimally, students be exposed in the clinical setting to oncology patients, their comorbidities, and modalities of treatment in order that they might have a generalized view of oncology practices to take with them into their own clinical practice upon graduation.
In the clinical setting there are several teaching strategies that can be utilized in order to gain students attention and encourage active learning. One such teaching strategy is titled Pass the Problem (Herrman, 2016). In post conference, students are asked to write out on a piece of paper their assigned patient’s name, age, sex, primary medical diagnosis, pertinent background information, and the primary nursing diagnosis (Herrman, 2016). This paper is then passed from student to student. Each student is to look at the information presented, write down another nursing diagnosis and patient goal, and then pass it along to the next student who does the same until that piece of paper returns to the original student (Herrman, 2016). Each student will then have the outline of a care plan for his or her assigned patient.
Another teaching strategy that could be used for clinical instruction of students in the oncology setting would be Field Trips (Herrman, 2016). Implementing Field Trips in the curriculum allows the students to have alternate experiences that compliment their clinical learning (Herrman, 2016). Students can embark on these Field Trips in groups or individually. Alternate sites can include infusion center, oncology clinic, the breast center, radiation oncology, palliative care unit, bone marrow transplant unit, or the apheresis lab. This allows the student to have a holistic oncology clinical experience. A write-up after the experience should be encouraged, as this will allow the instructor to gauge the students learning from the alternate site experience.
With limited clinical sites and limited faculty to take students into the clinical setting there is a great need for nurses to pick up the torch and run. Nursing today demands well rounded nurses and varied experiences in the clinical setting will allow this. For a new nurse to be prepared to enter the workforce, various environments must be utilized and skills gained in the undergraduate educational setting.