Clinical immersion provides transition for graduating nurses

By Debby Nutt, DNP, RN

In fall 2015, the Carr College of Nursing Bachelor of Science in Nursing program implemented a clinical immersion experience for senior-level students in their final semester of the program. This experience was developed as a transition into professional nursing practice within the constraints of agency policies and pre-licensure status. These experiences are also a requirement of our new accreditation body the Collegiate Commission for Nursing Education.

In looking and reviewing our current B.S.N. curriculum, the faculty determined the experiences would fit well with our Nursing Leadership and Management course, which already included the following outcomes:

1. Use nursing judgment and nursing process in designing, coordinating and delegating managing the care of multiple, complex patients
2. Use nursing judgment and skills of critical thinking, communication and therapeutic nursing intervention in managing the care of a group of patients directly or through other nursing team members
3. Demonstrate leadership and management principles in the provision and the coordinator of care for individuals and their significant others

Previously, students spent the majority of time with the clinical director, manager or charge nurse with only limited time providing direct patient care. The faculty restructured the course so that the emphasis was on nursing leadership at the bedside. Students then worked 12-24 hours with a manager or charge nurse, but the majority of their clinical time was spent taking care of patients with a preceptor providing direct care. In most medical-surgical acute care areas, faculty planned for the students to care for three to four patients in one shift by the end of the semester. The goal was to start with one to two patients early in the semester and each week add another patient.

Students provided care such as assessing, documenting, administering medications, performing skills, receiving report, giving report, communicating changes to preceptor and other interprofessional team members as well as educating patients and families regarding the plan of care. In addition, they assisted their preceptor with care of other patients. Faculty at Harding visited the students and preceptors at he site every day throughout the experience to evaluate the students’ progress toward their personal objectives.

The benefits of this clinical immersion were that students had a better understanding of what it would be like in the real world as new practitioners. Students report this as one of their favorite clinical experiences because they put all the pieces together and were able to perform all nursing skills allowed for students at the clinical agency. They felt more confident and ready to take on the new graduate nurse role.

—Debby Nutt, D.N.P, RN