by Frank Tetler
When senior nursing students graduate from Mount Saint Mary College (MSMC), they’ll take with them the hands-on experience of working in a hospital intensive care unit (ICU) setting because they’ll have had real clinical practice.
The clinical program is part of the Complex Health Problems class, taught by Dr. Diane Murphy. Murphy is MSMC’s associate director of nursing since 1997 and a nurse of 40 years, who said the lecture correlates directly to the clinical.
“The week we’re talking arrhythmias, you’re in the ICU; you’re looking at the monitors,” Murphy said, explaining that clinical makes the textbook learning real. “When we’re talking about somebody’s respiratory failures and vents, we’re right there.”
MSMC clinical instructor Sandi Tetler leads a clinical group at Westchester Medical Center, where she also works full-time as an emergency room nurse. She has worked as a clinical instructor for four years and in nursing for 30. “As a clinical instructor you look toward facilitating the development of another, mentoring, and shaping the future of your profession,” she said.
Tetler looks to teach the students a team approach in the 10 to 12 weeks she has “to get them up to stuff.”
“Each week builds upon another,” she said, “strengthening assessment skills, developing nursing diagnoses and developing interventions toward patient’s positive outcomes.”
Tetler said the students have an “endless thirst for knowledge and growth in themselves and eagerness to apply book knowledge into practice, and that is what I strive for.”
Tetler said the five to six students she teaches each semester rotate through disease specific ICUs, including Trauma ICU, Neuro ICU, Medical ICU, the Burn Unit, and the Cardiac Cath Unit. There they witness and care for all kinds of illnesses and injuries ranging from assaults, stabbings, and gunshot injuries, to strokes and organ failure.
“It is here that you see the book knowledge in its application,” she said, “and ultimately, the effects of your efforts change the outcome of another person’s condition.”
Tetler said she doesn’t see any student as a bad student; instead, she sees each as having different challenges. Murphy agreed, “Everybody has different learning needs, so you work with each student’s strengths and weaknesses. By the time that you’re done, we really see that everybody has increased in their critical skills.”
There are 15 clinical groups, with five or six in each group traveling to various locations. “Students do their 10 hour clinical rounds at St. Francis, Vassar Brothers, Westchester Medical Center, Good Samaritan, Orange Regional, and Putnam hospitals. You might be going 45 minutes down to Westchester, or half an hour here, or half an hour there,” Murphy said. “It’s hard coordinating, I’ll tell you.”
Both remember their days in clinical and both said things are very different now. Tetler remembers hand writing charts and keeping medication index cards and said technology has changed a lot of that with “computer programs available so you can look up any medication in a minute.” Murphy agreed, adding that the acuity level of patients has increased and “nursing has totally changed.”
Tetler said she’s been asked why she teaches clinical and replies that she remembers those who helped to mold and to support her. “I also say, jokingly, that at some time, I may need a great nurse and this is my way of insuring that, and also, it’s good to pay it forward,” she said.
Murphy also said she sees personal benefits. “The funny part about it is that I end up working with some of the people who have been my graduates,” she said. “So that’s a nice part of it. You see results.”