Our solution to too many nursing students on a psychiatric unit.

Abstract

25 SHARING A CLINICAL FACILITY is a situation encountered by many nursing students and faculty members. Social and technological changes in modern health care are resulting in fewer inpatient settings (DiMeo and Reed 1984). However, the number of students needing experience with inpatients has increased. Consequently, it is not uncommon to find hospitals trying to accomodate nursing students from LPN, AD, Diploma, and BSN programs. In addition, there may be other types of students in the health care setting. Graduate nursing students, occupational therapy students, and students in pastoral care or social work also compete for time with clients. Each program has its own philosophy, objectives, and requirements for clinical experience. The personal styles and goals of each faculty member also add to this confusion. The situation becomes particularly complicated in communities with only one maternity, pediatric, or psychiatric unit. And, the problem may be further compounded when only a few patients on these units meet the criteria for student experience. As members of faculties of two nursing schools, the authors were confronted with the dilemma of sharing a psychiatric unit. For a number of years, the only nursing students on the unit, in a 550-bed general hospital (the only psychiatric unit in the county), were from the hospital's own diploma nursing school. Then, a new BSN program was developed at a local private college. Students in this program also needed experience with psychiatric inpatients. As we faced this situation, we were concerned about several difficult questions. Would it be possible to add ten more nursing students to a 34-bed unit where 12 students were already receiving clinical experience? This would mean assigning 22 students concurrently to the unit. Would the doctors and staff complain about having to deal with too many students? Would it be practical and in the best interest of patient care to increase further the number of students? (Patients and staff were already offering negative comments about the number of students on the floor.) Could the students obtain clinical experience without sacrificing patient care? Would psychiatric clients overstimulated by their own anxieties find additional changes disconcerting? Would the faculty member in the diploma school, who previously enjoyed unlimited freedom in scheduling and in assigning patients, be able to adapt to the addition of the new students? Our experience with sharing a unit, the problems we encountered, the solutions we implemented,