Clinical Quandry

[Lone Star]

After pulling two clinical rotations over the weekend (Friday and Saturday nights), I'm sitting here filling out the required paperwork for my instructor. Part of the packet must be filled out by the preceptor and part of it must be filled out by the student. The preceptor evaluates the student, and the student evaluates the preceptor. I find that I'm having some difficulty filling out a critique form for one of the preceptors.

There were things that I witnessed that strikes me as just plain 'wrong', but since one of the preceptors over the weekend is also an adjunct instructor for my class, I'm worried that if I give less than a 'glowing evaluation', I'll be left holding the dirtiest end of the proverbial 'shit stick'.

Knowing my instructor, I know that if I take my concerns to him, he will have a chat with the preceptor/adjunct instructor and I'll end up back on that dirty end again.

I also know that I'm supposed to fill out all the paperwork for my clinicals, but I really don't need to be dodging the retribution bullet for the rest of my class (I've still got a year to go).

This one has me in a real bind. My concience is telling me to slap the bull and the horns be damned.....but my logical side is telling me that if I say anything, I'll be committing 'educational suicide'.....

[HERBIE1]

What are your concerns about this instructor? Are they clinical issues, skills issues, or is this a personality clash? Tough call- unless this is a safety issue, clinical judgment problems, or is this a personality clash?

I guess you need to ask yourself what you hope to accomplish by an "honest" evaluation or critique? Will it address and/or correct a serious problem, or is this more of a personal problem?

If you plan to move ahead, I would be as objective as possible- specific examples to support your opinions and claims, and try to leave any personal opinions out.

Either way-tough call. I would say that unless this problem is a deal breaker, I would bite my tongue. As you say, this could seriously impact the remainder of your time in school.

[Dustdevil]

Definitely always a tough call in these all-too-common situations. I'm not proud of it, but I almost always chose to hold my piece. As long as I knew better than to believe whatever BS s/he was spreading, that was enough for me. Just like in the military and politics, sometimes you gotta just play the game. Again, I am certainly not advising you that this is the best way to go. It's just what I've usually done.

Since you are dealing with a preceptor who is also an instructor, if you feel strongly that this needs to be addressed, I would meet with a dean first. Either the Dean of Health Occupations/Nursing, or whoever is over the program, or the college Dean of Instruction. Let them know that you are submitting an honest, but negative critique to your instructor, and that you simply want him/her to be aware of it ahead of time, should you encounter any negative repercussions. They've heard this before, so they should be understanding. Tell him/her that you are not looking for any intervention on his/her part, just CYA in case, and that you will report back with any problems after the fact.

I had to do this once in nursing school, and it saved my arse. And there were no further problems. Hopefully it will work out as well for you.

Rep points for your integrity, Bro.

[Eydawn]

I also want to know what the issue is. If it's unsafe practices, that are blatantly visible as unsafe, even to someone who is still a "novice," I would speak up, but I would take Dusty's route. If it's a matter of differing clinical judgments, then you may be on shaky ground challenging the instructor unless they did something that totally violated protocol. If that's what it is, I would most likely just tuck it away in my brain for future "I will NOT be doing this when I'm on my own" type deal.

Wendy

CO EMT-B

[Dustdevil]

You would know the likelihood of it more than me, but you should give at least passing thought to the possibility that the instructor and/or preceptor intentionally put you in this position as a "Candid Camera" type test of either your integrity or your knowledge. if that were the case, then not being forthcoming would be a bad thing. Like they always say, the cover-up can be worse than the crime.

Just a thought.

[Just Plain Ruff]

Whew Lone, I went through this exact thing in a refresher class. An instructor was having a inappropriate relationship with a student and she was getting quite high grades and I was sure that those grades were not validly given. He also was spending many hours with her giving her private instruction but not giving the other students the same level of attention.

I went to the lead instructor with my concerns and said that this had nothing to do with the instructor as a person but to the integrity of the program.

Well this went really really bad for me, I failed the class which was a direct result of my going to the lead instructor.

I went to the dean of the college putting this on and I showed him my class materials proving that I was pulling high 90's in the class. He brought together the instructor in question, me, the lead instructor and listened to all points of view.

In the end, it worked out to my advantage as the grades were changed to reflect my true grade, but I was forever not allowed into that instructors classes because they were always full. Even paying up front for the class when I arrived for the class I was told that the class was full and here was my refund.

My integrity was never in question but my understanding that some people can be complete assholes when confronted with questions of their integrity. I heard that the instructor and student did get married but divorced soon after the marriage and she took him to the cleaners. I guess that's prophetic justice if you ask me.

[Lone Star]

It all started when I showed up at the station. I'm not asking that someone bake me a cake to make me feel 'welcome', but don't make it out to be that I'm some sort of 'inconvenience'. I didn't pick the station, it was set up by my instructor (who just happens to be the department head for EMS Education).

Secondly, I don't care if you WERE a cop in a previous life, this isn't how EMS works.

Don't insult me by not knowing my name (you ARE after all, helping teach my class)...

Don't belittle me and make me do all the 'dirty work' simply because you feel it's 'beneath you'!

Do NOT tell a patient that you can't or won't treat them because they lied to you about when they ate their last meal!

Do NOT antagonize patients who are drunk/on drugs simply because you think it's funny that they're verbally abusing the crew in the back!

Do NOT assume that since I'm a 'mere student' that I'm just a 'rookie' who has nothing to contribute or prior experience!

If having students on clinical rotations bothers you THAT much, then by all means feel free to drop out of the Preceptor program!

Don't try to destroy my confidence and self esteem simply because I'm not able to perform certain skills (that I haven't used in a year and a half) as well as you can!

I've taken the issues to my instructor, who has advised me to 'write it up' so that it's a 'matter of record' and can be addressed.

I'm not happy about having to put it on paper, simply because there's now a 'record' of it and it doesn't prevent the adjunct instructor from being able to read it and use it against me at a later time...

[Just Plain Ruff]

It all started when I showed up at the station. I'm not asking that someone bake me a cake to make me feel 'welcome', but don't make it out to be that I'm some sort of 'inconvenience'. I didn't pick the station, it was set up by my instructor (who just happens to be the department head for EMS Education).

Secondly, I don't care if you WERE a cop in a previous life, this isn't how EMS works.

Don't insult me by not knowing my name (you ARE after all, helping teach my class)...

Don't belittle me and make me do all the 'dirty work' simply because you feel it's 'beneath you'!

Do NOT tell a patient that you can't or won't treat them because they lied to you about when they ate their last meal!

Do NOT antagonize patients who are drunk/on drugs simply because you think it's funny that they're verbally abusing the crew in the back!

Do NOT assume that since I'm a 'mere student' that I'm just a 'rookie' who has nothing to contribute or prior experience!

If having students on clinical rotations bothers you THAT much, then by all means feel free to drop out of the Preceptor program!

Don't try to destroy my confidence and self esteem simply because I'm not able to perform certain skills (that I haven't used in a year and a half) as well as you can!

I've taken the issues to my instructor, who has advised me to 'write it up' so that it's a 'matter of record' and can be addressed.

I'm not happy about having to put it on paper, simply because there's now a 'record' of it and it doesn't prevent the adjunct instructor from being able to read it and use it against me at a later time...

I have no notions of disbelieving you Lone so I'm going to say Methinks your preceptor is an ASSHOLE!!!!!!!!!!!

[Lone Star]

I have no notions of disbelieving you Lone so I'm going to say Methinks your preceptor is an ASSHOLE!!!!!!!!!!!

I wholeheartedly concur with your assessment of the situation and all subsequent findings thereof!

[Richard B the EMT]

I was never in any "Preceptor Program". If someone was assigned as a third on my truck, I would at least warn them that, with whatever else happened, we'd probably also take advantage of them, turning them into our "Pack Mule" for the tour. Except when actually carrying a patient down stairs, I never really did that.

I did, however become the "Pack mule" for one of the teams I rode third with, when I started in municipal service.