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In 1976, arranging for a clinical placement contract often involved nothing more than a "Gentlemen's Agreement" and a handshake. Written clinical contracts were infrequent. Not all agreements were honored, and more schools of nursing and clinical sites converted to contracts. In an effort to ascertain best content in contracts, a study was done that gathered information from 34 schools and was published in Nurse Educator in the May/June 1976 issue. Terminology defined in contracts included considerations, bilateral contract, and "between 2 or more parties." Some important considerations included cooperation, nondiscrimination, staffing, insurance, and instructors. Today, all of these considerations and much more are detailed in contracts between schools of nursing and clinical sites and can account for many pages of reading.

 

Currently, clinical sites are in demand, and schools compete for sites. Faculty spend much time creating other types of clinical experiences for students. When Nurse Educator began 40 years ago, there were no online nursing education programs. Today, online education is more pervasive, and contracts often involve more complicated out-of-state placements, even for 1 student. There also were no high-fidelity simulation laboratories in 1976, and state boards of nursing did not have to decide on the percentage of time that simulation could replace clinical experience. Other creative solutions published in Nurse Educator in the last few years include dedicated education units and clinical placements in prisons, schools, long-term care facilities, and rural areas. Academic and clinical institutions have moved far beyond a handshake to a comprehensive contract. Whether viewed as good or bad, clinical sites are more in demand, but the options for replacement are more abundant. What is similar today between 1976 and 2015 is the shared goal of educating nurses and maximizing the student experiences in each setting.

 

Submitted by: Alma Jackson, PhD, RN, COHN-S, News Editor atmailto:[email protected].