1. Doucette, Jeffrey N. DNP, RN, CEN, NEA-BC, FACHE

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When leaders and instructors collide

Q I have nursing students on my unit every week. The instructor isn't an effective collaborator and the students indicate that she isn't the best teacher. How should I handle this issue?

As a unit leader, your first and foremost responsibility is to ensure the safety of your patients. In order to do this, you must hold every care team member accountable for creating a safe and collaborative environment. This includes guests, such as nursing instructors and students. If you feel that there are safety concerns, I suggest taking immediate action by involving your CNO and the nursing school's undergraduate program director, and removing the clinical group from your unit while you sort through the issues. If there are no immediate safety issues, here are some suggestions for how to approach this challenging situation.

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The first step in the process is to establish a positive working relationship with the instructor at the beginning of the rotation. Building trust and collaboration on the front end will pay off tenfold down the road when problems like this arise. Assuming you've established a relationship with the instructor, the next step is a closed-door meeting to share your concerns. When you discuss the issues, treat the meeting as you would any other meeting with an employee or peer with performance issues. Have specific examples, know what areas you plan to address in advance, and lay out clear expectations for how you would like to see things change moving forward.


As with any crucial conversation, be sure that you carefully document the outcomes of the meeting. This can be done in an e-mail to the instructor recapping what was discussed. If your organization has a dedicated person who's the liaison to nursing programs, as mine does, you'll want to copy that person on any e-mail communication, as well as give him or her a heads up about the issues and how you plan to address them.


The more complicated piece of this scenario is how you handle student feedback that the instructor isn't an effective teacher. This aspect is really out of your purview as a unit manager; however, you can be a very helpful part of resolving the issue. Typically, these situations are handled exclusively through the school and its faculty evaluation process. Most schools have a formal evaluation that students complete at the end of the semester and then the faculty leader provides feedback to the instructor. In this case, it may be too long to wait. The best support you can provide to the school about instructor effectiveness is through your own assessment and observations.


As a faculty member myself, there are always students who you just don't click with and you would hate to take action on something that you didn't validate for yourself. As you round, talk with patients about the care they're receiving from students and the instructor. Seek input from your staff members about working with the instructor and whether they have examples of how the instructor could've been more effective. After you have established a solid basis to validate the student concerns about the lack of instructor effectiveness, share this information with your organization's school liaison. If you don't have one, discuss your concerns with your chief nurse executive. Together, you should develop a plan to communicate your concerns to both the instructor and his or her faculty supervisor. In this discussion, both you and the chief nurse should set clear expectations of what the instructor will need to do moving forward to continue to have clinical groups in your organization.


Having nursing students on your unit is a key element of a solid learning organization. Like any other leadership challenge, the best defense is a strong offense. Get to know the instructors assigned to your unit and foster the collaborative relationship from day one to keep learning on track.