Employer Quotes

The quotes below are about this issue:
When discussing the importance of clinical experience, employers state there needs to be improvements in clinicals, such as more communication between the educational institutions and the clinical agencies where students are being placed; more consideration of how many students clinics can realistically take; and more research into funding sources and fellowships for nursing students (especially students who are specializing). They would also like to see more long-term care placements.

Employer Quote	Region
"Question: Would the applicant have come to you with more clinical experience ten years ago? Employer: Well, maybe 20 years ago."	Northwest
"Getting my staff engaged in teaching students is hard. That's the first thing I hear. And I feel bad because I get calls from schools, but it's hard. How do I get them to take students when we're so lean that we don't have the capacity? Because a student does slow them down, and then they don't get out on time at the end of their shift. And that's important to the majority of my staff. They don't want the overtime. They want to leave at the end of their day. I don't know how other employers have dealt with the lean situation, but it is taking a huge toll on our lab. Nobody wants to take students..."	Metro
"I believe we house four different colleges. We have [MnSCU colleges and non-MnSCU college]. They come to us for their clinical, either preceptor or their clinical experiences, usually 64 hours, which is each class. We've just started getting a few more preceptors, and they're focused on an RN. They shadow that person for, I think, 80 hours. In that, you're going to see more of what they do. A lot of times, these students will have two or three patients to follow, and then that preceptor is overseeing them, as well as doing their own work, so it does slow them down. And it is a little bit frustrating. But another key for us is that we get a lot of LPNs who are applying. And if they are there as students, that's kind of a feeder program for us. And I know how they are as a student, so that's a benefit for us."	Metro
"I think for the younger people who are in the programs that real world experience is important. Seeing what it's like and being able to provide that feedback and be involved in different things. That's what really prepares them and makes them better when they actually hit the workforce—that they've got some experience as opposed to coming in green. I think that's a really important thing."	Southeast
"I think there needs to be more collaboration between the academic setting and the clinical agency. I mean, anytime you're talking about curriculum changes on the academic side, all of a sudden health care makes a change—or the clinical agency makes a change—and even though you're telling them, 'We're making a change,' sometimes academia doesn't hear it. Or, sometimes academia makes a change and the clinical setting isn't prepared to facilitate that change. So, I think there has to be more dialogue between the clinical agency and the academic area to make sure that we're both on the same page. For example, they say, 'Oh, we're going to increase our enrollment by 30 students,' and you go, 'What? Where am I going to put these students? I don't have any clinical space,' and yet the expectation is that you're going to take those students. Maybe that's kind of a lame example, but it's like all of a sudden they say, 'Well, you're going to take eight—my clinical group is eight students—and take them to the nursing home.' Well, that might not be reasonable, depending on the size of your nursing home. So, I think there needs to be more collaboration between the academic world and the clinical world."	Northwest
"I think we also have a huge problem with certain programs being able to make students find their own internships because they're taking valuable positions away from other schools. I have a really hard time with one school in particular. I get calls once a week about the [out of state college] wanting us to take their internships. The Department of Education at the national level—whoever accredits these schools—should really consider before...I just think it's not fair to those students. Question: Not fair to those students in that they have to come all the way to Minnesota? Employer: No, that they've got to find their own internships. And this is specific for labs. Labs have to have internships, and I have a really hard time. It's only if they are a health insurance employee will we consider taking them on for a rotation because that, to me, that takes a valuable slot for a [non-MnSCU college]. I don't know if that happens in other programs, but it does in lab, for sure."	Metro
"I want to go back to the suck-it-up budget. You know, just suck it up, and train them. Because in my many years in health care—most of it as manager—I've never seen that in my line items. It's trying to figure it out and to think creatively, admittedly naive, about what kinds of sponsorships—be they federal, state, or other—that would help bridge between education and practice. We do that well, I think, for physicians. And we receive funding from at least the federal government to help through med students, residents, fellowships, and interns. How do we do that with nurses? So that we can close that gap between the students paying for their tuition coming out with not enough experience to go into the health care world where insurers pay less than what it costs sometimes to even deliver the care? How might we find a partnership between the operational organizations of clinics, long-term care, hospitals, education, and insurers to bridge that year or 18 months or whatever it is, so that clinicians, nurses, and other lab techs could come in more seasoned? You just don't have a suck-it-up budget to train them for the two years, you know?"	Metro
"I was just thinking about the demands that being a large clinical site can put on an employer. And there are costs associated with taking all of those students, so how do we support that? And have we aligned where the students are going to end up working—where they are getting their clinical? In our acute care hospital, we had over 90 licensed practical nurse students and we only employ 15, so how does that balance work? And are we the site where they are going to work? And the other thing I was thinking about is that some of the more advanced practices or master's prepared students—you know, there's certainly been some funding support for that, but we're seeing that funding source diminish. So, how do we sustain those programs?"	Central
"I worked for a clinic that had a residency program for physicians, and it was cutting edge. They kept current on new technology and all sorts of different focuses in medicine. And we need to do that for nursing, too. Like I said, I read a couple of articles that said think tanks are in that camp, which is really good."	Metro
"I would love to see them have more clinical experience. I know the programs are only so long, and long-term and transitional is only a small sector of their training. They OB, and they have med-surg, but ours is in sub-acute. And if you're in our sub-acute, it is like a med-surg because we're getting sicker and sicker patients in our facility, and you're seeing a lot of different things. If you know your student is there, you can go and check other things—wounds and vacs and IVs and all different kinds of avenues there, pumps, all kinds of stuff. Our facility sub-acute is not your old traditional long-term care, so that's our biggest challenge. Question: It works more like a hospital? Employer: Right."	Metro
"I'm not saying we should go back to the diploma programs, but it's too bad that we can't tap into federal dollars and a newer model that would enable the current schools to exist but somehow partner with hospitals."	Northwest
"It doesn't replace clinical, but it augments your clinical experience. I think that there's a real shortage of programs for simulation. But now they're beginning to get dollars for their simulations. If they are able to write a grant, we get dollars in corporate electronic medical records. So, that whole piece. I think dollars need to be put into that for schools to build that even further. And I think that goes a lot with the way this next generation learns—they want more technology and that goes along with those kinds of simulation things. So, I think you have to look at the learner, and how they're learning in this generation. Question: So, that suggests more of these simulation deals. But how—I mean, where does the patient care part of this come in? How do they get that? Employer: There has to be a balance."	Northwest
"It would be nice if they did some of their clinical studies in a nursing home."	Central
"Laboratory has been utilizing simulation labs. And we had a Department of Labor grant that we used, and it's had huge success. I think right now, we haven't figured out the sustainability fees now that the dollars have run out, right, guys? But, boy, it's a way to address the bottleneck that we have in the hospitals. How it works is that the students go to the simulation lab first, and it allows them to cut down the time in the hospital by half. They get that practicum there, and they come, and we can definitely see the difference. The hospitals that take the simulation students—we can definitely see a difference that they've already had some middle-of-the-road real-life experience. It's a step in the right direction. But I don't know how we're going to sustain that. We've proven that the concept is a good one, but we haven't figured out how to sustain it yet."	Metro
"The amount of real world experience coming from the training that the schools offer is not quite meeting the criteria of the minimum that they need to be able to come in and start out running—or to have the understanding of what they need to do."	Metro
"There have been a couple of articles lately about nursing education and how it needs to change. And they talked about actually having fellowships or externships so that, once they get through that phase, they are ready for specialty positions and that kind of thing. It seems to be something that educators need to consider."	Metro
"Well, you can require that they have a part-time job or require that they have work experience before they enter a program. Question: Are they required to do internships or to be...? Employer: Somewhere."	Northeast
"When students have to do some of their school projects by partnering up with us, it's kind of a win-win situation. We're working with a student right now who's doing a project on patient safety. She comes and helps us out and gets our information. It's really a win-win and builds relationships. Another student is working on nurse-physician communication skills. Question: So, you identify a project that's meaningful to you that a student can...? Employer: Yeah. Something that aligns with a need that we have. We had a student a couple of years ago, who was doing some kind of cultural project, and we have a big cross-cultural fellows program that we're trying to rejuvenate. We worked together on that, and it helped. And, you know, it wasn't much of a formal process or planning. I have a lot of these kinds of things that are just, 'Oh, hey, I happened to notice 'x,' maybe I can do a project around that.' And then they get to work more in our environment, and we get to see them, and we do end up hiring these people because they are great. Question: And they may better understand your environment? Employer: Oh, totally, yeah."	Metro
"You make the time. If you want the student, you take the student. If you want them to have that practical experience, you have to give it to them. Schools can't teach that. They can't teach multi-tasking. Question: Do you expect that to be a part of their training? Employer: No, I expect to provide that as the employer. The position in the lab, that's my responsibility. Question: But when somebody graduates, do you wish there were a requirement in their curriculum that they have an internship? Employer: It is. It's required by accreditation. Interviewer: So, the big thing is finding the time for it."	Metro