What to do if you have a difficult nursing clinical instructor

Nursing school is one of the most challenging times in a nurse’s life. From getting into the program to adjusting to different clinical sites and instructors, your adaptability as a student will be tested many times. As difficult as this may be, it is preparing you for your role as a nurse.
But, what if you have a difficult clinical instructor? 

Some instructors want clinicals to be difficult so you are challenged and learn. Others may be unaware they are hard to follow or are not connecting with the students. On rare occasions, you will have one that feels impossible. This can impact your learning and clinical experience and even be the difference in how you are graded. These situations can cause an already stressed student even more strain and sometimes intimidation. 

Think deeply about the situation.

Take time to reflect thoughtfully on the issue, its root causes, and how you feel about it. Is your instructor picking up on your shortcomings or ones you perceive? Could you be being overly sensitive, or is the instructor extremely critical? Nursing school is a highly emotionally charged time, and nothing is more difficult than wanting to be further along than you feel you are. 

Clinical instructors can sometimes be demanding in a way they think is helpful to your learning, yet this can be hard to digest. Be sure there is a problem and then tackle it head-on. Clinicals are very subjective, and it is often difficult to determine your progress and competence. 

This can manifest in conflict with your instructor. Take extra time to be sure you are prepared for clinicals, work on skills you may need to brush up on, and understand challenging concepts. Inward reflection is crucial before you can work on resolving a problem.

Talk to your instructor.

Now is a great time to strengthen your conflict resolution skills. As a nurse, you will often deal with difficult people and situations throughout your career. Keeping lines of communication open is crucial when you are a nurse, and this begins as a nursing student. 

Discussing concerns and issues as they arise prevents things from festering and growing. Being honest and open with your instructors and professors are great ways to facilitate cohesive learning that is meaningful, positive, and effective. 

Communicate effectively and use scripting.

Take time to think about the issue and what you want to say. The delivery of a conversation is just as important as the information you want to convey. Using conversation starters can help set the tone for a meaningful and productive discussion while setting up mutual respect. 

Begin by saying, “I am having a tough time with clinicals, could we set time aside to discuss this privately?” Another great starter is, “This clinical rotation and information being learned are important to me. Can we discuss my performance?”  

After you set time aside in a more relaxed and private environment, continue the conversation with more scripting such as, “Could we talk about what happened…” or “Let’s discuss what happened, so it doesn’t happen again.”  “I’ve noticed that…” and then name the behavior you want to address. 

Getting into more challenging conversations about perceived conflicts between students and instructors can be more difficult. Beginning with, “I feel like you are unhappy with my clinical performance. Can we discuss ways I can improve?” is a perfect way to set a tone of concern and a genuine desire to resolve issues without attacking your instructor. 

It’s never easy to confront someone about a concern, and even more complicated when the person holds a certain amount of control over a situation. This is why these situations should be handled carefully and professionally. You will work with rude and demanding people throughout your career and often have to power through. 

However, a good instructor will address your concerns and be receptive to making amends on difficulties, as they are vested in your success and learning. Handling yourself by remaining cooperative, honest and direct will ensure the discussion is productive. Being a good listener is also extremely important. 

Document your exchange.

You will learn as a student nurse how essential documentation is for your patients. Documenting challenging situations is a great way to record events and help you to escalate them if and when needed. Be sure you are writing in a way that is professional and strictly factual. 

Sending a follow-up email after a discussion is an excellent strategy to establish a paper trail of documentation and helps to ensure follow-through and accountability while also being an icebreaker after a particularly tough conversation. 

A great way to start this email is with a statement such as, “Thank you for taking the time to discuss _____. I am glad we could get this matter resolved/discuss this further and develop a plan.” or “I appreciate you taking the time to meet with me.” Be sure your email is written so that should it be forwarded or escalated, it would be acceptable.

Collaborate and escalate.

If problems persist with an instructor, escalate the matter to a professor. There are times when, with every effort and good intention, problems just are not able to be resolved. Escalating to a higher level is something you will do as a nurse and student. Reaching out to a professor or senior instructor to discuss alternative strategies or a next step can be very helpful. 

If you're having a challenging time with an instructor you cannot communicate effectively with, discussing the matter privately with another trusted instructor or professor may shed light on the situation. However, being mindful not to be gossipy and keeping the problem private is critical.

I had a tough instructor during my critical care rotation. I wish I knew these strategies and conflict resolutions I have now, as I handled it poorly. I was going through a very emotionally charged time in my life, as my mom had passed away, and it was very difficult to be in the ICU setting after spending months at my mom’s bedside in the same setting before her passing.

I also can now reflect that if I had expressed my difficulties and how I was unable to separate them from my learning experience, I think it would have helped tremendously. I escalated to a professor. However, by that time, things had deteriorated with my clinical instructor with a complete breakdown in communication that affected my learning and mental health. Ironically, I chose ER as my senior practicum and thrived and had a completely different experience with a wonderful RN mentor I was paired with. 

This rotation created a love and passion for ER nursing that has lasted my entire career. I was grateful to have developed resilience through this challenging situation that has carried me through other complex nursing relationships.

Dealing with a demanding clinical instructor is never easy and should be dealt with carefully, honestly, and professionally. Being sure you advocate for yourself as a student is a significant step in caring for your patients and their families. 

Effective communication and expressing yourself during challenging times in your life while in nursing school lays the groundwork for your nursing career. Never hesitate to speak up when you need to, as the educational environment and culture are just as vital as the skills and information you are learning.