As faculty for an accelerated baccalaureate degree (ABSN) nursing program, punctuality as an expected behavior for the professional clinician is often a topic of discussion for me. Although new care providers are taught they are expected to arrive on time to the clinical area, I am amazed at the number of students who arrive late without explanation.
Often, when asked for a reason, it becomes clearly evident a lack of pre-planning is the culprit for their lateness. Honestly, this is my pet peeve. In practice, I have always made it a point to arrive at least 15 minutes early to the clinical setting.
To be successful, this involves careful pre-planning and preparation on my part. The night before clinical, my ritual begins. I neatly arrange the necessary items such as my clothes, shoes, papers, pens, car keys, stethoscope and hospital ID where they are accessible, easily remembered and able to be gathered quickly. In addition, the necessary time needed for a morning shower, application of make-up, coiffure, cup of coffee and commute time are carefully calculated into the mix.
All considered, this generally places my wake up time at 4:30 in the morning. This work routine has become my way of life and in my wildest dreams, I could not have anticipated how my previous reputation as a prompt nursing professional was about to be challenged and put to the test.
It happened the Saturday before my next scheduled obstetrical clinical experience with students. I awoke to the realization that I had no hot water! Zilch! The diagnosis – a broken water heater! Not to worry. Clinicians have a strong constitution, don’t they? I made a plan to grin and bear it. With caution I stepped into the shower, hesitantly stepping under the shower’s icy stream. The plan: I would scrub quickly, exit the stall, dry off and dress warmly as quickly as possible.
Sometimes the best of plans do not work and midway into the experience, while wet and soapy head to toe, teeth a-chattering and eyes filled with tears due to the cold, the realization hit – this is not going to work! I can attest to the fact that I actually experienced an acute onset of a cold-induced headache while trying to wash my hair in the frigid water.
Finally dry and dressed, it took close to 40 minutes for me to easily flex my joints and lose the sensation of being chilled to the bone.
The Problem Solvers
Thankfully, clinicians are able to use critical thinking to solve daily problems.
Assessment: Hot water heater breaks over a holiday weekend and a new replacement heater cannot occur until the following Wednesday.
Diagnosis: Alteration in comfort related to NO hot water manifested by generalized systemic cold stress involving all ADLs requiring the use of heated water.
Plan: Heat water in receptacles and transport as needed to necessary areas of use.
Implementation: By Sunday morning, two pots containing water filled to the brim were repeatedly stove heated for use in the upstairs bathroom sink for bathing and in the kitchen sink for washing hair. For convenience and effective time management, supplies were carefully dispensed and stored in these two areas, including body wash, shampoo and towels. An earlier wake-up time (4 a.m.) was instituted to allow for the added time needed to transport heated water stored in pots upstairs for bathing and to allow for a separate trip down stairs to the kitchen for hair washing – Whew!
Evaluation: This system was highly effective and most importantly, I was able to meet my scheduled clinical appointment with my students on time.
Cost of Tardiness
The next time students arrive late to the clinical setting I will teach them when a care provider arrives late for duty, the workload of the existing staff must increase to compensate for the tardy clinician. As a result, the care provider about to complete a shift is often mandated to work overtime. Since that person must be compensated for extra work time, this places a costly burden on the employing institution. In addition, I will share my hot water distress story with them.
Clinicians as faculty are important role models for students, especially concerning the professional behavior of punctuality. The student needs to see their teacher as mentor is not asking them to do something they themselves wouldn’t do. Arriving on time involves commitment and planning.
As the saying goes, cleanliness is next to godliness . but so is being on time!
Joyceann Fileccia is assistant professor or the ABSN program at UMDNJ School of Nursing, Newark, NJ.