The practice of clinical instructorship

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Tuesday, August 12, 2014

A TEACHER is to classroom; a priest is to church; a doctor is to a hospital.

These enumerated statements are just some of the examples of how we perceive the world to arrange itself.

The world is like a game of ‘matching types’ they say. And I too had a share of this kind of game.


For the countless time, I was recently asked to which hospital or health facility I was affiliated to practice my dual yet allied professions.

I am often asked this same question almost everywhere I go once others find out I’m a health professional.

Whenever I do, I simply tell them that I am a clinical instructor and then the most frequent respond I get is a frown and a false assumption that I were not a practitioner because for them a nurse’s sole rightful place is the bustling hospital, not in an armchair-filled classroom.

Unfortunately, this is a vicious stereotype so to speak: to limit the practice of nursing or midwifery to health facilities.

At the core of this stereotype is a narrowed perception of what nurses or midwives ought to do for them to be considered fully functional in their chosen profession.

Legally speaking, Republic Act (RA) 9173, which is otherwise known as the Philippine Nursing Act of 2002, states that among the scope of nursing practice includes but is not limited to:

(1) Provide nursing care through the utilization of the nursing process.

Nursing care includes, but not limited to, traditional and innovative approaches, therapeutic use of self, executing health care techniques and procedures, essential primary health care, comfort measures, health teachings, and administration of written prescription for treatment, therapies, oral topical and parenteral medications, internal examination;

(2) Provide health education to individuals, families and communities; and

(3) Teach, guide and supervise students in nursing education programs including the administration of nursing services in varied settings such as hospitals and clinics; undertake consultation services; engage in such activities that require the utilization of knowledge and decision-making skills of a registered nurse.

In the similar vein, RA 7392, or the Philippine Midwifery Act of 1992, defines some of the scope of midwifery practice as: “performing or rendering, or offering to perform or render, for a fee, salary, or other reward or compensation, services requiring an understanding of the principles and application of procedures and techniques in the supervision and care of women during pregnancy, labor and puerperium management of normal deliveries, including the performance of internal examination during labor except when patient is with antenatal bleeding;

Health education of the patient, family and community; primary health care services in the community, including nutrition and family planning in carrying out the written order of physicians with regard to antenatal, intra-natal and post-natal care of the normal pregnant mother in giving immunization, including oral and parenteral dispensing of oxytocic drug after delivery of placenta, suturing parietal lacerations to control bleeding, to give intravenous fluid during obstetrical emergencies provided they have been trained for that purpose; and may inject Vitamin K to the newborn and supervision of midwifery students in their assignments.”

Summarizing these selected provisions of both the nursing and midwifery laws, legally, I am or any nurse or midwife in the academe, for that matter is considered a practitioner.

Furthermore, allow me to walk you through what nurse or midwife educators typically do.

I believe they find themselves in a very unique position.

As academicians, they perpetuate the stereotypes of a teacher: they give lectures, administer examinations and pass or flunk students.

They prepare course outlines and do a good deal of research works.

As clinicians, they go on-duty to specific wards or special areas of the hospital or health facilities and do the things that regular nurses or midwives do—inject medications and provide nursing or midwifery care.

However, one thing added is that they bring with them their students and let them perform clinical bedside skills.

It can be implied that students are able to render nursing or midwifery skills while using the license of the clinical instructor.

This perhaps explains why most clinical instructors are too uptight and stringent as they are answerable to the potential errors that students might commit.

Another point stated by the Nursing Law is its provision on health education to promote health as part of nursing practice.

Therefore, the mere fact of writing my health column in this paper is an act of practicing nursing.

I think the bottom line of the points I’ve raised in this paper is that most people are so absorbed in the stereotypes our society uphold for certain professions.

While it is true that we live by the expectations set by our society, we must not limit ourselves to what others uphold all in the name of conformity.

After all, at the end of the day, it is we who must get by the day in our lives; not others.


Published in the Sun.Star Cagayan de Oro newspaper on August 12, 2014.


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