How to deal with slack students - page 3

So, I've started precepting in my ICU. The students I've had thus far have been senior BSN students and new graduate RN's. When I was starting out in nursing, I would read the night before, ask "smart" questions, and make every... Read More

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    During my clinicals I noticed several things. One of the things I noticed was the unit I was asigned to normally set the tone of that experience. When the nurses are busy doing their jobs the students tended to stay busy also, but when the nurses wanted to sit at the desk and use the students like rented mules the students soon became disenchanted. In my second semester I did a trauma clinical rotation. When I was finished with my 2 patients I would walk around the unit and see if anything interesting was going on. If so I would ask if I could help, to heck with watching. My second day there I assisted with putting a halo on a woman with a broken neck, helped with removing a chest tube from a gunshot patient. My clinical instructor actually called the school and bragged about how much she enjoyed having me.

    In another setting, L&D, there was not much going on, so some of the nurses thought myself and another student were there to do all their "dirty work". The third day in Labor and Delivery, two of the nurses sent me and another student to change the sheets on every bed in the unit. After the 5th or 6th bed I noticed neither nurse had moved. They were still sitting at the desk shooting the bull. I walked up and told them they could find me something else to do. I was a 4th semester student and I was there to learn, and I think I have changing sheets down pat by now. They thought I was lazy and it was my place to do the crappy jobs. Doing crappy jobs is not why the students are there, they are there to learn something. Not be treated like something that is beneith a nurse.
    GooeyRN, cjcsoon2brn, and fiveofpeep like this.

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    Thanks for your reply. There are generational gaps between many nurses. While doing a rotation in OB i worked with an old lady nurse who believed she was God of the nursery. During the rotation she railed me with questions, quizzing me and impatiently telling me how to perform tasks. Ridiculing me when answers were answered incorretly. I was later informed that back when she was doing nursing school it was like the army (?) Attitudes of the crusty old ladies on OB sucked and greatly reinforced my decision to not become an OB nurse. I will always remember her poor precepting abilities and never treat a student that way when i become a preceptor myself. ....and I will care for the old "God of the Nursery" in the ER when she falls and breaks a hip
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    I apologize for this response not pertaining to the original poster's question, but the question you had about the pt. with a decreased O2 level and drop in SAT'S and what happens to the body and how the pt. compensates for the decreased O2 intriqued me and was driving me nuts. I love the challenge of a difficult question! So, I like to take a chance at answering it and if you could give me some feedback as to whether or not I'm on the right track. I would so appreciate it!!

    Okay, here goes. If the patient has these low levels I would immediately think of respiratory acidosis. This is due to the fact that more CO2 is binding to the hemoglobin which results in less O2 being available to the tissues. As a result the patient develops hypoxemia and becomes cyanotic. They may have additional symptoms such as dypsnea, tachycardia, tachypnea, sweating, etc. In addition, the patient will develop neuro changes such as confusion, decrease in LOC, etc. The body compensates by increasing the respiratory rate, increasing the heart rate, increasing body temperature, etc. Sorry, can't think of any more additional symptoms off the top of my head.

    Anyhow, so that's my overall summation of the question. Again, any feedback would be welcome and greatly appreciated. I am a newly licensed RN (got my license in June, so I guess that makes me still a new grad?). I'm currently looking for employment (like all the other new grads!). My desire is to be hired in the ICU as a new grad. The reason why is because I love the complexity and detail (and challenge!) of critical care. I enjoy all that pathophysiology and the technology that goes along with it. In additon to how the other aspects (such as intrepretation of labs, blah, blah, etc.) fit into the overall picture. I apologize for blathering on, but I could talk about this stuff forever!! Man, this stuff is so exciting to me.

    Okay, I really need to conclude this as I need to work on my resume that I've been procrastinating on. Thanks again for reading this dissertation that has continued on forever!!

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    Can I start by saying that the new grad RN's behaving like this should remember that there are tons of new nurses waiting for their job! I can't fathom behaving like this, my parents taught me better, however if they didn't when I started nursing school my instructors further put the fear of God in me about such behavior lol! I am a new grad with a new position in the ICU and I do like what one poster said about their preceptor that laid everything out from the beginning of the morning, that is very helpful. I am a hardworker and can go 12-13 hrs without sitting down, however it is frustrating as I am being bounced around different preceptors and they all have different styles and give me different levels of autonomy. I also have difficulty because I feel like a stalker and a few of my preceptors seem to like for me to "go away" (in a nice way, but these are the vibes I get). The ICU I am working at has by far the best team work I have ever seen, I was told from day one, when 1 is working, we all work, I don't expect to see you taking a break while someone else is drowning, and they don't! I love it! Now when all is calm, everyone gets a chance to breathe

    As for the student nurses, I believe you should talk to your management. Our school strictly prohibited any unprofessional behavior, and forget your cell phone, you better leave it somewhere! Our area is inudated with schools, and it is very competitive for clinical placement, if students here behaved like this the hospital would inform our school (names included or not) and we would get a very stern talking to as a group that a,b, or c happened and it would not be tolerated, and it worked! Our instructors also would not inform us who/what/where the complaint came from, for all we knew it could have been a family member. I did have a classmate get expelled for cell phone usage. If we had any "down time" which didn't happen so much, we were expected to answer call bells, stock, etc.

    My advice from the other side of the fence is to try asking what their comfort level is/how many days of orientation they have had and laying out your expectations and plan of the day, it really is helpful and breaks the ice. The other thing is having a talk about team work, reiterating how to access protocols and suggest working with those during free time.

    I do have a comment about "smart questions". It is amazing the stupid things that can spurt out of ones mouth when confused or put on the spot. I have been an EMT basic since I was 17, hence, I have known and studied the heart for 10 years now. I had a preceptor that was teaching me about EKG interpretation at a very high level, had me sooo confused that I actually asked him a question about "the superior or inferior ventricle" lol, I have no idea why, and I definitely know there is no such thing~! How big of an idiot does he think I am?

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