[pebbles]

I remember the HUMILATION of simply asking a question about the drug being used to sedate during a procedure and getting the "THIRD YEAR AND YOU DON"T KNOW THAT???" response from the nurses. I have never darkened the door of that facility again and I never will.

I think it's not unreasonable to expect that a student may never have spiked an IV bag in previous clinicals, depending on the type of patients he had or what the nurses did instead, etc.

[KYCNM]

I teach in a BSN program. My teaching assignment provides an opportunity to teach across the curriculum (sophomores, juniors and seniors). The growth I see as students progress through the program is enormous, however that growth is not measured in abilities such as "spiking" IV bags, but in the ability to approach patients in a variety of settings and assess their needs on all levels. Thanks to all who have provided more supportive replies that could improve nurse-nurse relations

I recall a professional colleague saying "I learned everything I needed to know in my diploma program". She said that after she had completed a BSN and MSN. As an educator, I felt sorry for her because what I heard her saying was that "I didn't get it." She saw no value in all courses she took or the experience she gained in those educational programs.

Every day I learn something new about nursing, about myself and about the world. They are all intricately intertwined. I will never tire of being a nurse on whatever level.

[JRD2002]

Originally Posted by GratefulHeart

The next time you see a student struggling like that, you might want to try, "I can see you're having difficulty remembering how to do this. Can I help walk you through it?"

I love that you said this! BTW nursing school is great but it really only lays a foundation. I am sure that we can all think back to a time when spiking an IV bag wasn't something we could do with our hands tied behind our back, blindfolded, and hanging upside down. Given the right amount of experience I am sure that the student mentioned above will be more than competent when it comes to changing IV fluids. On a slightly separate note, has anyone watched some experienced nurses change IV bags and they pull the spike out with the bag still hanging and get a nice little shower. I know a few that do this regularly...cracks me up every time...

[Nurseismade RN]

just to add my 2 cents...I graduated from an ADN program, I call these programs boot camp for nursing Even though I was signed off for IV meds in school, it was not until I was an RN working that I really was taught how to really do IV meds and many other skillls...... Why? because I rarely had patients at my clinical sites that required IV meds. I do remember having one patient in the second semester where I had to mix a med in the IV then hang it.....but you do forget.......

[amj12]

Maybe the student just lacked confidence. As a new grad, I know in school even when I knew how to do something I still lacked the confidence at times b/c what student wants to screw something up?!!? They may have done it one or more times before, but in that particular setting was just a little nervous to do it on their own.

[aprzx84451]

I am a student nurse in an associates program and will graduate in may.

The worst feeling is when a nurse looks at you like you are an idiot when a student expresses that they are not sure of a procedure or how to answer a question. We are students are nervous regarless of where we are in our program we DO NOT want to mess something up. In my program we are not allowed to touch any meds in the peds without an instructor. That student probably did know what they are doing, but was just maybe hesitating to make sure that things were in place before changing the bag. When you make judgements as you did, it justs makes us feel even more incompetent. Have patience and remember that you were a student once before regardless of the program you were in.

[ranaazha]

I graduated from a BSN program at a university that isn't all that great... but we learned this skill in first semester in the LAB before even stepping foot in the hospital. In fact, we had to pass a lab skills test (which included this) prior to being allowed to do clinicals.

Once I was in the hospital, I remember having issues getting the tubing primed properly or set up correctly in the chamber without the IV machine beeping on me, mercilessly... but I never thought twice about spiking a bag!

Sounds strange...

[ranaazha]

Originally Posted by llg

... And at the peds hospital where I work, students are never allowed to do anything with an IV, regardless of what semester they are in.

This is a REALLY good point! At my school, we rotated through many different hospitals in town -- along with students from several different nursing programs. You could tell the difference between us all by our uniforms/scrubs. Regardless, although the hospital itself welcomed us, the staff nurses didn't. We were usually thrust upon them at the beginning of a semester. In general, they didn't know what we were / were not capable or, nor what we were / were not allowed to do. I always felt like we were getting flubbed by this plan... If the hospital is going to contract with the school, then why not have some sort of understanding with your staff nurses??? As an RN now, I realize this must be just as frustrating for the staff nurses - like the OP.

[janfrn]

Originally Posted by llg

... And at the peds hospital where I work, students are never allowed to do anything with an IV, regardless of what semester they are in.

I WISH!!! When we have students on our PICU during their pediatric clinical experience, they aren't permitted to do much. But if they came back for their practicum, there are very few things they aren't permitted to do, from what I'm seeing right now. We have five of them (yes FIVE!) and some shifts all five of them are on at once. I overheard one student on the phone telling his clinical instructor that he'd given rocuronium to a patient, which made my hair stand on end. It's hospital policy that GRADUATE nurses are not permitted to give neuromuscular blockers, cytotoxics or any med IV direct. In fact, we have a certification program for all three that each registered nurse must pass annually and policy states taht patinets on neuromuscular blockers must be attended by a certified RN at all times. When I asked him about it, he said that his preceptor (someone who has only worked in our unit since October!!) told him it was fine, he could just go ahead. When I told our manager about it, he looked alarmed, but then just shrugged. Before I had a chance to discuss it without educator, she broke her ankle and is off for eight weeks...

[llg]

Originally Posted by ranaazha

This is a REALLY good point! At my school, we rotated through many different hospitals in town -- along with students from several different nursing programs. You could tell the difference between us all by our uniforms/scrubs. Regardless, although the hospital itself welcomed us, the staff nurses didn't. We were usually thrust upon them at the beginning of a semester. In general, they didn't know what we were / were not capable or, nor what we were / were not allowed to do. I always felt like we were getting flubbed by this plan... If the hospital is going to contract with the school, then why not have some sort of understanding with your staff nurses??? As an RN now, I realize this must be just as frustrating for the staff nurses - like the OP.

My hospital has contracts with 8 different programs ... and each school has its own curriculum. In addition, the unit may have one group of students from one school in the morning and other group of students from another school in the afternoon. Also, within each school, each instructor emphasizes different things with her students. Finally, the students come at different stages of their programs. Some students come early in their programs: others come later. Even within the same program, the students' level of skill changes throughout a given semester.

In short ... the staff nurses have no way of knowing the exact level of expertise of the students who arrive on their floor on any given day. Each student must communicate well and regular with the staff nurse responsible for her patients. It's not fair to expect the staff nurse to "just know" anything about the student's abilities. The student is a stranger who might be very knowledgable and skilled -- or might be a beginner student or a student who is on the verge of failing the program ... etc.

As for "having an understanding with the staff nurses..." Yes, our staff nurses are well-aware that working with the students is part of their job. But it is unrealistic to expect them to automatically know the skill/knowledge level of each student who walks in the building. We can have 70 nursing students per day from any one of our 8 schools.