[4x4country]

Originally Posted by GratefulHeart

In my experience, the best *teaching* nurses are the ones who are eager to show or talk me through a skill they can see that I'm clumsy with. Instead of expressing shock about what the student doesn't know (how does that attitude help the situation?), try looking for ways to come along side to help them improve. IMHO your attitude of shock that the student isn't up to your expectation is a real barrier to you being an effective teacher. If they sense you're disgusted with them (and I'm sure they do), the last person they'll want to turn to for help and instruction is you.

It really doesn't matter when their nursing program teaches a particular skill or what you learned by their stage in school. There's an old saying that goes, "No one cares how much you know until they know how much you care."

My gut response to your original question, "Are they supposed to know this by now?" is does that really matter? They're at where they're at. 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 am currently a nursing student, however, have been raised in nursing. As a student, I have observed other students beening fearful to ask staff nurses questions d/t being preceed as stupid. I think that it is very unfortunate and sad that ones that are so eager to teach, can treat others this way. Sure, we might be in your way or ask to many questions, but this is our time to learn.

Personally, I learned to spike a bag first semester of lab, however, if I did not review the steps for a specific prodcedure, I would be nervous too. I have never, not once, spiked a bag on clinicals, so my only experience has been one day in lab. Sure I have mastered other skills, caths, gtube feedings, ng placements, etc. I have even been a CNA for many years however if you dont use it, you lose it.

My two is, be nice, if you like to teach, then try instead of judging the student.

[methylene]

I'm currently a second-semester ADN student and we just had our lab over IVs a couple of weeks ago. I still have yet to spike an IV or change/prime tubing in clinicals. Heck, others in my clinical group have yet to even give a shot.

Lucky for me, I have extensive experience with these skills from working in the ER/ICU for years, but I can understand how the scenario can occur.

[papergirlRN]

WOW!

I managed to get through nursing school and my time as a graduate nurse without ever having given an IM shot. I have been a "real" RN for about 2 months now, and the other day when I was passing meds, one of my pts had an order for an IM abx. I got all of my supplies ready, quickly reviewed landmarks in my pocket nursing guide, and asked the charge nurse to come "hold my hand" while I gave the shot.

As we walked down the hallway, he reviewed the basics with me. When we got to the patient's room, he watched while I found my landmarks and everything. Now I have the confidence to do it by myself - in fact, I'm an old pro by now.

Had he said "Oh my god! Shouldn't you know that by now?!?", I don't know how I would have reacted. And I'm not a student ~ I am a full fledged RN.

We were all new once. We haven't always known how to spike a bag, give a shot, or even give a patient a bath. There is a first time for everything. And to those that have the patience and willingness to share their knowledge and "hold our hands", I for one say THANK YOU! And for those that wonder if we shouldn't know that by now, try to think back. Unless you were born with an IV bag in one hand and a tubing set in the other, there was a first time for you, too!

[Hopefull2009]

I'm in my second semester of nursing school and we haven't even TOUCHED an IV bag or even did a lab of how to administer one.

Yeah, I'm pretty upset about it too.

[SMK1]

Every student who arrives on the floor should take 3 minutes with the nurse they are assigned to, to address what they are allowed to do and cannot under any circumstances do. What they can do as long as the RN is in the room, and what they can do on their own independently. Also this is the time to say what you are uncomfortable doing on your own and will need help with. (in my case as a GN, I have never gotten to deal with a trach patient, so you can bet your bottom dollar I will want and need a watchful eye if I am cleaning a trach or suctioning one for the first time etc...) This allows everyone to be on the same page, and allows the nurse the opportunity to decide if he/she wants to watch the student do certain tasks and assess what the students plan for the day is and tweak the plan if need be. I did this with pretty much every nurse with whom I was paired and only had one or two nurses who still were "problem" nurses throughout my student clinical experience.

[ilstu99]

In the program I graduated from, EVERYTHING depended on who you had for a clinical instructor. Some would just dump you off on the RN, and sit in the lounge and read or watch TV for the entire clinical. Others were very hands-on and right there with you....you know....teaching! If you had an RN who was very busy, or resentful about having a student foisted upon them, you spent the day looking for anything to do...and honing your bed-making skills.

By the time I was a junior, I felt very behind some of my classmates due to the luck of the draw. Of course, I was a PRO at making beds.

One of the things about our lab, at least, is that it's not like we start with brand new equipment and supplies. Most of it has been used by many students before. So, even if you had never seen something before, the holes/marks pretty much told you how it worked.

Take the same stuff and park it in a room with a frustrated patient, beeping alarms and no "road map" to follow, and it's easy to get stumped momentarily. Sometimes being in the hospital is like information overload. Not to mention that many of the supplies in the hospital are very different from lab, or even the next hospital. When I first started working, the IV bags were totally different. I remember thinking, "Uhhhh....this one has 3 holes and 2 rubber thingies. Poke which??" I'm SO glad I had a great preceptor.

And...IMO....good/strong nurses come from all types of programs....just like poor/weak nurses.

[nurseby07]

We have a running joke on our unit between the adn/bsn nurses. If a bsn rn doesn't know something we (adns) say something along the lines of "Didn't you write a paper on that in apa format?" The other night two bsn's came up to two of us adn's and asked how to get a ng unplugged. We both said, "Did you try Coke?" What? Where did you learn that? "Community college, go write a paper on it" If I am stumped on something they poke right back, "We learned that at University" All said in a snooty, funny, 3 o'clock in the morning manner. It is never mean, it is just funny. I want my BSN too, someday. Like previous posts, it doesn't matter, there are good and bad nurses from both programs.

[BumblebeeRN]

Originally Posted by nurseby07

We have a running joke on our unit between the adn/bsn nurses. If a bsn rn doesn't know something we (adns) say something along the lines of "Didn't you write a paper on that in apa format?" The other night two bsn's came up to two of us adn's and asked how to get a ng unplugged. We both said, "Did you try Coke?" What? Where did you learn that? "Community college, go write a paper on it" If I am stumped on something they poke right back, "We learned that at University" All said in a snooty, funny, 3 o'clock in the morning manner. It is never mean, it is just funny. I want my BSN too, someday. Like previous posts, it doesn't matter, there are good and bad nurses from both programs.

LOL that is so funny. but the BSN is a lot of writing, and in my ASN degree it was all nursing theory and clinical. but I love it.
I know all the nurses in my floor are great nurses who went to a university for nursing. and they are wonderful.

I never meant to say 'oh the ASN is better than BSN' because that is not true.
I just know that the school where the student was from, is where I wanted to go to school originally (BSN) and peds is after medsurg, and fundamentals. so spiking IV's is something very simple that the student should have known, since he stated "oh I was gonna do it" (assuming that he already knew how to it) and if he wasn't sure he should of told me. If I would of left him alone.... since I was on my way to clock out after giving my report, all the IVF would of been ON THE FLOOR!!'

If I don't know something i ask.... and often I have my co-workers looking at me like I am a big dummy or they laugh at me... but I just brush it off, learn and move on that's all.

As you can see in the first part of my post, I showed the student how to spike the IV. and I did it in a kind way without looking down on him....(he was such a cute, tall, handsome nursing student BTW)
and he thanked me after it was done, and asked me if I was the nurse for the patient, and I said "I am gone!" and he said "oh you are night shift" .....

[BumblebeeRN]

Originally Posted by SMK1

Every student who arrives on the floor should take 3 minutes with the nurse they are assigned to, to address what they are allowed to do and cannot under any circumstances do. What they can do as long as the RN is in the room, and what they can do on their own independently. Also this is the time to say what you are uncomfortable doing on your own and will need help with. (in my case as a GN, I have never gotten to deal with a trach patient, so you can bet your bottom dollar I will want and need a watchful eye if I am cleaning a trach or suctioning one for the first time etc...) This allows everyone to be on the same page, and allows the nurse the opportunity to decide if he/she wants to watch the student do certain tasks and assess what the students plan for the day is and tweak the plan if need be. I did this with pretty much every nurse with whom I was paired and only had one or two nurses who still were "problem" nurses throughout my student clinical experience.

my point exactly, my student should of told me to walk him thru it! but I noticed and ended up doing it anyways.

[BumblebeeRN]

Originally Posted by papergirlRN

WOW!

I managed to get through nursing school and my time as a graduate nurse without ever having given an IM shot. I have been a "real" RN for about 2 months now, and the other day when I was passing meds, one of my pts had an order for an IM abx. I got all of my supplies ready, quickly reviewed landmarks in my pocket nursing guide, and asked the charge nurse to come "hold my hand" while I gave the shot.

As we walked down the hallway, he reviewed the basics with me. When we got to the patient's room, he watched while I found my landmarks and everything. Now I have the confidence to do it by myself - in fact, I'm an old pro by now.

Had he said "Oh my god! Shouldn't you know that by now?!?", I don't know how I would have reacted. And I'm not a student ~ I am a full fledged RN.

We were all new once. We haven't always known how to spike a bag, give a shot, or even give a patient a bath. There is a first time for everything. And to those that have the patience and willingness to share their knowledge and "hold our hands", I for one say THANK YOU! And for those that wonder if we shouldn't know that by now, try to think back. Unless you were born with an IV bag in one hand and a tubing set in the other, there was a first time for you, too!

I am very new myself! just off orientation for 2 weeks, and never have I said nor did I say to the student "you should know that by now" because I wouldn't like that to be said to me.

there are tons of things that I haven't done. but I admit to them, and ask before doing anything. I always go by "better be safe than sorry" attitude. I have people laugh at me, makes me feel like a dummy......but I don't care, I still ask, and if they laugh at me, I laugh back!