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Posted: May 08, 2008 09:05 PM
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Student clinicals can be very stressful for students. Some clinical instructors will pre-select the patients for the students. However, other clinicals will require that the students select their own patients. Often these students are instructed to select a patient that has conditions related to the conditions they are studying in the classroom. Rarely, are they told the pitfalls they may encounter when given the opportunity to select their patients.
During clinicals, students need to protect themselves from being taken advantage of by nurses, certified nurse assistants (CNA's) and patients. Often when a student is on the hospital floor reviewing charts for selection, a seemingly kind nurse will tell the student about a great patient they should select. This can be a trap. That one patient may have so many needs that they are actually like having three patients. The patient may be hostile or very demanding. A student should carefully review the charts and question why the nurse doesn't want the patient. An easy way to handle the situation is to thank the nurse for the suggestion and inform them that a decision has already been made. There are, of course, many kind and helpful nurses that would never dream of unloading a high maintenance patient onto a student.
CNA's can also be a challenge for student nurses. Sometimes the CNA's will not help out the student or act superior to the student. Many CNA's don't realize the student was once a CNA or know how hard the student has worked to be accepted into nursing school. Students are often required by their schools to do the work of the CNA in addition to the work of the nurse. This is very demanding for the students. Students are required to clean soiled patients and take vital signs. CNA's are supposed to help the students when needed. All too often, when a student needs help turning a heavy patient or cleaning up an incontinent patient, the CNA cannot be found. If the student must provide care for several patients then it would be wise for the student to mix high care level patients with low care patients.
Try to select the patients based on your best judgement not on the suggestions from others. If you know you will need to provide care for several patients try to select a range of low need patients with higher need patients. Look at the medication list for the patient. If it is much longer than most, then the patient will need more care than the others. If you are interested in working with that patient, then it is a good idea to try to also select a patient with lesser medication needs. Balancing high need patients with low need patients is a wise decision for the student nurse. It is also important to use caution when a patient is "advertised" to the student. A student nurse that is close to graduating will have learned the pitfalls of patient selection, but for a newer student nurse good advice may be the only advice.
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