another staffing question

  1. my hospital has a nurse extern program. in this program people who are enrolled in nursing school are allowed to work on the floor alongside an rn. their job description varies depending on what year of school they are in, but the all basically have the same job...assessments, dressing changes, charting (the rn has to sign off on the chart). the only things that they really aren't allowed to do is pass meds, call mds, write orders (i think that is it)...
    currently, the externs who have been oriented get the same number of patients as the rns (5ish). then the rn is paired with the extern. so the rn is caring for 10 patients?! we recently had a doctor say that he didn't want his patients coming up post op any more because he doesn't feel that it is fair to the nurses or patients. i think that the nurse should get their patient load and then the extern is paired with them. this would provide for more teaching/learning opportunities and less stress. do any of you have similar programs? and if so, how is it implemented?
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  2. 6 Comments

  3. by   Nurse Ratched
    Our program is supposed to work in that the nurse intern/extern can carry his/her own pt load. That's the theory. They are not supposed to count in staffing, so we can utilize them however we see best fits the needs of the unit. Typically that means the nurse is paired with the intern carrying her usual pt load (not double.)

    HOWEVER, in my facilty the interns are often relegated to tech/aide duties. The house supervisor sees one unit is short and pulls one of our techs there "because you have a nurse intern." In their eyes, the NI and tech are interchangeable, but that is not the way it's supposed to be. If the NI is busy doing tech stuff - a huge job in and of itself - there is no time left to learn "nurse stuff."

    We've fought this because it's unfair to the interns and certainly doesn't make them think the hospital would treat them any better after graduation. But TPTB haven't budged on this one, and our retention of NI's after passing boards is pretty abysmal.
  4. by   live4today
    I worked as a Nurse Extern in my senior year of nursing school. We were NOT allowed to take a patient load, but were utilized as a "little more than a CNA" in that we could do all assessments on the patients, but could only chart our findings that pertained to the patient's "below the waist" status. All cardio/pulmonary assessments could only be charted by the RN we worked with.

    It is indeed unfair for a nurse to be given "twice the patient load" just because she has a Nurse Extern working alongside of her. If hospitals are allowing this to occur, they should be reported to the Board of Nursing for having a student nurse work for pay in the capacity of a RN when they are not licensed to do so. This is just another way hospitals are exercising their own "labor abuse laws". Idiots!!! :chuckle
  5. by   RyanRN
    How can you possibly teach or learn with TEN patients. Nuff said, idiots!
  6. by   maizey
    RyanRn. Answer is you can't possibly teach with 10 patients and the intern cannot possibly learn anything. This is just managements way of getting cheap labor at the expense of the patient and the staff. Idiots!!!!!
  7. by   Dayray
    I was a nurse Intern. I was so excited when I got the job. The job description said I could do all sorts of cool things. I was suposed to follow nurses and help them assess, do treatments and assist with charting.

    In reality I was a CNA heck most of the time they even called me that. My name would apear on staffing in the CNA slot. I got to learn allot about baging up and throwing out trash and cleaning butts. I also learned that those littel vents on heaters are real hard to get BM out of.

    I think our intern program started out like the one you are talking about but it just doesnt work well. It's not fair to nurses to have to carry a double load and the hospital can't afford to pay an intern without getting work out of them. So they eventualy started useing them as aids.

    I still think it's a good position for students but I wish they would have let me know what it would really be like. I never got to do any of the stuff they promised me and when I tried to watch procedures or ask questions I was told to get to work.
  8. by   mark_LD_RN
    i worked as an intern and it was great most of the time, i got to do assesments ,insert foleys, give im injections and a lot of other procedures , could do almost anything if rn was present ,some of the things and parts of assessment had to be signed off by an rn. the rest of the time i was a tech. i learned a lot and enjoyed it.

    HEY DAYRAY were you been have not seen you post much lately.hows everything going?

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