Need tips for working with student RNs!

  1. Today I had a student RN in year two. I myself only graduated in March last yr and have only been on this floor for two months. Its a mostly surgical floor, some medical. She took two pts., but was not allowed to hang IV meds, give po meds or do any nursing activity unsupervised by me. Her slip stated if she could not give the med because of time constraints, she was to observe me instead.

    OMG! When I was a student our instructor would not let us go with a nurse and take two pts unless SHE had checked us off giving PO and IV meds. The instructor had to observe them, not the nurses. It took so much time to wait for her to look up meds, prepare them and administer them. I got out an hour late because of my own sick pts and not being able to chart on time.

    Anyone got any tips? I know they will be back....

    PS, I am NOT dissing students, I love students, I just never had to time manage with a student yet...my co worker had the same problem...
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  2. 26 Comments

  3. by   MIA-RN1
    I would talk with the instructor and discuss your concerns. What is the instructor doing, if all her students are being taught by nurses? Maybe you could ask her for help.
    When I have students they have never been allowed to pass meds, but that will change because the new group coming in will be allowed to give them under my supervision (and my license! I have to sign off on the MAR). Not sure that I like this idea.
    You also have the option to request no students be assigned to you if it gets to be too much. But I would start with the instructor first.
  4. by   santhony44
    Is this something the schools are doing to get around not having enough clinical instructors to supervise the students? I'm sure there is a ratio they are supposed to have, one instructor to "x" students.

    When I was a student, back when dinosaurs roamed the earth, the instructors were responsible for us, not the nursing staff. I never gave a med without the instructor's eagle eye right there on me.

    I don't know that I would like this at all as a staff nurse; after all, that's the position you took, not a clinical instructor position.

    I also don't think that it's fair to either you or the student to have a student assigned to you when you have less than a year's experience yourself and are still new to that particular floor. It doesn't sound like it's particularly fair to your patients either, if you're too tied up with the student to do your own work in a timely manner.

    Can you refuse to take a student? Can you negotiate a lighter patient load when you have a student?

    You also mentioned having to wait for the student to look up meds. If the student gets the assignment ahead of time, that should already have been done. If the student gets the assignment upon arriving on the floor, maybe the student can take time to sit down and look up the meds while you are doing other care for other patients.

    It sounds like a tough spot to be in!
  5. by   HommerRN
    when I have had students on our floor they could all pass meds...however I needed to get them out of the pyxis for them and supervise any IV push meds. I am also responsible for the patient and need to do my own assessment. Most of the students had all of the meds looked up a head of time and had a spread sheet with all the info that they needed. It does take extra time to have students but that is how they learn. The nursing instructors should be checking in on the students frequently and we could always reach an instructor via phone no matter where he/she is in the hospital. they usually have up to 10 students per instructor and have been scattered on different units which is the reason why the staff RN's end up supervising the students right or wrong.
    Deb
  6. by   AnnieOaklyRN
    I am a student and we pass meds, but we are supervised by our instructor and not the primary nurse. My school instructors emphasize to us that we are to ask them questions first so that we do not interupt the primary nurse from taking care of their other patients. The only time the primary nurse might supervise us with meds is when the instructor is tied up and they do not mind doing it, especially when pain medication is involved.

    Swtooth
  7. by   lauralassie
    i agree, i would talk with the instructor. don't much care if the scools are short staffed on instructors. setting the presidece that every nurse should teach students is wrong. if it is so important that nurses have all kinds of degrees to do such work, then what's up -- all the sudden we're smart enough to teach?(or, as they call it "be observed by a student"). the schools just need to figure it out. nurses are short staffed over worked as it is , in general i just don't need another job. besides, the students don't get, the supervision they need. they need to be asked spacific questions and be able to cooralate many aspects of care to dx etc..! if the school wants nurses to pair up with students, then they should offer spacific training for those nurses and the nurse should get extra pay. (payed by the school not the hospital) after all if the school needs more instructors thats their problem. we need extra nurses, they don't care about our needs. nurses pay a lot of money for their education....they sould get what they payed for !:studyowl:
  8. by   ann945n
    My school is the same, the RN who has our pt is our RN for the day. They watch us give meds ect. I would talk to her instructor about picking up the pace a bit or that you will only watch her give meds to one pt. You should not be getting out late because of a student the student needs to respect your time too and pick up the pace.
  9. by   Roy Fokker
    Uhhh, where's the instructor?!

    We were told to not be afraid of asking the nurses - but get a hold of the instructor first. I remember my peds rotation clinical instructor (whom I love dearly. She was AWESOME) ... "Remember, that's what I'm here for. I need to see you do things. I'll give you challenges. I'll give you any and all help you need. This doesn't mean that the nurses on the floor are off limits - but they tend to be very busy and we need to respect that."

    I really blossomed during that rotation (and I still wanna work peds).

    I would honestly let the charge nurse/director know about the situation. Pull aside the instructor and let her know that the current situation is becoming unmanageable and unsatisfactory - is there some way the instructor and you can work out a compromise ?

    It's important that students learn but it's also important that you get your work done.

    I agree with the others - an intervention is required.

    good luck,
  10. by   futurecnm
    our instructors are responsible for supervising us giving meds. The nurses are too busy to do that. We are to ask our instructor to help us with things. We are to watch the RN and can ask questions etc but they are too busy to be really doing a lot of teaching.
  11. by   jjjoy
    I think any nurses who are working with students or new grads should have a lower patient load so that the teaching/learning needs can be accomodated. Of course, that won't happen because it COSTS MORE MONEY. Sigh.
  12. by   swatch007
    Quote from Fairlythere
    Today I had a student RN in year two. I myself only graduated in March last yr and have only been on this floor for two months. Its a mostly surgical floor, some medical. She took two pts., but was not allowed to hang IV meds, give po meds or do any nursing activity unsupervised by me. Her slip stated if she could not give the med because of time constraints, she was to observe me instead.

    OMG! When I was a student our instructor would not let us go with a nurse and take two pts unless SHE had checked us off giving PO and IV meds. The instructor had to observe them, not the nurses. It took so much time to wait for her to look up meds, prepare them and administer them. I got out an hour late because of my own sick pts and not being able to chart on time.

    Anyone got any tips? I know they will be back....

    PS, I am NOT dissing students, I love students, I just never had to time manage with a student yet...my co worker had the same problem...

    The students' clinical instructor is getting paid for her responsibilities that you are doing. Your patients are your priorities not these students. Why don't you simplify your life by letting the instructor knows that you are busy to accomodate requests but the clinical instructor is welcome to be with the students to help them out. Be professional, but be frank or else you will burn yourself out unnecessarily. Most importantly, all good advices here are useless unless you put them in action. So go and MOve!
  13. by   nurse4theplanet
    Quote from Fairlythere
    Today I had a student RN in year two. I myself only graduated in March last yr and have only been on this floor for two months. Its a mostly surgical floor, some medical. She took two pts., but was not allowed to hang IV meds, give po meds or do any nursing activity unsupervised by me. Her slip stated if she could not give the med because of time constraints, she was to observe me instead.

    OMG! When I was a student our instructor would not let us go with a nurse and take two pts unless SHE had checked us off giving PO and IV meds. The instructor had to observe them, not the nurses. It took so much time to wait for her to look up meds, prepare them and administer them. I got out an hour late because of my own sick pts and not being able to chart on time.

    Anyone got any tips? I know they will be back....

    PS, I am NOT dissing students, I love students, I just never had to time manage with a student yet...my co worker had the same problem...
    This was not the way things were done at my school...the clinical instructor was responsible for us, and the nurse for that pt was a resource, but not our supervisor/teacher.

    I agree with the others. Talk to the instructor about your concerns. She could assign her student one pt, or only require her to pass meds on one pt. And if you don't get anywhere with her, talk to your charge nurse or nurse manager.

    I wonder if this is the school's policy or the instructors policy? I would clarify that as well...maybe causually ask the students if all their clinicals have been that way or just this one.

    And finally, if you don't have time to let that student hang EVERY IV and pass EVERY po med...then don't. Let the student do as much as you can handle as you are caught up. The last thing either of you want is an error to occur. If you are in a rushed spot, just have the student observe until you have the time to go over things more clearly with her.

    I also don't think that its a bad idea to request not to have a student since you are still a new grad yourself...or at least a student who has only one patient.
  14. by   dansamy
    In my community college's clinical groups, we had one instructor per 8 students. The instructor was required to sign off on our meds. It was her license, not the staff nurse's.

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