Nursing School Patient Loads - page 2

by Tait 8,537 Views | 62 Comments

There is a discussion going on in the Nurse Educator forum related to clinical expectations. Anyway something that has come out of it is the amount of patients this student is responsible to take on. In my ADN clinicals back... Read More


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    Hey, I have a BScN, which is the entry to practice standard here in Canada. When I was in school we started with one patient and worked our way up to 3. Our instructor said she would like us to take 4 but there were six of us on a 22 bed unit.... So that didn't work out. Of course, preceptorship was a full patient load.

    We were also allowed to give all meds unsupervised (some needed dose co-signs) and do most procedures without our instructor. I never did clinical on a floor where students did not have access to the medication cart or Pyxis. We even did our own narc count with our instructor at the end of the day so that we could have a narcotic key available to us.

    I think more patients is feasible provided the students have some leeway to act independently. In the city where I am now we would get some students on the floor in their final placement (prior to preceptorship) who took 2 patients but weren't allowed to do very basic things without their instructor. Some of these students would miss out on things with their patients because of the time constraints of the instructor (eg. I am not waiting 15-20 minutes to give a PRN neb for respiratory difficulties, I'll do it myself).
    onewill likes this.
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    I didn't do a traditional senior clinical but the folks that did I believe ended their senior capstone with 1-2 patients independentlyI'm assuming depending on acuity and under supervision.

    For junior clinical which we had 1 time a week, we did 1 patient each (prepared for that patient) but we would be under the watch of the RN except for vitals and easier things. But we would help with other patients (if one patient had a PCA pump and mine didn't I could go see that for example).
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    By the end of my ADN program we were expected to take 2 patients, do all meds, assessments, charting, etc. On and off throughout all of nursing school we'd occaisonally get two patients but that was the exception, not the norm.
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    Just have to add that recently there was a thread where a senior student had something like 5 patients and believed that was not appropriate.

    Instead of being supportive, people were incredibly rude to the OP and told her to suck it up. I was upset and wrote a response back to those people. These are just students, they are not trained in anything. 99% of nursing I learned on the floor after graduation not during clinical. I just thought people were quite b!tchy to the OP.
    onewill, KelRN215, and WeepingAngel like this.
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    Quote from Tait

    Your situation sounds similar to the one we are discussing, though I am not sure how the RN factors into the other students day. Maybe, if you have time, you could pop over to this thread and offer some advice on managing that many patients.

    http://allnurses.com/nursing-educato...ml#post7257692
    Yes, I have lots of tips. I'm on my way to class now but will respond when I get home.
    onewill and Tait like this.
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    Quote from chrisrn24
    Just have to add that recently there was a thread where a senior student had something like 5 patients and believed that was not appropriate.

    Instead of being supportive, people were incredibly rude to the OP and told her to suck it up. I was upset and wrote a response back to those people. These are just students, they are not trained in anything. 99% of nursing I learned on the floor after graduation not during clinical. I just thought people were quite b!tchy to the OP.
    I agree. I think many (if not the majority) of the responses in that thread were ridiculous and inappropriate. I also agree that 99% of nursing I learned on the job.
    hiddencatRN likes this.
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    In my last semester we had up to 4 patients. Our class was spread out over two adjoining units. We stayed on the same unit for the last 8 weeks of the semester. We had 2 6 hour days of clinical. We had the same pateints 2 days in a row usually with the exceptions of transfers or discharges.
    onewill likes this.
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    Quote from chrisrn24
    Just have to add that recently there was a thread where a senior student had something like 5 patients and believed that was not appropriate.

    Instead of being supportive, people were incredibly rude to the OP and told her to suck it up. I was upset and wrote a response back to those people. These are just students, they are not trained in anything. 99% of nursing I learned on the floor after graduation not during clinical. I just thought people were quite b!tchy to the OP.
    I didn't see the thread, but I am not surprised. It is interesting how people respond differently to students vs. nurses or just in how the OP phrases the comments. There is another thread over in Nursing Educators about the overuse of power point. After I read the OP I had to sit back and drop the frustration I had with how she phrased some of it, because it sounded like ANY use of ppt was lazy and boring and showed a lack of ability on the part of the instructor. However, after a bit, I was able to come back and make a meaningful post on how I love ppt but that ti is a tool to aid in teaching, not something designed to teach for you.
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    My last rotation, I had 5 pts and was able to pull from the Pyxis and give meds unsupervised. I was encouraged to delegate to the aides. I was not allowed to call the doctor or take off orders, but the floor nurse let me know to do a bladder scan or d/c a foley or whatever. We were expected to be as independent as possible, but be smart enough to know when to ask questions and seek help. I did okay, but I only managed it because I didn't have the full-on responsibility the floor nurse had.
    A few of my peers never got more than three, one of my peers could hardly manage one and another one of my peers managed six.
    Thank goodness we did not have to have someone with us to pull the meds! But sometimes it depended on the hospital. Another hospital we went to required the instructor, but fortunately, we only took 1-2 pts at that time.
    I graduated in 2011, but apparently things have changed since I left school. In my last rotation, I was able to go to the ED and start five IV's. I know a student now who is at that same hospital and they are no longer able to start IV's-- anywhere.
    That's a shame.
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    I graduated last year from a BSN program where we had 1-2 patients per clinical. During my final semester we did a transitions course where we shadowed a RN in our specialty of choosing for 40h a week for 6 weeks. We worked our way up to full patient assignments and did all charting, meds, etc on each patient.
    onewill and PMFB-RN like this.


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