Student/instructor issue?

Airidis · Feb 20, 2011

I'm a student nurse and your that patient's primary caregiver not the student. I would put something in there to cover your ass! I'd hate to see it brought to court and you get grilled in the future.

melmarie23, MSN, RN · Feb 20, 2011

I know from when I was in clincials that if my clinical instructor did not co-sign my charting, the RN in charge of that patient for that shift did. Also, when I was doing my externship/immersion, my preceptor always co-signed my charting/notes.

delilas · Feb 20, 2011

I'm amazed the other nurses don't chart. It will be on them if something escaped the student's notice.

Talk to your manager about your situation, and see if maybe she can follow up with the school about that instructors behavior. If the instructor is ignoring you, its time to ladder climb.

Whispera, MSN, RN · Feb 20, 2011

I'm an instructor. Everything my students do falls under my license. I co-sign what they write and am on them like white on rice as they complete their tasks and their charting. Don't let this slide. The instructor is not doing her job by leaving things up to you unless that was your agreement with her or the agreement between the school and your facility (and then you should have been informed).

As for the infusion. It was not "negligible". It was a med error for which the instructor was responsible. Whatever your facility does about med errors should have happened then. It irks me that this instructor was so "oh well" about such things. She's teaching her students they don't need to be exact, and that rules can be stretched, and she's not giving patients the care her students should be giving.

casi, ASN, RN · Feb 20, 2011

As a student nurse my instructor was responsible for double signing my charting. Frequently I would have an instructor that went through all my charting and make a list of things missed and make us go back and correct them.

The staff nurse was responsible for doing their own assessment during the shift as technically it was their patient and they needed to covers their butts.

netglow, ASN, RN · Feb 20, 2011

Wow, mouthy instructors are the worst.

I'd have told her the issue just as you did, then gone right over to your manager. I had a instructor who used to try the mouthy tactic because she was obviously lacking in her floor experience (lots of hiding, etc. nervous laughter). I had to constantly appoligize to my RNs for her behavior. Matter of fact, I remember this instructor cutting off an RN right in the middle of this RN going over a procedure with another student. I heard it and turned around, locked eyes with the RN and motioned the "gun to head, blowing my head off now" expression. She nodded in agreement. I think some of the RNs felt sorry for us, and some were just angry at the situation - the instructor and students.

I'd get that PITA instructor in line, or it's also gonna be a long semester for all you guys on your floor. That instructor is a subordinate, remember that.

llg, PhD, RN · Feb 20, 2011

I coordinate/schedule/trouble the students who come to my hospital. Defintely talk to your manager and report the bad practice of the instructor. Someone needs to contact that instructor and/or her supervisor and inform them that standards are not being met.

I've been known to call Deans and Program Directors and tell them that instructors can't come back to my hospital anymore. It's premature for that extreme action, but it should be reported and followed up from your unit/facililty leadership.

JaneyW · Feb 20, 2011

I am an instructor in CA and the students don't fall under my license. They are responsible for their own behavior. I am responsible to supervise them adequately. So, if I know a particular student needs more supervision, I should be spending more time with them. Also, the patients they care for are not my patients. They are the staff nurse's patients. I try to get to see every patient (There are 10 students with 1-2 patients each), but I cannot be responsible to co-sign every student's assessment because I can't do an assessment with every student. I am good, but I am not magic. It is the responsibility of the staff nurse to assess their own patients or somehow do it with the student and document appropriately.

That being said, the instructor you are discussing is out of line on the piggy back issue. I agree that it sounds like a med error and that is indeed her responsibility if she hung the med with her. I definitely co-sign on meds I give with students, because that is an RN function. Our students are also required to sign with their credentials of student nurse and school. I agree that you should follow up with your manager. I make sure I check in with managers and charge nurses constantly so I know what is going on and what I or my students need to change or keep doing. We are guests at your facilities and I want to keep my clinical sites. They are the best!

elkpark · Feb 20, 2011

I've taught clinical in a number of different settings over the years, and have always considered the students' documentation to be my responsibility -- it would be unacceptable to me for a student to have a staff nurse at the facility co-sign her/his charting (it would be unacceptable to the administration of every nursing school in which I've taught, also). I also agree that the situation with the abx is completely unacceptable (inc. the instructor's response when you approached her about it).

I would encourage you to report these concerns to your NM AND to the person at your hospital who is the liaison to the nursing schools -- this is often someone in the education department of the hospital, or someone in the nursing administration. That person may want to consider whether or not this particular instructor, or this nursing school in general, is welcome back at your facility.