YOU as a Pt-what would you allow a student nurse to do?

[KellNY]

I had mentioned in another thread that I wouldn't allow a student nurse to attempt insertion of a foley on me (unless I'd been anesthetized prior).

So that got me thinking....

What would I and what wouldn't I allow a student nurse to do for me?

Here's my personal thoughts

I WOULD allow:

Vitals

Venipuncture

PO meds dispensed and IVPB meds to be hung (and main fluid bag changed/hung)

*SC or IM meds administered

EKG

SLIV/HLIV flush

D/C IV or SL/HL IV

Foley emptying and flushing (if RN with SN for flush)

Unchecked assessments for lung sounds, bowel sounds, DTRs etc (as in, SN can do it, as long as RN there to assess and verify)

I WOULD NOT allow:

Catheterization

IV insertion

*SC or IM meds administered

IVP meds

NG tube insertion

*I listed SC and IM under both categories. If SN had experience giving injections, well, then shoot away. But if not, sorry. I've seen way too many students get scared or try to be nice, etc, and push the needle in so slowly, push the med too fast into the tissue, not feel comfortable with location and hit a bone, etc.

I know I'm leaving lots of stuff out--haven't slept in over 36hrs, so brain ain't what she could be right now, yk?

What about you all? Where are you willing to aid the learning process and where do you draw the line(for you personally-not your kids/family)?

***We're assuming these are not emergency situations. ie, I'd let a student venipuncture me, but not if it were for STAT Mag levels because they think I have MagTox, or T&S because I'm bleeding, etc.

Can't wait to see your answers.

[hikernurse]

Open to anything pretty much, as long as their instructor is present.

:yeahthat: Or a nurse. It might take longer than with an experienced nurse, but what else am I going to be doing in a hospital

[brissie]

I graduate school in five weeks, it would all depend on the individual. I would have let some of my classmates perform procedures on me but not others, similarly there are some nurses that I would gladly allow to treat me and others who I wouldn't let touch me with a ten foot pole.

[CritterLover, BSN, RN]

i finished ns without ever having started an iv outside skills lab, never giving an im inj, & no ng insertion.

i had been a nurse for over two years before i ever gave an im injection. i worked icu, in an exclusivly trauma unit, and we gave everything iv. everything, that is, except vaccines. this was before everyone was screened for pneumonia/flu vaccine status, so the only vaccines that were given regulalry were the hib/pneumovax for splenectomy patients; and they were usually given in the er, before the patient went to surgery. so my first experience was with a patient who hadn't gotten his vax prior to having his splenecotmy. i was terrified, and i had to go find someone to show me where my landmarks were. (and i remember asking if i could combine the two in one syringe and just give one shot! in the end, a co-worker gave the first shot in one deltoid, and i gave the second in the other deltiod, under his supervision).

as for what i'd let a student do, i think it would depend on how i was feeling at the time. if i was feeling really rotten, and irritable, i'd want to just be left alone, and probably wouldn't feel up to having anyone "practice" on me. but if i wasn't feeling too irritable, then i think i'd be ok with it. i love to teach, and generally try to be helpful.

i'm pretty wimpy, but i've got pretty good veins. so i think i'd let them try an iv, as long as they wern't going to put it in my hand. definatly ok with a blood draw, esp an a/c stick. i'd probably be ok with the ngt, too. probably ok with the foley. i'd definatly be ok with meds as long as they talked me through them (knew what they were giving/how to give it). no im abx, but i'd refuse that from any nurse, not just a student (i'd rather have it iv; yes, i'm a horrible patient :) ).

i think i'd be more willing to let a nursing student "practice" on me than a medical student, though. experience has taught me that nursing students are much better prepared (education-wise) than medical students are. while a nursing student has more than likely at least done the procedure first on a rubber person in a lab, the same cannot always be said of a medical student. and along those lines, i'd never let a medical student try a central line on me. i've seen waaaay too many ptx's from medical student practice.

[lilypad2424]

No way! I am a nursing student, and there is no way I would let a student do anything invasive. I tell my fellow classmates all the time that I am amazed how receptive people are to letting us do procedures on them.

[DeLana_RN, BSN, RN]

I might draw the line at an enema... not that I've ever given one. Actually, do they still do them?!

DeLana

[Soup Turtle]

I've only been practiced on a few times. Once was just for a simple blood draw, but the student had a lot of trouble and had to try about six times. I just kept encouraging him to try again and eventually, he got it.

The other time was with medical students and a urinary catheter. That didn't go as well as I was not really comfortable and found the procedure painful. In fact, I ended up stopping the whole thing and getting sedated so it could be finished. I don't know how it went after that!

So, I guess my answer is that I would allow anything to be practiced on me if it was not painful OR I was not conscious.

[lily_lover]

When I was a student nurse, I was only turned down one time for an IV start, and it was because the patient had TERRIBLE veins, to the point that the CRNA had to start it. I always really appreciated the people that would let me practice on them. You can only learn so much on a schools dummy. I also never got to start a foley on a "real" patient in nursing school, but I now insert at least 3 a week, more when I'm on the day shift. (Foley caths are ONE skill you learn cold in the OR). When I was pregnant, I never refused to have anyone in the room with my doctor. I hate needles, but I'd suck it up and let a student start an IV on me, as well as a foley if need be. To all of those who are willing to let a student practice on you, Bless you, you made it just a little easier to get these skills down.

[mommy2boys]

I'm not a nurse yet (trying to get into NS) but I would let a SN do anything one time. If you can't get it on the first try, sorry but get someone else (it could be a different SN).

Now if it was for my kids, sorry I only want experienced nurses and doctors working on them.

[Kay Ciel, RN]

I WOULD allow:

Venipuncture

I WOULD NOT allow:

IV insertion

Why would you allow venipuncture but not IV insertion? Other than replacing the needle with the plastic catheter and flushing, there's virtually no difference in either. Or is there something I'm missing? :uhoh21:

As for the question, it entirely depends on the student's own characteristics.

[KellNY, RN]

Why would you allow venipuncture but not IV insertion? Other than replacing the needle with the plastic catheter and flushing, there's virtually no difference in either. Or is there something I'm missing? :uhoh21:

.

To answer-I have a few reasons. Venipuncture-you "blow" the vein drawing blood, no big deal. You flush or run fluid into tissue after evacuating the vein, even if it is just NS, that's PAINFUL. You're not injecting anything into me when you draw my blood, and you're much less likely to get tripped up on a valve. Gauge is usally different (25g butterfly compared to the 18/20g IVs we have to use).

And last, but not least....

In my experience, both as a SN and an RN helping SNs--SNs do not get enough practice with the equipment involved with IV insertion--everything from the catheter (as simple as how to advance) to the stop cocks to the connections to the tubing itself. Also, they are not given enough time to practice securing the IV in place with tape/tegaderm to develop any semblence of a technique (this stuff can be done on a dummy). I blame this on the schools mostly.

I mentioned in a later post that if a SN could show me proper use and familiarity of the equipment, I'd seriously consider letting him/her place the IV. Otherwise, I'm not going to be all tourney'ed up, maybe bleeding, and definitelt uncomfortable while they decide a good way to secure it in, or remember that they forgot the extension tubing or lock tubing or whatever.

[EarthChild1130]

I would let students do lots of things, but for more invasive things I would prefer that either their instructor or another nurse be present...I'm pretty open to students and I enjoy when they work on my unit! After having graduated and NEVER getting to put in an IV or an NG, I always make a point to both look for and point out opportunity!

[EricJRN, MSN, RN]

It would depend on the student. A confident, intelligent go-getter: Knock yourself out. A hesitant, nervous student - nothing invasive.

:yeahthat: