Advice to Nursing Students in Peds Rotation

[shelbs3]

If I am up doing something with a patient you should not be studying for your test. I know nursing school is rough but I also know your clinical time is limited. This is your chance to see what we do day in and day out.

If I am running around like a crazy person and you are still sitting at the station studying it makes me want to bonk you on the head with your text book. IT also makes me want to tattle on you to the instructor. Offer to help! I may say no but I may take you up on it!

Please please please don't question my practice in front of the patient and their parents. Yesterday I had a student ask why I wasn't using adhesive remover to take off a 20 mo olds port dressing in front of his parents. I was well into the process when she asks this and he was screaming his head off. This is a very good question but this was a horrible time to ask it because it makes the parents think I am not doing what is in the best interest of the patient. Luckily my charge was there and was able to say (loudly, in front of mom and dad) that our adhesive remover can make the removal process be 2-3X longer without much relief in pain and at his age it's better to just quickly get the trauma over with. Ask away-just do it at the right time.

You may know that this is not the place for you when you become an RN however that is an opinion that you should probably keep to yourself. I don't want to hear that you have no interest in peds because it makes me not want to teach you anything. Along the same lines I also don't want to hear that you think my job is depressing. I understand that this can be an emotionally trying area but I love my job and most days do not feel depressed at all!

One more piece of advice...

Compassion and pity are not the same thing. Almost every nursing student I have walks in to our oncology patients rooms and says something along the lines of "ohhh you poor thing" These kids do not think of themselves as "poor things' and we try to have an attitude of encouragement with them. We try to talk about the positive, remind them that they may be having a rough day but its not going to be like this forever, we will do our best to treat their pain, nausea, etc. and we try to help them develop coping tools. Of course I feel bad for these patients and their families, having a sick child is devastating. Parents and patients alike will look to us for how they should be acting so we want to present a positive for them to emulate.

Don't see this as a mean rant against all students. I just want students to have some insight from a nurse before clinical.

[Amistad, RN]

Along the same lines I also don't want to hear that you think my job is depressing. I understand that this can be an emotionally trying area but I love my job and most days do not feel depressed at all!

YES thank you. I recently started working in onc/BMT and I feel like I get this reaction from everyone! I love my job and find it uplifting to work with patients and their families, although it can certainly be hard at times.

[Ciale]

Just my two cents on this...I think it's important to remember that nursing students aren't there to "work". Students know how to get a patient water and a blanket. I think if I was a preceptor, I'd try and find out what skills they need to work on and what they feel comfortable with before the shift starts. That way, you've laid the ground-work for when they NEED to be in the room with you and when they can take a few minutes to study at the nurse's station. I do not believe students should be stuck to you like glue. I've literally seen them almost follow nurses into the bathroom while at clinical.

Good advice/observation on the while "pity vs. compassion". I saw this on adult med surg units too. You've GOT to have a positive outlook to make it in nursing or you'll be depressed.

[shelbs3, BSN, RN]

I feel like I should clarify myself on a few points. I do not expect students to follow me like glue however there have been multiple times where I have told the students that I am going to pass 9am meds (sometimes the only PO meds they will get on shift) and they tell me "Ok I will be here." PO meds may not be exciting but a big part of peds is getting compliance from your patients and giving PO meds is a great way to get some practice with that or at least see how they respond. I just want students to take advantage of every opportunity they are offered during their limited clinical time.

As far as the dressing removal story I do absolutely want students to as questions! I do want them to think about the appropriate time to ask them however. Asking that question in front of the parent while we were in the removal process was not ideal. It makes mom think that we are not doing what is best for the patient and in that case what was best was to remove the dressing in a timely manner to reduce the amount of time we had to hold the patient down. (Think stages of development- toddlers hate being restrained, loosing control ect.) We did not yell at the student, the reason we had to raise our voices was because the patient was screaming and we wanted both the student and mom to hear the reasons behind why we chose not to use adhesive remover.

[i♥words]

Thanks for the tips. I just finished my first week of nursing school, and I start clinicals in a couple of weeks. Your advice applies to more than just peds. I'm really surprised that students would even be allowed to study at clinicals. My school has very strict rules about what we are allowed to bring and what we should be doing at clinicals. I should (theoretically) make time to document, but definitely not study. And I'm not going to be sitting when I could be giving meds! Also, the clinical instructor continually walks around the floor and monitors students. Honestly, it doesn't even make sense that a student would want to study while at clinicals. I mean, that's really the only way we can prove ourselves to our instructor (and ourselves). The first thing I learned in school was how to talk to patients in a compassionate, yet not pitying, way. Makes me wonder what this student's school is like.

[senvang2000]

Thank you!! for so many great advice. I have peds clinical next weekend so I'll keep this in mind.

[JC1130]

i Just started peds although my rotations start in the elementary school (vision, hearing, scoliosis screening) ill take you advice into consideration! Thanks!

[Ciale]

I'm really surprised that students would even be allowed to study at clinicals. My school has very strict rules about what we are allowed to bring and what we should be doing at clinicals. I should (theoretically) make time to document, but definitely not study.

This is an interesting debate. "What's the point of clinical?" When I was going through school, I already worked in a hospital as did most of my classmates. There are definitely SKILLS to be learned during clinical (IV insertion, foley caths, meds...etc. etc.) but I feel like you only need to do a handful of these skills to "get the picture" and you'll get that experience when you're working on the floor as a nurse.

That said, clinical (for me) was a time to learn how to "think like a nurse". What's going on with my patient (big picture)? What can I expect to do for my patient? What do the labs mean? What do my patient's s/s mean? A lot of times, I felt like I was too bogged down with "tasks" and just blindly following orders when I should have been studying about what's GOING ON with my patient at clinical especially in my last two semesters

[BrandiJones12]

Thank You!!

I am new to this site and your article is one of the first that I have read, and the most informative. I am still completing my pre courses before apply for nursing school and would love to read more information from people that are in your same situations with nursing students. I would love to gather more insider information from your side of "teaching" so that I am aware of the requirments that are expected of me as a nursing student.

I have found this very informational and hope to read more from you in the future.

Thanks again!

[i♥words]

A lot of times, I felt like I was too bogged down with "tasks" and just blindly following orders when I should have been studying about what's GOING ON with my patient at clinical especially in my last two semesters

Very good point. Probably, the skills will come (a little) easier than our abilities to think like a nurse. I guess when I read "studying" I thought of studying for a test, not studying the patient, but you helped me to see it differently. Learning about the patient and putting it all together into our nurse brains is really important.

[Satori77, ADN]

This is some great advice, thank you for sharing your view. I bet Peds oncology is challenging, but very rewarding! Keep up the great work, you sound like an amazing nurse.

[Stephalump]

This is an interesting debate. "What's the point of clinical?" When I was going through school, I already worked in a hospital as did most of my classmates. There are definitely SKILLS to be learned during clinical (IV insertion, foley caths, meds...etc. etc.) but I feel like you only need to do a handful of these skills to "get the picture" and you'll get that experience when you're working on the floor as a nurse.

That said, clinical (for me) was a time to learn how to "think like a nurse". What's going on with my patient (big picture)? What can I expect to do for my patient? What do the labs mean? What do my patient's s/s mean? A lot of times, I felt like I was too bogged down with "tasks" and just blindly following orders when I should have been studying about what's GOING ON with my patient at clinical especially in my last two semesters

I definitely agree with this. I spent my first year of clinicals trying to help everyone as much as possible, and ended up spending my days in a to-do list way. That left me feeling completely lost as to the real art of nursing. Yay, I can make a bed and put in a catheter and answer call lights. But I could teach my 10 year old to do all of those things pretty quickly.

When I'd pull my study materials out I had a feeling of guilt, like I should be up working. But by looking up labs, patho, care plans, etc, I AM working. I'm learning how to think like a nurse on the job, instead of going home and thinking about it all in retrospect.

[Mrs.Angel]

I haven't started nursing school yet, but this is GREAT advice. Although it should be common sense not to study in clinicals... tsk tsk