Walking on eggshells at clinicals

not now, RN · Mar 31, 2007

I take the vitals at the designated time and the B/P is 30+ points LOWER than the last reading. I tell the primary RN who tells me to cross out what I wrote on the document and take the B/P again. I take it again and it is about 10 points higher. "It is probably the machine" she says. I also report this to my instructor. I'm told it's probably the machine...I take the next BP reading at the next designated time and it is still low and I document it. I tell the RN. I'm told to get another machine. I get another machine and it is still low.

Next time you get a wonky BP that you think is wrong or dangerously high/low forget finding another machine take a manual BP. That way you can say "Well, I took it manually and here's what I got." It's harder to dispute a manual BP.

The RN comes in and flushes the line twice and says "why is this not flowing?" Then she proceeds to open the flow of the blood line because I guess whomever initiated the transfusion never fully opened the flow after starting the transfusion.

My very high strung pharm/clinic instructor will start blood slow because if they have a reaction the least amount possible was infused. Keep in mind that this is the same instructor that lists death as a potential complication to almost everything. I was scared to start IV's because I thought I would kill someone. :uhoh21: Anyway, the RN leaving the floor or the RN you were working with should have opened the flow on the blood. When it comes to something like a blood transfusion your nurse should not be holding you completely responsible. You are new at all of this. He/she should be in there with you explaining what he/she is doing and why.

Don't worry about rudeness, sometimes they get irritated when they screw up in front of at student or when a student points something out that they should have noticed.

kukukajoo, LPN · Mar 31, 2007

Daytonite, I wish I could work under you as a new grad!! You have so much knowledge and understanding I just know it would propel me into my career and prepare me for anything!!

Jelli_Belli · Mar 31, 2007

I had to post this because it was such a bizarre coincidence. My clinical group was supposed to finish the semester on a ortho\total joint floor too, but after two clinical days there our instructor told the nurse mangaer we would not be coming back due to the rude and hostile behavior of the nurses. Now we are finishing out clinicals out back on the ambulatory care unit we just left (which is cool by me, it is such an awesome floor).

I wonder if it is something about ortho floors that makes nurses nasty. My instructor said she thought it was most likely a jealousy thing because the majority of the nurses on this floor were LPNs and we are RN students. Who knows? I know if I was one of those nurses I would have been grateful for all the help. Oh well, life goes on and it worked out for the best because know we are back on a much better floor.

RN BSN 2009 · Mar 31, 2007

Anyone else feel like this? My group has had a few bad encounters with the RN staff. I feel like we are bothering them and they HATE us. One of them flogged another student on Thursday evening while we were there to get our MAR's and round reports for the next day. One refuses to let us help him. He's needed a BGL, or TED hose, or vitals and when 2 different SN's said "I'll take care of it for you", he's said "no, thanks. I'll find my CNA". So to keep the peace we ask as few questions as possible and stay out of the way. It's in no way a learning experience, for sure. I had one nurse who hung blood on a patient that I was assigned to do vitals for during the transfusion. She hung the blood and left. At the first 15 minute increment, her temp had gone up 3 degrees. I went to look for her to let her know and she had left the floor. She didn't tell anyone she had just hung blood, just left the floor. I asked and they said "Oh, she went upstairs, she'll be back in a few minutes", meanwhile I'm terrified this patient is having a reaction. I've hated every minute of this semester's clinicals and I dread every Friday. My clinical instructor said because it's a total joint floor and they are so overworked they are just tired and cranky. I just can't accept that. This is a teaching hospital.
Are you guys having similar problems?

That's awful... there are a lot of situations like that... unfortunately... students need a good supportive culture... Hope this ends soon so you can learn and move on

kate1969 · Mar 31, 2007

you know, its not that easy learning things for the first time, and when I went through respiratory school I kinda had a leg up, I was a nurse aid years ago, I went to medical assisting school and graduated, I worked as a unit secretary in a hospital too, and through all of this, I have seen the students get the pooey end of the stick, and it wasn't just nursing students, the medical interns and residents, cna students, respiratory students, they all got handed the sh%$. I felt so bad for them, but when I went through school, I knew it would happen to me and it did, one respiratory therapist threw an E tank at me and asked me to trouble shoot it, so I did for about 3 seconds and she grabbed it back and asked me, "You failed the tank class didn't you?", wow, I was floored...I haven't failed a class in all of my life....I told my instructor that she had done that to me and my instructor asked how I responded, I told her I didn't say what I wanted to...I stayed professional..then later, I found out that that RT had only been an RT for 4 years...I passed that clinical, I had that lady for 20 clinical days and I made it through, but I'll tell ya, through clinicals, you get to know where you would never want to seek employment...that was my best learning experience...hehe, just try to get through it, its hard, but when you're done, you're done!! good luck

katie

charlies · Apr 1, 2007

I have to disagree with this. If what you are saying is true, then that would account for all the bad-tempered nurses who just want student nurses and new grads who are trying to learn something from them to get out of their way and leave them alone. Is that the kind of nurse you want to be paired up with in your clinical rotations? I don't think so. So, did you really mean to say that

Yes, I did mean that. I am shocked that you disagree with me. lol

However, I might point out that I don't think that it accounts for ALL the bad tempered nurses out there. 'All' is kind of all-encompassing. I would say many, but not all. Some just woke up on the wrong side of the bed.

Princess74 · Apr 1, 2007

I agree with Daytonite, it is part of the nurses job decription to teach students as well as patients. This is especially true of teaching hospitals.

leosrain, BSN, RN · Apr 1, 2007

Part of the official scope of practice of a RN in my province is teaching students. This includes times when you are buddied with a student. If we don't take time to appropriately teach the students, we are in breach of our our responsibilities. And I think that's the way it should be! There's no reason not to help students learn.

Teaching patients is a nurse's responsibility, teaching students is an instructor's responsibility.

charlies · Apr 2, 2007

well, at least we get paid better to teach students than the instructors, eh? I didn't have anything else to do anyway.

arciedee · Apr 2, 2007

The ANA Code of Ethics for Nurses states: "The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development."

To me this means that nurses have a responsibility to assist in the education of student nurses. Of course the ultimate responsibility lies with the clinical instructors, but when there is only one instructor to eight students (or whatever the mandated ratio is in your state) and the nurse still has the ultimate responsibility for the patient, then it often necessarily falls to the nurse to make sure that the student has the information necessary to do the work at hand. I've heard too many stories of students hiding out in broom closets from fear. It's ridiculous. The nurses who tell us how much they love having students because we lighten their load... those are the ones that make us want to work all that much harder. We're all on a team, here. The more I know -> the less I bug you -> the happier we'll all be.

charlies · Apr 2, 2007

The ANA Code of Ethics for Nurses states: "The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development."

Please, that is a little general isn't it? It doesn't specifically say we have to educate students. You might as well say that that quote means we have to administer their education program, and develop their curriculum. Why not, right? After all, what else are we going to do in 12 hours?

But whatever, you teach the students all you want, I don't care. Unless your teaching of the students means your not getting your job done and I have to take up the slack. Because I will not do that.

WDWpixieRN, RN · Apr 2, 2007

After all, what else are we going to do in 12 hours? Unless your teaching of the students means your not getting your job done and I have to take up the slack. Because I will not do that.

Sorry to chime in here, but can I clarify from a student perspective all I'd like to see?

Technically, the pt we work with in clinicals is YOUR pt (from what we've been told and what it says on the whiteboard).

I am required to report in to you when I start my shift. If the pt needs a procedure done and my instructor is not sure how YOU want it handled or when, we are told to "check with the nurse". If there is a med in question (apical heart rate up or down; glucose in question, etc.), we are told to check with the pt's nurse to get the final decision about whether to admin that med. When the pt has VS that are off, or a dressing or drain that seems to be not quite right, I am supposed to come tell YOU to determine the next course of action. If the dr. writes up new orders during the day, I am supposed to come check with you to see if you're on board with that. When I go to lunch or leave for the day, I am required to report off to you.

I try not to "bug" you otherwise; you ARE busy and most of us who are half conscious can see that. I don't necessarily want you to TEACH me about those things; that IS what my school and instructor are for.

But please, don't act like I am a pain in your neck. Don't roll your eyes at me or sigh or act like you really wish I didn't exist. Acknowledge me with something other than a scowl and act like you CARE that I am trying. If I HAVE to come to you with these questions (and sometimes I am not any happier about it than you), please be somewhat thoughtful and let me know you appreciate OUR consideration for YOUR pt and give me the insight I am asking for. Many times I am in as big a hurry as you are to be on my way and getting MY work done.

The majority of us try to stay out of your way, particularly when we know we are a blight on your landscape. But we can't help but love those nurses who act like we aren't the biggest idiots who roam the face of the floor of that hospital. Who, even though they're swamped, will either tell us that the time is not right, hang on a few -- or stop, think, and then look us in the eye and answer our questions, explain it if they think it will help, and then either come help us with it or tell us to let them know if we need help with it.

Somehow, I don't think that requires a nurse to abscond her position of responsibility with their pt and expect you to pick up the slack or that it will require anymore time of you than if you did it with YOUR pt to begin with.

Then again, I am JUST a student and perhaps you can educate me otherwise.