This "us" vs "them" mentality.... - page 8

I've been reading through the posts from the last few days, and I'm completely astonished by the "us" vs "them" mentality that is showing up between the nursing students and the staff nurses. Maybe I'm idealistic, but... Read More

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    Just want to shout out a big THANK YOU to the ICU & ED nurses I worked with this last rotation. More than willing to share & teach, even when we were so busy! Had one patient circling the drain for 3 days straight & we were chasing him all day long! The ED nurses showed me around that ED, and did not get frustrated with me when the NG tube would not go down (btw did not go down for her or another RN either). They were great!!!! Thank you, from this RN Student.
    Orange Tree likes this.

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  2. 1
    All it comes down to is, be appreciative to just soak things in. Don't expect that the RN you are paired with is going to teach... we do not get paid any extra to add more of a load onto our plates. If all you get to do is follow the RN and watch... you learned more than being in a classroom! And be happy for that.

    Some RN's like to teach, and some don't; but even those that do have days where there is no time to focus on you as a student. It is not our duty or job to educate you as a student... please do not punish us for your university's lack of clinical focus!
    wooh likes this.
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    Esme, you read me wrong. Believe me, I do not have a sense of entitlement, at least I do not intend to come across that way. The only thing I am entitled to is a good education that I am busting my fanny for and paying mostly out of pocket for.

    No, it is NOT the staff nurses responsibility to teach the students. You are paid to do your job. But what the OP is addressing, (or at least it seemed to me) is that there does seem to be an air of animosity towards students. In the hospital setting and even on AN sometimes. And I agree with her. As I said, I have seen several posts this week by students that it just seemed they were getting slammed.

    I agree with another poster that it is not too easy for me or any student to make an asumption on what it's like to be a nurse. You are the only ones that have done both: been a nurse and a student.

    But I don't think it is fair that as students we are given very little support in the way of making our own. Is life fair? Nope. Do we need to get over it and put our big girl and big boy britches on? Yep. But this is supposed to be a place to vent, even for us sometimes.

    Try to remember all students do not have this "give me, give me" mentality and, "what can you do for me??". Trust me, we don't. We know you are over worked and under paid and appreciated, and we will be right there with you in a few years, even a few months for some of us. And that's all we ask is to remember that. We will be right there with you.
    JRP1120, RN, woahmelly, and xtxrn like this.
  4. 12
    Quote from SeeTheMoon
    Esme, you read me wrong. Believe me, I do not have a sense of entitlement, at least I do not intend to come across that way. The only thing I am entitled to is a good education that I am busting my fanny for and paying mostly out of pocket for.

    No, it is NOT the staff nurses responsibility to teach the students. You are paid to do your job. But what the OP is addressing, (or at least it seemed to me) is that there does seem to be an air of animosity towards students. In the hospital setting and even on AN sometimes. And I agree with her. As I said, I have seen several posts this week by students that it just seemed they were getting slammed.

    I agree with another poster that it is not too easy for me or any student to make an asumption on what it's like to be a nurse. You are the only ones that have done both: been a nurse and a student.

    But I don't think it is fair that as students we are given very little support in the way of making our own. Is life fair? Nope. Do we need to get over it and put our big girl and big boy britches on? Yep. But this is supposed to be a place to vent, even for us sometimes.

    Try to remember all students do not have this "give me, give me" mentality and, "what can you do for me??". Trust me, we don't. We know you are over worked and under paid and appreciated, and we will be right there with you in a few years, even a few months for some of us. And that's all we ask is to remember that. We will be right there with you.
    There are times students bring it upon themselves. The "Do my homework for me" threads. The "I'm just a student, but I would never do blah, blah, blah" posts. The "I may only be a student but I wouldn't want you taking care of my father/mother/sister/parakeet" posts. The "My preceptor hates me...she didn't say 'Hello' this morning" threads.

    We know how hard it is for students. Who would "get it" better than someone who already walked that walk?
    elkpark, carolmaccas66, ChristaRN, and 9 others like this.
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    Quote from VICEDRN
    I guess that's what it comes down to. I don't think they missed anything. I think they missed out on something that they have defined as nursing: namely, skills. I certainly knew a lot of people who felt like that when I went to school too. Its too easy to call nursing a collection of skills and its too easy to point to it as being what they missed out on. Thank god nursing professors do not spend their time worrying about what a bunch of nursing students think they should be doing. IMHO, its almost narcisstic: this desire to "do" something to the patient. How about PAY attention to the clinical picture instead?

    Let me just say to those folks: you won't save a life because you know how to start an IV. There will be plenty of people in the room who can do it instead. You save a life by advocating for a patient that you observed to have a serious situation. (critical thinking and advocacy, not skill sets.)

    PS: Your future employer won't care to ask you about how many ivs you started or foleys you did. They will ask, "Now, what would you do in this situation?" to judge your ability to make decisions, act under pressure and think.
    But getting out of nursing school does imply that someone is competent to sink an NG, put an IV in, a Foley, check NG placement for meds, do accucheks when conditions change on a diabetic, etc.....the SKILLS are very basic- and not CNA-level. Yes- they also need the critical thinking- but if they can't get past cramming food into a lethargic, diaphoretic diabetic, how can they be trusted with anything else?

    Nursing involves skills and thinking/planning. How many students "drop off" their homework here ,and don't even participate in the discussion? No thought involved at all- just the ability to make two fingers flutter around a keyboard (gotta give credit to the ones who at least don't "text" message- LOL

    Yes- in a code situation an IV could save a life....and NO not all places have someone else to do that job (that is a HUGE myth). Why have the attitude that someone else can do it? They have the same RN license- why is someone else picking up the slack for someone else's ineptitude??? Why is that even remotely ok?

    Now, there are units in hospitals to deal with that- which should not be the hospital's problem. They are the clean-up team for lousy nursing schools. It's pathetic. AND unfair- to the students, and the nurses who do not want to teach. I enjoyed it. But my patients were my first priority- NOT the student who has a clinical instructor who isn't doing her (his?) job. THAT instructor probably scraped by with a whole lot of "mediocre" and was accepted into the teaching end of things because of not being able to do the job herself (not ALL--- I know there are some good ones being identified- but the MIAs can't be considered as competent when they're nowhere to be seen.

    JMO..... And it's not likely to change - but I do feel badly for both sides of the issue. The staff nurses are out of school...this is not their battle to fight. The students need to demand decent education- by not going to schools that don't emphasize clinical skills; theory can be learned later (even us "trailer park" ADNs can think with the "gated community" BSNs- and have the clinical chops to earn our keep-- the housing issue is just a metaphor- don't anybody go getting all twisted up over that- the battles don't stop with student vs staff nurse....the distaste and condescension continues w/some major superiority attitudes towards more than that).

    ChristineN, kids, elkpark, and 5 others like this.
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    I think it's funny how this thread turned into an "Instructor Bashing" thread (I only got through page 3 or so). And yeah, I'm being sarcastic.

    It seems that we are dealing with a lot of different methods of teaching and learning in programs throughout the country. We're dealing of schools of different calibers, different standards/guidelines.

    I'm not sure what upsets me more here: the seasoned nurses who are blaming the schools/instructors for the disconnect between student and graduate, or the number of people who state that the instructors are not teaching while in clinical. I am not naive by any means. I only know what I do (and the rest of my colleagues in my school and neighboring schools, as reported by my RN friends/colleagues), so yeah, I feel the need to defend myself, as well as enlighten some of you on how some schools run their clinical days.

    I NEVER leave the floor while my students are caring for patients. I'm afraid to even go to the bathroom . Am I with every student with every patiient contact? No, I can't clone myself x8. But I am there to assist, answer questions, question them, go over things that are relevant, and there to administer every single medication with them (since it's my signature on the MAR). BTW, do you have any idea how long it takes to get 4 students ready to give meds? This is what the majority of my clinical day is spent doing.

    Where I work, we don't have check-offs in clinical. Anything that they need to be signed off on is done in lab, and we (the instructor) checks them off. And if we did had clinical check-offs, I'd be the one signing them off. That's not the nurses job.

    I am very grateful for the nurses who help me out in any way they can. A select few on my unit are awesome: they love having students, and they utilize them in a way that I cannot possible oversee. They'll ask them to check on one of their other patients, maybe do a set of vitals, empty a foley, whatever. The students are learning, keeping busy and learning to communicate with staff.

    At the very least, I expect these things from the floor nurses:
    - A brief report for the student (I want the students to hear what they feel is important to know)
    - Any serious/pertinent updates during the shift
    - The common courtesy of communication (it goes both ways, and my students know this)
    Anything they choose to do above that is gravy. It's my job to teach my students.

    In return, my expectations from my students:
    -communication toward the staff nurse (don't just walk into pts room, let the RN know you are caring for THEIR patient)
    -updates on pts condition that they may discover
    -sign off at our day's end

    I learned this early in my teaching career: the students need to know which questions come to me, and which go to the RN. I got balled out for a student asking the RN a stupid question (don't even rememeber what it was, a long time ago). When in doubt, they ask me, and I'll let them know that this is a question/issue for the primary RN.

    So, in short: while I feel that many said it in a rather kurt way here, I do agree: it is not the RN's job to teach the students. Unless they signed up for precepting, or are on a DEU (which I think is a great idea). I've never thought as a teaching hosptial in a nursing sense. We utilize clincial sites that are not teaching hospitals.
    murphyle, VICEDRN, Orange Tree, and 2 others like this.
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    Then you aren't one of the problems
    highlandlass1592, CCL RN, VICEDRN, and 2 others like this.
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    The reason I won't teach nursing students (besides the obvious facts that I am not nursing faculty, am not adequately educated in pedagogy and am not being paid to teach) is that I get all of the responsibility and no power. IMNSHO, the bar is set way too low for today's NS. I'd throw half of them out for being a) lazy and b) stupid. My cousin is in a RN program, and that girl is dumber than a sack of hair. I read posts here all the time from people that I desperately hope are not really nurses, b/c they sound dumb as he//. Half the nurses I know are an embarrassment to the profession and given the opportunity there is no way I'd ever have let them pass. So if you wont give me pass/fail authority, don't ask me to teach them anything more than where the bathroom is. I hope they already know how to flush the toilet and wash their own hands, but I know better than to count on it.
    DragonPurr, kids, elkpark, and 8 others like this.
  9. 0
    Quote from xtxrn
    But getting out of nursing school does imply that someone is competent to sink an NG, put an IV in, a Foley, check NG placement for meds, do accucheks when conditions change on a diabetic, etc.....the SKILLS are very basic- and not CNA-level. Yes- they also need the critical thinking- but if they can't get past cramming food into a lethargic, diaphoretic diabetic, how can they be trusted with anything else?

    Nursing involves skills and thinking/planning. How many students "drop off" their homework here ,and don't even participate in the discussion? No thought involved at all- just the ability to make two fingers flutter around a keyboard (gotta give credit to the ones who at least don't "text" message- LOL

    Yes- in a code situation an IV could save a life....and NO not all places have someone else to do that job (that is a HUGE myth). Why have the attitude that someone else can do it? They have the same RN license- why is someone else picking up the slack for someone else's ineptitude??? Why is that even remotely ok?

    Now, there are units in hospitals to deal with that- which should not be the hospital's problem. They are the clean-up team for lousy nursing schools. It's pathetic. AND unfair- to the students, and the nurses who do not want to teach. I enjoyed it. But my patients were my first priority- NOT the student who has a clinical instructor who isn't doing her (his?) job. THAT instructor probably scraped by with a whole lot of "mediocre" and was accepted into the teaching end of things because of not being able to do the job herself (not ALL--- I know there are some good ones being identified- but the MIAs can't be considered as competent when they're nowhere to be seen.

    JMO..... And it's not likely to change - but I do feel badly for both sides of the issue. The staff nurses are out of school...this is not their battle to fight. The students need to demand decent education- by not going to schools that don't emphasize clinical skills; theory can be learned later (even us "trailer park" ADNs can think with the "gated community" BSNs- and have the clinical chops to earn our keep-- the housing issue is just a metaphor- don't anybody go getting all twisted up over that- the battles don't stop with student vs staff nurse....the distaste and condescension continues w/some major superiority attitudes towards more than that).

    The skills you refer to are absolutely suitable to a CNA/tech and I have seen a tech do every ONE of the skills you just mentioned. IV starts, foleys, even drop an NG (was a nursing student but unlicensed all the same). In homes and schools everywhere, people are receiving all kinds of meds and feedings through all kinds of accesses and they are being administered by NON RNs and the patients are surviving.


    The logic that you need to have basic manual skills to grasp concepts of patient assessment is flawed at best. You do not need to "earn" the respect of other nurses by "proving" you can start an IV before being exposed to actual patient care. In fact, its bullying and its very common in nursing and its one of the ugly unprofessional sides of nursing that make me often embarrassed to be counted among us.

    Imagine the pressure. You are weak at a skill or just never got exposed to it in nursing school and now, some undereducated bully is judging your entire ability to provide safe effective care because you just never dropped an NG before. So sad for the little newbies.

    Unless you plan to code the patient yourself, there will always be another person in the room besides an RN. For example, an MD will likely attend and while I have no idea how many codes you have attended for patients that have no access but its a common issue and even the best sticks in the house may still not get it. Don't know how many times I have had to stick another nurse's patient because she just wasn't getting it and I don't make some big stink about it like its a reflection of her skills and neither does the MD when they drill the IO or start the central line.

    I have no idea why anyone would call that a "myth" and I certainly can not entertain justifying that starting an IV is more important than identifying a coding patient but hey, that's just me. Don't know how many times I see nurses minimize or undervalue a tanking patient. I would trade any of their "skills" in to rewind back a few hours and have them identify and intervene when it would be more effective.

    As for the educational units described in this thread, I am not remotely impressed by the argument that hospitals now have to "make up" for nursing schools' failure and that this is somehow costly to the hospital. Most of us came out of school to expensive, time consuming contracts that ensure the hospital gets all of its training money back (though I have to see a single RN get all of the training as promised) AND most of what they "teach" you when you start in a hospital is a requirement of regulatory bodies that require hospitals to show that each member of the team has received appropriate training in their field.

    For example, every hospital will require you to check off on the accucheck machine and while you can sit here and fuss about how nursing students just "SHOULD ABSOLUTELY KNOW" that, they will soon be wearing their fancy RN scrubs with a fresh RN name badge....aaaaand...wait for it...sitting through some two hour class and check off on the glucometer. And the next job you take or I take? Yup, we are gonna be checking off on it too. JCAHO requirement after all.

    The real issue here is a philosophical one. Which direct is nursing moving? Will it be a skills based job? (Gosh, I hope not! We are overpaid and overtrained for it if so) Or will it be assessment based? (Hope so!) The tension you describe in your last paragraph is real and palpable to me too but I suspect we sit on different sides of the aisle.
  10. 5
    The ED is not the same as the floor....whatever- we're both firm in our positions.

    We still have lousy new grads out there with no skills. All the theory in the world will not get the job done without the ability to actually DO something.

    Have a ball in your padded-staff situation...pray you never hit the floors as a staff nurse there.

    Techs aren't allowed to do all of that in every state...you want those patients sent to your lovely little Nirvana of so many unlicensed staff???

    If you did bedside nursing, you'd probably get it- aside from just wanting to let someone else do the job....?????

    And skills being required for assessment skills wasn't my issue- of course they're different. They need BOTH.
    Last edit by xtxrn on Oct 1, '11
    kids, elkpark, No Stars In My Eyes, and 2 others like this.


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