Nursing students who do not understand what nursing is about - page 7

by DNS on the go 8,425 Views | 69 Comments

Yesterday, in post conference a students asked me when are they going to learn "real" nursing. Each student had done med pass on one or two patients that day. When I asked the student what he meant he stated that nursing is not... Read More


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    I think that this goes for other careers too, not just nursing. It doesnt matter if you were CEO of a company before coming to nursing, its a new career and you gotta learn it starting from scratch. If the particular student thinks certain aspects of nursing are beneath him well then he should quit his program now. He seems to be on his high horse and that certainly isnt going to get him very far. Nursing is about caring for the patient no matter how "beneath him" the task is. Its students like him that give the rest of us students a bad rap. I value my instructors and hang on to what they have to say, they have the experience and we need to learn from them!
    Fiona59 and bsnanat2 like this.
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    Quote from jmira
    I think that this goes for other careers too, not just nursing. It doesnt matter if you were CEO of a company before coming to nursing, its a new career and you gotta learn it starting from scratch. If the particular student thinks certain aspects of nursing are beneath him well then he should quit his program now. He seems to be on his high horse and that certainly isnt going to get him very far. Nursing is about caring for the patient no matter how "beneath him" the task is. Its students like him that give the rest of us students a bad rap. I value my instructors and hang on to what they have to say, they have the experience and we need to learn from them!
    When I was in nursing school, we had a student that could be described in the way the OP described her student. He was former military, was all about task and delegation (understandably so) and thought that when he got his license, he would do the "important" tasks and delegate the day to day tasks of bathing, vitals, changing linens, emptying foley bags, etc. to the aides. While he seemed to be focused on what he needed to learn, he proved to be very argumentative in class, thus taking up valuable class time to debate current nursing theory as erroneous. He came across to the instructor and to his fellow students as impatient when learning the basics of nursing practice. Needless to say, when clinical time rolled around, he was a hot mess. Unorganized, blundering, deer in the headlights, completely and painfully out of his element. He was not used to being in the trenches (no pun intended) and rather envisioned himself as a lofty sort who had no time for menial tasks. This guy BARELY passed each semester, and ended up flunking out the last semester because he could not adequately perform basic nursing skills. He left the program embarrassed and deflated. However, he returned the next academic year with a renewed humbleness about him and succeeded in graduating. As I have said before, sometimes we must fail in order to grow.
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    Quote from DNS on the go
    Yesterday, in post conference a student asked me is he going to learn "real" nursing. Each student had done med pass on one or two patients that day. When I asked the student what he meant he stated that nursing is not about vital signs and passing pills, hanging IV's, etc.

    He wanted to learn "real" nursing.

    I explained to the group that the responsibilities of the nursing include medication administration, patient assessment and documentation. He then stated that those were jobs of the aide or the LPN and that he wanted to make decisions about the patient care.
    Except for the part about delegating to aides and LPNs, I get what the student was saying.

    Over and over on this site and in my school, we are told that being a licensed nurse is much different from being a student. Do you not believe that? I have passed meds, completed assessments, and documented from Clinical Day 1, but that doesn't make me a nurse. What would make me a nurse is knowing what to do with that information when the patient is completely my responsibility. From my reading, from this site, from my instructors, and from my own current experience in a preceptorship, knowing what to do doesn't even magically happen when I earn my license!

    I'm sure you are familiar with Benner's Novice to Expert model. He could have been asking from that perspective.

    The students in the class are second degree BSN candidates. The saddest part is that when we had our introduction on the first class it was apparent that most of then were "failures to launch" i.e. they never got started in their respective first career choice and where now in nursing because they perceive it as an area with opportunity. I do not understand how or why they have the perception that nursing is a leadership or decision making profession.

    In previous classes, the majority of the 2nd degree BSN students had been in other fields and wanted to make a change to nursing. Most entered nursing because their first career did not pan out or they did not have what it takes to succeed in their first career choice. A few wanted to really be a nurse but passed it up the first time around they went to college.

    My concern is that these students do not understand the healthcare system or the role of the nurse in the system. Many times I wish I had the courage to be blunt with then. I am honest with then and try to deflect them by telling them about NP training but I feel that our schools admission department should have screened out some of these students for their own sake.
    I'm interested in knowing what your early 20-somethings for whom this is a first degree answered during the introductions. In fact, I'd love to know why the very experienced nurses on this site chose nursing, especially those who went into nursing school right out of high school.
    Not_A_Hat_Person likes this.
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    Some where, some how, someone, something is feeding into their minds that abc procedures are for LPNs, and only "real" nurses do xyz. Society as a hold is teaching these students differently.

    I am a student and I would NEVER entertain that doing any procedure would be below my standards of giving quality care even if I have to clean butts all day long. A rude awakening is set forth for them. And I really hope the OP puts his/her foot down and tell it like it is.
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    I'll try to not be too long winded here but I'm a junior (almost senior ) nursing student getting my BSN (went to college out of high school) and I wanted to weigh in a little on the matter...
    "Yesterday, in post conference a student asked me is he going to learn "real" nursing. Each student had done med pass on one or two patients that day. When I asked the student what he meant he stated that nursing is not about vital signs and passing pills, hanging IV's, etc.

    He wanted to learn "real" nursing.


    I explained to the group that the responsibilities of the nursing include medication administration, patient assessment and documentation. He then stated that those were jobs of the aide or the LPN and that he wanted to make decisions about the patient care.
    "
    "...why they have the perception that nursing is a leadership or decision making profession."


    I agree that this student definitely has a misconception about the roles of a nurse, and that was definitely a moment that could have been a chance to set him straight. I as a student would appreciate a discussion about delegation (what can be delegated, not delegated, when would it be better to just do it yourself :P). However as other student's have noted we often get told in school that we are too "skill focused" and are constantly told that nursing is more than skills alone, its knowing when to use those skills to help your patients. One of my clinical instructors this past year would always remind us that we as students are learning to "think like a nurse." I know many posts had the "whole walk before you run" vibe to them, but I feel that its easier to learn that critical thinking if throughout your education you get glimpses of what good clinical judgment is and what the concepts are to making good judgments.
    I feel that nurses make decisions every day, whether or not to hold a med if it is unsafe, calling the MD when needed, or really anytime that you feel an intervention is needed on behalf of the patient. Indeed as another poster mentioned we are not the end-all-be-all of patient care, but we're certainly important, and are often the last line of defense for a patient if a mistake is made.
    Nursing is in a unique spot in my opinion in that there are opportunities for leadership within nursing on small and large scales. From leading a unit, or leading a patient education class, to administration, etc...


    "My concern is that these students do not understand the healthcare system or the role of the nurse in the system. Many times I wish I had the courage to be blunt with then. I feel that our schools admission department should have screened out some of these students for their own sake."

    I do agree here, there have been many students that academically will get into the school, but are just plain unsafe, even with repeated interventions from their instructors.
    Just my
    dudette10 and jmiraRN like this.
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    OP, I seem to remember a particularly heated debate surrounding whether "bright" students should enter medicine or nursing; if memory serves, you had some pretty cutting things to say about the standard of nursing education and nursing students in general. I am therefore not surprised that some of the responses have been "negative."

    However, it seems that the student you describe is one who might be better suited to medicine, as he clearly thinks the "grunt" work is beneath him. As for the quality of nurses currently entering the profession, it is something that deeply saddens me. Ten, twenty years down the line, all of us "old nurses" will be retired, leaving patients to the mercy of the new crop who, in my country at least, are entering the profession predominantly for money and status. The best hope for healthcare will then be "second degree or diploma" students who have been there, done that, and finally decide to enter nursing because they wish to be of service to people in need. Or, as we used to say, "called" to a "vocation".
    Fiona59 and nep1980 like this.
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    Quote from canesdukegirl
    When I was in nursing school, we had a student that could be described in the way the OP described her student. He was former military, was all about task and delegation (understandably so) and thought that when he got his license, he would do the "important" tasks and delegate the day to day tasks of bathing, vitals, changing linens, emptying foley bags, etc. to the aides. While he seemed to be focused on what he needed to learn, he proved to be very argumentative in class, thus taking up valuable class time to debate current nursing theory as erroneous. He came across to the instructor and to his fellow students as impatient when learning the basics of nursing practice. Needless to say, when clinical time rolled around, he was a hot mess. Unorganized, blundering, deer in the headlights, completely and painfully out of his element. He was not used to being in the trenches (no pun intended) and rather envisioned himself as a lofty sort who had no time for menial tasks. This guy BARELY passed each semester, and ended up flunking out the last semester because he could not adequately perform basic nursing skills. He left the program embarrassed and deflated. However, he returned the next academic year with a renewed humbleness about him and succeeded in graduating. As I have said before, sometimes we must fail in order to grow.
    Well said indeed I will always believe that nursing starts with the most simple of all tasks and basic patient care. It then builds upon itself ever growing and changing. It is a priviledge to do for others what they cannot do for themselves. I realize that it becomes frustrating to empty that urinal or provide a bedpan for the 7th time in 4 hours. I swear if I ever get to the place where I think that patient care is somebody else's job, just shoot me! That's the kind of nurse that gives our career a bad name. These are the same nurses that gave me a hard time when I was a CNA. These are the same nurses that attempted to make it difficult for me as a new grad. (no luck there old crowes!) Some people are in our profession for the money and job security etc, and I think those are the people who have those unrealistic viewpoints in school. We had them like every other nursing school and for the most part they did flounder in clinical. When students come to our units now, I see the same thing. Impart to your students that nursing starts with the little things.
    jmiraRN and GHGoonette like this.
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    [QUOTE]
    Quote from Five&Two Will Do
    Well said indeed I will always believe that nursing starts with the most simple of all tasks and basic patient care. It then builds upon itself ever growing and changing. It is a priviledge to do for others what they cannot do for themselves.
    Absolutely. The bulk of nursing care, and that which caused nursing to be referred to as "the caring profession", is basic care. Any nurse who believes this is beneath him/her has chosen the wrong career path.
    jmiraRN likes this.
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    i'm a 2nd degree BSN student and i also work in a hospital as an intern. i understand what the OP is saying. sometimes i will answer a call light and to my surprise it will be an experienced nurse who has hit the light to summons my help changing/turning a total care patient ONLY bc she can't physically do it herself. other times i will answer a call light and it will be a new nurse who needs help cleaning a patient (which they could probably do without help) and they have NO CLUE how to go about doing it. this happened just last night. the new nurse had grabbed some wipes (the wrong kind) that we use to bathe patients vs. wipes we use for incontinence. she didn't know what a chux pad was. she didn't know we needed disposable pads. she was generally clueless. i was thinking to myself what a sad state of affairs nursing is in that a nurse doesn't know how to do something as basic as cleaning up an incontinent patient. she asked me, "do we have everything?" and i said, "hang on" and went and got all the supplies. i was telling HER what to do, how to move him, etc.

    i understand that nurses are busy and aides are typically available to do tasks such as cleaning/turning patients - BUT that's not always the case. sometimes an aide might call in sick, it may be short staffed, or a patient may simply require 2 people (if not more) to be moved. nurses should at least KNOW how to carry out such "menial tasks" IMO. really, if you don't know how to wipe my butt, i'm not sure i'm going to have much faith in you when it comes time to save my life. just saying.

    edited to say: after re-reading i feel like i was making excuses for why a nurse might be excused from knowing how to clean up a patient (i.e. if an aide calls in, short staff, etc) but aside from that - the patient is ultimately the responsibility of the nurse. it doesn't matter WHAT the reason is for the patient not being cleaned up (even if it's because the aide was hiding in the bathroom tweeting on her blackberry) it falls back on the NURSE. for that reason, i'd never want to RELY on someone else to do my job. would i expect ASSISTANCE with my job? yes. however, it's hard to delegate a task to someone that you can't/don't/wouldn't even know how to do yourself.
    Last edit by JSlovex2 on Apr 4, '11
    Fiona59, Chin up, jmiraRN, and 1 other like this.
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    Quote from JSlovex2
    i'm a 2nd degree BSN student and i also work in a hospital as an intern. i understand what the OP is saying. sometimes i will answer a call light and to my surprise it will be an experienced nurse who has hit the light to summons my help changing/turning a total care patient ONLY bc she can't physically do it herself. other times i will answer a call light and it will be a new nurse who needs help cleaning a patient (which they could probably do without help) and they have NO CLUE how to go about doing it. this happened just last night. the new nurse had grabbed some wipes (the wrong kind) that we use to bathe patients vs. wipes we use for incontinence. she didn't know what a chux pad was. she didn't know we needed disposable pads. she was generally clueless. i was thinking to myself what a sad state of affairs nursing is in that a nurse doesn't know how to do something as basic as cleaning up an incontinent patient. she asked me, "do we have everything?" and i said, "hang on" and went and got all the supplies. i was telling HER what to do, how to move him, etc.

    i understand that nurses are busy and aides are typically available to do tasks such as cleaning/turning patients - BUT that's not always the case. sometimes an aide might call in sick, it may be short staffed, or a patient may simply require 2 people (if not more) to be moved. nurses should at least KNOW how to carry out such "menial tasks" IMO. really, if you don't know how to wipe my butt, i'm not sure i'm going to have much faith in you when it comes time to save my life. just saying.
    True That!


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