I need some honest opinions from people outside my circle, as all of my fellow students share my same opinion and all the faculty blow sunshine up my you know what, when I even hint that the situation isn't right. So here is the deal...
Me: Adult senior student in BSN program at local university
Preceived problem/issue: Clinical assignments
History:
Fall semester junior year - 10 wks clinical mostly focused on CNA duties w/some assessment
Spring semester junior year- 7 wks med/surg where I passed meds 3 times, then 7 wks mental health where I observed patients (not shadowing nurses) in different settings (eating disorders, adolescence, geriatrics, etc)
Fall semester 2011 -
14 wks med/surg at a nursing home, where I (a BSN student) shadow an LPN whose primary duties is to administer medications to 30-45 patients in their 8 hours shift.
*LPN's, please don't be offended or turn this thread into an arguement of LPN's vs BSN"s. I fully appreciate that I can learn a lot from an LPN and these people bust their A** all day, every day. My issue is that my university placed me in a clinical situation where I am shadowing a nurse who 98 % of the time is handing out PO meds to long term residents, who are primarily stable (because they take 17 meds 3 times a day...OMG).
Community clinical-public health nursing- 7 wks at a local health dept whose budget has been desimated, so we spend our time watching CD's, observing employees in the Lead Poisoning program, or shadowing health inspectors. One was lucky enough to do an at home visit w/an actual nurse meeting w/an at risk mother.
My feelings- I am ANGRY. My primary complaint is that I feel like I am paying a ton of money to learn how to do everyone elses job. My mental health clinical taught me the job of behavioral health specialist (the counselors), my current med/surg clinical is teaching me what it is like to be a full-time CNA (as when I am done assessing and medicating my patient I answer call lights all day, as there are never enough CNA's to help the residents and my community clinical, where I am learning the jobs of health inspector and other misc health dept personnel.
The final thing I will say is I appreciate that all of these people are part of the health care team and I need to have an understanding of what they do, but I have a finite amount of time to learn NURSING, and it feels like I am learning anything but. While I think every student nurse would do well to be exposed to a nursing home setting, I am spending the greatest chunk of my clinical experience there, while my classmates in other clinical groups are one on one w/ICU nurses, in IV clinics, and in hospitals with acute patients, experiencing hospital nursing.
Am I wrong? Should I believe my instructors who give me the party line of "it's a good opportunity to learn____" fill in the blank. I feel like the clinical portion of this nursing program is substandard and I keep getting sunshine in an attempt to deflect the fact that I am in fact right. Please tell me what you think, as I am about to lose it!
Yeah I know we avoided hospice patients like the plague when I was in nursing school but if you have a spare moment see if you can grab the hospice nurse and ask her a few questions. In most specialties you'll come across patients like that and it's good to be prepared. Just scratching my head to think up as many ways as I can for you to salvage your experience.
I lucked out that when my group had to spend our term at a LTC that our instructor was firm that we were only going to be working on the subacute and not in the main part of the nursing home. Learned alot about ventilators, trachs and GT's and that experience landed me my first job.
BTW if you ever met me you'd think I was the least suited nurse to hospice that you'd ever meet until you get under the shell. You never know how special you are until your there :)
Yeah I know we avoided hospice patients like the plague when I was in nursing school but if you have a spare moment see if you can grab the hospice nurse and ask her a few questions. In most specialties you'll come across patients like that and it's good to be prepared. Just scratching my head to think up as many ways as I can for you to salvage your experience.
I lucked out that when my group had to spend our term at a LTC that our instructor was firm that we were only going to be working on the subacute and not in the main part of the nursing home. Learned alot about ventilators, trachs and GT's and that experience landed me my first job.
BTW if you ever met me you'd think I was the least suited nurse to hospice that you'd ever meet until you get under the shell. You never know how special you are until your there :)
I did have a hospice patient a couple of weeks ago because census was low and there weren't many patients on the floor that day. I was okay with it but I was afraid to touch her. The reason is that it was believed she was in pain even though she was unresponsive. It was ordered that she get morphine before being moved but everyone seemed to think that was a ridiculous order and didn't follow it. So, basically, I was leary of moving her or doing anything, really, worrying that it was causing pain.
I have a hospice rotation coming up, I think next week.
You did the right thing. Usually towards the end we try and disturb them as little as possible turning q2h to prevent skin breakdown is secondary to providing comfort. How sad that she didn't get the pain relief she needed because others thought it "silly"
You did the right thing. Usually towards the end we try and disturb them as little as possible turning q2h to prevent skin breakdown is secondary to providing comfort. How sad that she didn't get the pain relief she needed because others thought it "silly"
Regarding the pain medication, my instructor said he just didn't see the point and the nurse said and I quote "I'm not going to be the one to kill her."
Ugh ignorant ignorant ignorant. If morphine does hasten death it only does so by hours or minutes. Hospice is about quality of life. I am really glad that you have a hospice rotation coming up also that you do broaden your nursing knowledge by coming on allnurses.com Those nurses who just lap up what their instructors give them are scary. I mean at most you are exposed to about a dozen nurse instructors in school. Here thousands of years of experiences.
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tothepointeLVN, LVN
2,246 Posts
Yeah I know we avoided hospice patients like the plague when I was in nursing school but if you have a spare moment see if you can grab the hospice nurse and ask her a few questions. In most specialties you'll come across patients like that and it's good to be prepared. Just scratching my head to think up as many ways as I can for you to salvage your experience.
I lucked out that when my group had to spend our term at a LTC that our instructor was firm that we were only going to be working on the subacute and not in the main part of the nursing home. Learned alot about ventilators, trachs and GT's and that experience landed me my first job.
BTW if you ever met me you'd think I was the least suited nurse to hospice that you'd ever meet until you get under the shell. You never know how special you are until your there :)