I could use some opinions on a situation with a nursing student today. To give some background I've been a peds nurse for about 5 years. I'm very pro-teaching and really like having students with me. I've never had any negative experiences teaching until today. So today I asked one of the nursing students if they'd like to insert an NG tube. She stated that they hadn't learned that and I said I'd be happy to teach her if she felt comfortable. We go over the procedure a couple times and it all seems good. She goes to enter the room and starts getting freaked out that the patient is on airborne precautions for TB. I told her that we have the appropriate masks but if it was a big issue than I'd ask someone else. I happened to know that the students get fit tested prior to clinical but didn't want to make a big issue out of it.
She indicated that she wasn't comfortable doing the NG tube so I decided I'd see if someone else might like to do it. Another student wanted a chance so we went over the procedure. Both come in to the room with me and the second student starts to insert the NG. I had the child's head and asked the first student to hold his arms. She didn't even want to touch that patient due to her fear of TB. At this point I decided to take over but still try to explain the process. When we all came out of the room I told the first student that there were many areas in nursing where she'd be exposed to potentially communicable diseases so it might be a good idea to get a little more comfortable with them. I let the instructor know that I had some concerns about the student's refusal to even touch a patient with TB (she was fully masked, gowned, and gloved BTW). The instructor's response was that "I had chased 2 people away from peds today" (referring to both students I guess). I couldn't believe that she said that to me given the fact I felt like I had really tried with these two students to at least give them some clinical exposure.
Do you think I was too harsh? If I had pulled that in clinicals my instructors would have kicked my butt!
Oh man I would have loved to work with you! Clinicals in nursing school are all about getting as much experience as possible, its a shame this girl missed out just because of her fear even tho she was fully protected. I'm sorry you got the blame though, I hope this doesn't change how you act with future nursing students because I know there are a lot of us who would have loved the opportunity to work with someone like you!
I am doing my peds clinical rotation now, and I would LOVE to have a nurse like you, who would actually let me touch the patients and I could perform skills!
Specializes in Critical Care; Cardiac; Professional Development.
Totally jealous and wish it had been me. I would have jumped on that opportunity. I think the student was a wuss and needs to rethink her career plans if she is that easily spooked. Thank you for being pro-teaching. There are definitely those of us out here who are anxious to get linked up with nurses like you.
Specializes in Aged Care, Midwifery, Palliative Care.
I love getting nurses like you in prac , I've been lucky enough to have quite a few and they are the reason that I'm getting more confident in my skills and hopefully will hit the floor running when I'm a grad nurse. I have also been unfortunate enough to have just a couple of nurses/Midwives who have left me out in the corridor, not wanted to show me something that I was studying at Uni because she felt it 'would be over my head', and been given a blank Observation sheet to study for 2 hours while standing in the corridor. I was in second semester at the time and had worked the medical ward in the previous semester for 2 days a week doing obs and pretty much felt competent in blank vital sign sheets . (I would have preferred to go and take obs, or give me a filled in one and ask me later what is going on with the vital signs in a disease process, relate it to the medications and I would have actually been learning something).
If it wasn't for nurses like you, doing what you do for us students, I would be stuck in corridors looking at blank charts. Actually I know some students who would think that was an ideal day.
I admit that giving a NGT to a Paed patient would cause me to be anxious, I would be worried that I would hurt the patient. However, I'm on the ward to learn how to be a nurse, so for mine and the patients sake I would suck up any fear and concentrate on my nurses directions. Going by the replies on here I wouldn't be the only one willing to do this procedure and learn from you. So please don't give up on us, some students just give us a bad rep.
I don't understand the instructor though, I don't know what was going on there? Maybe she is just listening to their side of the story. What was the other students problem? Why did she feel chased off the floor?
I also agree with everyone else saying that she needs to 1. trust in the precautions taken for infection control and ensure she is safe... and 2. work on her interpersonal skills and not make the patient feel uncomfortable about their condition. So in a nutshell, No I don't think you over-reacted.
I just wish I had more nurses like you during MY clinicals. Many of the nurses I encountered were extremely rude and acted like they hated students being around, much less trying to teach them anything!
I did see this fear of disease in several of the students in my class. One young lady refused to take care of a patient with HIV. I volunteered to be his nurse and generally ended up getting most of the HIV patients after that episode. I can't help but wonder how anyone entering the medical field thinks they can pick and choose who they will have as patients.
As a ADN nursing student, I know for a fact my instructors would have my hide if I acted the way these students did. I really hope this experience doesn't change your feelings about teaching students because you sound like the type of nurse that students hope they get.
Thanks again everyone! I was feeling bad because I have only had positive experiences from teaching/precepting. I'm still going to take students because it's awesome to have people who want to learn. Too many nurses forget that and students get so freaked out. To all of you in clincals please hang in there. It gets so much better when you are really out there. If you can try to be an extern or a tech because I think both helped me so much. I had great mentors in both cases and was way more prepared when I became a nurse. Many hospitals offer part-time tech positions and if any of you are in NJ and interested in peds send me a PM. I'd be happy to pass along information on the tech positions if we have any openings. Not sure if my hospital is taking externs (I really hope they are) but send me a PM if you're interested and I'll keep you up to date. Don't forget we're all in it together and were all exactly wherever you are now. Anna
You was not in the wrong at all for one the students was at wrong because they did not want to touch the person that was so not good. I believe that if they made in their minds they wanted to do the NG why go in and then not do nothing. This is how you find out who is in nursing for the money and in nursing with a heart. I find the professor to be in the wrong to because there is two sides to a story next time they try to bring students to your unit before hand I wound tell the nurse manager dont give me anyone or dont allow them to come to the unit. You did good as a preceptor.
I think you met some of those who think they will walk into management, research, whatever dream job they have of nursing right after school.
You know the ones who post here about being unsure about nursing because of the "gross" stuff and get reassured that "there's more to nursing than patient care" replies.
I have a different concern, which I'm surprised no one else has brought up yet. The OP mentioned that, when she first approached the first student about dropping the NGT, the student replied that she hadn't learned that yet. In my own experiences as a student, and in every school of nursing in which I've taught over the years, it has been strict policy that students are not allowed to perform any clinical skill in the clinical setting until they have learned the technique and have been checked off on it by the school. I've spoken many times (pleasantly!) to staff nurses about how I (as the clinical instructor) need them to not take students into someone's room to learn something new that they've never seen or done before; observe, sure, but do? -- not until it's been cleared with me as the school instructor who is responsible for the students. Any students I've ever had in clinical would have known to tell the OP that when she made the offer. These policies are mandated not only by the school, but, also, typically, by the hospital/facility -- and not following them can create big problems for the school (like being told by the hospital that they aren't welcome to do clinicals there any more).
So, while I agree that the responses in this situation by the students and the instructor were unfortunate and inappropriate, if I were the instructor in this scenario, I would be having a v. pleasant conversation with the OP about how, although I really appreciate her enthusiasm about teaching and mentoring students, these are the specific guidelines and limits that the students and I need to follow, and thanking her for her cooperation.
OP, you may want to clarify with your NM or hospital educator-person what the specific expectations and limits are on your participation with nursing students -- I don't mean that in any negative way at all, just in the sense of protecting yourself and being responsible with the students. In my experience, the staff nurses on units used for clinical are typically not aware of policies in place regarding nursing students, and don't mean any harm, but those policies are there to protect everyone, including you. :) Kudos to you for being enthusiastic about participating in educating students!
Hecks no. What is going to happen when they graduate?? You can't act that way in the real world.
Actually, you can. I've worked with one nurse who pulled every trick in the book to avoid patients she didn't work. From calling in the union at any and every excuse, accusations of favouritism, racism against the Charge who made the assignment, to "the masks' irrirtate my skin".
If you have enough nerve, it seems that you can do whatever you want.
, I've been lucky enough to have quite a few and they are the reason that I'm getting more confident in my skills and hopefully will hit the floor running when I'm a grad nurse. I have also been unfortunate enough to have just a couple of nurses/Midwives who have left me out in the corridor, not wanted to show me something that I was studying at Uni because she felt it 'would be over my head', and been given a blank Observation sheet to study for 2 hours while standing in the corridor. I was in second semester at the time and had worked the medical ward in the previous semester for 2 days a week doing obs and pretty much felt competent in blank vital sign sheets 
. (I would have preferred to go and take obs, or give me a filled in one and ask me later what is going on with the vital signs in a disease process, relate it to the medications and I would have actually been learning something).
Tarabara
270 Posts
Oh man I would have loved to work with you! Clinicals in nursing school are all about getting as much experience as possible, its a shame this girl missed out just because of her fear even tho she was fully protected. I'm sorry you got the blame though, I hope this doesn't change how you act with future nursing students because I know there are a lot of us who would have loved the opportunity to work with someone like you!