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!
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!
So glad you brought this up...I was wondering if perhaps the student was afraid of getting kicked out of school, not of getting TB! Perhaps she was not confident enough to say "No, I am not allowed to do that", so she kind of freaked out. Maybe not the best response, but it could happen. In my NS we had a student get kicked out for hanging IVFs with the nurse, because she had not been checked off on the skill. There were other issues with this student as well, but this was the big one that directly led to her being removed from the program.
Specializes in Trauma Surgery, Nursing Management.
(Insert big eye roll here) I cannot believe the instructor said that to you! If the students were in such a fearful state, then the instructor SHOULD HAVE BEEN IN THE ROOM WITH THEM WHILE YOU WERE TEACHING!!!!!!
The blame lies squarely on the shoulders of the instructor, not you.
Specializes in Nurse Leader specializing in Labor & Delivery.
I've only read the OP, but IMO, the student needs some remedial education in transmission of illness. If she's concerned about TB, it makes no sense that she would go into the room, but refuse to touch the pt, and it tells me that the student has a basic lack of understanding of mode of transmission.
I think, since both students had not incerted a ng tube yet on a pediatric student, and that the patient was on TB precautions, I would have asked the instructor first. You put yourself out there for a hanging. Her response to you was rediculous, but you probably should have asked her. She may wanted to be there, then she could have seen for herself how it all went down. Some students can twist things around pretty good.
If you did scare the germophobe away, GOOD FOR YOU! She's not anyone I would want caring for Me or My family.
This is an Alice through the looking glass scenario for sure. You go above and beyond by offering these students hands on experience on a real patient ahead of their class, and *you* get berated? I'm truly sorry.
Purple_Scrubs, BSN, RN
1 Article; 1,978 Posts
So glad you brought this up...I was wondering if perhaps the student was afraid of getting kicked out of school, not of getting TB! Perhaps she was not confident enough to say "No, I am not allowed to do that", so she kind of freaked out. Maybe not the best response, but it could happen. In my NS we had a student get kicked out for hanging IVFs with the nurse, because she had not been checked off on the skill. There were other issues with this student as well, but this was the big one that directly led to her being removed from the program.