Are students in the way?

I recently had the experience of working with a student nurse a couple of weeks ago. As a new grad, I was happy to have the help. Being that I work in a teaching hospital, we love to have students. Some nurses that are having a very light day seem to enjoy having students more because they are able to show them things. But the nurse who may be having a hectic day may be short handed and become frustrated with the student. As a student I didn't understand why some of the nurses acted as if they didn't want us around, but now I understand. Even though the student feels that she or he is actually doing total nursing care, that RN is still accountable for that patient. Here we have computer charting that the students cannot access, so even though they may do an assessment, they still can't chart it. So basically we have to double check over everything that the student nurse does even if the clinical instructor does so.....besides....even though the student is practicing under the instructor's license, your patient is still your responsibility.

btw.. it's a myth that students work under the instructors license

It is?

I didn't realize that was a myth either. In fact I've said something to at least one instructor along the lines of, "It must be nerve wracking having these students working under your license." I wasn't corrected. Hmmmmm.

btw.. it's a myth that students work under the instructors license

Whose license do they work under?

In my fundamentals book it says that everyone is responsible for their own action, and noone works under anyone's license

That would be really interesting to find out, who's license the students are working under. We always thought it was the instructor's, also. We have a lot of students come to our area for practice in starting IV's. We don't mind helping them but sometimes it's just too hard to keep up with the patient flow and yet, take 10 minutes per patient to walk a student through the IV. It slows our business down considerably, especially if the students don't even know what supplies to pull to take to the patient's bedside.

Some of the nurses were saying they weren't comfortable teaching the students invasive procedures like that, but our nurse manager said that everyone was responsible for teaching them and that everyone needed to do it. Seems like a lot of responsibility to give nurses when they aren't comfortable teaching. They're being paid to provide care, not to teach someone else how to provide that care. Teaching is an art and not everyone is cut out to do it. The nursing instructors are the ones that have committed to accept that responsibility. Some of the students are downright scary in their lack of skill and it's frightening that they may hurt one of our patients and we'd be to blame.

I'm a PICU person, so students with us are just shadowing and don't really do much of anything (if they do anything at all). I'm the newest one (actually, not anymore... just replaced last week by a new-new grad!), so I often get students. I usually love it, especially when a student is really interested and wants to get a good experience. I had a student one day when one of our cardiac kids coded and needed chest tubes and intubation. Her eyes lit right up, so I sent her over to watch. My load was light, so I was able to pop over frequently, lend a hand, and explain the goings-on to my student. We BOTH got a great experience that day, because I had to know what I was explaining!

Some days are tricky with students. I recently had one who was eager to learn, but I just didn't have the time in the day to teach her as much as I would have liked.

So, if you're a student out there and the nurse you're with is less than friendly, just check to see when the last time she sat down or breathed was. Chances are, she's just busy. (At least that's how it works in the fantasy-land of my brain...)

I am going to quote this from my Med-Surg III syllabus-

The student:

a) does not practice on the instructors license.

b) is permitted by state law to perform tasks that generally only a

licensed RN can perform

- under supervision of licensed proffessionals

- with person accountability for patient outcomes

c) can be sued for that performance of negligent acts.

(I am in Michigan)

I have to add my two cents about the way students are treated by the nurses at the facilities where we have clinicals. 90% of the nurses (LPNs and RNs) that we have worked with have been great! They have been willing to take the time to explain anything that we have needed help with or had questions about. Anyone can have a bad day. But when you're working with a nurse that continues to have a less than professional attitude towards students, talk to your instructor. This is unacceptable and steps need top be taken to correct this behavior. It needs to be remembered that the nursing students today are your coworkers tomorrow!

In my fundamentals book it says that everyone is responsible for their own action, and noone works under anyone's license

Since a student doesn't have a license to do patient care, they would have to work under someone's license. My instructor says we work under her license. Maybe it varies from state to state

As for nurses being cranky with students, I understand. I'm not even a nurse yet but I get a feeling for how frustrating it could be to deal with your patient care and try and teach a student at the same time. I don't hold it against them when they are less than friendly. I understand the pressure they are under.

As a student I try my best to at the very least be helpful. If I see there is something I can do to make the nurses' day and the aids' day easier I do it - take away empty meal trays, take vital signs, do Accu-Cheks, etc. I try and communicate to the nurse what exactly I can and cannot do so that she can plan her day around that. I figure if I can make things easier for her, it will free her up to teach me a thing or to or help me out if I need it. If I get with a nurse who appears to be in no mood to be with a student at all, I graciously thank her and move on to another nurse who appears to be having a better day.

In my fundamentals book it says that everyone is responsible for their own action, and noone works under anyone's license

Try explaining that to the cream puff trial lawyer when it is your patient who went to meet jesus after being inadvertently infused with intravenous Jevity Pulmocare. It has happened before.

When i was doing clinicals in NS, all nsg notes and med notations were done on the computer. Our instructors wrote the notes, then added our initials as well as hers. So, theoretically, that means that my instructor was the one vouching for my actions. I would assume that in this instance I was indeed working under her license. This must vary from state to state, though.

Listen, one thing is to be tired and frustrated and shorthanded while having a nursing student. it is quite another to be given complete and total attitude, some going as far as look at me in the eye and say "i dont do nursing students". I'm sorry, she must have been born a nurse.

While i nursing school i came across a good deal of nasty nurses. Fortunately, i also had a good deal of excellent nurses, who were nice and polite enough to say "sorry kiddo, i'm really busy today so you'll just have to watch and stay out of the way, but why dont you do X, and if i can figure something out, i'll come get ya".