Being a student preceptor

Published

Hi,

I work in a remote hospital. We are chronically understaffed. Frequently on my Medical ward I am the only RN out on the floor. I find that I am frequently trying to do too many things at once and fight the urge to take the easy route and have the student nurse attend to ADL's.

How can you give a student a unique learning experience in such an environment? How can you adequately supervise a student and find time to teach them?

Any advice would be greatly appreciated?

Dark nights.

Up Vote Up Vote ×

I truly think teaching ADLs is truly a needed experience for students. It is a great assessment tool. It may seem silly but I do not feel my male patients are "clean" unless they are shaved. It is a great way to assess how functional people are as well and a way to get to know them. I have a student now and I think the challenge for me is that she lacks initiative, how do you teach that?

Up Vote Up Vote ×
Specializes in NICU.

I am happy to help with ADLs as long as you also come get me for other things too. More more more :)

Up Vote Up Vote ×

:-)

That's the attitude I love, students who jump right in and don't mind getting their hands dirty.

How can a preceptor facilitate such an attitude in students?

I've read stories about student nurses in the U.K refusing to help with ADL's, saying it isn't their job. It seems that some RN's there share this view. There's lots of negative feedback from doctors and nurses about this.

As a student you can learn a lot from showering a patient. In the shower a person will often have the most meaningful discussion with you. You get to do an all over body visual assessment. You get to assess their exercise tolerance. You see what they can and can't do. It is not just a shower.

Up Vote Up Vote ×

I agree with Hypersaurus...give me more! Being a rising senior in an ADN program, I learned very early on that I must advocate for myself...there are lots of "us" and our preceptors and clinical instructors are very busy! If we want to learn something, we have to go after it. And doing ADL's with patients, i have found, has been one of my most valuable learning experiences. You'll never be able to perform procedures on those "parts" if ya can't wash 'em first! :D

Up Vote Up Vote ×
Specializes in Peds/outpatient FP,derm,allergy/private duty.

You sound like the kind of nurse who will be a wonderful adjunct to the student's experiences. It's too bad your hospital isn't adequately staffed so you can spend more time teaching the more advanced skills.

Are the instructors able to come in and supervise them on the skills they still need observation with?

Up Vote Up Vote ×

Our students come here for the remote experience. They come from 700+ miles away, on their own.

Unfortunately we don't have an educator either.

The students seem to love being here. They say they don't get to see such pathology in their city hospitals. We often get pts diagnosed with cancer on our ward, in the advanced stages, and immediately made palliative. We have the worst stats for health so we see advanced chronic illness, often in patients with many comorbidities.

We don't have an educator to spend time with the students either.

Up Vote Up Vote ×
Specializes in Emergency Dept. Trauma. Pediatrics.

Working night clinicals their are some things I haven't gotten to do yet that are mainly done in the day time. Sat I have a clinical make up day and it will be during the day so there will be much to learn. I was another student though that jumped at experiences. I had many nurses that I wasn't assigned to that would let me help with things as well if not much was going on with my patients. I got to see and do some pretty "cool" (not cool for the patients) things right off the bat.

I have never shaved anyone though and I must admit, this would scare me. I would be so afraid of cutting them. I have a hard enough time shaving myself and coming out unwounded :| I have never done a bed bath either, but not because I am against it, just haven't had the opportunity.

Up Vote Up Vote ×

Bed baths are easy. If they're an old patient they'll probably be quite comfortable. Just chat to them. Start at the face and work your way down, groin last. Roll them onto their side and do their back, with bum last. That's all there is to it.

Shaving is easy. If they're an old man remember to stretch the skin. If you nick them, no big deal. It won't kill them. We have a pt who gets nicked every time he is shaved. He has dementia and is combative so he won't keep his head still while you try to shave him.

A year after you've been out there working you'll have lost count of the shaves and baths you've done. After a few years you'll be tired of doing them and wish you didn't have to.

Up Vote Up Vote ×
Specializes in Peds/outpatient FP,derm,allergy/private duty.

We had our clinicals in 2 hospitals. One of them was not technically "remote", but it was small, had everything but OB, and we were the only school affiliated with them. We really got to get up close and personal with the procedures and especially surgeries. I really enjoyed it there.

They come 700 miles on their own? Actually, Darknights, your facility almost sounds like a throwback to an earlier era. It's not great that people are coming in already so advanced with cancer that palliative care is their only option, but it is a population and a slice of life that can enrich any nurse's experience.

Up Vote Up Vote ×

Unfortunately we don't have enough GP's here, and the ones we have I wouldn't go to if I was unwell. Living and working in a remote area we have to cope with what we've got, and decent doctors don't want to come out here.

Sometimes I feel like I'm working in a hospital that is 50 years behind the times. You should see when the docs decide to insert a chest drain, or do an ascitic tap. We have to put together equipment including a urine catheter collection bag, spinal needles, and rig up tubing made from what we can find. Our medical teams come from the city 700 miles away too. They stay for three month rotations. Before they arrive here they have only done rounds in a teaching hospital and they've had little responsibility. They get here and find they have to make decisions and it scares them. Our ward includes psych and palliative care and they ask us what they should prescribe because 'I haven't done that rotation yet.' We just get them trained and they leave.

Up Vote Up Vote ×
+ Join the Discussion