Student Nurses in ICU for clinical

[New CCU RN]

I am wondering anyone's thoughts/experiences on this issue. Before I start, I just want to say that I am totally for education and totally open to helping anyone learn. I am a new grad myself ..just four months now out in the real world of nursing and will never forget my roots as a student.

However I was shocked by something that happened today. After morning report I find out that a senior BSN student is working w/ one of my patients. That's fine....I have no problem with this whatsoever. I let the student know that we need to talk over a plan of action as far as who is doing what. This patient is sick, vented, etc etc. Anyhow, the student looks at me and says, oh we do everything. Everything...let's clarify this. I am just off orientation and I know nothing close to everything....ha. Then I find out that there is no teacher around to clarify with me who does what, who is responsible, who is cosigning notes and assessments. I asked other nurses on the unit and they said that this is a totally new thing for the school and that they just do it all together. I let the student know that I want to go through the assessment and documentation together. We did and for the most part everything went smoothly. Then at the end of the shift the student's professor finally comes strolling in, does not even ask who the RN responsible is, takes a peek at the student;s note and then leaves.

I just am wondering about the legality/responsibility of this. Who is responsible? Is this student practicing under my license? It seems as though it should be made a little clearer as to what is going on with this. I was schooled in a program that even our senior year we had a prof with us, we checked the meds with the prof, we talked about plan of care with the prof, we okayed notes with the professor, the prof was always there.

I also was schooled in the belief that your time in school was to develop fundamental skills. We observed a day in CCU, MICU, SICU, and ED but we didn't come close to taking on a patient like an assignment. We spent it in med-surg and then of course, OB, Peds, Psych, homecare. I had heard of many other programs allowing students to do ICU classes or specialty programs, however my university was adament that even our senior semesters of a BSN we spend it brushing up on skills. Not ICU skills. The rationale was that you should have the broad basics and then if you want to move onto a specialty that is fine as a GN but the workplace when you graduate or as a job as a PCT while in school is where you get that. I firmly believe in that. It is hard as a new grad with a great orientation process to be there in CCU nevermind as a student taking on assigments.

I know that I am new so maybe it is just my newness making me nervous if you will. And Ihave no problem answering questions. But I feel like I was doing the job of the absent professor. Any one agree?

I was thinking about mentioning it to my manager but wanted some insight from you all. Thanks

[New CCU RN]

Well, perhaps that could work BSN to BSN ... however I do have my BSN but still didn't feel as though it was safe or fair to the RNs that we were the ones pretty much instructing the students. Never did we see an instructor....nor did we ever get any sort of guidelines from the school.

If it was a paired RN-student type situation....where the student was known to the nurse, and the nurse knew that she was mentoring a student, the situation would have been different. However, it wasnt like that.

And for me personally, I was just out of orientation... still on "protected time" and I was paired with a student.

[shaz]

as a new RN you may not feel you have the right to question your senior staff when a SN is given to you to look after. but you must set ground rules at the start of the shift. you go to your senior and ask what the student is and isnt allowed to do and sit down with the student for 10 minutes and ask them what their goals are and what do they know about CCU. In australia the legal responsibility lies with the university and the hospital. so if you are practicing within your scope of practice and following hospital protocol you should feel comfortable. and if you are not comfortable with a SN you must speak out because it will be detrimental for you both.

[New CCU RN]

I do have no problem speaking up for myself to the senior nurses... it gets you no where to be quiet and not be heard. And I addressed the situation with my NM who agreed with me as well as the charge RN who was a student of that same university and also agreed. The instructor should be there, it isnt fair to ask the RN to be the instructor of the student.

I agree with what you are saying .... however, I still feel as though the instructor should be there ....that it shouldnt fall on to the staff's shoulders and even if the "university" and instructor is responsible.......I as the patient's assigned RN am responsible for the student......sooo say while I am in the other room with my other patient, the student does something that is not in the p/p and causes damage to the patient..... well, I could still be held liable.

It isn't safe to have students without an instructor. We were never given her name or beeper or any way to contact her. In the CC setting, it is just asking for problems.

[New CCU RN]

By the way, this is new...this year...not having the instructor there... I found out from various sources that it will be the last year bc I was one of many who complained about this situation

[nadia562002]

I am about to graduate from a BSN program. During my med-surg rotation about half way through the program, my instructor evaluated each of her students to see where they would do well in for those extra rotations to places besides general med-surg floors. She felt very comfortable sending me to the CICU because she saw that I had the qualities to do well there.

Aside from that, she and all my other clinical instructors were available when I ever I needed them. The students work under the instructors license. The instructor also verifies that each student is capable of doing certain tasks before they are ever allowed to run free. I always felt comfortable asking questions of the nurses for what ever I needed. THere were several nurses who seemed to disappear though when they found they had a student. THat was a little nerve wracking to say the least.