Clinical Vent

geneva007 · Sep 21, 2011

Hang in there. It sounds like something I was similarly faced with a few weeks ago at clinicals. A CNA took over feeding my Alzheimer pt so I could eat lunch with the other group of girls doing our clinicals. I marked off for it. Totally stupid and uncalled for but that's the way they do things.

Sounds to me you may need to get clarification on what exactly can and can not be done. Many nurses will push for you to do things you haven't been marked off in lab yet. Just be careful! Glad to hear you're not getting kicked out, keep your head held high!

Streamline2010 · Sep 21, 2011

Didn't the school give you a meds policy that says exactly what the rules are for a student passing meds? Generally you can't do it without the instructor present, until you get to a certain level. The policy should be in the student handbook if you got one.

bri2012 · Sep 21, 2011

@geneva007 we were marked off in lab last week for iv pumps and hanging primary and piggy backs so I thought it was ok. Im happy I didnt get kicked out too!

@Streamline2010 we were told that we could not give meds to our assigned pts without the instructor because we had to get checked off for them. idk.... i just know not to ever do that again! :nono:

1southernstudent · Sep 22, 2011

Wow! I'm surprised they didn't make that clear in your orientation. That is usually the way it's done. As you progress and get a little more experience you'll get a little more freedom. When you are in clinicals you are their responsibility. You work under their license. They worked just as hard as you're working to get it and they don't want to loose it. Try to learn as much as you can and be thankful for that "safety net". You'll be out on your own before you know it.

Camille.e · Sep 22, 2011

You are not licensed to give meds as a student, therefore you MUST have an instructor. As you said, you can do CNA work, but CNA's don't give meds. Piggy backs = meds, even plain old NaCl 0.9% = meds.

This is for the patients safety, which should always come first. Not because schools don't want you to learn. Since you are operating under your instructor's license, it's also to preserve that :doh:

Lifeofanurse · Sep 22, 2011

Definitely be cautious in the future. I was asked to do LOTS of things that I wasn't 'allowed' to do. Yes I was capable but everything in due time.

They can't have students going all willy nilly and doing procedures, and giving meds until they feel your ready. But it's one thing to be standing there handing equipment to your nurse while she hung a piggyback then you hanging and attaching it. Use your words carefully in relation to what you actually did.

Don't even TOUCH those meds. oral or otherwise unless your instructor has specifically said you, as in YOU PERSONALLY can do it.

You can help out...but don't touch the pumps. PERIOD.

We weren't even allowed to turn on or change the oxygen settings until Level 3 (last semester)....its' considered a med.

Watch for the tricky stuff. Your changing a patients disposable brief and the nurse says you need to put some lotion on the area...look at that label. If it's anything that has a hospital Rx label...you can't do it. That REALLY annoyed our nurses but it's a med...can't do it.

It's just for your protection. Go with it and be careful about what you do.

If in doubt don't do it.

In postconference...be cautious. I tend to keep my mouth shut unless specifically asked.

Nurse Kyles, BSN, RN · Sep 22, 2011

I cannot tell you how many times I have told nurses No. Usually they are very respectful and understanding. You don't have to be rude just say "I have to wait for my instructor. Either you can do it, or I will do it when my instructor gets here."

The importance is not in doing the task. You will have plenty of times to spike the bag and hang it etc. The most important thing is THINK about WHY you are doing what you are doing. Why are they getting this med? How is it working? Is this med compatible with the fluids that are running? Is the site patent? Tubing need to be changed? etc. You will never get in trouble for thinking! :)

Good Luck! I certainly hope you don't get kicked out!

Nurse Kyles, BSN, RN · Sep 22, 2011

I cannot tell you how many times I have told nurses No. Usually they are very respectful and understanding. You don't have to be rude just say "I have to wait for my instructor. Either you can do it, or I will do it when my instructor gets here."

The importance is not in doing the task. You will have plenty of times to spike the bag and hang it etc. The most important thing is THINK about WHY you are doing what you are doing. Why are they getting this med? How is it working? Is this med compatible with the fluids that are running? Is the site patent? Tubing need to be changed? etc. You will never get in trouble for thinking! :)

Good Luck! I certainly hope you don't get kicked out!

allnurses Guide · Sep 22, 2011

Use your time when following the nurse to evaluate how she is doing things. There is more to this learning than just the medical side. How is she prioritizing her tasks and why? Don't know? Ask her. What is she assessing and why? What are her findings and how does she document them? What does she delegate and to whom? What does she not delegate and why not? How does she organize her day? etc.

Yes, you will lose many skill opportunities because you have to go get your instructor and the nurse either cannot or will not wait for you. That is just the way it is. You don't get autonomy until you have earned it.

As far as the CNA stuff not being what you are in nursing school for, you will do well to disavow yourself of that notion. CNAs can have certain things delegated to them, it is true. But ultimately everything they do is a nursing task and responsibility. You are being made to do those things now because that is where your skill level is at. It is also time in which you learn to get comfortable talking to, touching, smelling, dealing with patients and their illnesses. You will not always have a CNA to delegate those things to and for certain patients, even if you do, you won't want to. The time spent will be valuable for your assessment. Clinicals are for practicing nursing care. Everything a CNA does is part of nursing care.

Best of luck. Sorry for your frustration. I have noticed we seem to get the responsibility we long for right at the time that we are suddenly very nervous about having that responsibility. And I think that is probably not a coincidence.

ashleyisawesome, BSN, RN · Sep 22, 2011

weird, my clinical instructor always pushes us off onto the other nurses and has us give meds with them.

chinacatSN · Sep 22, 2011

I would double check the policy. At my school, we're allowed to give any type of meds as long as either the instructor is there or our nurse (for the patient) is there and feels comfortable doing it.

We had a special "orientation lab day" at the beginning of the semester where we learned and practiced everything about IVs and various other skills. If we were marked off on these skills, we could perform them in clinical with either the instructor or nurse present. With our clinical schedule, there's no way we could only pass meds with our instructor there. If we did it that way, there would probably still be people who had never hung a piggyback or done an IV push - most of us are only at one clinical site for a week or two, then go somewhere else. The instructors would never be able to keep track of who had done what in clinical.

At least now you've learned your lesson - make sure you always clarify everything with your instructor before you do it! I always ask my instructor at the beginning of the day what she wants and expects and what we can and cannot do. I also make sure to have another student there (if not all of them) as a witness - that way the instructor can't try to say she told us something when she didn't. Good luck!