clinicals

OrganizedChaos, LVN · Jul 13, 2015

Count! That's a total of 21 staff members for 15 patients. Also it's a specially designed quiet floor. Which means, the call lights don't come on. The nurses and PAs carry phones and when the patient pushes the call light the phone rings, they answer and go and see to the patient's needs. So we walk the halls glancing in rooms to see if someone looks like they need something.

But there is a difference between staff & students. Staff already know what to do whereas the students are learning. I still don't see the problem with the number of patients. It's 9-10 students & then staff.

No one is forcing you into nursing. If you hate how your forced to stay during clinicals & hate staying during your lunch break. Once again, find another profession where you can leave during lunch. Because you seem to find this so important.

littlepeopleRNICU · Jul 13, 2015

I would love to be able to take a walk around the hospital or just find a quiet place to sit by myself for a little while!

Although you may not be able to do this now, a lot of hospitals, etc. do allow this as a nurse. Many nurses stay in break rooms to get a break from their floor/coworkers while staying close, but I know of some that do go eat downstairs alone or walk around a little bit. There is more autonomy as a nurse in these regards, however, I know of no nursing facilities that allow you to leave the campus altogether, and for good reason. What if something happens to your car(or you), and you can't fulfill your shift? What if something happens to a patient, and they can't get in touch with you? On the campus, you can be paged overhead or given an IP phone and called on that so you can respond in an emergency. Yes, whoever relieves you knows emergency skills. But nobody else will know your patients and what went on earlier that day like you.

It's unfortunate that you feel so tied down by your school's rules regarding lunch, and even more unfortunate you can't respectfully accept that this is a rule. It won't be the last, or probably even most restricting rule you face in nursing school, the actual field of nursing, or even a real world job. If you were to change programs, there would be something else there to make you feel like a child because this is school.

Someone else calls the shots, and that's how it's going to be regardless of career, school

Or location.

futurepsychrn, ADN · Jul 13, 2015

I think the biggest thing you are missing is this is considered class time. Yes, the school is responsible for you during class time.
I do understand the frustration of being required to stay and have to sit with your instructor. It sounds like you have a terrible clinical set up. Not just the sitting with the instructor for lunch, but that there are so many staff to so few patients and so many nursing students trying to learn. Are you attending a private school or in a rural area? That environment is not conducive to learning and is absurd to think a reputable school would allow clinical in such a way. I have never been to a clinical where there were more than a handful of students to a floor of 25 patients. Its how we get opportunities to practice skills while still learning how to manage patient care.
For our clinicals we can not leave the facility. This is both a school and facility policy for students. It does not make me feel like a child. I am there to learn and abide by the rules. I understand I am a guest at the hospital. However, we are not required to sit as a group with our instructor. We go to lunch whenever our assigned nurse goes or says its ok for us to go. We don't always get to go together. We can bring lunch or purchase from the cafeteria. We get 30-60 minutes. Time depends on how busy the floor i we are assigned to and how long the nurse says lunch is.
Even though this frustrates you, keep in mind that you are merely a student. You must follow the rules in order to get that golden ticket known as the ATT for NCLEX at the end of the road. Once you are a nurse, you can take your lunch (if you get one) all by yourself, or with friends, or whatever you like. Just make it through your 2 years and move on.

This was my whole point before everyone jumped on me. I just want the opportunity to take a few minutes at lunch (not necessarily to leave the site) for myself to regroup and relax. I love being outside and would maybe just like to sit in the sunshine and eat lunch. I never really meant to start a big argument over this, just wanted to know if this was the norm for clinicals.

littlepeopleRNICU · Jul 13, 2015

This was my whole point before everyone jumped on me. I just want the opportunity to take a few minutes at lunch (not necessarily to leave the site) for myself to regroup and relax. I love being outside and would maybe just like to sit in the sunshine and eat lunch. I never really meant to start a big argument over this, just wanted to know if this was the norm for clinicals.

Have you tried talking to your instructor in private and explaining how you feel? Maybe they would be willing to work with you if you only are aiming to go outside.

OrganizedChaos, LVN · Jul 13, 2015

Have you tried talking to your instructor in private and explaining how you feel? Maybe they would be willing to work with you if you only are aiming to go outside.

Exactly.

Your clinical instructor is the one you need to talk to. He/she might have a reason for what they do. If not, they might let you sit outside or by yourself.

futurepsychrn, ADN · Jul 13, 2015

Nursing school is a means to an end. My philosophy was suck it up, play the game, keep my head down, do the work (regardless of when or how often I thought it was simply busy work or ridiculous), take what I could from it and let the rest roll off my back. Just get it done. What is the point of fixating on the policies that you have no ability to control or change during your very temporary time in nursing school?
By the way, since I have started working as a nurse, I have not stepped foot off my home unit once while working unless it was to carry out a job related duty. Not to go to the cafeteria, or to find some quiet time, or to (god forbid) leave the facility. The docs that I work with don't leave the facility while on duty either (although I don't know how that's relevant to your gripe about not having personal/alone time while at clinical as a student).
Also, I feel compelled to add, as a "futurepsychrn," you may want to dial the angry fist waving down a notch. Getting so riled up about what, IMO, is such a trivial matter may not be conducive to portraying the cool, calm, collected, controlled demeanor that I've seen presented by some of the very talented psych nurses I know. Just sayin'.[/quote

futurepsychrn, ADN · Jul 13, 2015

Nursing school is a means to an end. My philosophy was suck it up, play the game, keep my head down, do the work (regardless of when or how often I thought it was simply busy work or ridiculous), take what I could from it and let the rest roll off my back. Just get it done. What is the point of fixating on the policies that you have no ability to control or change during your very temporary time in nursing school?
By the way, since I have started working as a nurse, I have not stepped foot off my home unit once while working unless it was to carry out a job related duty. Not to go to the cafeteria, or to find some quiet time, or to (god forbid) leave the facility. The docs that I work with don't leave the facility while on duty either (although I don't know how that's relevant to your gripe about not having personal/alone time while at clinical as a student).
Also, I feel compelled to add, as a "futurepsychrn," you may want to dial the angry fist waving down a notch. Getting so riled up about what, IMO, is such a trivial matter may not be conducive to portraying the cool, calm, collected, controlled demeanor that I've seen presented by some of the very talented psych nurses I know. Just sayin'.

Who's angry? I actually find it amusing that an innocent question over lunch caused this big of an uproar. Geez! You guys act like I asked if it was ok to perform surgery by myself!

Samantha Harris · Jul 13, 2015

I'm not seeing any growth or reflection in the OP's replies.

futurepsychrn, ADN · Jul 13, 2015

Students don't have the same freedoms as RNs do, that's just the nature of the game.
It is often an expectation that students remain on hospital or school property during clinical and lab time. This is for liability reasons for the respective facilities. It has nothing to do with your status as an adult.
Although, as an adult, you would be expected to face the consequences of you leaving the premises for lunch. Namely, corrective disciplinary action up to and including expulsion. That seems kind of a silly reason to risk getting kicked out of your program.
Also, each school and each clinical instructor has a certain set of rules that they must follow to meet state licensing requirements. Nursing students generally are only allowed to perform tasks once they have proved competence, whether it's invasive or not. Manual blood pressures aren't invasive, but you have to be checked off on these, also. There can be big consequences for basing interventions on faulty info from a student, including losing the clinical site, aside from possible harm to the patient. The school and the instructor will rarely risk that.
As a student on the floor, it is your responsibility to report clinically concerning findings to your instructor and the primary nurse for your patient. As much as you want to help the patient and are itching to perform interventions on your own, you are not clinically safe to do so until you have been evaluated.
The big things to take away here are that you are a student, and you must follow the policies and procedures of your school and the clinical facility if you wish to remain a student long enough to graduate. Please be safe and stop trying to circumvent the instructor.
If you were my student and you displayed the same kind of kind of attitude in front of me that you have displayed here, we would be meeting with the head of the program and discussing remediation.

What attitude would you be speaking of? I asked a simple question about LUNCH! Everyone jumped on me like I asked a question about performing some very complicated procedure all by myself! LUNCH! Geesh! Also, how am I trying to circumvent the instructor and perform procedures by myself? Let's see, I reported to my instructor, reported to the nurse, went to find my instructor to ask permission to help an RN perform a procedure, and most importantly, DID NOT JUST DECIDE THAT BECAUSE I COULDN'T FIND MY INSTRUCTOR I WOULD JUST GO AHEAD AND DO IT!!!!!!!!!!

nurseprnRN, BSN, RN · Jul 13, 2015

Teachers, attorney's, police officers, office workers, everyone who has a job. How many physicians do you know that are made to stay in-hospital for meals?

Lots and lots. The house staff are all on beeper and have to respond.

As to the rest, your inexperience and assumptions are misleading you. All of those jobs have facilities called "break rooms" for a reason. All the attorneys I know eat at their desks or, if out, with clients (i.e., still working). Cops may pick up a sandwich or eat something brought from home, but they are still at work on duty when they do it. Teachers are usually found in the teachers' lounge. Every office I ever worked in, we were in the break room -- or at our desks. I used to eat a lot of meals in my car traveling between appointments with patients and physician offices.

I hear you say you feel internal pressures to perform, and part of your student experience (One patient? One?) is to learn to deal with that by becoming more competent and confident in gradually increasing skills. You are not being treated as child or restricted unfairly by staying in the hospital for meal breaks. You are being socialized into the realities and constraints of floor nursing. Imagine who might be in the break room or cafeteria when you punch the emergency button on the floor. Oops, nobody! They all left the premises.

As to the whole group going to lunch at once, my students were explicitly taught to pair off, decide who would take first lunch and who second, and report off to each other as well as the RN. Not an onerous duty for only one or two patients, and good learning practice on several levels. I was the only one who never left the floor during clinical-- I scarfed down my sandwich during the first five minutes of conference while the students did a five-question med calc quiz. They were better at it than the other groups by the end of the semester, and I got my blood glucose back to normal. :)

Samantha Harris · Jul 13, 2015

I am referring to the dramatic I want to do what I want, and I want to do it now attitude.

You may have started out with lunch, but you progressed to getting away from your instructor and classmates even though you spend most of your clinical time wandering around, and then to wanting to do interventions you haven't been checked off on.

And all the while you have been railing at the people who are trying to help you.

That's the attitude I meant. You aren't demonstrating your safety to practice as a nurse. Neither are you demonstrating a willingness to learn.

ETA: I see you edited your post and are now screaming at me. I feel there is no point in speaking to you further as you have proven to be unwilling to listen.

futurepsychrn, ADN · Jul 13, 2015

I'm not seeing any growth or reflection in the OP's replies.

Growth or reflection? I asked a question about lunch! There is nothing to reflect upon. I'm truly sorry that you don't think it's ok to be able to take a few minutes to sit by myself and decompress during lunch. Perhaps if more people did this during the day, less mistakes would be made. I, for one, don't think I am superwoman and realize my limits and when I need to step back and take a minute. Never mind! I'm over it. This is one of the reasons I'm seriously reconsidering my choice of nursing. Apparently to be a nurse you must be better than everyone else and have an attitude with those trying to learn. Afraid that's not me. Sad really!