Cranky floor nurses? Or snotty students??

ARmickie · Apr 23, 2004

I'm not a nurse, only a fellow student at this point, but when I read your post something immediately sprang to mind, and I wanted to share it with you. A few months ago, I was among other family members at a large teaching hospital where my nephew was in ICU. It was not uncommom for us to see the nursing students around the unit, and we were all comfortable with that, until two of the students who routinely popped in and out of his room stood very near to the family and were discussing their class situation. A family really doesn't need to hear that someone who is in any way responsible for their loved one has failed a certain test in a really big way over material that actually would pertain to the loved one's diagnosis!! Granted, the med students are normally closely supervised, but when there is such an intense setting as the ICU, any doubt at all about the staff or caregivers is a very bad thing.

Again, I know I'm not who you were looking to for advice here, but sometimes looking at things from the other side is helpful also. I will add that I don't believe that the students thought anything of their discussion, and probably didn't know which patient we were with, but the end result was still the same.

Renee' Y-Y · Apr 23, 2004

I have always been very supportive of students...as long as they are putting forth the effort themselves...not sitting in the break room expecting me to come find them for learning experiences. I have also worked with students that didn't feel they needed to participate in the less-than-desirable aspects of nursing care (bathing, cleaning...grunt work).

My recommendation would be to offer help to nurses...whenever you can during your clinical...and not just the nurse you're working with...if they see you out there bustin' your tail to help them out, they might be more willing to help you out.

I'm going to get on my soapbox now so you can delete now if you wish. It is a well known fact among nursing staff, educators, and faculty that there has been a very distinct shift in students these days (I know, I know, I sound like an ole-fogey). When I was a student I either did what I was supposed to or I didn't...I either earned a good grade or I didn't...but it was my responsibility and I owned it...I didn't whine when I didn't do well...and knew I wasn't going to do well because I didn't step-up. It is now very common to see students whining and moaning all over the place because they are having to work too hard...or the faculty isn't accommodating enough.

I had a nursing instructor about 20 years ago that was rough...her class was no push over...she eventually was forced into retirement because of all the student complaints. But you know what? I worked harder in her class than any other, I learned more in her class than any other, and by God I had my stuff together when I showed up for clinicals...on-time, not late, and knowing what-the-heck was going on with the patient that I had selected. And what did she get for making me a better student & nurse?...shoved out the door.

So, there you go.

waves · Apr 23, 2004

I had a nursing instructor about 20 years ago that was rough...her class was no push over...she eventually was forced into retirement because of all the student complaints. But you know what? I worked harder in her class than any other, I learned more in her class than any other, and by God I had my stuff together when I showed up for clinicals...on-time, not late, and knowing what-the-heck was going on with the patient that I had selected. And what did she get for making me a better student & nurse?...shoved out the door.
So, there you go.

I would thrill to have an instructor who was confident in her instructor shoes. In my pre-nursing-student life I had to work with many young folk (I am nearly 40) who had a hard time following the work rules, uniform guidlines, etc. I am still amazed when other students who are in that 19-24 yo age group spend time arguing their rights to express themselves through their personal appearance, instead of studying. The uniform is supposed to free you from having to make those time-consuming fashion decisions.

Our instructors talk-the-talk but can't always walk-the-walk. Sometimes they appear to be crippled by the system or political correctness or a need to be liked or something beyond my understanding. Students are allowed to turn in papers late, come to class late, etc. Rules are layed down and then randomly enforced. In fact lately, the instructors are picking on the top of the class and not the folks who don't score passing (75%) grades. There have been times when the average test score was so low, that the lead instructor went back and dropped questions off to bring most scores up enough to raise the average test grade. It seems a good nurse re-assessment would be to look at the teaching-testing method to determin why teaching objectives were not met. Guess it's easier the other way.

There are actually students in our program who COMPLAIN that they shouldn't be expected to READ the textbook assignment...because they are very busy people. They expect to pass without opening their books! Okay- it's a practical nursing program in a rural area...and the nursing shortage is huge...but PLEASE!

I can see why nurses see a difference in students today. It's not PC to be a tough-old-battle-axe instructor. And those type of instructors are replaced with the new breed. Conscientious students know they are suffering through a mediocre experience. There are a few of us who are very frustrated by the lack of responsibilty anyone assumes in our education. We are told time and again it is up to us...as if the instructor is already seperating herself from any responsibilty for the quality of the nurse she helps produce. I'm sure the old instructors were proud of everyone that they passed; and were confident to have their name associated with that student. I don't think our current lead instructor feels that way.

But please floor nurses...try to discriminate between students who care and students who don't. We are finally far enough into our clinicals, that the nurses recognize the students they see becoming good nurses; but they still have to suffer through those that don't too. Thanks to those floor nurses have allowed me to assist in special procedures, or gone out of your way to time a procedure when I wasn't cleaning up another patient's backside. Students need good, strong nurses for examples...because we may not be getting that in class.

fergus51 · Apr 23, 2004

I have been on both ends of the stick. I love having students and enjoy teaching, but some of them are just brutal. Rude, uninterested, convinced they already know everything, etc. There is nothing worse than a student who is convinced they know more about nursing than actual nurses!!! Fortunately most of them are eager to learn and I like having them, even though it adds to my workload.

I can remember being a student and having some rude nurses. Believe me, they are still there when you graduate and not a bit nicer:)

Marie_LPN, RN, LPN, RN · Apr 23, 2004

I'm kinda seeing both sides of the fence right now. The other day, i was SUPPOSED to not bathe 4 of my pts. because the students were supposed to. All the vitals on teh floor were supposed to be gotten by the students. Well out of 30 pts., 12 pts' vitals were done, and those 4 baths that their instructor specifically asked me NOT to do bease the pts. were assigned to students were not done until after noon.

Here's the fun part:

Two students actually said "well it's not like we're ever going to have to bathe patients or do vitals when we're an RN. That's what the aides are for." I tell this to the instructor, and she says "oh i'll talk to them". Yeah we've all heard that song and dance before. Ironically these students had wondered aloud weeks ago why the aides never looked or spoke to them. Can't imagine WHY?!

And like i'd said on another post, when i went up and introduced myself to a nurse (as a student), and her reply was "Great, another ****ing student". If people would start with basic human respect and do what they're supposed to do, you'd never see threads like this.

#1rnstudent · Apr 23, 2004

Hi, all,
I am a student at a big teaching hospital and university, and I am curious what sort of experiences you students are having with the floor nurses. I would also like to hear from you floor nurses about what the students do that you like or dislike.
It seems that there is a huge disconnect between the students and floor nurses. Some floor nurses ignore us, say rude things (ex: "Well, what DO you know, then??" "So, did you do ANYTHING with your patient today??") have parties with food and don't offer us any, ignore the fact that we are assigned to the patient and try to do all the care themselves without involving student, or never even show up to check in on the patient and the student can't find nurse to report off when it's time to go (because nurse is MIA and clinical instructor is tapping her foot).
Seldom does a floor nurse say, "Hey want to see this?" I know that they are tired and overworked--would it help to get extra brownie points/money to be more instructional to students? I know that we have clinical instructors that do this, but if all our assigned patients are stable but patient down the hall is interesting, wouldn't it be nice if nurse told clinical instructor?
I know that we students can probably get annoying, too, and underfoot, or sound superior. What is your perception?
The problem is that pretty much everybody in my program at this point swears they will never work on a Med-Surg floor if they can help it because of the negative vibes they get now.
Comments???
Oldiebutgoodie

Hi Oldiebutgoodie

Our clinical experience had a couple of student friendly nurses and the rest ignored us or gave us a hard time, some harder than others. It felt like we all spent the time in hospital butt-kissing to even get the simplest things we needed and our teacher was absolutely no help. We didn't learn a lot. It was a really big disappointment. I guess it is true, those that can't teach criticize.

MandyInMS · Apr 23, 2004

I see both sides as well..and NO there's no excuse for rudeness on anybody's part.Like LPN2be said...basic human respect.

I had to laugh when a student RN last night who was in ER came to our Med/Surg floor and went on and on about how glad she'd be when she graduated and didn't have to clean pts...I kindly and politely told her that no matter what letters followed her name , if she was involved with pts that she would have to get a little **** on her hands...and smiled

manna, BSN, RN · Apr 23, 2004

:chuckle

The axe swings both ways, right? :)

Long Term Care Columnist / Guide · Apr 23, 2004

I'm a floor nurse who loves to teach......and nursing students who love to learn are my favorites! I'll take a student who peppers me with questions, isn't afraid to get their hands dirty, and dives in when there's a new experience to be had any day, over one who thinks they know it all or one who waits for experiences to be handed to them on a silver platter. And the ones who never seem to have any questions scare me the most......to my mind, the only stupid question is the one that isn't asked, and if a nurse is too arrogant, too lazy, or even too shy to find out what they need to know to take care of a patient, I certainly don't want them taking care of MY patients.

Another thing I think students need to understand is that as nurses, our responsibility is to the patient first, and the student second. While I'd never attempt to justify anyone's being rude, sometimes a patient's situation changes so quickly that we become intensely focused on what's happening with them, and we aren't thinking about you---we need to call that code, run for the crash cart, push the amp of D50, transfer the patient to the ICU, get the restraints on someone who's out of control, or whatever. Don't take it personally! :)

And even when things aren't as desperate as all that, we are frequently understaffed, or a patient's family member dumps all over us, or the doctor tears us a new one because the labs he ordered haven't been done yet, or the patient with C. diff has just had another massive incontinent stool five minutes after we changed her bed for the 10th time this morning. We get hungry and tired, we get cranky, and sometimes the social niceties are the first casualty of a long, frustrating shift. Again, it's not personal.......contrary to popular belief, nurses are people too, not perfect angels who never get upset or have a bad day. We've got mortgages and screaming kids and overdue bills just like everyone else. If someone is rude or condescending, that's a shame, and it does reflect badly on nursing as a profession.......but people are rude and condescending in other fields, too, and yet we rarely hear about nasty investment bankers or petty insurance agents.

Just my perspective. :)

orrnlori, RN · Apr 23, 2004

I like most students that I have. I haven't had a problem with any of them acting like they know everything. More often, it's that they aren't engaged, inquisitive, or attentive. That's bugs me a great deal. Sometimes I have students that are 4th year students and when I ask them basic anatomy or physiology, I just get a blank stare, even when I give them hints to the answers I'm looking for. I think the idea of precepting is to connect their education with practice. I'm a little shocked when they don't know which side of the body the liver is on, or where the paraTHYROIDS are. I try to understand that they are in the OR and maybe a little overwhelmed, but still, that's pretty basic stuff. So I'm a little concerned when the basics can't be answered at this late stage in the game. Afterall, when they are in the OR it's because they have asked for that one day to see what it's all about. It's not a standard rotation, so I would think they would be more involved. But it's great when you get one that is excited. I had a 40 year old student the other day that was nearly giddy at being in surgery. We had a great time. Those are the ones that make precepting so rewarding.

NursesRmofun, ASN, RN · Apr 23, 2004

My opinions:

Students that are a pleasure:

Do at least the basics...eyeballing the patient, v/s, temp, a little fluffying here and there, bedpans, toileting, and tell the primary if something is wrong.

Everything else above and beyond that is gravy to me and a better learning experience for the student. However, I don't want a student to do things they don't have any experience with unless I am there and/or their instructor is there and approves.

Students that make me a little upset:

Do not do vitals unless asked, do not give bedbaths unless asked... and, in general, don't do much of anything unless asked....and usually can be found at the nurses station or in the lounge. Also, just the opposite...They may do things without any knowledge of how to do it and don't ask how. That is very bad.

I have had good and bad experiences with students.

And, as a student myself in the past, I had some "not so good" experiences with nurses on the floors too. Sometimes some nurses do abuse students!