Dealing with Students in Clinicals: What would you like to see?

[bsf312]

Hello all!

I'm starting in an ADN program Spring 2019. The beautiful and frightening thing about ADN programs (or at least mine) is that you start clinicals the second semester.

I'm 30 years old, an LMT, Licensed Esthetician, and trained electrologist in Texas. I hear all sorts of things from "friends of friends" about how they like older nursing students, etc.

My question to all nurses that work with students during clinicals: what behaviors do you like to see in students? What makes you most willing to extend help? What information that may not be commonly covered early on should I familiarize myself with?

I know a lot about people and my current specialties, but I also know enough to know that I know nothing about the world of nursing. I am interested in all of your thoughts and experiences!

[bsf312, ADN]

I'm a second career BSN student and I would LOVE to just have a drug book and leave my cell phone out of the patient room. However, my program REQUIRES the phone to be on us at all times because our apps are on the phone and there is a push to show patients we how "nurses are integrating technology into caring for them". So when we are looking up drugs we are to tell the patient "I'm using my phone to verify your medications are safe to take together and the dosage is calculated correctly to ensure we are preventing medication errors." Most patients still seem rather annoyed and I honestly don't blame them. I find it to be less personal and makes me look distracted but I also don't want to flunk out of my program just because I didn't follow their rule of keeping it on me and using it.

I get this 100%. I took a little snoop at the past handbook for my program and it requires that we have a "handheld device" for various materials we have to load on it. Thinking of using an iPad instead, but the one I have is quite large. I guess I will see if it foots the bill when I start classes, otherwise I will be in the same boat. I don't think any of us want to seem disrespectful to patients or our teachers, but we have to operate in the parameters set for us.

[TriciaJ, RN]

Thing almost any nurses want to see is willingness to help us out. Even when you're assigned to your own one patient, volunteer to help us with our patients such as do vitals,answer call bells,toilet patients,change incontinent briefs, help us with washes,ambulate patients or help us with transfers requiring 2 people. When we see these kind of students we usually seek them out when there is something interesting for them to see such as blood transfusions,catheters etc and have the students watch or help out.

Amen to that. I got a lot of mileage as a student by making the most of my "downtime" (something unheard of once you graduate). When my fellow students were giggling in corners because they didn't know what to do with themselves, I would find a busy nurse and ask if I could take any scut work off her hands. Or find a full laundry hamper and empty it. People did notice and I got invited to observe or even participate when interesting things were happening.

As a nurse, I appreciate a student who is self-directed and takes initiative. I don't have time to find someone and give them boots up the bum. Since you will likely have to leave for post-conference before the end of your preceptor's shift, please plan a few minutes to check in with him/her before walking off the unit. Nothing is worse than finding a patient in a raised bed, side rail down and a bed bath half completed with the student long gone (true story).

You seem mature and self-directed. I think you will be fine.

[JKL33]

However, my program REQUIRES the phone to be on us at all times because our apps are on the phone and there is a push to show patients we how "nurses are integrating technology into caring for them". So when we are looking up drugs we are to tell the patient "I'm using my phone to verify your medications are safe to take together and the dosage is calculated correctly to ensure we are preventing medication errors."

Oh. My.

A little advice to tuck away for the future, from the common-sense corner:

1. Yes. Technology has been and is being integrated. I advise not going into a job situation in the future with the idea that you will be utilizing whatever apps you like to do official business. Most places (hospitals, at least) have specific drug references they endorse either unofficially or by policy. These are what you will be using. That way there will be no problem with "well, my reference said to do it this way...." Drug references approved/preferred by the employer are integrated with the EMR now; even within the eMAR itself.

>>If hospitals want to show patients how cool they are with staff utilizing this technology, they need to vet it, approve it, purchase it, make it available for use, maintain it and keep it up to date in the manner they see fit. Just like all other electronic equipment we are to use.

2. Don't mess up your personal life/phone with your employer's business. Multiple problems. Just don't do it. (MHO)

3. As soon as you get out of school, forget canned phrases when conversing with patients.

4. Personal cell phone use while doing patient care....nasty. Germs.

I did not know we needed any push to show patients how nurses are integrating technology. I think they know that, since the majority of the time we are clicking and scrolling.... This whole thing sounds so...."nursing school."

[JKL33]

what behaviors do you like to see in students?

Sustained interest

Initiative (not to be mistaken for inappropriate independence)

Pleasant attitude

Lack of moseying

~Good luck!

[bsf312, ADN]

Oh. My.

A little advice to tuck away for the future, from the common-sense corner:

1. Yes. Technology has been and is being integrated. I advise not going into a job situation in the future with the idea that you will be utilizing whatever apps you like to do official business. Most places (hospitals, at least) have specific drug references they endorse either unofficially or by policy. These are what you will be using. That way there will be no problem with "well, my reference said to do it this way...." Drug references approved/preferred by the employer are integrated with the EMR now; even within the eMAR itself.

>>If hospitals want to show patients how cool they are with staff utilizing this technology, they need to vet it, approve it, purchase it, make it available for use, maintain it and keep it up to date in the manner they see fit. Just like all other electronic equipment we are to use.

2. Don't mess up your personal life/phone with your employer's business. Multiple problems. Just don't do it. (MHO)

3. As soon as you get out of school, forget canned phrases when conversing with patients.

4. Personal cell phone use while doing patient care....nasty. Germs.

I did not know we needed any push to show patients how nurses are integrating technology. I think they know that, since the majority of the time we are clicking and scrolling.... This whole thing sounds so...."nursing school."

This is an excellent point. If my iPad is acceptable for use for all of my apps required through my program for learning purposes, do you have a suggestion for a statement regarding its use to put patients at ease? I would never want to make a patient uncomfortable or feel as though I am not giving them my full attention, but if I am trained to find the information I need for learning purposes on my electronic device, I would like the most diplomatic and caring way to communicate that.

[JKL33]

A simple, "all of our reference materials are electronic now..." will do. Or, "I'm going to take a moment to do my medication checks..." or, "let me look that up in my drug reference..."

In other words, speak to people like people. Scripting has it's place, and that place isn't during general interactions with patients. It can be recognized as scripting from a mile away. The classic example from working nurses is that many of us have been advised to say things like, "Is there anything else I can do for you right now? I have the time!" - - Meanwhile the patients see us practically running from one thing to another - - so we look like we don't have time and now it's clear that we're also insincere in our words.

The previous quote shared above bugs me because 1) I don't need a phone to ensure I am preventing errors and mostly because 2) the patient will recognize this as something someone has been told to say; this type of thing is everywhere now. It's classic scripting in attempt to affect patient survey answers/scores.

[Chrispy11, ASN, RN]

The first thing I was told before setting foot into clinicals? DO NOT EAT THE NURSES' FOOD! This is in addition to a lot of things I already read. Every semester on the last day of clinical, the group would take up a collection and provide breakfast of bagels, spreads, fruit and coffee for the nurses and everyone on the floor that worked with us and we would sign a thank you card. We all had breakfast with the staff this day and thanked them.

Other than that. Be prepared to work hard as if it were your own job. Do not give medication unless you are with your clinical instructor as you are learning under their license. Ask questions. No job is beneath you. Help CNAs and they help you work through the maze of your clinical rotation and you can learn a lot from them.

Lastly, someone posted to not do homework but my last clinical instructor requested a Braden, CAM and Heinrich II Fall risk (assessment tools) completed after our initial assessment first thing in the AM. She also wanted our care plans hand written and completed so she could go over with us at clinical post-conference. It depends on your instructor. I will say that for every single clinical I had to go over patients and discuss nursing diagnoses on the PERSON format.

[K9lover, ASN, RN]

Just don't be doing anything with patients that you shouldn't or without asking your instructor or the patient's nurse. Some nurses are pretty crabby when it comes to students in general. Don't take it personally.

Assured it will be taken personally; "instructor nurse was mean to me!!!!!!!!!!!!" Have had this happen, was just having a bad day unrelated to student, she went as far (as) stating I'd said I did not like students which I had not. She was actually furthest thing from my mind and I used to like students. Don't know how they are going to cope with patients and managers...

[Nurse SMS, MSN, RN]

The first thing I was told before setting foot into clinicals? DO NOT EAT THE NURSES' FOOD! This is in addition to a lot of things I already read. Every semester on the last day of clinical, the group would take up a collection and provide breakfast of bagels, spreads, fruit and coffee for the nurses and everyone on the floor that worked with us and we would sign a thank you card. We all had breakfast with the staff this day and thanked them.

Other than that. Be prepared to work hard as if it were your own job. Do not give medication unless you are with your clinical instructor as you are learning under their license. Ask questions. No job is beneath you. Help CNAs and they help you work through the maze of your clinical rotation and you can learn a lot from them.

Lastly, someone posted to not do homework but my last clinical instructor requested a Braden, CAM and Heinrich II Fall risk (assessment tools) completed after our initial assessment first thing in the AM. She also wanted our care plans hand written and completed so she could go over with us at clinical post-conference. It depends on your instructor. I will say that for every single clinical I had to go over patients and discuss nursing diagnoses on the PERSON format.

We have a clinical instructor coming here now who has been telling her students to use their clinical time to do care plans, BRADEN scales and the like. We have had to request she stop this. The students sit around at the nurses stations and in the break room, getting in the way, not participating in care and in general becoming a nuisance.

[chacha82, ADN, BSN]

Students who sit at the nurse's station on their phones, on Instagram. Now...there are some nurses who do it, so I guess they think it's fine.

I graduated school only 3 years ago and we would have been sent home for such behavior.

I don't have any time during my shift usually for being on the phone unless I am on a break.

I don't like taking it out of my bag as a rule. Too easy to leave it somewhere, too gross being around germs.

Being on social media all day is not a good thing. Put the phone down and do ur job already.

I say this as a young nurse.

[Chrispy11, ASN, RN]

We have a clinical instructor coming here now who has been telling her students to use their clinical time to do care plans, BRADEN scales and the like. We have had to request she stop this. The students sit around at the nurses stations and in the break room, getting in the way, not participating in care and in general becoming a nuisance.

I would've loved that. I felt I wasn't getting the full experience but she likened it to documentation, which she said should not take that long. 10 minutes on the assessments and I did the care plan on lunch.

[CNAtoBSN&Beyond]

Very helpful information. I appreciate you sharing this.