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

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runningknows has 1 years experience.

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So we shouldn't bring cookies? I start clinicals in two weeks and I was gonna bring cookies :)

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Nurse Magnolia is a RN and specializes in NICU.

1,509 Visitors; 110 Posts

I am in my second to last semester of nursing school and I will tell you I have not quite figured out what makes some nurses not like students and others love them. I've had both kinds of nurses and I am the same student to both. I am on time, conscientious and go out of my way to find extra work to do when things are slow. I stand all day so that I don't take their seats and I get all of my tasks done on time and charted quickly. I also check in with my nurse throughout the day to update her, but I never, ever hover. I do observe the things she does in the room with my patient though. I am fully aware that I am a guest in their unit and I behave as a guest.

Most of the nurses I've worked with have been awesome. The younger nurses that remember what it's like to be at clinical and a guest on a floor of possibly unhappy nurses because they don't want students, are usually the best. They clearly remember that uneasy feeling of walking onto the floor the first day to see whether they are welcome....or not.

Two weeks ago I started a new clinical rotation on a new floor. Due to some red tape, we did not have access to the charts on our own that day, so we had to use our clinical instructor to log in with us to look at the charts. Cumbersome, but it's what needed to be done. I received the nurse handoff from my instructor, but didn't get a chance to look at the chart yet myself. The very first thing on the top of the nurse handoff was that the patient was in isolation. However, when I went to the patients room, I found the night nurse in there and there was clearly no isolation going on. I introduced myself and asked the night nurse about the isolation and whether this patient was on isolation or not. She had no idea he was ever even on isolation and got super angry that I asked the question. I excused myself to go talk to my instructor so that we could look at the chart together. While my instructor and I were looking this up, she stomped past us to her computer, looked it up came back came back and told me he WAS on isolation but then removed....although it WAS still in there as an order. Then she loudly exclaimed to her fellow nurses...."Oh my god...I HATE students".

It was not a good start to the day. I will NEVER understand a nurse that gets angry when a student asks a reasonable question...I would assume they'd rather us learn now, than be an incompetent coworker some day. I can't say what was going on with that nurse and whether she maybe had a bad night or whatever....and had I not been a student I would have asked her what I did to offend her. Instead I just kept quiet and went about my day working with a nurse who could not have been kinder.

Moral of the story - some nurses will absolutely not like you for the one and only reason that you are a student. But for every one of those, you have two who want you to end up to be a good nurse and will teach you. They also especially like it when you take the initiative to make their day better. When I am a student with a patient, I try to do every single thing for that patient that I can legally do. I really do try to lighten their load. I get that I'm in their way - so I try to be as helpful as possible. Be kind to your nurses and MOST of the time, they will be kind to you. But if you come across a nurse for whom you can do nothing right, just move on and don't take it personally.

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Megan1977 has 38 years experience as a MSN, RN.

603 Visitors; 55 Posts

So we shouldn't bring cookies? I start clinicals in two weeks and I was gonna bring cookies :)

YES- bring cookies :-)

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9 Followers; 22,873 Visitors; 3,024 Posts

Two weeks ago I started a new clinical rotation on a new floor. Due to some red tape, we did not have access to the charts on our own that day, so we had to use our clinical instructor to log in with us to look at the charts. Cumbersome, but it's what needed to be done. I received the nurse handoff from my instructor, but didn't get a chance to look at the chart yet myself. The very first thing on the top of the nurse handoff was that the patient was in isolation. However, when I went to the patients room, I found the night nurse in there and there was clearly no isolation going on. I introduced myself and asked the night nurse about the isolation and whether this patient was on isolation or not. She had no idea he was ever even on isolation and got super angry that I asked the question. I excused myself to go talk to my instructor so that we could look at the chart together. While my instructor and I were looking this up, she stomped past us to her computer, looked it up came back came back and told me he WAS on isolation but then removed....although it WAS still in there as an order. Then she loudly exclaimed to her fellow nurses...."Oh my god...I HATE students".

It was not a good start to the day. I will NEVER understand a nurse that gets angry when a student asks a reasonable question...I would assume they'd rather us learn now, than be an incompetent coworker some day. I can't say what was going on with that nurse and whether she maybe had a bad night or whatever....and had I not been a student I would have asked her what I did to offend her. Instead I just kept quiet and went about my day working with a nurse who could not have been kinder.

Moral of the story - some nurses will absolutely not like you for the one and only reason that you are a student.

I would see this completely differently than your take and I think the moral of the story you took away from it is reductivist, although I would never have reacted the way the nurse did.

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Nurse Magnolia is a RN and specializes in NICU.

1,509 Visitors; 110 Posts

I would see this completely differently than your take and I think the moral of the story you took away from it is reductivist, although I would never have reacted the way the nurse did.

So how would you take it that within the first 5 minutes of me being there a nurse said loudly "I hate students" after I asked her, very nicely, for clarity on an isolation order that was on his chart? I didn't ask a 'stupid' question. Even my instructor was surprised by her reaction. I didn't ask her in front of any patients either. It was unnecessary frustration - but as I said, I simply just chalked it up to displacement. Maybe she had a bad night. But regardless, I didn't do anything wrong by asking the nurse a question.

And if you think there aren't nurses out there that give you a hard time simply because you are a student....well, I don't know even know what to say to that. It may not be the majority - but it certainly exists.

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9 Followers; 22,873 Visitors; 3,024 Posts

So how would you take it that within the first 5 minutes of me being there a nurse said loudly "I hate students" after I asked her, very nicely, for clarity on an isolation order that was on his chart? I didn't ask a 'stupid' question. Even my instructor was surprised by her reaction. I didn't ask her in front of any patients either. It was unnecessary frustration - but as I said, I simply just chalked it up to displacement. Maybe she had a bad night. But regardless, I didn't do anything wrong by asking the nurse a question.

And if you think there aren't nurses out there that give you a hard time simply because you are a student....well, I don't know even know what to say to that. It may not be the majority - but it certainly exists.

I enjoy (most/many) students, myself. They generally like coming to my area (ED) and are excited about it, which I find motivating and nearly all of my coworkers do too (except the ones who have their plate full just keeping up on their basic tasks). In addition to all the things there are to see and talk about, there's nothing like helping a student go back to post-conference on cloud nine because they've just put in their first IV ever, or just having them leave excited, in general. Which is often the case. I enjoy new grads/orientees, too for some of the same reasons. I think a solid nursing foundation is necessary for any kind of legitimate success and I'm happy to help anyone who genuinely wants that.

So, if I could, I'd ask you to hear me out with an open mind. Let's think about this not as someone being wrong and someone being right, but whether a do-over could yield a different result. I think it could.

Sounds like the person you encountered has a pretty bad attitude; that outburst can't really be defended.

But your timing/approach might have (silently) disappointed even someone who generally does enjoy students, such as myself. I wouldn't have said anything rude, but rather just "Let's check it out..." since I would know that you meant no personal offense.

I know you didn't say this, and I'm sure you were pleasant, but this is how it translates: You approached someone in the last minutes of 12 hours' worth of running, and in essence said, 'Hi, I'm Katie....so, question - have you been doing your job wrong all night long?' When I read your post that was my immediate reaction - as an understanding person: Geez, nice to meet you, too/can we get to know each other a little first? :)

The fact is, you did not need that information from that individual at that instant. And, I truly, sincerely hope you will try to see another's perspective on this, because communication is so important. I would recommend that in this situation, in your position, the absolute best thing to do would have been to go back to your instructor/the report information. Then, when the timing is appropriate, ask the day shift nurse for help in clarification if you and your instructor aren't able to figure out the discrepancy. Or listen to the shift report and see if the issue is clarified/ironed out during that process. Or, at the very least, if you do discuss it with the off-going nurse, you could start with an acknowledgment that your information is second-hand and that it might be incorrect. A few minutes of general rapport first wouldn't hurt, either.

There are no two ways about it - your question was innocent and not inappropriate per se. But it meant that someone was going to need to evaluate whether or not they had been doing something wrong for 12 whole hours. And where the mix-up occurred. And deal with the fall-out. There were other ways for your legitimate question to be answered. Unfortunately your approach reinforced someone's prejudice, since your information was wrong.

I hope this makes sense. It's just food for thought. We are all responsible for our own emotional reactions - so this nurse's reaction is on her. At the same time, we all are also responsible to understand how our own communications could be received in particular contexts.

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Nurse Magnolia is a RN and specializes in NICU.

1,509 Visitors; 110 Posts

I enjoy (most/many) students, myself. They generally like coming to my area (ED) and are excited about it, which I find motivating and nearly all of my coworkers do too (except the ones who have their plate full just keeping up on their basic tasks). In addition to all the things there are to see and talk about, there's nothing like helping a student go back to post-conference on cloud nine because they've just put in their first IV ever, or just having them leave excited, in general. Which is often the case. I enjoy new grads/orientees, too for some of the same reasons. I think a solid nursing foundation is necessary for any kind of legitimate success and I'm happy to help anyone who genuinely wants that.

So, if I could, I'd ask you to hear me out with an open mind. Let's think about this not as someone being wrong and someone being right, but whether a do-over could yield a different result. I think it could.

Sounds like the person you encountered has a pretty bad attitude; that outburst can't really be defended.

But your timing/approach might have (silently) disappointed even someone who generally does enjoy students, such as myself. I wouldn't have said anything rude, but rather just "Let's check it out..." since I would know that you meant no personal offense.

I know you didn't say this, and I'm sure you were pleasant, but this is how it translates: You approached someone in the last minutes of 12 hours' worth of running, and in essence said, 'Hi, I'm Katie....so, question - have you been doing your job wrong all night long?' When I read your post that was my immediate reaction - as an understanding person: Geez, nice to meet you, too/can we get to know each other a little first? :)

The fact is, you did not need that information from that individual at that instant. And, I truly, sincerely hope you will try to see another's perspective on this, because communication is so important. I would recommend that in this situation, in your position, the absolute best thing to do would have been to go back to your instructor/the report information. Then, when the timing is appropriate, ask the day shift nurse for help in clarification if you and your instructor aren't able to figure out the discrepancy. Or listen to the shift report and see if the issue is clarified/ironed out during that process. Or, at the very least, if you do discuss it with the off-going nurse, you could start with an acknowledgment that your information is second-hand and that it might be incorrect. A few minutes of general rapport first wouldn't hurt, either.

There are no two ways about it - your question was innocent and not inappropriate per se. But it meant that someone was going to need to evaluate whether or not they had been doing something wrong for 12 whole hours. And where the mix-up occurred. And deal with the fall-out. There were other ways for your legitimate question to be answered. Unfortunately your approach reinforced someone's prejudice, since your information was wrong.

I hope this makes sense. It's just food for thought. We are all responsible for our own emotional reactions - so this nurse's reaction is on her. At the same time, we all are also responsible to understand how our own communications could be received in particular contexts.

I appreciate your perspective. I was going in to check on my patient as we are required to do first thing. My patient was a 2 week old infant. When I got yo the door expecting to gown up, the night nurse was coming out of the room, ungowned. I introduced myself and then just asked if she knew whether or not this patient should be on isolation. My information wasn't incorrect. The order for isolation was still in the chart. We had to dig into dr notes to find where the dr said the patient didn't need isolation...but regardless, the order was still current. I was not accusing her of anything. When she said she didn't know that he was ever on isolation, I thanked her and went to consult with my instructor. This is when she stomped past me....etc

This nurse should have known at least that he had been on isolation because it was still there at the top of his chart. I'm not sure how I could have waited longer in the day to ask because I have tasks I must complete by a certain time per my instructor.

I do appreciate your comments and I will take them to heart in future communication, but honestly, I don't really see how my question justified her behavior.

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UniqueUserName has <1 years experience.

194 Visitors; 25 Posts

Sustained interest

Initiative (not to be mistaken for inappropriate independence)

Pleasant attitude

Lack of moseying

~Good luck!

What would be considered inappropriate independence? For example, if I had answered call lights with permission and then all the nurses on the floor were busy with their patients and I answer a call light on my own accord, is that ok? I worry about over stepping boundaries as a student nurse sometimes.

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9 Followers; 22,873 Visitors; 3,024 Posts

What would be considered inappropriate independence? For example, if I had answered call lights with permission and then all the nurses on the floor were busy with their patients and I answer a call light on my own accord, is that ok? I worry about over stepping boundaries as a student nurse sometimes.

Most independent decision-making. I would say some of the more common examples involve oxygen (taking it off, especially), giving patients food/drink, and deciding to ambulate patients. Mind you, these things may not be wrong, but they generally are not decisions that students make completely independently.

An example of initiative vs. inappropriate independence: You have reason to believe that your patient might not need to continue the oxygen that was started in the ED - so after reviewing what you know about the situation, you seek to discuss it with the nurse and it is agreed that the patient could have a trial of room air and then you are involved in monitoring how the patient tolerates that. Versus deciding that the patient doesn't need oxygen and taking it off.

Answering call lights is a great way to get in there and interact with patients and get general experience fielding their requests/hearing their needs and preliminarily assessing general situations. When you answer the light you would (for most things) do a quick check w/ the nurse: "Mr. X in [room#] would like to go for a walk. I have time to do that with him, if that's okay." Then the two of you could review safety precautions particular to Mr. X, etc.

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UniqueUserName has <1 years experience.

194 Visitors; 25 Posts

Thanks for the feedback! I definitely double check before giving food or drink to a patient. When ambulating it's taking the patient to the bathroom or to shower, which is ok'd by the pct so I think it's alright.

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WittySarcasm has 10 years experience as a BSN and specializes in rehab.

4,576 Visitors; 152 Posts

Biggest things among everything else-

It's not 'tech' work and 'nurse' work. It's patient care. If you don't want to wipe butts, bathe, help them dress then maybe rethink if you want bedside nursing.

And dont proceed to act like you know everything. What you read in the textbook is the perfect world. Don't stand and recite the perfect world. We try to do as 'perfect' world but patients will screw it up. Listen and learn from your nurse. They might even give you cool tips that will help you when you're on your own.

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