While I understand that you're proud of your clinical skills derived from your prior experiences, if they are beyond the scope of the license for which you're currently a candidate, they have no bearing on your current preceptorship and frankly, your continual reference to them is tiresome and makes you appear insecure - or even condescending.
I understand that you were a super suturer and a fabulous intubator as a military corpsman or paramedic but those skills are beyond the scope of what we're licensed for here so please spare me the continuing commentary and instead focus on what we're doing *here*.
Specializes in Medical and general practice now LTC.
ok i have removed several posts that was either violation terms of service by attacking other members or quoting posts that was attacking members. please please remember the terms of service that you all agreed to when you joined the site. personal attacks will not be tolerated although friendly debates are more than welcome.
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So, do you believe a student is SUPPOSED to know how to insert an IV out of nursing school? Because if that's the case, the law is being broken. Only an RN, not a student is allowed to start an IV. (And remember, you're not a nurse until you pass the NCLEX). You could be a graduate of a nursing program, but not an RN. So if you expect said student to start an IV right away, the law was broken somewhere.
And if you're volunteered as a preceptor, you could always JUST SAY NO.
I call 'em as I see 'em, too.
Um...students at the nursing school I attend do start IVs. In the 3rd semester.
So to you who've judged me as mean, etc, did you actually *read* my complaint?
I did not lament the student's lack of skill or preparation. Rather, I criticized the student's self-aggrandizement in continual speaking of all the advanced practice activities which they did prior to nursing school - none of which are within the scope of the license for which they're a candidate. How you go from that to the statements that you've made is beyond me.
The really ironic part is that most of the students love me - precisely because I go out of my way to seek out opportunities for them to practice their skills... even at times when I'd prefer to practice them myself.
To those of you who understand what I'm saying... thank you.
Obviously I haven't gotten through every response to this post, but that being said, I am a student nurse. I get what you're saying. Nothing about not being prepared, we're talking someone who believes they're SO prepared that not only can they practice as a nurse, but that they can practice skills that are reserved for an NP, a PA, or an MD because they're not a part of the nursing practice. I get it. Sometimes having prior experience in certain settings are a detriment to the student. Save the suturing for the war field and the intubation for the ambulance, you'll get sued if you do it as a nurse. You're practicing beyond your scope. Good thing they've got preceptors like you to tell them they're not allowed to do those things, because if someone didn't get through to them in nursing school they (and their facility, and their school) are at risk for losing a lot.
In my nursing school there is the LPN and RN year. They don't teach IVs in the LPN year but do in the RN year. I hear they are going to change the cirrculum and teach IVs in first year. I ended up quitting my RN year to work as a LPN, luckily IV is taught first, so I did have a bit of an idea as far as doing blood draws. Lucky I say, b/c I work day shift in LTC and we do all the labs in the AM so they can be taken to the lab ASAP. Nothing like some on the job training though. I was trained by 5-6 different nurses (b/c my position was open and there was no set person to train me, whoever signed up for the empty shift trained me). I don't do things exactly as every nurse. I took little things from each nurse. But I was a blank canvas! I'm still learning (though on my own now). I have a good relationship w/the other nurses and ask questions freely, they answer them. They are the veterans and I trust them!
Just had to throw this out there... I don't think anyone means that you should be expert by any means at any skill as a new grad and even if they weren't practiced on a real person while in school, you should know how it's done. So yes, you should know how to start an IV, even if you don't get it, you are expected to know how to do it. Doing it well, on the other hand, takes some time. Thanks to those who precept and an even bigger thanks to those who enjoy it. Maybe the preceptee that the OP refers to will be a great nurse, maybe they do have some great skills, but this doesn't make them any less annoying or arrogant and attitude can go a long way in life. I start my preceptorship next month and I expect my preceptor to expect things from me. They better expect that I know the basic mechanics behind skills but also know that it may very well be my first time starting an IV on an arm that isn't plastic with huge bulging veins. And I didn't find the OP's post to be mean in any way. Thanks for precepting!
Specializes in Peds/outpatient FP,derm,allergy/private duty.
According to you a student who is rubbing the entire staff wrong doesnt deserve a chance to be a nurse?! What about a patient who is rubbing the entire staff wrong? He/she doesn't deserve to be your patient? A lot of nurses don't want to admit that no matter how much new grads or students try to do their best the preceptors hate those who are not catching on right away.
The point is years ago when these preceptors did't have the experience and didn't have the skills they have today how did they feel?
Years ago there were no "preceptors". Years ago we had 2 weeks of classroom orientation and 2 weeks of working with a "buddy". After that it was grab a non-busy nurse to run you through it the first time. This was in an infants DOU unit so the "patients are sicker today" argument does not apply. It literally never occured to me that I should be coddled along for as long as it takes for the preceptor to turn me into a good nurse, and "understood because I'm really insecure when I act like a grade 1 *******" while I'm supposed to be learning from, not bragging to.
In any case, the preceptor is a teacher and a good teacher knows how to turn any student to a good nurse. With patience and building confidence in this student the skills and everything that is needed would come along. And if you don't have patience than don't take a job.
The bolded area there is pretty much a summary of the difference in perspective then and now. All the scenarios above cast the student in a passive role. The preceptor should be able to turn the student into a nurse. The preceptor has to build confidence in the student. The preceptor must be patient for decades if it takes decades for he or she to turn every student into a good nurse, because there are some students and new nurses who =gasp= might take 100 years to turn into a good nurse. Meaning that some people will fail. It's just the way it is. Maybe everyone getting "I participated" ribbons in school instead of ranking 1, 2 3 etc has instilled the idea that participation=success now because we just want everyone to feel good about themselves at all times.
I'm with the OP. People that self-grandiaze (sp) are a PITA. They take up instructional time and add very little to the subject. I am paying for instruction and not someone's life story.
I think there are unrealistic expectations on both sides. A student should not expect a preceptor to force them to take initiative, challenge themselves, think critically, or let go of insecurities. A student is responsible for his/her own learning and for his/her own feelings of inadequacy. There may be preceptors who are willing to help a student work out his/her feelings but to flat out expect it is pretty ridiculous. If you need a shoulder, call your parents or a close friend. While you've got 'em on the phone, get some advice on how to appropriately manage your feelings in the workplace. Talk to a counselor or therapist if you have to.
On the other side, it should not be assumed by the preceptor that every student they work with will be the embodiment of what they believe to be the perfect pupil. It just doesn't work that way. The great majority of them are going to come to you exhibiting various compensatory mechanisms for insecurity and fear of failure. Expect that. If after considering what you'll be dealing with you don't think you can do so without at least the very basic of human decency and respect, get out of the assignment if you have a choice in the matter. If you don't have a choice, consider your options instead of reluctantly accepting and blaming the student.
So, do you believe a student is SUPPOSED to know how to insert an IV out of nursing school? Because if that's the case, the law is being broken. Only an RN, not a student is allowed to start an IV. (And remember, you're not a nurse until you pass the NCLEX). You could be a graduate of a nursing program, but not an RN. So if you expect said student to start an IV right away, the law was broken somewhere.
And if you're volunteered as a preceptor, you could always JUST SAY NO.
I call 'em as I see 'em, too.
Sorry Tyler- As a 20 year vet, I'm calling it as I see it, and you are WAY out of line here. Nowhere in the OP did it say students are supposed to know how to do everything. The point of the post was that it is exhasperating to have a student who "knows it all." These are the types of people who come out into nursing with an "I know everything, you can't teach me anything attitude.....right up untill they kill their first patient." I precept as well, because I honestly love teatching, and helping the next generation of nurses. After 20 yrs of this I still learn things...and I'm not afraid to admit it. 99% of the nursing students I come into contact with are great. That 1% that is either lazy' or used to be a surgeon in their old country can be a royal PIA- Those are the people who scare me with their arrogance. In certain situations, a bit of humility and appreciation can go a long way.
So, do you believe a student is SUPPOSED to know how to insert an IV out of nursing school? Because if that's the case, the law is being broken. Only an RN, not a student is allowed to start an IV.
Well now, I guess that would depend on the state in which you are a student. In my state, even early students can insert basic IVs under the watchful eye of an RN. My school even had an optional IV class, but even that isn't necessary. Later in the nursing program, after your preceptor is confident in your abilities they do not have to watch. They just need to be near should you need to ask them for help.
Such practice is *invaluable,* in my opinion, toward building skills and confidence.
"In any case, the preceptor is a teacher and a good teacher knows how to turn any student to a good nurse. With patience and building confidence in this student the skills and everything that is needed would come along".
Uhhh no!!!!!!! This is not true. There are some people who will NOT be good nurses, no matter what the preceptor does. I knew a new grad who was the very same as the one described in the post. He thought he knew everything already, refused to learn the way things were done, relied on his background (not in nursing) but was a smooth operator. Got himself hired (can you say warm body?), made a major error with a patient and damn-near killed him and finally was fired.
And he had a great preceptor, someone who had the patience of Job and tried every trick in the book to get this guy to listen and understand that he did not know it all, that lives were in his hands. His incompetence was reported every step fo the way in the process, but was hired anyway. I can honestly say I did everything in my power, as his preceptor, to prepare him.
Silverdragon102, BSN
1 Article; 39,477 Posts
ok i have removed several posts that was either violation terms of service by attacking other members or quoting posts that was attacking members. please please remember the terms of service that you all agreed to when you joined the site. personal attacks will not be tolerated although friendly debates are more than welcome.
debates
we promote the idea of lively debate. this means you are free to disagree with anyone on any type of subject matter as long as your criticism is constructive and polite.
personal attacks
our first priority is to the members that have come here because of the flame-free atmosphere we provide. there is a zero-tolerance policy here against personal attacks. we will not tolerate anyone insulting another individual's opinion nor name calling and will ban repeat offenders.
i am reopening this thread and any further posts that are attacking in nature will result in action from a staff member and may result in the thread being permanently closed