I am not sure if it is true or not, but I heard that RNs get a little extra pay when they work on a day where nursing students are present. If the charge RN assigned a student to an RN, then they get the extra pay.
I am talking about college nursing students not training a new employee.
It just came on top of my head because I have been assigned to lousy RNs during my clinical rotations and it feels like they should be more engaged with students
The horse is dead, for sure. The entitlement of the students here is astounding. My how nursing school and the ones going through it, have changed. The CI's must love having us do their jobs for them. So wrong. Glad I am in a specialty that there are no clinical rotations for students. I don't have to deal with the attitudes and the laziness of their clinical instructors. Saw a lot of this in the hospital, for sure.
Good luck, and I mean it, to all the students who are there to learn and have the right attitudes. I wish you all the best. The rest are in for a real eye-opening when they become RNs themselves.
Same here-Hospice doesn't utilize students, either.
However, last month a few of my patients at the facility were assigned to students, and no one bothered to tell the CI they were Hospice.
I pulled her aside, and suggested that Hospice patients probably wouldn't give the students the clinical experience they needed at that particular time-no labs, no tests, minimal meds, treating symptoms rather than disease processes., etc.
I told her that next semester I would let her know who the Hospice patients were before she made assignments. She thanked me and asked (key word here, children-asked. Politely.) if I had the time, would I be willing to give a short explanation of Hospice after they were done for the day.
Was I willing?? Of course I was. I had the time and I do love to teach. The students were polite, asked about a million questions, said they hoped they were still as passionate about nursing as I was after 36 years (oh, my, they were so YOUNG!!).
At my facility we most certainly do not get any extra pay for teaching the university students doing clinicals or externships, nor for precepting new employees. The hospital has a new grad internship program, and the only pay give to the facilitators is for the once monthly group meeting, although the "facilitator" usually spends upward of ten to fifteen hours monthly working with the new grad intern. That's all on your own time! It is certainly an important and worthwhile endeavor, but it is also a lot of work.
At my facility we most certainly do not get any extra pay for teaching the university students doing clinicals or externships, nor for precepting new employees. The hospital has a new grad internship program, and the only pay give to the facilitators is for the once monthly group meeting, although the "facilitator" usually spends upward of ten to fifteen hours monthly working with the new grad intern. That's all on your own time! It is certainly an important and worthwhile endeavor, but it is also a lot of work.
I wonder if this is current practice. Back in the day, nurses precepting new grads in the internship programs were most certainly compensated for that. And they should be!
Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.
As a student nurse, here's what I would like:
-Reduced CI:student ratio. When you have 1 CI to 10 students, and the CI must be there for nursing tasks (med passes, Foleys, etc.), you're obviously not going to get an adequate amount of time to do all of those things.
The ratio of CI to students is set/limited by the BON, in New Mexico it is 1:8; Texas 1:10.
I once was told while in the ER with my students that I was the only instructor who stayed in the ER the whole shift, including running to the ICU & cath lab to check on my students there. I was very surprised, until I needed to find another instructor on the med-surg floors & was told by former students/now RNs that I would find her in the treatment/tub room. Yeah, she was in there with the door closed! A student knocked on the door to inform her she had opportunity to start IV & was told by her instructor to "have your nurse watch you". Oh boy, I told her it was our job as CIs to do the "watching". It happened with other CIs so I know that not all CI are doing what CI should be doing. I even instructed students to answer the phone, " on third ring pick it up, Say name of unit, your first name, how may I help you?" I also answered the phones too. I had one student who started 8 IVs in one day in the ER, she held the record, but yeah every IV, I watched, from priming the tubing, helping them slide the catheter off the stylet, reminding them to release tourniquet, charging for it & documenting. Many times I literally held a students hand for the first IV, my face would be right next to theirs. I would sterile glove for their first foley insertion, loved the reactions when I would point out the female urethra with a sterile q tip, nope real people do NOT look the manikins in lab.
I also had first semester fundamentals students ask me if I had seen the CNA for the unit. Turns out they answered call light, and found pt had bowel movement in bed, so they (and they had just been checked off on bowel & bladder care/foleys/skin care/ bed baths) they were looking for the CNA so they could "tell her about the patient needed bed change". Yeah, they & 2 others got to practice total bed bath complete with mouth care, hair wash, the works while I supervised. I was actually told by these 2 students that they did not think RNs did baths/ change briefs! (Why do you think we spent all that time teaching you?) One further told me she was going to be an ICU nurse. Took her down to visit the ICU to show her there are no CNAs there, one or 2 techs, but RNs do all pt care there. Yes I have had students tell me, the instructor, that they had already done an injection, foley, dressing/other skill/ etc ONCE!
There are 2 acute care hospitals in my city, 3 nursing schools (LPN, ADN at community college, & university that has a traditional BSN, ABSN for second degree & Masters' Entry into nursing) which means the nurses have students there every day of the week, even Saturday & Sunday.
I work at an urgent care & we occasionally have students there both undergrad & NP students. I sent one undergrad home when she told me she already knew how to do whatever skill I asked her to do, another said she had already seen a procedure once, sent her home too. Really, you've done it/seen once & you are an expert? Also, had some want to sit in break room the whole shift, yeah they go home too. After they call their instructor & inform them they are being sent home & then I talk to instructor. I also submit an addendum by email to the instructor about the incident.
Also, many of them can not tell me why they are there, course objectives,what expectations for you to learn/what skills? They can tell me what semester they are in (semester 7, 8 etc) which is meaningless as I taught at their program 5 years ago & courses have changed. If you can not verbally tell me what classes your are taking, what lectures you are covering, & you did not bring your books/syllabus, then I don't know what skills/subjects to teach about.
Never have any problems with the NP students though, it is so much fun having them there, they really pick my brain.
I think this post should be closed. Dead Horse Beaten to Death!!!!
OK, maybe I'm not qualified to answer this thread, but I'm going to anyway, after reading up to page 7. I'm in my last semester of my ADN program. We've been doing clinicals every semester, and yes, there have been a couple of nurses each time who just didn't like having students. That's not my "read", that's what our CI told us each time. When we've had issues with staff who for whatever reason either wanted to pass their work off to us (a CNA or two, complaining, in essence, that we weren't doing enough of their work) or were basically the "I'm hungry and NETY" type, we talked to our CI and she talked to either them directly or their boss. This was infrequent.
I'm in a clinical group of 10 students, one CI per rotation, and I've yet to hear of a nurse with whom we've had direct contact have an issue with my team. They may not be gushing praise, but nobody is complaining about us, either. I know I've thanked the nurse assigned to the pt as well as the pt him- or herself each clinical day, too...and many times, been thanked with what looked like sincerity as well. Maybe that makes as much a difference as actually being focused on both learning and on the needs of the pt. My advice, if anyone cares about a student's advice, to those coming through the same process behind me is: Forget your class requirements. You're not there to get checked off on this or to do a med pass or to witness that. You're there to take the best da*n care of that pt. that you can. If the pt asks a question you can't answer, seek out his or her nurse. If you have a question you can't answer, seek out your CI, or better, your books, later.
Going in with the attitude of meeting your own needs is what I think builds the frustration some of the experienced nurses here are expressing. You ain't there for you, and it's not about you. You're there for the pt, and what you get checked off on or observe along the way is icing on the cake.
Nursing is about service to others. It's only when you've taken care of people for a while that you realize that giving of yourself is the best gift you can give yourself.
Bill
When I was a student I never felt entitled to any attention from nurses, if anything I knew they were doing ME a favour by teaching me when they had the time.
When I was in clinical, my CI knew which nurses didn't want students, so she would make sure we weren't paired with them.
I understand we are overworked and having someone following us all day expecting to teach them can be an extra stress, but let's not forget how that student feels.
Students see these nurses as role models, and want to learn from them. If you are having a bad day, try to make arrangements so you can get "rid" of the student, most facilities ask you before you take anyone ( the ones I know ) . It's better to do that than to make the student feel awful for trying to learn.
This entire thread shows how nurses "eat their young". Sad to see because as a new grad myself, I have nothing but admiration and respect for older nurses.
I learned most of my skills and "critical thinking" from amazing nurses on the floors, who opened up to me. They helped me gain confidence and I will forever be thankful.
Also, we do have a responsibility towards nursing students (not only patients). They are the nurses of tomorrow, and it would be a shame for them to see how much separation and anger we have among each other .
I vividly remember once arriving with my clinical group and overhearing the nurses say with dread in their voices "Oh great, students"! We were crushed and didn't understand why they felt that way. As an experienced RN I always welcome students, but it truly does take twice as long to do something while explaining it to a student (or 3). I also believe that talking while working can be a dangerous practice, as it distracts from the task at hand leaving room for error. That's why medication prep areas have signs stating "Do not interrupt--Quiet Area". One of the nurses I work with routinely tells students that if the nurse seems irritated to have a student it probably is just because he/she is having a rough day--that it's not always about the student.
After reading the entire thread the main point I've taken away is boy, have times changed! And not for the better. Not a single experienced nurse recounted memories of their clinical experiences that included their clinical instructor dumping them and disappearing. Probably because years ago that just did not happen. It was never expected that the nurses working were there to teach the students at all. If they were able to that was a very much appreciated bonus, but as students we all knew who we were suppose to go to with questions..our instructor. Any student with anything even resembling a less than humble and respectful attitude was very quickly corrected, again by the instructor.
I don't blame the current students for this, I don't even necessarily blame the instructors. This is just another case of the awful do more with less attitude that prevails in nursing today. Most if not all instructors are overworked and underpaid just like the rest of us.
I know this sounds like another "back in the day" rant but I honestly never had a clinical rotation with more than 5-6 students and our CI was there, and I mean there breathing down our necks the whole time we were on the floor. We could do nothing without that CI right there, heck it was the last year before we could even pass oral meds without direct supervision, and even then we could only pass those meds after we convinced our CI that we knew what meds we were giving and why.
Students should feel entitled to a proper education, after all they are paying for one. Students should not however expect to get that education from anybody other than the school they are paying their money to. To beat that already dead horse a little more, it is not the nurses job to make sure the students educational needs are met. Finally, no that nurse that just happens to be assigned to the same patient the student is assigned to does not get paid more.
Nursing students, we love that you have chosen nursing and look forward to working with you one day.
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But the time you spend with us is only the tip of the iceberg. Please don't take it personally. It also might not be anything about you. If I have patient in labor who after hours of pain might have to do a C-section, it's not the time to explain to her I have a student with me that day. Or if I have a comfort care patient on a geri floor and the family is distressed, also not a good assignment for a student. It just isn't. Sometimes we have to protect the trust we have built with our patients. What you may see as a less than perfect assignment is us doing the right thing by our patients.
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We will give you the best experience that we can, but it isn't a guarantee. Be flexible, compassionate, and have good manners. This serves you well no matter what type of nursing you will end up doing.
During my OB/Peds rotation, we had 9 other students in our group (10 total) coming onto a reasonably busy OB/postpartum floor. Our CI was there, on the floor with us, and it was to her we reported, as well as to the RN... those of us that could... when we weren't assigned to neonatal observation or to standby and witness a delivery. Of course, the CI went to each pt on the floor to whom a student might be assigned and asked for their permission, and of course, being a male student precluded some pts from agreeing. We were told privately that when assigned to observe the NICU team, permission did not need to be sought, and we were to just go with the team as if we were a part of it. I did so, and the pts nurse quickly approached me in the delivery room and asked me who told me I could be in there. I told her my CI had said to go with the team, and she told me the pt had requested no students. I left the room with professional grace, but I'm a little embarrassed that I didn't keep that grace after leaving.
I have to say, I was displeased. The pts that refuse to allow a student to observe this beautiful miracle, instead thinking that "oh, that pervert, he just wants to see my naughty bits!" doesn't think that about the male MD, and the hypocrisy was maddening, especially considering that if I chose to go into OB nursing, which I was considering, she would da*n sure expect me to know what I was doing, and might not have the choice of someone else whose parts look just like hers, only less pregnant.
Then I chilled out and thought about the fact that it IS her right to decide who sees, and it wasn't personal against any of the male students. It was shortsighted and narrow-minded, but pts have the right to be both of those things. I'm still displeased, and this is part of the reason I have now abandoned the thought of going into OB. That kind of prejudice is not the uphill battle I want to fight my whole career. Your point about honoring that trust you've built with a pt is the priority, though, and that's a point students, myself included, need to understand.
I'd also like to thank you for the tone of your post. It tells the story you want it to, without the venom that some posts seem to barely contain. (That latter is meant not as an insult to anyone, and I recognize the venom is not at the students themselves, but at the perceived sense of entitlement... and at the mgmt actions that make floor nursing less beauty and more duty.)
After reading the entire thread the main point I've taken away is boy, have times changed! And not for the better. Not a single experienced nurse recounted memories of their clinical experiences that included their clinical instructor dumping them and disappearing. Probably because years ago that just did not happen. It was never expected that the nurses working were there to teach the students at all. If they were able to that was a very much appreciated bonus, but as students we all knew who we were suppose to go to with questions..our instructor. Any student with anything even resembling a less than humble and respectful attitude was very quickly corrected, again by the instructor.
I don't blame the current students for this, I don't even necessarily blame the instructors. This is just another case of the awful do more with less attitude that prevails in nursing today. Most if not all instructors are overworked and underpaid just like the rest of us.
I know this sounds like another "back in the day" rant but I honestly never had a clinical rotation with more than 5-6 students and our CI was there, and I mean there breathing down our necks the whole time we were on the floor. We could do nothing without that CI right there, heck it was the last year before we could even pass oral meds without direct supervision, and even then we could only pass those meds after we convinced our CI that we knew what meds we were giving and why.
Students should feel entitled to a proper education, after all they are paying for one. Students should not however expect to get that education from anybody other than the school they are paying their money to. To beat that already dead horse a little more, it is not the nurses job to make sure the students educational needs are met. Finally, no that nurse that just happens to be assigned to the same patient the student is assigned to does not get paid more.
Take heart. Some schools still provide that experience. I take my last final in 11 weeks, God willing, and I still give NOTHING without the CI right there. I have one instructor who insists that she be present for every med passed by every student, every day, and does it, even with 10 students. I am still in awe of her ability to do that, and still get meds passed (mostly) on time.
The floor nurse is a resource to us, and a gift at that, and we're taught (less by word and more by attitude) to respect that fact.
Take heart. Some schools still provide that experience. I take my last final in 11 weeks, God willing, and I still give NOTHING without the CI right there. I have one instructor who insists that she be present for every med passed by every student, every day, and does it, even with 10 students. I am still in awe of her ability to do that, and still get meds passed (mostly) on time.
The floor nurse is a resource to us, and a gift at that, and we're taught (less by word and more by attitude) to respect that fact.
Thanks for your perspective.
You have no idea how much I appreciate that! It is gratifying to know that there are still programs that actually teach, and teach well. Of course since this is an internet forum people are much more likely to complain about the negative than praise the positive but after reading nothing but so much negativity about so many programs across so many threads I was really starting to believe good programs were beginning to be the exception rather than the norm. Thankfully now I know of at least one that seems to get it right. Gives me some hope for the future!
I'm in a clinical group of 10 students, one CI per rotation, and I've yet to hear of a nurse with whom we've had direct contact have an issue with my team. They may not be gushing praise, but nobody is complaining about us, either.
I'm not saying you're wrong about that, but just wanted to point out that, in my experience, nurses don't bother to complain about students (unless someone really did something dangerous) because plenty of people have in the past and discovered that neither the school personnel nor our superiors really care what we think. Everyone else involved in the process wants to maintain the status quo and keep churning the students through. I think that phenomenon contributes to the grumpiness so many of us have about having students.
Jensmom7, BSN, RN
1,907 Posts
Same here-Hospice doesn't utilize students, either.
However, last month a few of my patients at the facility were assigned to students, and no one bothered to tell the CI they were Hospice.
I pulled her aside, and suggested that Hospice patients probably wouldn't give the students the clinical experience they needed at that particular time-no labs, no tests, minimal meds, treating symptoms rather than disease processes., etc.
I told her that next semester I would let her know who the Hospice patients were before she made assignments. She thanked me and asked (key word here, children-asked. Politely.) if I had the time, would I be willing to give a short explanation of Hospice after they were done for the day.
Was I willing?? Of course I was. I had the time and I do love to teach. The students were polite, asked about a million questions, said they hoped they were still as passionate about nursing as I was after 36 years (oh, my, they were so YOUNG!!).