Experienced nurses: What do student nurses do that drives you nuts?

Flying ICU RN · Sep 30, 2010

Passing through the ICU on tour in large groups, makes me feel like a monkey on display.

Please have the consideration to bring me a bag of peanuts, I'm usually hungry.

bekindtokittens · Sep 30, 2010

I graduated in May 2009 so I still remember how awkward and in the way I felt almost every day in clinicals.

That said, I do have a pet peeve when it comes to nursing students. I work psych, and I understand that not a lot of students are planning to go into psych. But they always seem to group in the nurses station and avoid me and the patients as much as they can. Just because you don't want to work psych doesn't mean you can't learn something. Psych diagnoses and psychotropic meds are everywhere in health care.

And this has happened more than once--complaining about how boring/stupid/scary psych clinicals are and how they will never work psych--where my patients can overhear. That is just not therapeutic.

However, it makes my day when a student comes to me with an insightful comment, question, or observation about a patient or the milieu atmosphere. And of course, coffee and bagels go a long way.

LeapfromLVNtoBSN · Sep 30, 2010

It drives me nuts when students sit at the nurse's station working on their care plans. That can be done at home, they're at the hospital for a reason and that is to work and learn. I've had very few students that work like if on the payroll. They offer to give baths and have initiative to do other things other than sit around for 6 hours. ugh!

Doing the care plans at the nurses station is what we're TOLD to do. Ask the clinical instructor before getting preterbed at the student.....I know our clinical instructor wanted the care plans done before we left the floor that night! Hhhmmmm, how else to do it? Go hide in an empty room???

Also as a student, you have to be working with a LVN or RN who is going to have the patience and time to teach you, and tell you to come along to some procedure......not dread it when they see students show up.

Also, it is frustrating to students who want to learn, that other students are standing around and giving the whole group a bad name!

Forever Sunshine, ASN, RN · Sep 30, 2010

I worked with students at my last job, at a peds hospital. Being a relatively new nurse myself, I felt that I was very sympathetic to students, and I really enjoyed working with them.
Having said that, here's my list of annoying things that SOME (not all) students did:
1) Showed up late and, worse yet, didn't even apologize. Expected to still be able to jump in and do patient care, and expected me to give her report and tell her what to do! For heaven's sake, show up on time, or at least apologize for being late!
2) Didn't know what they were allowed or not allowed to do -- had to go ask the instructor if they were giving meds that day, half an hour into the shift. You should know this in advance. I didn't care if students were or were not giving meds, but I needed to know, and you should know before you get there!
3) Took all the chairs in the report room/at nurses station. Let the nurses sit first, then if there's any extra chairs, go ahead and sit (I always did this in nursing school). I developed plantar fasciitis and my feet always hurt like hell -- having to stand always put me in a grumpy mood.
4) Took the charts into another room and didn't leave a note (as they are asked to do) saying where it was.
What I appreciated was students who showed up prepared and ready and eager to jump in and do the work. Even if you know you're not going into peds, you can still learn something from the rotation, if you have the right attitude.
Good luck!

#3 burst my bubble. I hear old nurses saying that years ago nurses had to offer their chair to the doctor if they entered the unit. For a nursing student to grab a chair and sit as if it was their own desk/table baffles me. It even baffles me when CNA's do this. I have work to do and I can't do it with people hanging around me and I definitely cannot do it standing.

Forever Sunshine, ASN, RN · Sep 30, 2010

Doing the care plans at the nurses station is what we're TOLD to do. Ask the clinical instructor before getting preterbed at the student.....I know our clinical instructor wanted the care plans done before we left the floor that night! Hhhmmmm, how else to do it? Go hide in an empty room???
Also as a student, you have to be working with a LVN or RN who is going to have the patience and time to teach you, and tell you to come along to some procedure......not dread it when they see students show up.
Also, it is frustrating to students who want to learn, that other students are standing around and giving the whole group a bad name!

Well if the nurses station is busy and bustling.. find somewhere else to do it. Such as a breakroom or a lounge area or a conference room on the floor.

catshowlady · Sep 30, 2010

I hate to say it, but the thing I hate most about having students is that they are slow! I know they can't help it, but I worry when it's 10:45 and my 10:00 meds are still not passed. The other thing that bugs me is taking charts out of the nursing station. Spent 20 minutes one day looking for a chart for a chronically grumpy doc. It was in the conference room with the students. If you need the chart, tell the nurse, charge nurse, and the unit clerk where you are going with it, please.

I think the thing that would help me most is if the students would communicate better with me. "I have XYZ pt, I will be responsible for an assessment, PO meds, VS, and accuchecks. I am not assigned bathing or IV meds today." And tell me if you and the CI are running late, so I don't worry.

The other thing is knowing what a particular clinical group is allowed to do, i.e. IV's, foleys, etc. I will look for opportunities for the students if I know what they are allowed to do.

I really enjoy teaching, but please, be willing to learn and work!

:paw:

LeapfromLVNtoBSN · Sep 30, 2010

and I would, but just playing both sides.......our teacher wanted us "on the floor" and to "have our care plans done".....(LOL, I usually got just ok grades on my care plans because I didn't spend enough time on them, because I'd rather be on the floor learning skills)...so I'd back up against a wall, out of the way and write on my clipboard.......but others didn't and I know it looked bad and was rude at times.........

LuckyinKY · Sep 30, 2010

My class just finished our first clinical rotation and I like to think that we were not very obnoxious. We mainly were there to practice taking a nursing history and patient assessments. We did things like take vitals, toileting, transferring, and baths, but mostly we sat and talked to the patients. The nurses in the facility were very kind and were great about gathering a few students if there was something going on like a dressing change or giving a med through a PICC line. We always made sure to thank the nurses (and the patients) and brought a thank you card and muffins on our last day.

I guess it helps that my clinical group is made of mostly mature students, many of us already have bachelors degrees, families and jobs. I lucked out to have a great group of people to work with. We all subscribe to the philosophy that you will catch more flies with honey, so we are courteous and polite and try to stay out of the way of the nurses. We do do alot of charting while there since we need information from the patient's charts, but we used an empty room to do that so we were not disturbing anyone.

One thing that helps beyond being polite to the staff is being polite and helpful towards the patients. I know from my experience as a patient during a complicated pregnancy that you sometimes feel like you are under a microscope. Often before diving in to poke and prod the patients, we gave them time to wake up, make themselves comfortable and just had some chit chat time. Often you can collect a decent amount of assessment and nursing history data just from doing things like talking or giving a bed bath.

One of my classmates told me that her patient (who is in isolation and has no close family) talked about how he missed small things like being able to have a diet Mt. Dew. After checking with his nurse to make sure it was ok, she went and bought him a cold Mt. Dew. That made his day. Sometimes it is just the little things that can make a difference. Listen to your patients frustrations and concerns and try to help resolve issues if possible. I think that the regular nursing staff is overwhelmed and cannot devote hours to listen to their patients, but as students, we can. The patient has a captive audience and may be more open and forthcoming with information and concerns.

themoreyouknow · Sep 30, 2010

Wow. Lots of great points made already. I work Labor and Delivery so I'll add mine:

Peeves:

*Student nurses who hide. They pop into the locker room or find a nook and cranny and they hide to avoid patient care. This is your chance to do patient care with an experienced RN at bedside to help. YOU have to make your clinicals into the experience you want it to be. Studen nurses who seek out opportunities on our floor WILL find them.

*Students with no idea what they can and can't do. I can't read your professor's mind. Please know this in advance. Do not get into a room and say "Um, I don't think I'm allowed to do ....." You have now made my patient uncomfortable. Please do not make our patients feel like guinea pigs.

* As others have mentioned - do not crowd the nurse's station. If you need to, take the chart (let me know first!) to the report room for short intervals. Why do I say this?

---------On our labor/delivery unit students wear hospital scrubs. Because we are all dressed alike, family members do not know who the students are and who the nurses are and even though there are 20 of you at the desk, it never fails that you can not help the patient's family member who has asked for something. When I come back to the desk, I hear "Um, some guy came from *that* hall and wanted a blanket. We didn't know where to get them." This makes US look bad to the patients because the "nurses" at the desk couldn't help them and we have no clue who that man was. If you are hovering and a pt needs something, PLEASE say "I'm a student nurse doing clinicals today. I don't know where the blankets are, but if you tell me your room number, I will find them for you." Then, tell us in a timely manner. Do not wait until 30 minutes later and "Oh! Hey..!"

-------- This bears repeating: When there are a bunch of you hovering around the nurse's station, our family members do not understand why it is taking so long to get their medicine and their call lights answered. When they complain, upper management doesn't care that there were 20 SN on the floor that day. They care that *this nurse* and our unit didn't meet that family's expectations. Family doesn't realize that we must move at a slower pace with students to help teach them. They do not know that giving medication with students can take a very long time. All the family/patient can see is a bunch of nurses standing around the desk "doing nothing" while their loved one needs "x".

-------- There is a limited amount of seating and I have to chart! Yes, I know you're doing clinicals BUT I am legally responsible for this patient. I am the licensed nurse who can get in trouble if my charting isn't finished because I couldn't find a seat at my own nurse's station. Our charting is done on computer and my director wants "real time" charting as often as possible. She doesn't want me to wait until after 4 when I can finally get a seat and chart for the day. Please remember, we live here. You are just visiting for a few days.

* Badmouthing fellow nurses. Please, please, please do not tell me how mean, lazy, or horrid my coworker is. If you do, you are going to think there are now TWO witches on the floor. I will stop you short and tell you to address your professor if you have concerns. I am not going to listen to you badmouth a fellow nurse. I'm certainly not going to join in the conversation. It's unprofessional. If you are having a hard time with the nurse, talk to her first. "Sherri, have I done something to offend you?". Give that nurse the opportunity to rectify the situation. If that doesn't work, talk to your clinical instructor. Do not just stand around a badmouth said nurse. Our director makes us very aware of student groups who run and tattle to our boss that the nurses are mean.

* Gawking and pointing. Please do not do this. I know we are a labor and delivery unit. I know it is exciting to see a new baby being born for the first time. Please do not point and gawk. Whisper quietly. Write notes to each other on paper DISCREETLY. Do not say things like "Is it normal for her to be having a bowel movement now?" *(true story!) and embarrass my mom. This is a very intimate, private time they have invited you to share. Share it respectfully please.

* Just like in preschool - no talking in the halls please. I realize there are exciting patients. Please, please, please do not discuss them in the hall. Yes, I know the patient in 5 has had her 3 other children removed for having a meth lab in her home. Yes, I know she is positive for three types of drugs and this baby will not go home with her either, BUT the rest of the world does NOT need to know that. She still deserves my compassion and yours too. The report room or one of our locked pyxis rooms are the place to go if you must discuss pt care. AND...if you are discussing pt care - please do it in a way that expands your learning. Saying things like "Oh my God, that girl in 5 is a druggie and that baby is NOT going home with her" to draw attention to yourself because you have an 'interesting' patient is only going to make me want to fire you as my student. She's a person too. You do not know what has happened to her in her life to lead her down this road. Treat/talk about my patient badly and I will go to your clinical instructor. My director will back me up.

* Don't get upset when patients do not want a student nurse. It isn't personal. Don't make derogatory comments about that patient because they chose not to involve a student in their care.

* Be present. I mean be present in the moment. A couple weeks ago we had a group of students. 2 were in the nursery when they brought the new c-section baby in. Those two SN were leaning against the while, barely peering over their avon catalogs to acknowledge the baby. The nursery nurse called them over "Do you girls want to see what we do after the babies are brought to the nursery after a c-section?" (She had already told them what to expect. "No. We're good." The family can see through the large nursery window these two "nurses" rolling their eyes. Then one said to the other "Oh look. That baby is actually advanced for his age because his eyes are already opened. He must have been over 40 weeks." :eek:

* Keep your nurse informed! If we've asked you to do something (remove a foley) and you can't do it, do not just mumble "OK" and walk off. If you can't do it. Tell us. Don't wait until an hour later when we ask "How much urine did you drain when you d/c'd that foley" and then say "Oh..I'm not allowed, so I didn't do it." GRRRR! You should have said something. That foley was ordered to come out an hour ago and now it looks like *I* didn't do my job! Just tell us "I am not allowed to do that skill yet" but be prepared for me to tell you "Great, you can watch me. Now let me tell you what we are going to need before we go in there." Do not think that saying "I'm not allowed ...." is a free pass for you to sit at the nurse's station and gossip. It isn't.

What we do like?

* SN who ask questions.

* SN who are prepared (mentally and physically) to be here.

* SN nurses who WANT to learn. I was a SN. I remember that you only have a short time on Labor and Delivery. Tell me what you still have on your checklist so I can make it happen for you. Do you still need to do a catheter? I'll tell the other labor nurses so you can do one on a pt who has an epidural! She's numb and you'll get the experience! Do you still need to see a vag delivery? Let me know! Tell me what you need from me.

* SN who are pleasant and respectful to our patients.

* Assertive SN who offer to help the stray family member looking for a blanket or extra pillow instead of shrugging their shoulders and saying "I don't know where they are." Again..you are in OUR blue uniforms so they assume you are staff.

* SN who tell us where they are going. Do you need to go work on your care plan now? Please let me know.

This saves me from trying to hunt you down for 15 minutes because there's an epidural getting ready to start and I think you might want to see it.

* SN who thank the staff at the end of the day. Just a simple "Thanks, Sherri!! See you next week!" as you walk out the door.

I love teaching. It's part of the reason I love Labor and Delivery and Post Partum. If you are willing, I will teach you everything I know! I love having students! No question is too small and I will not embarrass you if you ask. I do remember what it is like to be an SN. I know many of you have families, are working, and are stressed out. Guess what? Me too! I have a big family, a full-time job, and am in school full-time for my BSN too! :)

In the end, it all boils down to common sense and courtesy. Treat the nurses the way you want to be treated. Treat our patients like they are the most important woman on the planet (because today - they are). Nursing is a profession. A proud profession. BE PROFESSIONAL even if fellow students and some of the nurses are not. Be the kind of nurse you would want. Do the job that you came to do. I promise you - if you were another RN and you weren't doing your job on our unit - we would let you know. We don't just give "attitude" to student nurses who aren't pulling their weight. We keep each other in line too.

~Sherri

dudette10, MSN, RN · Sep 30, 2010

I wish there was more communication between the charge nurse for a shift, the clinical instructor, and the facility. That way, so many of these issues could be addressed--the nurses wouldn't feel the students were underfoot and the students wouldn't feel underfoot. Most students really don't want to bother the nurses too much. :)

The absolute WORST situation I was in: an always-full floor with teeny-tiny nurses station that doubled as a narc med room at the back, telemetry station, and at least seven nurses on the floor with way too many patients assigned to each. The nurses' break room was our pre- and post-conference room. The nurses were extremely nice and helpful, but with that environment, I was surprised that they never strangled all of us. Especially when they had TWO schools of nursing on the floor at the same time for a couple of days!

I see it as a systemic and environmental issue. Think about it...if there was a space on teaching floors for educational groups, many of the issues that you all mention would NOT be an issue at all. Medical and nursing education and the unique space needs for it are not incorporated into facility planning and nurses stations are overcrowded just for the nurses that actually work there (not to mention legitimate members of the healthcare team). It's frustrating for all involved!

JenTheRN · Sep 30, 2010

I think Sherri covered everything.

My main "irk" is when students sit at the nurses station and use the computers. Please don't. I know the school supplies all the students with laptops. Bring yours if you need to work on computerized care plans and what-not. I need to use that computer to do my charting and to put in orders. And stealing chairs. I hate sitting on the floor.

canesdukegirl, BSN, RN · Sep 30, 2010

I surprised myself this year with the knowledge that I love to teach. I am willing to work with a student who is confident, shows the basics of what I am trying to teach them, asks lots of questions, no matter how "dumb" they think the question is, and who shows a real passion for learning.

My only pet peeve is when SN's feel that they must apologize for breathing. WOW! I hate that they feel so underfoot that they apologize at every turn, however I understand that they feel completely out of their element, and I just overlook it. We all felt like Rainman when we were in clinicals. Good Lord, I felt soooo awkward.

I think that clinical instructors should give thought to who their SN's are being paired with on the clinical floor. Some RNs hate to teach. Some love it. But we were all students at one time or another in our lives, and I take students under my wing and show them the vast array of possibilities that our profession proposes.