Fellow nurses...does this make sense?

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Specializes in PACU, ICU, OR, ODSC.

The following pertains to a student nurse who is a personal friend of mine. Said person was in clinical and got to follow a patient for the day. This patient was intubated and being moved to interventional radiology for a procedure. In IR the patient's assigned nurse asked the student if they would like to insert the foley catheter before the case. As the student nurse had checked off this skill in lab they figured it would be a great opportunity. In the end all the student nurse was able to do was setup the sterile field and the nurse inserted the foley for the sake of time. (we've all been there)

At the post-clinical meeting the student nurse said they got to do a foley. That's when things turned for the worse. It's my understanding that at this school of nursing the student is not allowed to do any nursing skills without the instructor present. Their justification is that the instructors license is in jeopardy if the student messes up. I can't find ANY literature to back that claim up. The Illinois nurse practice act, from my interpretation, reads like their is protection for nurses and instructors in the event a student messes up. Can anyone find something different?

It's my opinion that this school is not utilizing best practice in effort to enable their students to learn with the few opportunities they can get. What are they trying to say? 1.) That they don't trust their own lab instructors who check the students off on clinical skills? 2.) They don't trust the staff nurse who is overlooking the student?

The nursing school I went to promoted all hands on! If I was trained in the skill and had a RN with me then dig in! The opportunities for IVs, foleys, etc are few and far between. I say take them!

Anyways, I'm baffled by the school's punishment of this student. As a professional I'm embarrassed by the outright lies of the clinical instructor. The instructor went to the administration and said that the student verbatim said they INSERTED the foley even when questioned and told that they were not allowed.

I won't list what the punishment was for privacy of the student but the fact that the clinical instructor went to such great lengths to lie and write up a sworn statement boggles my mind. Are clinical instructors so eager to eat their young? Did the student do anything wrong? I'm thinking of telling them they are going to the wrong nursing school!

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At the post-clinical meeting the student nurse said they got to do a foley... The instructor went to the administration and said that the student verbatim said they INSERTED the foley even when questioned and told that they were not allowed.

First, I would've assumed the SN also inserted the foley if they announced in post conference that they got to "do" a foley.

Second, it is up to each and every SN to know the policies (of the school, facility, and instructor) regarding what they are able to do (or not do) and with whom they are allowed to do it.

I'm sorry your friend is having a stressful experience and hope all works out for the best.

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Specializes in Family Nurse Practitioner.

I want to hear the other side of this story. Something is up. Somehow I don't believe that this is the only thing that this student messed up on. When I was a nursing student I wrote in my journal one day that 2 nurses let me start IVs on them. After the fact, my CI was very clear with me that I should not be starting IVs on hospital staff. I got my warning and that was the end of that. Somehow I think there is more going on...

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I've been to nursing school twice in the past 10 years: I attended a vocational/practical nursing program in 2005 and an LPN-to-ASN transition program in 2010. In neither program were students permitted to practice invasive skills if a clinical instructor was not present to oversee.

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Specializes in ICU, M/S,Nurse Supervisor, CNS.

The students at my hospital are allowed to perform tasks with either their instructor or, with the permission of the instructor, with one of our RNs.

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

In my school, the rules were gray regarding doing skills without the instructor present. Some instructors were okay with it if the RN was present and some teachers said never do anything if the instructor wasn't present.

If a nurse was willing to take me under her wing to do a procedure I did it (with the nurse at my side) and didn't disclose it during post clinicals.

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Specializes in PACU, ICU, OR, ODSC.

Awesome responses everyone. I'm surprised it's nothing new that schools are restricting the learning potential of their students.

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Specializes in critical care.

When I've been on the floor at the same time as students, I've asked permission from the instructor to have students join me for things. I'm new enough that I don't get assigned students, but I still love to seize teaching moments if they present themselves. I had one fantastic day with a PEG, central line, foley and flexiseal. We had a group of first semester students there that shift and they were climbing over each other to check this patient out. I absolutely loved being able to walk a couple of them through management of all the lines and tubes. When I was in school, we rarely, if ever, saw these things.

My alma mater's program has an internship that is not directly supervised, and we were encouraged to jump in at every opportunity, with supervision of course. It bums me out this program is discouraging that.

I agree with other posters, though, that saying, "I got to do a foley," implies insertion. Your student friend has that nurse as a witness. I would encourage an appeal, putting the story in context, and maybe admitting that the intent was there, with an apology for not realizing it would have crossed a line. This would be genuine, and likely appreciated. It might be a good idea at that point to ask for clarification of policies relating to what students are allowed to do without instructor supervision.

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Specializes in ICU/PACU.

It's been awhile, but from what I recall all foley insertions or IV starts were done with our clinical instructor present. Once I was in my last semester and doing my preceptorship in the ICU, obviously there was no instructor present, and I was allowed to do skills with just the nurse present.

I am not surprised to hear of a nursing instructor being hard on a student though. I was written up for ridiculous things as a student, now that I look back on it.

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Restricting the learning of students is nothing new. The schools cite liability issues and frankly, it is their call. It is not optimal for the student, but no student has the means to fight this battle. Why this student would announce in post conference that they had violated a rule is beyond me. I hope they are able to recover from this incident.

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at my nursing school, the first year we had to do everything with the instructor. After that, we had to show our skills with the instructor at least once to show safety. By the end, we were expected to do everything on our own.

we were all told that the license of the professor is not injeopardcy. that this is why we get insurance. We were told this before we graduated. as an a-ha moment.

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As a clinical instructor, I make it very clear in the beginning that students are not allowed to do anything, ANYTHING, without me seeing them do it the first time. I don't let them change a brief until I'm sure they can do it right. I don't give a crap about liability, either, it's about patient care. I do not want them to cause harm by doing something incorrectly because they don't know how to do it.

I also do not trust "check-offs" by other instructors. I have seen some students pass their VS check offs and completely screw up taking a blood pressure. I have seen so many students cross their sterile fields and touch the patient, then touch the foley, that I don't allow students to do foleys alone, even if they do it perfectly for me the first time.

That being said, I give my students the benefit of the doubt. If someone says they did something with another nurse, I remind them about my rules and then I talk to the nurse and NM about limits on my students. I do not attempt to get the student kicked out. I am there to help turn them into nurses, not have an ego trip.

If a student uses poor judgment and does something stupid to get a patient harmed, though, then all bets are off. In this case, based on this very one-sided anecdote, I think the instructor went too far. I also think that the OP's second-hand information is probably inaccurate and there were extenuating circumstances.

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