First Clinicial Experience

[Marly18]

Hi all..

I'm a first year nursing student and have just done my first prac at an aged care facility. I was really shocked at what i saw. The nurse that i was partenered with had no regard for wearing gloves, washing hands or manual handling. I needed to get this off my chest because as a student, i'm trying to learn best practice and to me.. Well lets just say that is kinda wrong. The patients are lovely but the nurse had no respect for their dignity when changing and toileting them. And pulled them by herself when changing their position in bed. The amount of pressure area's and bruising was terrible. I dont know if it was just this nurse or the facility fault but someone needs to do something about it..

Has anyone else come across something like this?????

[qt2168]

Some nurses are more old school then us noobies btw and dont bother wearing gloves for many things. I have seen seasoned nurses stick their hands in things that would gross me out even if I was wearing gloves, and a gown, and goggles... and doing it with a 10 foot pole. Some of them were taught not to wear gloves and still dont want to use them. Just don't judge any nurse until you have been one. Good luck tho!

[Virgo_RN, BSN, RN]

Click on the "Students" tab at the top of the page. There you will find the discussion forums for nursing students.

[nursemike, ASN, RN]

I suggest you approach your clinical instructor with your concerns. I don't see a big problem with bare, intact skin touching bare, intact skin during a bath. In the past, it was felt wearing gloves for a bath might offend the patient. I haven't found that to be the case, these days, but as another poster noted, some nurses are "old school," and it's almost inevitable that in a hurried moment, one may come in contact with urine or feces bare-handed. If your skin is intact, thorough hand washing should be enough. Gloves or no gloves, hand washing is necessary, afterward. Some of the other problems you mention may be a matter for the Board of Nursing, but again, run it by your instructor. She or he will have the knowledge and experience to know whether to contact the nurse's supervisor about sloppy practice, or whether it rises to the level of pt abuse.

And yes, there's a ton of good info for students in the student forums.

[racing-mom4, BSN, RN]

In school you learn the ideal way, you have ample amount of time with your pt. In lecture you only talk about 1 patient, where as in reality the LTC you were at the nurse probably had 30 patients!! I am sure in your mind it was going to be a "more relaxed-peaceful-I am going to give a 20 min bath" type of scenario and then you walk into real world and it is overwhelming.

I know I myself was appalled at the "conditions" of my 1st LTC clinical. And this nursing home won many of awards and was known as the cream of the crop. I thought they were blind and crazy--how could this be the best??

Thinking back now and knowing what I know---they were pretty good and did the best they could with the situation presented to them.

[Fun2, BSN, RN]

I think you should worry about you....don't let the 'old ways' blind you!

I wear gloves probably for more things than I should, only because bacteria is invisible to the naked eye!!!

Intact skin or not....something could be a ticking time bomb on any patient!!!!

[jjjoy, LPN]

In school you learn the ideal way, you have ample amount of time with your pt. In lecture you only talk about 1 patient, where as in reality the LTC you were at the nurse probably had 30 patients!!

It's sad that that IS the state of affairs. It is ALSO sad that schools/nursing education doesn't acknowledge the reality as part of instruction. They seem to set students up to be shocked and confused by what they see in practice. This also leads to increased tensions between students and staff.

[jjjoy, LPN]

I think you should worry about you....don't let the 'old ways' blind you!

How would it be benefitial for a student to NOT be concerned when they witness what they've been taught is improper practice? Part of clinical experience is to LEARN from those with experience. But if you see questionable practice at the most basic of tasks, a student is right to question if they can trust anything they learn from that person. So, then, their learning opportunities at clinical are diminished. Learning what NOT to do is not a substitute for learning what TO do.

Sure, there is "more than one way to skin a cat" but the big problem is when the witnessed practice is just plain wrong. It is very confusing to students to see unprofessional/unsafe practice and be told to just ignore it and only worry about their own practice. Ignore it?! if it's wrong, how can you just ignore it? Doesn't it need to be reported and remediated? This issue of how students can ethically and professionally deal with witnessing questionable practice both as students and professionals should be directly addressed in school, not just dismissed with a quick word of advice to "just worry about your own practice" or "now you know how NOT to do it."

[Fun2, BSN, RN]

You should be concerned, but we are also taught, "We're a guest in the hospital"..... Therefore, you pick your battles.

The instructor should be told, don't get me wrong, but overall....it is the responsibility of the student to maintain standard practice protocols, and not get sucked into doing what she/he feels is incorrect.