Following a nurse during clinicals :(

Editorial Team / Admin · Oct 9, 2017

You do realize you pay money to the school to teach you, and not to the bedside nurse, yes? It is also quite possible that the nurse who had the patient you were assigned to already had far too much on their plate- sadly, it seems instructors do not take other things into account when assigning students, such as nurses barely off orientation themselves who are still learning how to do the job. And honestly, students add a lot to an already overwhelming workload.

How to deal with it: Utilize your instructor. That is who is paid to instruct. The nurse is getting nothing but additional work. Realize that nurses are humans just like the rest of us. Not all of them have great people skills and not all of them have what it takes to work with students.

You had one day in clincials with one nurse. Don't let 1 experience color your perception of all nurses and how all of your clinical experiences are going to be.

NurseSpeedy, ADN, LPN, RN · Oct 9, 2017

As a floor nurse I have no problem with a student following me and shadowing. Most instructors at least give me the courtesy of asking if I am okay with taking on a student and my response is usually, "Sure, if they can keep up", literally. I am not going to slow down my pace in order for a student to chase me, so it's up to them if they want to run around for their clinical day.

We don't get any additional pay for the responsibility of a student. We still get the same number of patients that we would have if we were working independently. We are usually short staffed and while we understand you are learning and want a good clinical experience, it is your school's responsibility to provide that quality education to you, not ours. It IS our responsibility to assess all of our patients, pass our meds on time, handle admissions/discharges/ and the oh-so-poorly-timed rapid response all at once, and all of the various tasks in between (q1 hr pain meds, blown IVs, 20 stat orders including two foley catheter insertions, a million dressing changes, a darn wound vac that won't stop leaking and alarming, mostly isolation patients, and why oh why is it always that scabies patient that won't stay in bed setting off their bed alarm every five minutes?!).

It's not that nurse's don't like students. It's just that the facility is not going to staff us appropriately so that we can do your instructor's job for them. Our shifts are 12 hours and if I'm already running behind, I sure as hell am not going to stay overtime because I went ahead and explained everything to a student step by step. My management wouldn't accept that as a reason for running into OT either.

Turtlepower · Oct 9, 2017

You make a great point, and I agree with you to a degree. Just like you say that nurses are human too so are students nurses. There is a line between treating a student nurse in a disrespectful manner and just simply saying I'm overwhelmingly busy and can't help you right now. But it's okay, I completely understand that nurses are busy and might not have the time, knowledge or ability to teach. For all I know they might not like to be put on the spotlight because they are put in a vulnerable position where someone else is watching over their every move...I get it

Don't get me wrong, for me, despite the lack of communication between the nurse I was shadowing, I was still able to get a lot accomplished... All is not lost! I utilized other resources that didn't mind helping me and figured out how to overcome this obstacle. I was just curious as to how others dealt with the same situation.

Honestly, I am glad I was put in a situation like this, it allowed me to see that not all nurses are created equal, some are more helpful than others. I embraced the challenge and moved forward from this.

You are correct about not perceiving every nurse the same way based on 1 nurse. I absolutely agree with you there.

Thank you for commenting!

Nightmaren, BSN, RN · Oct 10, 2017

It depends a bit on the institution, but sometimes the nurses are being compelled to take students due to it being a requirement for advancement within the institution. Other times, they are simply having a bad day, have a lot on their plate, or are dissatisfied with the staffing for the day -- there can be any number of possibilities.

Even so, I disagree with any nurse's decision to treat you as a burden or as a pest. Even between students and nurses, there is a degree of professionalism that should be followed -- the nurse's verbiage towards the student would immediately raise an eyebrow from our unit manager. Most schools allow you to evaluate your preceptor at the end of your clinical so that the instructor can make better decisions next time. If able, please utilize this capability, not in a vindictive way but in an honest informative way about how you felt it affected your clinical experience.

That being said, you had a valuable experience that let you identify a poor learning dynamic with your preceptor and you did the right thing -- offered to help out around the unit. As the other pointed, you are there to learn so it was very appropriate of you to seek out opportunities to learn rather than being pigeon-holed all day with a preceptor that would not teach. You will come across situations like these from time to time, but as long as you maintain your professionalism even in the face of such experiences, you will come out having learned.

Heylove, BSN, RN, EMT-B · Oct 10, 2017

I experienced the whole spectrum of nurses during clinicals. I had one that told me "I'm too busy for a student. I don't want you to do anything today, just watch me if you have to." Okay? I had one that was upset that I wasn't doing everything. That one complained to my instructor that I didn't have enough initiative. I had one nurse that asked me to do things that, as a student nurse, I had to ask my clinical instructor permission first. She said "no, I'm your nurse today, you're going to do what I tell you to do right now." Today, I am most grateful for this nurse by the way. She explained to me afterwards that she had witnessed how my clinical instructor had been treating me and that she thought I was going to be a great nurse, and she wanted me to build my confidence in my abilities and not constantly question myself or worry about what my clinical instructor was going to say to me. Clinicals were a challenge for me, as you can imagine. I am so glad they are over!

I would always start my introduction with "I'm here to help you do whatever you need me to do today in order for us to both get through today." Let the nurse know what time you are leaving, and when you expect to take lunch (or if you're going to take your lunch at the same time as the nurse.)

There were the nurses that were obviously less-than-thrilled about having students, and some that loved having students. I know what type of nurse I will be if I ever get the chance to have a student.

FolksBtrippin, BSN, RN · Oct 10, 2017

Let your instructor know that this particular nurse did not like to be shadowed and wanted you to attend to a task instead. Next time you go on the unit, spend your time with the patient, not with the nurse. If you are allowed, give the patient a bed bath, ambulate the patient down the hallway, practice your head to toe assessment. If the patient is on a regular diet and without fluid restrictions (hint: listen in report to find out) ask the nurse if it is okay to get water, crackers, coffee etc for your patient and then do it.

If your patient gets sick of you, answer call lights. There usually will not be a lot you can do, but you can find the person who can do it and do it with their permission (or watch), and you can always practice your therapeutic communication. Learn where the blankets, pillows, towels, etc are so you can fetch them when they are needed.

If a patient has to go to x ray, cat scan, interventional radiology, ultrasound, etc. Ask to go. These are good learning opportunities for you. Observe. Write down any questions that come up and ask your instructor in post conference. Avoid asking staff unless they encourage you to ask questions. It can be very hard for them to teach while they are giving care. You will find a few who can, and that is great. If someone can't do that don't get upset.

Don't feel sad or demoralized by a nurse who seems cold to you. Often nurses are overwhelmed with their own work, behind on things, and students slow them down. Stay out of the nurse's way if that happens. If the nurse goes into your patient's room though, make sure you are in there! You can watch all kinds of stuff that way.

neuron · Oct 11, 2017

You make a great point, and I agree with you to a degree. Just like you say that nurses are human too so are students nurses. There is a line between treating a student nurse in a disrespectful manner and just simply saying I'm overwhelmingly busy and can't help you right now. But it's okay, I completely understand that nurses are busy and might not have the time, knowledge or ability to teach. For all I know they might not like to be put on the spotlight because they are put in a vulnerable position where someone else is watching over their every move...I get it
Don't get me wrong, for me, despite the lack of communication between the nurse I was shadowing, I was still able to get a lot accomplished... All is not lost! I utilized other resources that didn't mind helping me and figured out how to overcome this obstacle. I was just curious as to how others dealt with the same situation.
Honestly, I am glad I was put in a situation like this, it allowed me to see that not all nurses are created equal, some are more helpful than others. I embraced the challenge and moved forward from this.
You are correct about not perceiving every nurse the same way based on 1 nurse. I absolutely agree with you there.
Thank you for commenting!

Understandable ya'll don't want a student, you were once a student also, but you are 'paid' by the hospital and work for someone else who DOES accept students. The nurse really doesn't have a 'choice' not to take a student. I am always grateful when the nurse teaches me something, and I do catch up to them and let them work.

KelRN215, BSN, RN · Oct 11, 2017

So, I'm starting this topic bc I believe that many of us have crossed paths w/ nurses who are downright mean and unhelpful. Today was my 1st day @ clinicals where we all received our for 1st patient. I introduced myself to the nurse I was following and he instantly gave me the cold shoulder, and wouldn't even shake my hand. He continued what he was doing on the computer and turned his back towards me... very awkward. When it came time to do shift report, I listened in on what the night nurse had to report to the day shift nurse, half of the things she was saying about the patient I have never even heard before. I was out of my element and completely nervous. My nurse I was following wasn't very helpful at all and just basically said "do what your instructor has assigned you to do" with a straight up attitude. I asked him if he needed anything and he told me "no" He then proceeded to ask me how long I was following him in a tone and manner like he was fed up that he got stuck with a student nurse which was the case...hahaha)
I later decided just to ask if the other girls needed any help with their patients and they were happy to share their patient.
What have you student nurses in the past done to get through a situation like this?

You know, it actually isn't the staff nurses' jobs to be helpful to you or to give you extra things to do. It is your instructor's job to teach you so telling you to do what your instructor has assigned you is fine advice. The staff nurse has an assignment of patients besides the one that you are assigned to. He may very well have looked at his assignment and knew he had to hit the ground running to stay ahead of the game for the day and you hovering and interrupting his report with the night RN slowed him down/prevented him from starting his day. If you have questions about your patient, you should review them with your instructor.

allnurses Guide · Oct 11, 2017

Instructors cannot know ahead of time which nurses will have any given patient; assignments are made at the beginning of the shift. A student in our school is expected to go in the night before and get their assignment, review everything and be ready to care for them in the morning. There is no way to avoid the nurses who don't want students around, but courtesy is expected.

Couple of times, we had more students doing their day in the ER (from several programs) than we did nurses. Some nurses had THREE students following them around. And yes, they were nice to them.

NurseSpeedy, ADN, LPN, RN · Oct 11, 2017

I just remembered one of my clinical days in Day Surgery. I ended up being used as the transporter to wheel people down to one of the many exits this hospital had for discharge. I am not good with my sense of direction. Some patients ended up with a nice "tour" as I navigated our way to meet up with their ride home.

Another time I had an instructor from my RN program that made it a point to tell the nurses that we were all LPNs already so there was a lot that we could do unsupervised. One took this to an extreme and said, "Great! Let me give you report. I'm going to lunch. Any questions just ask so and so". She then told the other nurse that she was going to lunch and her student was watching her patients. If it was the floor I would not have been so stunned but it was the ICU (a real ICU, not the kind that I was used to floating to in the past)!

I guess you could say as a student I wasn't ignored... I was, um, utilized?

California22 · Oct 13, 2017

This is extremely common, especially when starting out! Clinical can be really hard if the nurses are not interest in a student, but its just part of the deal I guess. Good job on finding other nurses to follow. Thats what I always did when I realized my nurse was not going to want a student there, which was usually within the few minutes. Don't worry about it being a difficult first day, just keep learning and also be aware how you come on the shift. Nurses like when students stay on the down low while they are getting report and try to stay out of the way the first hour. Its going to get better, I promise!