Frustrated with SN

Published

Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.

So this past week I precepted a 2 year ADN student nurse in her last 2 days of clinical before her internship. So I ask "what are your expectations today" as I had not worked with this SN before. So she said I'll take care of 3 pts. Okay, good, I was standing back, giving advice when asked and oversaw documentation, skills etc.

She did great with patient care when she did it but I had to prompt her to do everything! Okay, you should give those 0900 meds since you're here assessing. Okay, you should be checking the vitals before you give all those cardiac meds.Okay, those vitals were taken at 0600 and now it's 0930, yes, YOU need to take a new set of vitals. Okay, make sure the tele gets taken off soon since it was D/C'd. Okay, it's 3 hours later so I took the tele off the pt it was D/C'd from.

Didn't have ANY clue how to set up a bag of maintenance IV fluids with a piggyback nor put a pt on tele.What the heck have these students been doing during their 'lab' time?

Then to top it off, she stated she wanted to work on this unit. I politely reminded her of the over abundance of nurses and how she needed to really go above and beyond to get noticed and make an impression.

You don't get a second chance to make a first impression.

I know, I know, not all NS's are this way. I was just so frustrated I wanted to scream, take some initiative and take responsibility for your education!

Up Vote Up Vote ×

Whatever happened to the "take the vitals when you take on a patient" that was beaten into my head at College?

I'm also amazed at how little new grads will show initiative to do.

The IV thing? Seen it happen as well.

Up Vote Up Vote ×
Specializes in LTC.

In before "LOL I'M SUCH A BETTER SN OH MY GAWD!"

Yeah, new or not, after two years in school you should be about ready to start getting your stuff straight.

Up Vote Up Vote ×

Since I belong in the crust old bat society... I am terribly afraid I would have told her she was going to have to take the initiative. My patience wears thin on laziness.

Up Vote Up Vote ×
Specializes in ER/ICU/STICU.

Could it be that these attitudes tie into the other thread about high new nurse turnover?

Up Vote Up Vote ×
Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.

I DID tell her she would need to take full responsibility for these 3 (low acuity) patients. But it seemed to go in one ear and out the other. I had to remind her that a bed alarm going off on her risk to fall patient DOES take precedence over charting. She looked at me like I was nuts when I said go ahead and get your noon chemstick on Mr. So & So, the CNA is busy right now and we have some extra time. She also seemed shocked when I told her that RN's really are expected to do the majority of pt care and the CNA's are there to assist us not do all the butt & scut tasks.

The not being competent piece doesn't bother me as much as not ATTEMPTING to become competent on the unit your clinicals are on. Ask other nurses to watch or participate in a procedure they haven't seen. I always sought out tasks to get tasks "checked off" in my clinical. I would have a fair grasp on frequently used meds, procedures, common admission dx's, telemetry lead placement (ALL patients are monitored!).

In the end, it really comes down to, IMHO that the lazy student is just throwing their money away by not taking full advantage of the time and resources they end up paying for.

I wasn't rude, catty or passive-aggressive as I love having students whether just shadowing me or vice versa.

Ah well maybe I just expect too much.

Up Vote Up Vote ×
Specializes in M/S, ICU, ICP.

Sometimes I think expecting a certain level of maturity and accountability seems to be asking too much.

Up Vote Up Vote ×

Well, in SN defense, yes, you are in the lab; but, there are multiple students needing to do those skills and each lab day, you do something different. Then, it's a hit or miss in clinical. Either you get to practice a certain skill or you don't. I have had clinical days where I was with a nurse and I've tried to do the scanning, and triple checking meds and whatnot and they act like I am too slow or they just set the pills in front of me to open without letting me see the computer. I've done blood sugar checks and given insulin with certain nurses and others will not let me do it. I mean, maybe, SN didn't know what she was allowed to do and what she wasn't.

Up Vote Up Vote ×
Specializes in Med Surg - Renal.

The student was clearly in over her head and had no business taking care of three, even three low acuity patients. Employees on my unit can't even do that without a few weeks of orientation and a week on the floor.

I would have (and have) cut her back to one patient when it was clear early on she was doing everything via prompting.

Up Vote Up Vote ×

we are only given one patient in clinical anyway to focus on and the rest of them are just kinda learn what you can.

Up Vote Up Vote ×
Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.

If she had not been in her last days of clinicals I would not have said she should. I've talked to the nursing instructor and this is her expectation also. They're graduating in 3 months! I think that's the problem with some NS. You have some students who have taken they're opportunity to learn with a preceptor (I don't care how long it takes as long as its all correct) and didn'ttake it seriously. So now they'll graduate being totally overwhelmed because they never caught on and they'll feel inadequate and/or be unsafe with pt care.

Up Vote Up Vote ×
Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.
we are only given one patient in clinical anyway to focus on and the rest of them are just kinda learn what you can.
Only one patient? How did you ever learn to take a full load?
Up Vote Up Vote ×
+ Join the Discussion