Lazy Student Nurse Preceptors!

Nurses General Nursing

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I am furious over my most recent clinical experience. I'm in my last semester of school and graduating in May. Our school waits until 4th semester to learn IV's. Well, the "goals" for this semester is to get as much IV experience, practice on all other procedures/shots, and shadow a real RN. Well, my first clinical night with a new preceptor was a disaster. I was assigned a travel/agency RN from NY. This was her 2nd night in a new hospital and a new state. She is given specific instructions to let me do all IV's, meds, procedures etc on this patient. She happily agrees, but doesnt listen. Next thing I know, she's hanging IV's, giving heparin shots, and changing tubing. All these things were supposed to be done by me and checked by her. When asked, she kept saying, "Oh, I'm sorry, I forgot". It was as if she resented me being there and just wanted to get the job done without taking time to teach me. Next thing I know, she is volunteering me to give this hemiparetic, 250+ comatose man a bed bath and mouth care. Not that I think this is not a nursing role by no means, however, this is not something I need to learn again. How is it she forgets to teach me IV's, but suddenly remembers I can do a bed bath? I was furious. I learned how to do bed bath's 1st semester and certainly did not need the practice now. So, I essentially spent the whole evening doing "tech" stuff and learned nothing about IVs or the nursing role. Again, I'm not saying bed bath and oral care are not important, however, I need to be practicing procedures and IVs not bed baths. So, I guess my point was why are some RN's so reluctant to teach students and others so great? I felt she was using me to do the jobs she didnt want to do. The other students were doing caths, NG's, etc and I got stuck with a bed bath and oral care. Just wanted to get some input from the veteran RN's out there.

That's what I was going to add Natalie...thank you! We carry our own and work under the instructor's license. Only when I am at work as an Intern do I work under an RN's licensure.

We don't "follow" nurses during our clinicals. We have our own patients and our instructor is with us when we pass meds and such.

I had never seen this shadowing of staff and no instructor until the university came to the hospital. They have students on 3 floors with one teacher....how then can they pass meds, etc...? It is thrown on the nurses, which is unfair.

I agree with whoever said that when you have 18 hours of work to fit into 12, you can't be quizzing people on meds or watching them do every procedure. It takes a great deal of trust on the RN's part.

We also have an instructor with us on the floor at all times.

If we float to specialty areas such as ER or ICU there are only limited things we're allowed to do.... passing meds is *not* one of them.

I can see both sides of this problem. I am an LPN but I am also a student in transition program,God willing I will take my boards in December and be an RN.My class is now made up of traditional students who have not worked a liscenced shift yet and some old mares such as myself.I see that quite a few of the "new" students don't really have a realistic grasp of what a day in the life of a nurse entails.Many of them do have an "Im entitled"attitude. That will change in due time.The reality check is not always easy.

At the hospital I work at.if a staff nurse is going to be a preceptor to the students,they go through a training course ,and are paid an additional differential on the days they precept. These same nurses are our preceptors for new hires.The preceptor program is strictly voluntary,which I think is a good thing because not every one wants to do it.I dont think it is fair to blame a staff nurse,or call her a "lazy preceptor" if she is not suited to that position nor wants to be a preceptor. I know that there is a shortage of instructors,but that is neither the staff nurses fault or problem.Your instructor made a very poor choice in assigning you to a nurse who was not herself oriented to her surroundings.She is the one you should take issue with.

And, I have found that people who believe in that old tired mantra about nurses eating their young, wear it out on their sleeve and are the most likely to get eaten. If you go looking for it,it will most likely find you.

While I see many good points, I also see an opportunity for some improvements that will not only help the students but the nurses that are preceptors also.

Perhaps, as a group, the nurses could approach the facility, and ask that a "student preceptor team" be formed (don't laugh too hard!). This would entail that the hospital/facility cover the for the nurse doing the precepting. Extra pay diff (again don't laugh too hard). Help the hospital/facility alleviate some of the nursing shortage there and help the student, when they graduate, hit the floor at at least a jog and not a dead stop. I feel that this could be run, possibly, through the education department of the facility and offer the nurse doing the precepting the extra training so that they do not feel so overwhelmed with having a student nurse "shadow" them.

I have been talking to our facility about this type of program and they are looking into it. They feel that, if such a program is implemented, they would treat the nurse preceptor as an "extra" on the floor with an assignment of no more than two patients for them and the student to care for. They would have total care (even the bedbaths) for the patient throughout the entire shift. I really hope that this program takes off. I feel that it would be a great asset not only for the student nurse but also the facility.

By the way, I am a tech also along with a nurse extern, so I do my share of bed baths, mouth care etc. While it is not my favorite thing to do, I try to put myself in the place of the patient and how I would feel if no one had the time to take care of me. I have also heard students that I attend school with state that "I can't wait until I don't have to do that anymore"...my answer to them is always, don't count on it...you will be the nurse that cannot find a tech to help them!

Just my two cents worth!

Specializes in Home Health.

In total agree ment w mattsmom and fab4fan, re the "eat their young" phrase.

And flo, it is rather nervy of you to make such assumptions about mattsmom, when have you workd beside her??

I am very pro-students. I LOVE working w students. I spent three years as a nursing ed instructor as well, and I love to teach other nurses, BUT, I do see the entitled attitude in some. Maybe, just maybe, the preceptors are picking up on that tude of giving you a dose of humble pie! Labeling a thread "Lazy nurse preceptors" is not a good way to present your cause, for starters.

You think this nurse was LAZY??? It was her SECOND DAY in this facility!!! Besides the fact it is totaly inappropriate to assign the student to a NEW (to the facility) travel nurse, If I were her I would be royally pizzed!! I'm flexible, but not that much. Personally I would have declined to be your preceptor in this situation. I just wouldn't know enough about the P&P to properly advise you.

When you get out of school, guess what? Some days you will get the team or nice assignment, and some days you will have the pt who has unending diarrhea. You better get used to the idea that nurses and not just aides do clean shyt, give baths, and do mouth care. If you cannot find anything to take out of the experience you had, then you are not taking enough advatage of your clinical time. Open your mind!!

Specializes in Nursing Professional Development.

This is a really interesting thread for me to read because I am the liaison between my hospital and the local nursing schools who use us for clinical experience -- 8 different nursing schools to be exact. In previous jobs, I have also done a little teaching and been a staff nurse, charge nurse, and CNS.

I think a lot of people have made some great points. I think the key one is that it is a difficult situation for EVERYONE.

1. The students need the experiences and sometimes have trouble getting them because of the current stresses in the health care environment.

2. The instructors are being asked to supervise more students than they possibly can as well as being incredibly underpaid.

3. The staff nurses are also overworked and not always comfortable with supervising students -- or compensated for doing so.

4. The hospital is probably receiving nothing from the school in exchange for providing clinical experiences.

5. The school of nursing is probably losing money as nursing is one of the most expensive departments for a university to try to run because of the relatively small faculty-student ration. They are probably under a lot of pressure from the university as a whole to cut costs because the state is cutting back funding for education because tax payers want tax cuts. Anyone who thinks that nursing schools make money is ill-informed.

6. On top of that, everyone wants the schools to produce more nurses. Yet, no one is willing to provide the resources to do that.

The situation is one in which everyone feels "put-upon." Many people feel that everyone else has it easy and is just being "lazy" or "mean" or "unfair" or whatever, sometimes unable to see that the person they are pointing their finger at is in an equally difficulty situation.

The questions then become: Can we work together to solve the problems? Are we going to be able to each contribute something positive to the situation to help it evolve in a positive direction? ... or ... Are we just going to keep pointing our fingers at each other and dump more grief on them?

llg

There is a lot to be said about the situation, attitudes and responses.

First of all, on the surface, it was not a good assignment, but this is also part of your learning experience. While a student, I never started an IV and my first catheter placement was in OB with a lady whose bladder was about to burst because she had no feeling secondary to an epidural placement. That was my only experience with catheters.

But I learned a tremendous amount about interaction among nurses. I "cut my teeth" after I graduated on a med surg floor in a small community hospital that had all levels of patient populations and peds. I also made most of my "mistakes" there.

My nursing instructors were tough as were my clinicals. I was humble to the nurses during my clinicals because I had not walked a mile in there shoes and their job was not to teach, guide or train me. That was and should be the job of their instructor. This is the bottom line. I always ask the instructor when I have a procedure that the students may want to perform, under "her direction" not mine, and most important always, is whether or not the patient will agree to have a student be involved in their care.

You will learn and become proficient in the technical skills, however, the interpersonal skills are a continuing challenge of nursing. Instead of resenting the travel nurse, you could have taken the higher road and said "since we are in this together, I am willing to help you get through the shift as much as I can". I cringe when I have heard nursing students say, I am not going to nursing school to "wipe butts". What better way to assess your patient's skin? Think about the patient first, not your own inconvenience. You will learn the technical skills I promise you!

Great points llg. Will colleges put out the $$$ to hire additional instructors? Will students be willing to pay more for nursing school tuition IF the schools supply more clinical instructors? So much of this is about $$$.

I tried teaching...didn't like it...I had too many students (the whole hospital to cover) and couldn't do a good job (gee sounds just like staff nursing...LOL!)

For the record, I always put myself out for a student or a new nurse when I have one around. But nursing is a team sport...we get back what we put in and this goes for students too. If they are 'me-me's'and won't see the big picture and work with the team a bit...well, as was said we only have so many hours in a shift and patient care will ALWAYS come first.

In my area students practice under the RN's license when the instructor is not present, which is 99% of the time. So bottom line it IS the RN's decision regarding what he/she will delegate to a student (who is another form of a UAP).

Specializes in Home Health.

I would LOVE to be a nursing instructor in nursing school, BUT I will not spend 30,000 in blood sweat and tears only to take a job which pays 25K per year. If there is such a nursing shortage, why don't the schools consider utilizing BSN's, at least for assoc nursing schools, as instructors?? I would happily let the school put me through my MSN as a tuition reimbursement perk. I have a lot of experience, a lot of patience, and I love teaching , but w/o the MSN, in NJ, I am not "worthy" to be a nursing school instructor. Their loss as far as I am concerned. I think I have a LOT of offer, but they (PhD academia) cannot open their minds to the possibilities.

Perhaps the phrase of nurses "eating their young" wouldn't be heard so often if there wasn't an element of truth to it. The object is to attract more people to the profession, not drive them away from it. If students are treated like dirt, why will they want to be part of a profession that doesn't welcome them? It's not about students not getting their way...it's about courtesty and mutual respect. Most students are scared to death and could benefit from the guidance and support of a seasoned nurse. Sure, there will always be some students with attitude problems but that goes for any profession. Just as there will always be a lot of nurses with attitude problems. It doesnt' have to be that way. I have been mentored by wonderful nurses who are just as overworked, stressed and tired as the next person. They didn't snap at me for no reason, or complain about having a student, as if I were deaf. They didn't make me feel like a burden. They weren't rude or nasty. They had patience and made my clinical experiences valuable. In my opinion, these people truly define the word nurse. Too bad these lovely souls seem to be few and far between:(

As far as starting IV's are concerned, we do a rotation with the IV therapy nurse, as that is their specialty. It works out better that way. I guess every school is different and some are better than others. The quality of students probably varies as well. I can't help but feel defensive though, being a student myself. All I want to do is learn and I don't feel I should be shortchanged simply because each student doesn't have their own personal instructor. I work in a hospital and I know how busy nurses are. I try to do as much as I can on my own but there are times(gasp) when I have to "bother" the staff nurse. Also, usually I try to go to my instructor first and they defer you to the staff nurse. A lot of times they can be of more help than the instructor because they are the ones taking care of that person every day. It's tough all over. And I would rather annoy someone with questions than to try and go it alone and make a mistake. I think some students are afraid to ask for assistance because they have been ridiculed or make to feel incompetent. So please....can't we all just get along?

llg...I like the way you think:)

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