Lazy Student Nurse Preceptors! - page 9

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... Read More

  1. by   apricotkittycat
    Hey JF, I feel for you. But don't take it to heart. I have been a preceptor in the past, to nursing students and new grads and each time it is different.

    I don't think it was fair for you to be paired with a Travel Nurse at all. Especially one that had only been on the unit 2 days. They are having a tough time too learning each hospitals individual protocols and routines. It was not fair for either one of you.

    Sometimes you will just need to speak with your instructor to tell him/her that you are not getting your needs met. Another thing is to go to the charge nurse and ask which patients might be best for you to take. I used to work at a large teaching hospital and if we wanted practice doing blood draws we got to spend a day with phlebotomy. We did not have and IV team but got to spend a day or two in the GI lab doing prep on all the outpatients coming in for procedures. Lots and lots of IV's to be started there. A lot depends on the type of hopital you are in.

    I think I only started 2 IV's before I graduated from nursing school and no blood draws. As a preceptor I would go over my orientees check off list and tell the other nurses that if they had a specific task that a new nurse needed to get checked off on, to come get us. If I could work with her I would. But if not, the other nurse would stay with her during the procedure.

    Some nurses simply don't like to precept. Some precept for the money...or so they can slack off. Recently in an ICU internship I had a preceptor of mine sleep most of the night. Or have me take an assignment and then I couldn't find her most of the night. Then if something didn't get done she would get very angry and defensive with me. Then if there was something I wasn't comfortable doing or wanted her to at least watch me do it I'd get..."you've been a nurse 14 years," or "you really don't have a clue, do you?" Nice huh? It was very demoralizing for me and I quit the internship, something I've never done. It was an eye opening experience for me though. And I will remember never to say anything like that to anyone. Don't get discouraged. Be open, tell people what your goals or learning needs are, and if you are not happy or comfortable with a preceptor speak up immediately. Don't wait like I did.
  2. by   reejee
    I tend to agree with Matts Mom, I am a veteran nurse of 15 years and I see alot of entitlement in SOME of the new nurses. But some of the old nurses (managers) foster that attitude by giving in and agreeing to anything and everything to get nurses.
    Your nursing instructor is whose license you work under, not the staff nurses and certainly not a travelers. A traveler should never have been assigned to precept you. And by the way did you do a thorough assessment on the patient you bathed? Did you listen to anterior and posterior breath sounds when you turned them for their bath, did you assess them for skin breakdown? Did you shampoo their head and assess for lice and skin breakdown on the back of their head? You can learn alot about a patient by bathing them and frankly it was one of my favorite ways to assess a patient. If you did none of these things then you did not take advantage of an opportunity to learn.
    As far as expecting a traveler who has never seen you and does not know the reputation of your school to just let you do your thing and choose what you wanted to learn, well lets just say don't come to my unit and demand these things.
    The hospital I work at has set up a precepter program for new GRADS and I am one of the preceptors and I do enjoy it and it is marvelous to see the enthusiasm the new grads bring to nursing, but it also makes you more aware of what they are lacking as for as skills go when they graduate. The purpose of the program is to give them a jump start on the floor when they go there to begin orientation. As a preceptor I have to co-sign and oversee everything they do. And would have it no other way, most of them are NIP's and it is my license they work under. I wish you the best in your career, but hope that you understand the difference between assertiveness and agression as agression will get you "eaten", and the old timer will be justified. You are the child in nursing and we are the oldtimer who has been around and lasted and love a profession and prove it by the years we have stayed in it, you have proved nothing yet.
  3. by   Broederboy
    I have never had difficulty both as a Staff Nurse working in Critical Care or as a student. I know that as a Grad Student, I view how the processes work a bit differently, but I still see the information a staff nurse can pass along to a student is invaluable. The time management techniques I learned as a student was beneficial to me as a RN. The common sense that is present in most of the nurses who still work on the floor or in the units helps to save time. Little things like checking pulses. (Start at the Pedals and work your way up until you get a pulse. If you get a pedal, then the rest of them are there.)

    It is unfortunate that any student is placed with a nurse who is too new to a system to be effective in their position. In my current unit, there are a set core of nurses who are able to precept nursing students. We don't have their instructors with them all the time, but they are treated as peers, and are checking with us before they perform any procedures or give any medications.

    We have the opportunity to pay forward the skills and compassion that was shown to us when we were wondering to ourselves why we ever went into Nursing. (By the way, I still love it!)

    Oh yes...the eat your young thing...If you want to be a victim the rest of your life, that is fine. Nursing needs to build a thicker skin and get in line with the rest of the Healthcare professionals!
  4. by   SmilingBluEyes
    Originally posted by Broederboy

    Oh yes...the eat your young thing...If you want to be a victim the rest of your life, that is fine. Nursing needs to build a thicker skin and get in line with the rest of the Healthcare professionals!
    OMG i have to borrow Heather's word here:

  5. by   dearangel
    Originally posted by mattsmom81
    I will offer a dissenting opinion here and I'm sure many will disagree, which is OK.

    Nurses vary in their comfort level regarding delegation of tasks to students or other UAP's. It is OUR license after all and many nurses lose their licenses now due to complications arising from delegation. Perhaps this agency nurse had no choice in the assignment, then found herself reluctant to delegate due to her temp status. Facilities tend to look at agency through a microscope anyway...why take extra risks. I can see her point.

    Truth be told, I seem to detect some very unattractive, entitled attitudes in many of today's nursing staff nurses 'owe' them something and this troubles me. Hmm..

    While I agree the student IS paying for clinical experience, the nurses on duty are NOT on the student's payroll.....yet the SCHOOL is getting the money from the overworked staff's efforts. How fair is this really? Rude behavior is never justified of course, but a student should try to see the nurses' predicament too, just as the nurse should see the student's learning needs.

    Hard to hear but true: becoming 'assertive' with the staff nurses, 'reporting' them, or 'demanding' servicing to particular experiences, yet never wishing to help with basic care is not likely to endear students to overworked staff, know what I mean?

    It is also MUCH faster to do something myself than supervise another, and so often time is a luxury we have little of.

    Perhaps the SCHOOLS should take heat in these situations, as they are the ones making the big bucks and expecting staff nurses to pick up THEIR slack, when they are likely already overwhelmed. Novel thought I know.

    But it's easier to blame the 'mean ol' staff nurses' I guess. Nurses seem to take the blame everywhere else, why not here too...<sigh>

    Sadly, I have never in my 26 yr career had a proper orientation to a new job. We just aren't staffed well enough anymore. We learn fast how to put theory into practice and think on our feet; and we either sink or swim.... it's just the way nursing is these days in too many places, unfortunately.

    My advice to students is YES by all means let the nurses know what your shift goals are ...but also be open and work as a team this is how we survive nursing.

    And this is NOT a slam to students...just another viewpoint to consider. I wish you all MUCH I was once in your shoes, and remember the frustrations.

    Sorry so long...I'll step off the ol' soapbox now.

    As a nursing instructor, I have to agree with what you have to say. The student is ultimately responsible for the experience in clinical. If the student is not getting the experience that the preceptorship was designed to deliver, then the student should contact the instructor if the preceptor is not willing to allow the student that opportunity. The staff RN is not obligated to the student, but the instructor is!

    It is a partnership, both with the preceptor and the nursing school. When I assign my students with their preceptor, I personally talk with the preceptor beforehand. If the preceptor shows any signs of negative feelings about wanting to precept my student, then the assignment is not made. It should be a positive experience, and the preceptor is definitely given a choice. It is not a demand. It does require more of that staff nurse. We all know that it is easier to go do the task than to wait on the student to it. Teaching requires skill and not all RNs want to teach, and that's what the preceptorship is all about.

    Precepting a student can be a very rewarding experience and is a wonderful learning opportunity for the student. I will close this long post with saying that nursig school only equips students with the skills necessary to begin to nurse, and that in the first year of actual nursing, new nurses will learn more than they ever did in all the years of nursing school.
  6. by   icombs
    What were the options? maybe there were no other nurses avaible, so what does the student do go home because there is no preceptor? Here's a think out of the box idea, maybe the student could have went with the instructor as the instructor monitored the other the students. rather than make it a lose lose sitiuation, it could have been a win-win siituation, ,and the instructor could have went back to the school and told them of the conditions, and the learning expereince.

    Another thought, why did the hospital have a traveling nurse? (DUH) theres a nursing shortage!!!! What that nurse felt, you could be feeling in several years.

    About learning the IV stuff many schools only give you theroy but you don't really get to DO IV's until you start working, by the way when you'll have another preceptor at you new or first job.

    Good luck welcome to the wonderful world of NURSING.
  7. by   concert
    I don't want to shoot you down, but if you were paired with a travel nurse, there was probably no one else to pair you with that particular day. There is a nursing shortage, and it is not unusual for a unit to have only 1 or 2 "regular" staff people scheduled, with temps to fill in. If you have a proble with whoever is precepting you, talk to the preceptor, go to your instructor or to the charge nurse on the unit. And, remember that your preceptor is not getting paid by you to teach you anything. He or she is getting paid to provide nursing care, and if you run late it is the preceptor who will be held responsible.
  8. by   mattsmom81
    It's not unusual for me to work an agency shift with 6-8 agency/travelers and one staff person. Generally that staff person refuses to be in charge because they are afraid they will be held responsibile for the piddly things agency nurses might miss. (Like not color coding a spoiled docs labs for him...<sigh>)

    I feel the facilities are now paying the price for their poor treatment of nurses....they call it a 'nursing shortage' but it's more of a nursing boycott.....if facilities don't treat nurses well, they can go agency or travel. Or get out of facilities or nursing altogether. Which is what many are doing.

    And well they should.
    Last edit by mattsmom81 on Feb 18, '03
  9. by   oceanlover
    There's a good article in Critical Care Nurse this month about how nurses preceptors influence new grads. In summary it says preparation in nursing school only lays the groundwork for the nurse's career. Actual job training and guidance takes groundwork and starts building the skyscraper. I liked that metaphor. That experience will affect how you treat neophytes. I bet you'll be a great preceptor. The hospital I work at has an actual preceptor class, and the nurse chooses to accept students or not. But I think my hospital's policy is the exception rather the rule.
  10. by   Kathy of OK
    I am a nursing student myself and also a LPN. This is what I think you should do, make note of when the meds (IV's, ect.) are to be given and make sure that you are there before they are due so you can catch the nurse before she gives them. That nurse has a lot more than you to worry about and probably no time to try locating you. You will soon find this out when you are out of school and enter the "REAL WORLD". But when you are remember what it was like being a student and don't do the same thing.
  11. by   Y2KRN
    I think that your nurse was proably very qualified, however, I could understand her not wanting to let you fly because she was so unfamiliar with the place herself.

    Believe me I was in your shoes not too very long ago and you will get plenty opportunity to learn IV's etc.

    I went to shcool in New England and we were not even allowed to start IV's and you should see me go now others seek me out to start their iv's. You will get the experience you need.

    Good Luck

  12. by   mario_ragucci
    Learning at clinicals in nursing school can be either a good or bad experience. Yall may know that I failed my second quarter of nursing school because of a clinical failure. The variables that can effect how well a student nurse learns are often not covered, and therefore are unknown.
    How well can the preceptor communicate? Is the PT Hx all new to you? Is the unit extrememly busy? What does your instructor expect in order for you to pass? Have you had time to understand the theory of IV? Do you know what you can and can not do?
    Nursing is full of unexpected situations and it's being able to overcome these difficulties and insure PT safety and care which still attracts me.
    Nursing students have to be their own advocate and be able to recognize a condemned clinical situation and DO something about it. As a student tring your best to learn nursing, if a situation at clinicals doesn't seem right, it probably isn't. You should establish who you can get help from if your clinical education is effected by unknowns outside of your scope as a student. But remember! You are your own advocate.
    The clinical site, the PT, the instructor, the RN's at the site and YOU...all are seperate entities which YOU must be aware of at all times.
  13. by   Gardengal
    How did I miss this thread in the first fray of replies? What a lot of emotional responses are here. It's obvious from the responses that many of us see the 'entitlement' issue as being true. (I personally see this as a generational trend as opposed to a nursing student trend) It's also pretty evident that some believe that we eat our own young.....I still feel that I'm pretty much intact, and heard about how nursing eats their young back when I started over 20 years ago.(I have been chewed up a few times, but eaten?????)

    The original poster was voicing frustration at the situation, and as others mentioned I think the frustration should be directed at the clinical assignment, not the traveler. A new travel nurse should not have been assigned a student-for both their sakes. I can only assume that there was no other choice, because it was a routine student day and time, and it was a shift short of routine staff. Not a good situation but i can see how it could happen.

    I too would discuss the situation with the nursing instructor, and voice my concerns. If the assignments are frequently like this then perhaps the school should be reconsidering its clinical sites. If this was a freak assignment then I say that there was still something to learn from the situation, even though it was not ideal. This shift probably showed how a new travel nurse, although not really comfortable at a new hospital yet is able to take care of patients......It says a lot for the portability of our profession. The student was able to see what not to do with students or orientees when the reverse situation occurs.

    In regards to the tasks being addressed as tech work-I think that is an oversimplification of the situation. If we look at it-just learning the tasks described of starting IVs, doing dressings or inserting NGs and foleys is just looking at the technical tasks of nursing and not the overall role. Sometimes learning delegation is one of the toughest things. This student was exposed to what it feels like to be delegated an undesirable task while wanting to do something else. This experience should help her in her own future delegation.

    I believe that all nurses have some responsibility to be preceptors. I personally enjoy it and find it energizing. Assisting with the orientation of others is included in our RN job description. After all, to truly be a profession and not just a job we need to be able to assist the profession with growth and change.
    Last edit by Gardengal on Feb 26, '03