Nursing Student From Hell

Nurses General Nursing

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So I need help. I've been a nurse for 6 years now. I have a BSN & an MSN and am also a CNM. I've worked 4 years in critical care and the past two years in labor and deliver at a large suburban hospital. I've precepted several students and have always had positive experiences with them. I was not planning on taking another student this semester as I finally am transitioning into full scope midwifery practice but the local nursing school was desperate so they talked me into taking one last student. So in January, this student, let's call her Alice, started with me. When Alice first started she seemed very unsure of herself. She's a student though so not unexpected, even though this is her last rotation before graduation. But I got my teach on. We discussed anatomy and physiology of pregnancy and labor, walked through procedures at least 10 times, I stayed after every single shift to work with her, and she always went home with printed out policies and articles to read up on so we could discuss on our next shift. I felt like I was seeing improvement but I was always right there with her helping with her during the first 6 weeks of her rotation. When we had her midterm evaluation with her faculty member, Alice was told she was to take the primary role and I was to back off. So that's what I've been doing. Unless safety is in jeopardy, I've kept my hands off. And Alice is crashing and burning. To the point where I'm not sure how she's made it this far in her program. She is lazy, refuses to do basic nursing tasks such as starting IVs, and will just go hide to get out of things. We admit a patient. I go in to the room with Alice, she just stands there. I say "Ok, go ahead and get started." She says (in front of the patient mind you) "well, I haven't done many IVs so why don't I watch you one more time?" I say " you only have 2 weeks left, you only have so many chances left ... " Patient chimes in "I want you to start my IV please DWelly14!" .... opportunity lost. Fast forward to when the patient is complete. Alice is nowhere to be found. I'm in pushing with her and the charge nurse has to find her. Several of my coworkers have commented on her behavior to me, I've confronted her on it and she always makes excuses, and I've now emailed her faculty.

My question to all of you is do you have any tips for what to do? I feel bad just recommending that she not pass but at this point she only has 3-4 shifts left with me and I'm getting really frustrated with her. I'm really not willing to take her for any longer than the originally assigned amount of time because of the behavior I've observed. I feel like she's skated by through her whole program somehow and now she's finally having to actually do it and she can't. Help!

Fail her. Lazy and going to hide did it for me. Why would I want to meet another of her kind at work?

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That's too bad. It may be too late now, but were you very clear on your expectations for her? Did you talk with her how you felt they were not being met?

I remember being a student... this post brought memories of a not so pleasant rotation. The whole experience was bad and my instructor wanted me to be more independent than I felt comfortable with, but in general, I had trouble figuring out the role of a student nurse... I remember my instructor pulled me into a room for giving blood with another nurse--just as a learning experience. My other assigned patient happened to need a glucometer check at the same time, so I asked the nursing assistant to do it for me because I wanted to see the blood being given. My instructor chewed me out, saying my primary responsibility was to the assigned patient and I should have left the transfusion to take care of the glucose check myself. I really didn't know that's what she expected of me as a SN. So yeah, she probably thought I was shirking on my responsibilities too.

Failing someone is really big deal. If she really is slacking, then by all means, do so. That said, I would hate to have that happen to someone if the problem was communicating expectations. Maybe, since it's late in the game, talk with the clinical coordinator with your concerns?

Expectations have been discussed multiple times with her. The biggest issue is that she just laughs it off when you call her out on disappearing. So I'm walking in to go push with the patient and I saw her in an empty room opening a can of bleach wipes (she later told me she was in the bathroom) but I didn't have time to call her because the patient was about the birth. Later when we had a chance to talk and I said "why did charge have to come find you when our patient was complete and pushing?" she laughs and says "oh I was in the bathroom and didn't know where you were. If I had known where you were I would have been there." I was in our room for almost an hour before she finally showed up.

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I get that you've spoken to her, but she may not realize how serious this is. Have you actually used the word "fail"? She sounds nervous and terrified and may not realize that failing at a specific task (starting an IV) is not as detrimental as avoiding the task, altogether.

My first few clinical instructors were absent, for the most part. In my later clinicals, I felt behind and even more intimidated as a result.

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Expectations have been discussed multiple times with her. The biggest issue is that she just laughs it off when you call her out on disappearing. So I'm walking in to go push with the patient and I saw her in an empty room opening a can of bleach wipes (she later told me she was in the bathroom) but I didn't have time to call her because the patient was about the birth. Later when we had a chance to talk and I said "why did charge have to come find you when our patient was complete and pushing?" she laughs and says "oh I was in the bathroom and didn't know where you were. If I had known where you were I would have been there." I was in our room for almost an hour before she finally showed up.

Yikes! I think we were writing at the same time. That does sound pretty bad.

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Fail her. Lazy and going to hide did it for me. Why would I want to meet another of her kind at work?

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Specializes in Psychiatry, Community, Nurse Manager, hospice.

In my program people did not fail clinical unless they repeatedly did something very aggregious. Nothing like what you are describing here. No one failed their leadership/capstone clinical.

Your expectations for what a student should be comfortable with in their last semester may not match those of the school. Schools have shifted focus in recent years and this shift is based on research.

We ought not be having a discussion on whether or not you should fail her because that isn't your call to make.

However, you definitely meed to have a talk with her instructor about your concerns.

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Hi, I am not sure how the policy works at where you are working at, but when I was nursing student - we were not to start IV's.

As a reading policies... during nursing school... good luck with that.

However I was the main cleaning crew when it came to vomits, diarrhea, demanding difficult patient specialist and shower captain. Procedures only with our clinical instructor - who did that wrong, sorry, but she did... 40 years of nurse experience so rule #1 she is right, rule #2 is she is not right, rule # 1 applies, and she actually never realized calendar pages forwarded. Yet, should you do it correct way - the hell was upon you. So if I would have nice friendly nurse who would hold my hand and explain everything over and over 10 times, and show me again, and babysit me while I attempt myself, I would hapily jump on it. So I am not sure what are the expectations from Alice. And I am not sure why are you upset, it does not reflect on you... you can't change someones personality and probably not even attitude, so do not be upset, not your fault, seems like you had done all you could... And good luck to Alice in her first job. She may very well end up eaten alive by some senior hyenas of the floor.

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In my program people did not fail clinical unless they repeatedly did something very aggregious. Nothing like what you are describing here. No one failed their leadership/capstone clinical.

Your expectations for what a student should be comfortable with in their last semester may not match those of the school. Schools have shifted focus in recent years and this shift is based on research.

We ought not be having a discussion on whether or not you should fail her because that isn't your call to make.

However, you definitely meed to have a talk with her instructor about your concerns.

The school I'm working with it is my call to make as her instructor is not with her during this rotation. I am. I evaluate her and ultimately make the call as to whether she met the criteria to pass her clinical portion of her capstone. She can absolutely fail if she is refusing to perform the duties assigned to her. I honestly wouldn't fail her for anything else but there have bee 4-5 times that I literally have not been able to find her. If this were her job, I would classify that as patient abandonment. That's pretty serious stuff.

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In my program people did not fail clinical unless they repeatedly did something very aggregious. Nothing like what you are describing here. No one failed their leadership/capstone clinical.

Your expectations for what a student should be comfortable with in their last semester may not match those of the school. Schools have shifted focus in recent years and this shift is based on research.

We ought not be having a discussion on whether or not you should fail her because that isn't your call to make.

However, you definitely meed to have a talk with her instructor about your concerns.

Some programs do place the pass/fail call on the preceptor. Mine is like that. On the first day with my preceptor, I had to give her the paperwork where she has to grade me at midterm and at the end. My instructors informed us that if our preceptors failed us, then that's it. We fail.

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Why do I need to be evaluated? I tried to give her the benefit of the doubt and be a good preceptor. I'm not her school. I'm not her program. I bent over backwards teaching her. I know I have to fail her but I know it's going to suck. Thanks making me feel even worse.

DWelly, I'm not trying to make you feel bad, you're doing that for yourself. I'm not also trying to be harsh re your student but you simply have to pay more attention. We cannot afford to ever not be vigilant. You of all people should know this being in L&D. I find it impossible to understand that people can't understand that when our patients suffer from our mistakes, multiple entities are involved and not just physically but also psychologically and emotionally. You have to be prescient, vigilant, always!! We all make mistakes but if it involves myself, I can live with the consequences hopefully, but to through carelessness or inattentiveness cause harm, appears criminal. Your primary priority is to advocate for the patient and that means reasonable standards of care. And grow a set if you are to be effective at your job. The better the nurses you educate, the better they represent us effectively.

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Why do I need to be evaluated? I tried to give her the benefit of the doubt and be a good preceptor. I'm not her school. I'm not her program. I bent over backwards teaching her. I know I have to fail her but I know it's going to suck. Thanks making me feel even worse.

DWelly, I'm not trying to make you feel bad, you're doing that for yourself. I'm not also trying to be harsh re your student but you simply have to pay more attention. We cannot afford to ever not be vigilant. You of all people should know this being in L&D. I find it impossible to understand that people can't understand that when our patients suffer from our mistakes, multiple entities are involved and not just physically but also psychologically and emotionally. You have to be prescient, vigilant, always!! We all make mistakes but if it involves myself, I can live with the consequences hopefully, but to through carelessness or inattentiveness cause harm, appears criminal. Your primary priority is to advocate for the patient and that means reasonable standards of care. And grow a set if you are to be effective at your job. The better the nurses you educate, the better they represent us effectively.

I guess I don't understand what you are saying at all. No patients have been harmed. I have made sure of this. My student is just not performing and needs to be failed. I'm having a hard time with this because it is never easy telling someone that they are not able to do something that they have put so much time and money into (I'm not going to say effort because it does not appear she has put much effort into it). I'm not a heartless jerk who can just casually do that. I know that I need to fail this student because of the behavior I have witnessed. I was hurt by your originial comment which I interpretted that I somehow needed to be evaluated because I was a poor preceptor or teacher. I'm thoroughly confused by your more recent comment and how it applies to my student.

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Sounds just like this nursing student who was on my unit a few weeks ago. Sat in a corner, playing on her phone the whole time :no: Brought up my concerns to her clinical instructor, nothing was done. Very concerning. Always seemed to have an excuse to avoid patient care for her assigned patient (I'm working on my care plan, I'm looking up this medication, etc.). I would have sent her home and failed her if I was the clinical instructor. But with 5 patients, I didn't have time to deal with her laziness.

DWelly14, you sound like a great preceptor! You're patient, willing to teach, and put a great deal of effort into training this student. It's a shame that she is wasting such a great opportunity. I am a heartless jerk who would fail a lazy student immediately, but that's probably why I'm not a nursing instructor. You have given her plenty of chances and she hasn't put in any effort. You won't be failing her, she failed herself.

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