Student sense of entitlement

[kris113]

Hi,

I am a second year student currently doing my third semester of practicum. During a praxis session, our teacher and my class were going through comments that had been made during our placement, and previous rotations that she had had. She said that one of the most common comments that she has had through the years was " Students always have such a sense of entitlement".

I'm wondering what this means. The students that I have always worked with help out around the ward, although we are limited in some areas as per our scope of practice (and we do have to do extensive research on the clients we have).

Our teacher couldn't tell us what the "sense of entitlement" meant. In school we are taught to hold ourselves equal to the staff, and advocate for our patients. As we do not hold a full patient load (often we only have one or two patients), and do not work full twelve hour shifts, we cannot fully understand the position the nurses are in on the wards. We also do understand that we are probably the last thing that a nurse wants to add to their day- more questions and responsibility.

I am asking this question in the hope that some experienced nurses may clarify what is meant by a "sense of entitlement". What are we doing/ or should we be doing to display this? (We really do want to be good, hardworking students, which contribute!)

- K.

[FireStarterRN, BSN, RN]

I've always considered a 'sense of entitlement' to be a negative, abrasive trait. Self confidence is good, a sense of entitlement is presumptuous, at least in my book.

[Riseupandnurse]

I see students interact with nurses in which the nurses are annoyed at what they perceive as the students' sense of entitlement. Sometimes students do act that way. Students believe they should be able to practice skills at every opportunity and get so excited they forget the patients are human beings, not there for their education. Sometimes students also act as though the staff must take their opinions to heart and get indignant that the nurse doesn't give pain medicine, comfort a family, call the doctor about something the patient wants, etc. because the nurse is grappling with other more important problems at the time. Students don't understand the hospital culture, be it right or wrong, that says new nurses (and by extension students) have to prove themselves before they are given equal status with more experienced staff. All that can add up to what seems like a sense of entitlement.

[fuzzywuzzy, CNA]

Just look at that thread made by a student a while back called, "Why don't nurses answer their call lights [or something along those lines]."

[BradleyRN]

The most common thing i have seen is students judging their nurses based on a very limited knowledge or what they learned in a textbook. Ask questions of your nurse, but dont question your nurse. Of course i guess there can be exceptions to that rule, but (as in the case of asking why nurses dont answer their call lights), not usually.

[kris113]

Thanks for the replies!

[krenee]

I am a student, and I wouldn't personally say that I hold myself equal to the staff . . . they are more experience than I am, and technically the patients are THEIR patients, although they are my patients as well. I try to be very respectful of their experience and judgement. With that said, I am learning that if I really disagree with the RN I need to go to my instructor - the other day my patient's pulse ox was 74% and my nurse thought this was fine??? That freaked me out a little. But anyway - overall I would say be very respectful and a little bit deferential. Don't act like you know as much as the RNs because you really don't.

[talaxandra]

Keep in mind that 1) the nurse has other patients and therefore other priorities, and 2) they have more experience and knowledge about this particular patient than you do. For these reasons, things that you think are urgent or that should be addressed immediately may not be as significant to them as to you - Mr Brown might be in pain, but the RN is balancing that against her patient who just dropped his GCS by 5.

[eriksoln, BSN, RN]

"Sense of Entitlement" came up with our group once. It came up after a student hung a bad of IVF for a nurse. The nurse handed her the bag, told her "I'm very bussy, you guys already to meds, can you just replace the IVF in room blah blah".

The student was willing to help, informed the instructor (who was observeing a foley insertion at the time) and was told to go ahead. Well, when the instructor checked after the foley insertion.........guess what, it was the wrong IVFs. Student go written up.

For the rest of the day, a number of students made a lot of comments about "these nurses have lost their focus, are sloppy", or like mentioned before "these nurses dont even answer the call lights". To make a long story short, there was a lot of "I'll never be like these nurses" going around.

Thats when the topic came up. From the "I'll never be like these nurses" comments. By sense of entitlement, I think what your instructor is meaning is:

So many student believe they are already nurses while they are in school. They believe they are entitled to have their opinion on what is going on in the nursing field just the same as the nurse who has practiced since the 70's. But, first and foremost, they believe they are entitled to be a part of nursing...dont see where nurses have earned their way into being considered a nurse.

The group had this pointed out to us by the educator, that we should not judge staff nurses so harshly. It was very helpfull actually, not an aggressive lecture on the "social politics" of nursing, but an attempt to help us understand that as student nurses, we stand to gain nothing with "I'll never be like them" attitudes.

New nurses come out of school, want to go into the ICU or other specialty right off the bat, want to work only the shifts that are convenient to them, want to be accepted unconditionaly. They have not "earned their way" yet. They feel they are "entitled" to these things but miss the fact completely that there are veteran nurses galore who dont get it this good.

To finish, our instructor did withdraw the write up against the student with a condition. We all, even people like myself who were not involved in the incident and made no comments about the nurses, had to write a paper on what we see ourselves like now and what we think will be different when we have practiced 5 years. I didnt like the girl who got the write up and told the instructor in pvt. that I did not plan on writting a paper. She said I didnt have to, since I was a CNA and probably already understood the point of the paper.

The point of the paper was, as they told us in lecture, having a license does not make one a nurse. Knowing what to do when your pt. codes, knowing when our pt. is in danger and what to do about it, knowing how to prioritise our pt. needs so that safe effective care is given........is what makes us a nurse. In other words, we are not nurses who have earned our way until we have practiced a good 5 years or so. Thats why vet. nurses get frustrated with students who feel they are entitled to the same privledges they have earned.

[llg, PhD, RN]

When I see or hear the phrase "sense of entitlement" in the context of nursing student behavior -- it conjures up images of students who think that THEIR needs come before those of others. "I am a student and am here to learn and that comes first, before your need to have a reasonable work load, take a break, use the chart, etc."

I was struck by the OP's statement that her school teaches the students are taught to "hold themselves equal to the staff." That may be part of the problem. While all people should be treated with courtesy and respect, etc. .... the needs or desires of the students are NOT the hospital's primary responsibility. The staff's primary responsibility is to the patients, not the students -- and students need to be gracious as they sometimes have to "take a back seat" to the needs of the patients, the staff, and the hospital. Some students are better at doing that than others.

Perhaps in their efforts to be patient advocates, some of the students are giving the impression that they believe their patient's needs (or their learning needs) are more important than the smooth functioning of the unit as a whole.

[kris113]

I agree with the previous posts. (I am the OP). I find that there is an imbalance between our requirements for school and actual practice. I myself do not hold myself "equal" to nurses as some others do, as honestly, I have NO clue to what their day involves. The thing is, that we get written up by our instructors if we are not holding ourselves on an equal level (mind you, we never sit at the desk), if we don't question practices, etc. I just got a fairly dismal evaluation- my patient care was great, but my instructor didn't feel that I was interacting with the nurses on their level.( ie. I stay out of the way and help where needed, I don't tell them I'm taking a certain patient on, I ask if that's ok.)

It feels like we are being shot in the foot so to speak. (Although then we could practice our skills on ourselves.lol) I don't mind earning my way- or earning the trust. I know we don't know everything... Looking over this post, it could be construed as complaining and blaming, which I'm not trying to do. I just wanted to have a good understanding of the position that we (students) are in. I think I'll challenge the school instead lol.

[talaxandra]

Kris, it's really hard balancing your needs as a student with your need to impress the clinical teacher (who often hasn't worked int he field for ages and not long even then) and not annoy the nursing staff, while still carrying out patient care. You really do get stuck between a rock and a hard place. It sounds to me like you're doing the nest you can, and just being aware of the tension between these different roles has you a step ahead a lot of your peers (who still haven't quite got the concept that they're not the centre around which the hospital universe revolves). Good luck :)