taking students, precepting - page 6

I do not precept and I do not take students. At one time I thought I would never say this. However, students deserve better. I want you to learn and do well and have good experiences. ... Read More

  1. by   ngannon
    I just wanted to say...the student you chose not to teach today, could be the nurse who has no knowledge for the patient(you)tomorrow. The knowledge you have collected all along the way, could have been passed on, but you have chose to keep it to yourself. I know you feel you have justified your thinking by saying It's just better this way, but being a student I see more nurses treat me this way. For every nurse who is giving of their knowledge, there are many many more who are not. The question I have is.....What if the knowledge you chose not to share with me today could save your life tomorrow? Would you go back and teach me today, and live another day?

    THANKS so much for the nurse who choses to teach me today!
  2. by   Tweety
    Quote from ClinicalCutie06
    After reading many of these posts, it seems to me that most of the nurses who posted on here view nursing students as a burden and that being a preceptor for me is mentally exhausting.............. I understand that being a nurse is a high stress job, but having a negative attitude toward all nursing students is not the answer.

    I went back on this thread and reread the first three pages or so. I'll have to disagree. that most nurses on this thread posted negatively. I counted three people do didn't want to precept students. Two people who said the love students. Nine people who were neutral, acknowledging it's tough to precept students and carry a heavy load, but weren't against students.

    Also nine posts were from students. I stopped after that because it was to the point we were talking back and forth. But more and more students chimed in after that.

    Just because someone says it's tough to manage a heavy load and precept students doesn't mean we're anti-student. I personally feel an obligation to students and love teaching. But it's by no means easy. Most of the time, I'm left charting or finishing up long after the students leave, precisely because I took time with them.
    Last edit by Tweety on Nov 4, '05
  3. by   La Crosse Nurse
    I too have had my share of student and I have only "officially" been an RN since 2004. Having been a LPN and going back to school for my RN I can feel the pain of being a student. What I do not understand is...If a student has an instructor, which is paid a heck of a lot more than I do, WHY AM I TEACHING THEM????? Some, not all, of the instructors leave the floor and are not seen for hours. I have a patient(s) to take care of that day. If I don't get all of my work done, including that of a student, it is not only a reflection on me it is a reflection on the facility I am employed at. Sometimes for the sake of the student and their learning I keep quiet and let the student hear it from the patient. But, other times I already know the patient and know dare well it will be reflected on my care.

    We never have a choice in whether we want to precept or not, it depends where the instructor assigns them.

    I for one am getting prepared to tell one group of nursing instructors that they need to be more attentive to the "developing" nursing students. I am not getting paid to teach. I get paid to take care of the patients on the floor. I don't get paid to babysit on top of it all!!!!
  4. by   Tweety
  5. by   cajunnga
    Quote from P_RN
    Agnus I do understand. I'm out of the business now, but I guess things change and so do we.Fortunately USC and the Tech instructors were usually johnny- on -the spot at folllow up. Usually they found the problem and came to the nurses rather than vice-versa. I wasn't really aware that staff anywhere else was expected to teach students.
    I did and still do like precepting, but the clinical specialist usually did a skills check long before they hit the floor.
    I am in my last semester. We went through skills labs and checked off on everything we needed to, however on somethings that nursing students fight over like foleys and IVs--everyone doesn't get to do a lot of those in school and when we get to our preceptor we are kind of praying for a kind person to (unless it is an emergency of course) enable us to develop skills and if we are not doing something right to tell us, show us, teach us. I have worked my butt off the entire time I have been in school and have a family, a full time job and even picked up a prn job as a tech in the ED to help develop my skills. If one doesn't want to precept they shouldn't and if it is obvious that the student doesn't want to learn then they shouldn't be there but for those of us who have sacrificed so much and work so hard: Give us a break. We need it.
  6. by   jgrossberg
    Quote from tencat
    Howdy. I am a student, and I know that it is more work for the nurses to take me on. I hate the fact that my presence causes more stress, and I understand how you feel because it's a lot harder to teach people than people think it's going to be. The fact is that you all who take on students should get paid more for being a preceptor or should get a reduced patient load, or how about both! I know that it would be pretty impossible for the floor I'm on now to reduce a nurse's load because there are a ton of patients and a shortage of staff to begin with. Add students to the mix......Oy. I wonder how we could get you guys something in return for your time and patience......there are a lot of more important battles to fight in nursing, I know, but it would be a good thing if a student's presence could become a positive addition rather than the stress that it often is.

    I just have to say THANK YOU for sharing your workday with me. It means so much to me when I have a good nurse I can learn a lot from who is willing to help me out in my learning. And I have been lucky to work with some pretty amazing nurses during my clinical time. This student won't forget it!
    AMEN!!!!! And every one of my clinical rotation cohorts would say the same. You who have preceded us - virtually every nurse I have worked with - are often ALL WE HAVE to give us what we need to learn to be good nurses. Books and lectures CANNOT do that. THANKS.
  7. by   TraumaRN1983
    Quote from La Crosse Nurse
    What I do not understand is...If a student has an instructor, which is paid a heck of a lot more than I do, WHY AM I TEACHING THEM????? Some, not all, of the instructors leave the floor and are not seen for hours. I have a patient(s) to take care of that day. If I don't get all of my work done, including that of a student, it is not only a reflection on me it is a reflection on the facility I am employed at. Sometimes for the sake of the student and their learning I keep quiet and let the student hear it from the patient. But, other times I already know the patient and know dare well it will be reflected on my care.

    I for one am getting prepared to tell one group of nursing instructors that they need to be more attentive to the "developing" nursing students. I am not getting paid to teach. I get paid to take care of the patients on the floor. I don't get paid to babysit on top of it all!!!!
    I don't know how other nursing schools work, but at my school we have a definite shortage of instructors and more students that want to be in the nursing program than there are spots for them. At the hospital I do my clinicals at, I have two instructors, and each of them has responsibility for a total of 12 students. They try their best to get to all the different areas that students are at, but it is very difficult for them to do so when there are so many students. Because of this, I and other students in my clinical group gain most of our knowledge from our preceptors, and much of that knowledge has been invaluable. I learn more from my preceptors than I do from my instructors most of the time, and it has been a wonderful experience for me. Before we started clinicals, we spent a lot of time in the nursing labs with our instructors and we did learn a lot of the basic skills. However, we learn most everything about patient care from our preceptors. I think my nursing instructors do a wonderful job of "developing" us into better nursing students, but it is our preceptors that help us become better nurses.
  8. by   TweetiePieRN
    Quote from Tweety
    Most of the time, I'm left charting or finishing up long after the students leave, precisely because I took time with them.
    I love working with students, but time is the main problem. At my facility...management wants us out of there (charted and all) as soon as the shift ends. If we are sticking around charting late too often, we get called into the manager's office and get a nice lecture on time management. :angryfire

    Also, at my hospital (we are NOT a teaching hospital) students are assigned to certain patients. I have no say in whether or not a student will end up with one of my patients.

    I love working with nursing students because I am still really excited about my job and I love sharing that with people. I love watching the lightbulb go on in their head when they learn a new thing!!

    On the flipside, I can also understand why some nurses don't want to work with them. My personal pet-peeve is the nursing student who thinks she/he knows everything...then charts an assessment inaccurately (or performs a shoddy assessment) and then I have to go through and write a huge nurse's note to counter what they "discovered". I tell my students to please come get me when they are done with assessment so we can talk about what we found...then if something is different we can go back in the room and figure out what is actually going on. Good learning experience for both of us!
  9. by   mrscurtwkids4
    I have a lot of respect for Agnus speaking her true feelings on the precepting students matter. It's better to know yourself and how you handle certain things. As I know students can be quite trying. It's like when my children were 3 and asking all the "why" questions constantly. At first you are patiently trying to explain things in a fashion they can understand. Then after about 30 "why" questions, you start getting impatient and just can't handle hearing "why" one more time...lol. I'm a 33 yr old junior nursing student. I only just started our first clinical rotation at a nursing home last week. And my experience was one of mixed feelings. When I went to the nursing home in advance of clinical day to review over the chart of my client, I chatted with a couple nurses on the floor about their experiences in that facility and their knowledge of my client I'd been assigned to. And those nurses were very friendly and helpful. On the first clinical day, my partner (another student) and I were given directives to take care of the client and weren't really even checked on again. I knew pretty much what I had to do, and when I had a question, I generally went to my instruction and asked her rather than bother the nurse who was quite busy the morning routine. I completely understood that she was quite busy and is used to the routine and I didn't want to disrupt that routine. I just kind of felt like I was taught to doggy paddle and tossed into the deep end of the pool. Especially since my client is completely dependent, it just made me a bit nervous. But I jumped in and did what was asked and I think the shift went pretty well. Aside from my partner being one of those students that was wary of jumping in and getting to work. But I'm not discouraged. Now that I know what is expectd of me for clinical, I'll be able to do it much better on the next clinical day.

    It's much better that you know yourself and what you can handle than to end up in over your head. This wouldn't be helpful to anyone. I would hope that if I became a problem for my nurse that she would let me know so I could have an opportunity to change whatever she may not like. Then I could benefit her by taking some of her workload off of her and I would benefit by becoming a better self-sufficient nurse. But I still have a long year and a half to go...LOL
  10. by   SFCardiacRN
    Well said Cutie! We really do need to train our own. As an aside, My community college instructors make less than the nurses they teach!
  11. by   Tamerius
    I am currently a preceptee and I cannot agree more that if you don't want to teach don't. When I started rotations in the hospitals people asked me if the doctors were rude. I had to tell them the doctors are nice, its the nurses that are evil. Many nurses seem upset that students don't know what they are doing, but that is why we are there, TO LEARN. I know some students are annoying because I have classes with them, but the majority of us are humble and eager to help you or keep out of your way. We are so incompetent in the hospitals because we spend most of our time studying in classrooms, the only chance we have to learn to hang meds and chart is when we are with you. I have found the majority of nurses very unsupportive. I hearby pledge, that when I am a nurse I will be kind not only to my patients and coworkers, but also to those that are learning, because they need support.
  12. by   sjrn85
    Quote from Agnus
    Perhaps, I did not tell you that I used to precept. I took students eagerly and loved it. I still enjoy seeing students learn and often informally teach these students that I no longer precept. I love to hear what they are learing thier plans and dreams.

    I really have not had bad experiences so to speak that have turned me off. The vast majority (actually I believe all) were there to learn.

    Would you beat up or pass judgement on a beloved professor who decided to cut back and only teach occasionally because they had developed physical limitations? I am guessing, no.

    As far as "blaming" students for the added stress. I don't believe I am blaming anyone. Stress is. I simply stated the fact that students do add to that and I challege you to demonstrate that a student adds no stress what so ever. Part of the stress is that I care very much about what they learn and how they learn. This is not blaming it is a simple statement of fact as I see it. There are numerous stressors thoughout the day and this is one more period. I do not need one more.

    Even the student who just watches and needs to be prompted at every step is a gem. We call this student as being in observation mode. He is attentive but tenative in taking action himself. He is just so awed and unsure about his abilities and well it is pretty darn scarry for the new student to get in there and do things himself.

    Students hit this point not just at the beginning but at various points though out thier education process and then it hit again after they graduate. This is normal. Some are just afraid to ask questions or even more important do not know WHAT to ask. These are normal human reactions.

    Let me tell you a story. I loved where I worked and loved my employer. I eageryl stayed late when asked or took an extra shift when asked because I knew it was apreciated and I was respected.

    Then something started happening. I did not recognize it at first. EVERY single time I worked a few hours extra or an extra day I ended up calling in sick after I did this. After a while I saw the pattern.

    I went to my employer an told them the pattern that I saw. I said that I would not work extra anymore because if I was calling in sick after doing this then I was not doing my employer nor myself any favor, infact I was doing us both a diservice.

    That employer and every one since has agreed and been very respectful of this.

    It was hard for me. There are still times I would like to help out.

    I also hate it when I see nurse much older with the physical endurance that I once had. I used to be very high energy.

    I used some examples of student behavior as a means of demonstrating some of the minor stress that was added by taking a student. The student who did not want to do meds did some other really wonderful things for my patient that really needed it. He was not a bad student. I did not have the energy to address what he chose not to do. I believe that (especially since he was graduating in 6 weeks) that he had a responsibility for his own education. He knew enough to accept or decline a task. However, I feel he did not take the free oportunity to practice and that is a loss. I can not save the world. I don't know if he would have understood if I explained it the significance of the oportunity that he had that day and passed up. And I did not have the time or energy that day to do it.

    For the record that student was given to me with out my being asked. I really was not up to taking him but he apeared at my side when I was getting report and that was that. Later his part time clinical instructor who also happened to be a staff nurse on our unit came to me and apologized that she had not asked first and thanked me. (NO I had not complained or indicated in any way that this was a problem) She was just courtious I am sure, as people generally do ask first there.

    As far as payment goes. If you choose (yes it is voluntaiY) to precept for 12 weeks you get paid $1 extra. After the 12 weeks you get nothing extra. If another nurse takes the person that you are precepting for you one day that other nurse gets nothing.

    Some hospitals pay a bit extra for precepting or taking students some do not.

    Taking students where I am does not pay more.
    The precepting pay is for new graduates that are going to work on the unit, or for senior year students who are employed (paid) on the unit for the purpose of gaining additional clinical experience with a preceptor. Some places call these apprentices.

    The paient load for the preceptor sometimes is only slightly adjusted up or down due to the precenses of the apprentice. However, the apprentice and preceptor have a long term relationship and get to know each other very well.

    The student coming to the floor for the occasional clinical rotation does not have this. I assess as best as possible where a student is at in the beginning and try to find out what he can and can not do and what he wants from this day's experience. Then we go from there. In other words the student directs his own learning to an extent;remember these are adult students. Then when I see oportunities especially unusual ones I will direct the student to them.

    Some hospitals pay nothing to precept period. Some require you take students, new grads, new nurses to the unit etc.

    It IS NOT part of my job description. It is my decision if it becomes a part of my job description where I work, and the nurse who has agreed to this can change her mind.

    I hear a lot of shoulds. I HATE the word should. Should is a very judgemental word that comes from what we preceive others expect, whether we say you should, or I should. Should is a finger pointing word. When I point my finger at you and say "should" three more fingers are pointing back at me.

    Should is what is not and never will be. It is a fantacy word.

    Please join me in the real world with real people and acknowlege our individual and unique limitations. It is ok to hate our limitations. It is not ok to confuse that limitation with the person who has it.

    To the angry students who have posted here. I have been where you are and I am here now. You have not been were I and other nurses are do not be so hasty to pass judgement.

    If it scares you away from the profession to see nasty nurse then that is a good thing IMHO. Because if that turns you away you do not belong here. The sad truth is we do get pretty cranky. And you will have to deal with that your whole career. Though hopefully not all the time every second of every day.

    I hate to see people scared away because we need nurses so badly. And at the same time I am glad that you learn early on what you may be up aganist and make a decision early to get out rather than be just a warm body in the profession. It is sad and disapointing for you who are scared away. But reality is this is not a NICE NICE profession. Some times people come into nursing with an idea that is unrealistic.

    From the angry students that posted here, I hear tones and words written by you that suggest you are pretty contentious yourself. This does not help the profession. If you come in angry what is it going to add to the profession that is already over stressed and over stretched?

    You were treated badly by a nurse so you now have your dukes up. Not a good start.

    I was a student. I had classmates complaining on a daily basis about 'bad" nurses and recieving bad treatment. I had those same nurses sometimes work with me and I precieved the experience quite differently. Sometimes the same nurse on the same day as the other student who complained.

    Late on I did have a nurse that it was very obvious even to me the nurse did not want a student. My instructor could see it and aproached me. I verified that the nurse was physically avoiding me. We agreed that I would stay out of her way as much as possible and not make this any worse. I went to my instuctor with my concerns rather than tax this nurse any more than necessary.

    Some of it is our own attitude as a student. Recognizing a stressed nurse rather than a nurse who was "mean to me." As nurses we are grown ups. Please, recognize that everytime someone snaps or seems grouchy it is not about you. It is about that person's level of stress.

    Some of us are actually human. Stressors are not limited to the obvious ones we see others having at work. Though we don't necessairly bring our home life to work with us the stress we are feeling in other aspects of our life does not magically disapear when we choose not to bring the problem associated with it into the work place.

    I am under numerous stressors away from work as I am sure you are as studens, wives, moms, daughers (subsititues sons, husbands) breadwinners, living on own etc.

    You do not know where another person is at EVER. Please, do not compare their stress to yours. Perhaps you are under more stress but are handling it better. Perhaps the other person has less stress but has cumulitive effects from past stressors. Perhaps you have better coping mechanisms.

    However, if you are feeling angy and need to lash out pass judgement and or saying "should" then I would surmise that you aint doing so well you're self and maybe need to acknowledge that you and they both have limitations.
    Any time anyone wonders why there's a shortage of nurses working in the clinical setting, the above post should be used as a point of reference.

    One of my least favorite expressions is the old "Nurses eat their young." This thread has shown some excellent examples of the reverse (which happens more than people think). Heck, people who aren't even nurses yet are judging Agnus with a level or harshness usually reserved for drug dealers and theives.

    Agnus has given and is more than entitled to back down. It's absolutely sickening to see posts pummelling her just for doing something as simple as taking care of herself. (The nerve! For a nurse to have needs of her own! How audacious!)

    Some people really need to get a clue. Just because we're nurses doesn't mean we have to be all things to all people all of the time. I think it takes a great deal of courage (and caring) for someone to admit that he/she has limits.
  13. by   SFCardiacRN
    Part of my motavation for welcoming students is the poor treatment I received as a student. However, that does NOT make a nurse a bad nurse, just a bad teacher. Our unit is careful to assign students where they will be welcomed but it is not always possible when we get 6 or 8 on the same day.