YOU as a Pt-what would you allow a student nurse to do?

[KellNY]

I had mentioned in another thread that I wouldn't allow a student nurse to attempt insertion of a foley on me (unless I'd been anesthetized prior).

So that got me thinking....

What would I and what wouldn't I allow a student nurse to do for me?

Here's my personal thoughts

I WOULD allow:

Vitals

Venipuncture

PO meds dispensed and IVPB meds to be hung (and main fluid bag changed/hung)

*SC or IM meds administered

EKG

SLIV/HLIV flush

D/C IV or SL/HL IV

Foley emptying and flushing (if RN with SN for flush)

Unchecked assessments for lung sounds, bowel sounds, DTRs etc (as in, SN can do it, as long as RN there to assess and verify)

I WOULD NOT allow:

Catheterization

IV insertion

*SC or IM meds administered

IVP meds

NG tube insertion

*I listed SC and IM under both categories. If SN had experience giving injections, well, then shoot away. But if not, sorry. I've seen way too many students get scared or try to be nice, etc, and push the needle in so slowly, push the med too fast into the tissue, not feel comfortable with location and hit a bone, etc.

I know I'm leaving lots of stuff out--haven't slept in over 36hrs, so brain ain't what she could be right now, yk?

What about you all? Where are you willing to aid the learning process and where do you draw the line(for you personally-not your kids/family)?

***We're assuming these are not emergency situations. ie, I'd let a student venipuncture me, but not if it were for STAT Mag levels because they think I have MagTox, or T&S because I'm bleeding, etc.

Can't wait to see your answers.

[KellNY, RN]

Now, I haven't been to nursing school yet. I bet when I see the type of students in my class my mentality will change lol!

I wouldn't doubt it (unfortunately). One of my classmates DC'ed an IV. Yeah...without any gauze or tape ready. Pt (post op c-sec) bled all over the place. No harm, but scary for the poor pt and her 4 year old daughter. He didnt understand why the clinical instructor was cheesed at him "What's the big deal-she's still alive!"

Another tried to PUSH the heparin instead of SC it. Another was ready to give 25cc Reg insulin instead of 25units (on a peds pt no less!)

Too many students attempt to do something without first familiarizing themselves with the equipment, which can be 9/10ths of the skill.

So, no, I don't think I'm being hypocritical by being chosey as to what I allow to happen to my body, especially in regards to a perfect stranger. Now, if I knew the student well, or was precepting I may very well allow him/her to perform all necessary tasks. But that wasn't the situation posed in the OP.

[trulypampered]

I am a nursing student graduating this May. I am finished with my classes/clinicals and have 90 hours left on my preceptorship/externship. I am really surprised to hear some of you say that you wouldn't let students do certain procedures. I have had nurses not let me do procedures on their patients which has hindered learning a specific skill, and some GREAT nurses that would grab my hand and say "let's go! You are going to do this"! I thank the Lord for those nurses, because now that I am in preceptorship I AM doing those things. It is very much in my and my patients favor that I can start an IV and put in a foley correctly and confidently.

During my clinicals, any meds that were given, or any invasive procedures were ONLY done with the RN I was working with or my clinical instructor. Since the procedure was monitored closely, I would not have been able to have a med error or put the patient in danger in anyway. We all have to learn somehow, and it is much better to have students learn BEFORE they are an RN when they have someone there to guide them VS. being out there and doing it on their own.

[Mandylou]

I would let a student attempt just about anything on me (at least once or twice :wink2: ). However, when my son was in the hospital I was a bit of a bear. After a few days of nursing students I finally forbid them to step foot in his room again. I felt like a cardiac baby did not need to be poked and prodded every five minutes. I had several bad experiences with them. Now being on the other side of the fence I am grateful when I get to try a new procedure on a patient.

[starae]

P.s. I would 100% quiz them prior to doing an injection, foley, anything of that sort before I let them touch me. If they could tell me about it in great detail, then they have studied, know what they are trying to do, and should get the ability to perform said action.

I like this answer, but I would be worried that the student would be so nervous by the end of the "quiz" that their hands would be shaking and they would fumble with the procedure! :roll

I have been really good about students (nursing and MD) learning with me, but the last few years my gyn visits have all had students. There is nothing like a crowd for that exam, and even better when the student performs the exam and the teacher has to also do one when they are done. Two for the price of one, yippie!

[firstyearstudent]

I'd rather have ANY student insert a Foley (anesthetized or not) than the E.R. nurses I've seen do it. They haven't given a hoot about sterile technique. One nurse shrugged told me, "They're probably going to get antibiotics anyway."

[flashpoint]

I'm pretty laid back about students doing procedures on me. I even helped one fish for my vein. It's not like they are going to do anything that could be harmful (painful, yes, but not actually harmful) without an instructor present. I've even been known to ask if there was a student who needed to do a procedure before I let staff do it.

When I was a student, I never got to give an IM, never got to insert a foley, never D/Cd an IV, simply because it never came up for one of my patients. I try to give students as much opportunity as I can, unless I am sick as ****...then I don't care who does whatever needs to be done.

[flashpoint]

I'd rather have ANY student insert a Foley (anesthetized or not) than the E.R. nurses I've seen do it. They haven't given a hoot about sterile technique. One nurse shrugged told me, "They're probably going to get antibiotics anyway."

Don't judge all ER nurses by what a few do...when I worked ER, I was fanatic about doing things right.

:)

[TazziRN, RN]

I'd rather have ANY student insert a Foley (anesthetized or not) than the E.R. nurses I've seen do it. They haven't given a hoot about sterile technique. One nurse shrugged told me, "They're probably going to get antibiotics anyway."

Please don't judge all of use by the actions of one ER's staff. That's an insult to the rest of us.

[Hoozdo, ADN]

I would let a nursing student do most anything on me. My only exceptions would be to d/c an a-line or femoral sheath.

I am a lot more pickier on what I would let interns do to me. I have had a liver biopsy by an intern with a real doc standing by. I told him he was allowed one poke and that was it. After all, I am being charged big money to have a hepatologist do this........not an intern. There should be a discount on my bill if an intern did it :chuckle

[S.N. Visit, BSN, RN]

I'd allow pretty much anything by a student except a Foley/straight cath. (I had a terrible experience having one inserted from my OB/GYN nurses).

[santhony44, MSN, RN, NP]

I've never had a problem with a properly supervised student doing anything for me.

The only situation in which I had a problem, I didn't know the student was a student until too late. I had to have a trans-lady partsl ultrasound- a very very uncomfortable thing.

I didn't find out that the tech was a student until she'd finished and the actual tech came in and repeated the whole thing!!! I was not happy, but didn't push it any farther.

In all other situations dealing with students, I always knew ahead of time of the student status. I've had medical students do pelvics and even had a student phlebotomist draw blood by using my left arm, practically the only person to ever succeed in doing that! I told her that, afterwards.

So, 90% of the time, a student would not be a problem for me. The other 10% would be situations with very uncomfortable or painful things that might have to be repeated, and I wouldn't include IV's or Foley's in that category.

Oh, and the single most painful IV start I've ever had was done by an experienced anesthesiologist!!

[bethin]

I just had an experience with this Thurs when I had a colonoscopy. Didn't even know SN did a rotation in GI. Anyway, there was a RN, a tech and this SN assisting the MD. The nurse introduced the SN and explained that she would be observing. I'm a good judge of character. While this SN did not push any meds I would have felt comfortable with her inserting a a/c or starting an IV - although having a beginner start an IV on me could be disconcerting as I am a ver hard stick. But I would definitely not allow any student to do these things. For me, it's a case by case basis. I've had mvp and tachycardia for 10 years and crohn's and uc for 5. I enjoyed telling the student about my problems and explaining my meds, side effects and in general about autoimmune disorders. She seemed very intelligent and asked alot of questions. Personally, everybody has to start somewhere and you only learn by asking and performing (under supervision).

A recent new grad RN who worked as a CNA before graduating asked me to accompany her into a room so she could insert a foley. First, I'm a CNA and have not started clinicals. Second, she was 2 months away from graduation and she told me she had yet to start an IV or insert foley. What????? These are 2 very common things. I would not allow her to start a foley or IV on me considering she hadn't even done these in 2 years of clinicals. And she went to a very reputable college.

But to answer the OP's question: depends on the SN and the supervision.