YOU as a Pt-what would you allow a student nurse to do? - page 6
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... Read More
Mar 28, '07I've only been practiced on a few times. Once was just for a simple blood draw, but the student had a lot of trouble and had to try about six times. I just kept encouraging him to try again and eventually, he got it.
The other time was with medical students and a urinary catheter. That didn't go as well as I was not really comfortable and found the procedure painful. In fact, I ended up stopping the whole thing and getting sedated so it could be finished. I don't know how it went after that!
So, I guess my answer is that I would allow anything to be practiced on me if it was not painful OR I was not conscious.
Mar 28, '07When I was a student nurse, I was only turned down one time for an IV start, and it was because the patient had TERRIBLE veins, to the point that the CRNA had to start it. I always really appreciated the people that would let me practice on them. You can only learn so much on a schools dummy. I also never got to start a foley on a "real" patient in nursing school, but I now insert at least 3 a week, more when I'm on the day shift. (Foley caths are ONE skill you learn cold in the OR). When I was pregnant, I never refused to have anyone in the room with my doctor. I hate needles, but I'd suck it up and let a student start an IV on me, as well as a foley if need be. To all of those who are willing to let a student practice on you, Bless you, you made it just a little easier to get these skills down.
Mar 28, '07I'm not a nurse yet (trying to get into NS) but I would let a SN do anything one time. If you can't get it on the first try, sorry but get someone else (it could be a different SN).
Now if it was for my kids, sorry I only want experienced nurses and doctors working on them.
Mar 28, '07Quote from KellNYWhy would you allow venipuncture but not IV insertion? Other than replacing the needle with the plastic catheter and flushing, there's virtually no difference in either. Or is there something I'm missing? :uhoh21:I WOULD allow:
I WOULD NOT allow:
As for the question, it entirely depends on the student's own characteristics.Last edit by Kay Ciel, RN on Mar 28, '07 : Reason: spelling.
Mar 28, '07Quote from Kay Ciel, RNTo answer-I have a few reasons. Venipuncture-you "blow" the vein drawing blood, no big deal. You flush or run fluid into tissue after evacuating the vein, even if it is just NS, that's PAINFUL. You're not injecting anything into me when you draw my blood, and you're much less likely to get tripped up on a valve. Gauge is usally different (25g butterfly compared to the 18/20g IVs we have to use).Why would you allow venipuncture but not IV insertion? Other than replacing the needle with the plastic catheter and flushing, there's virtually no difference in either. Or is there something I'm missing? :uhoh21:
And last, but not least....
In my experience, both as a SN and an RN helping SNs--SNs do not get enough practice with the equipment involved with IV insertion--everything from the catheter (as simple as how to advance) to the stop cocks to the connections to the tubing itself. Also, they are not given enough time to practice securing the IV in place with tape/tegaderm to develop any semblence of a technique (this stuff can be done on a dummy). I blame this on the schools mostly.
I mentioned in a later post that if a SN could show me proper use and familiarity of the equipment, I'd seriously consider letting him/her place the IV. Otherwise, I'm not going to be all tourney'ed up, maybe bleeding, and definitelt uncomfortable while they decide a good way to secure it in, or remember that they forgot the extension tubing or lock tubing or whatever.
Mar 30, '07I would let students do lots of things, but for more invasive things I would prefer that either their instructor or another nurse be present...I'm pretty open to students and I enjoy when they work on my unit! After having graduated and NEVER getting to put in an IV or an NG, I always make a point to both look for and point out opportunity!
Mar 30, '07Quote from clee1:yeahthat:It would depend on the student. A confident, intelligent go-getter: Knock yourself out. A hesitant, nervous student - nothing invasive.
Mar 30, '07About 3/4 of my pts. in clinicals were nurses or aides. At first, I thought my instructors assigned me to them because I needed extra help. Later, I began to suspect they thought their ailing colleagues needed a laugh. Either way, it worked out. I got a lot of useful advice, and I'm sure watching me fumble around and sweat was pretty amusing. Didn't get to do much that was very invasive in school, though.
My two IV starts in school went very well. Actually, the first was a bit messy, because I started it right-handed. That was fine until I tried to put the hub on. Starting IVs was problematic once I was on my own, though. I had to start one on a pt who was an EMT, and she actually used a napkin to mop my brow as I stuck her. (My theory, then and now, is that you have to miss a hundred sticks to get good at it. Happily, it's taking a lot longer to miss the last thirty than it did the first thirty...)
I like to believe I'd be as generous toward students as my patients were with me. The point may be moot, though. After my last hospitalization, I took an oath that if I ever came back, they'd have to carry me in. No such thing as a "walk-in emergency." So I like to believe I'd be in no condition to object to a student, if I ever have to return to that living nightmare, again. (I had a spider bite. I got IV antibiotics q8h x 6 doses. If they had kept me a third day, I'd have been on suicide precautions. The hot compresses were nice, though.)
Mar 30, '07I think I would allow them to do any procedure as long as the nursing instructor was there by their side to make sure they didn't screw up. Have things changed or doesn't the instructors observe and walk you through procedures anymore? I graduated in 1996, so its been a while.
Mar 30, '07Just yesterday I was allowed by my instructor to Straight cath a male patient of another student. Said student REFUSED to do it, so I jumped right on in. I kept sterile technique, and did quite a good job according to my instructor AND the patient. Either way, tube down a penis isnt going to be a day at the beach
Its rare we get to do that out of the ER so I was very very glad that I got to practice a skill like that on a real patient.
Mar 30, '07Maybe I will be the odd man out here BUT...24 years ago I was a student nurse...and where would I be today if patients THEn had said 'no you can't do that on me/to me'...
We all have to learn and be patient while others are learning. Who is not to say that that student nurse isn't better at such and such procedure than an older nurse?
We need good nurses and people who want to be nurses need all the guidance and help they can get. We have to 'take care of our young' and help them the way WE seasoned nurses had someone help us...
Mar 30, '07Quote from prettypawsI do not allow students to do any sort of work on me- period.