How to deal with slack students

lweatherby · Jul 23, 2009

As a current (and older) student I completely understand your frustration. I am amazed at the actions of my fellow students during clinicals. The texting, breaking, looking bored/yawning and..... sleeping. Yes, there was one student that slept at the desk all day while I never sat down. Apparently, this was his MO throughout the clinical rotation. No preceptor had ever told our instructor that he was disrespectfully slacking during every clinical. Finally, another student got fed up with his embarassing behavior and told our instructor. She dealt with it swiftly. It is an embarassment to the school to have this going on.

If you do not want to confront the students directly here is my advice. Tell the instructor that as a group you feel the students are not coming to clinicals prepared and that they are violating rules (texting, etc) during the clinical. If you are not the manager of the unit, then have the manager give the instructor a list of expectations during the clinicals. Many times our instructor would tell us "This unit has high expectations. They expect initiative, they will ask questions, they expect you to jump in and participate. This unit is eager to teach, but they expect you to be eager to learn". She knew what every unit expected and would give us a good talking to before we went to that unit. If you have made it clear what is expected, then the students are asking to be "schooled" (as my classmates call it) if they do not deliver.

Alternatively, you can just have a talk with the student at the beginning of the shift and let them know what you expect individually. As a student it is sometimes hard to read your preceptor.... does she want me to jump in? Does she want me to wait to be asked? Does she want me to follow her every step or does she want me to back off????? All questions that we wrestle with in our heads. The absolute best day I EVER had was when I had a seasoned ICU nurse meet me eye to eye at the desk. She said "I'm glad you are here today. This is how I work. This is what I expect from you. I am here to teach you anything that you want to learn, but I will not beg you to follow me and get involved. I would love to have you right beside me all day long, but if you just want to sit at the desk, I'm not going to come and get you. I would love to show you how to do procedures, but if you don't want to try, I'm not going to beg you". She scared the crap out of me, but I knew exactly how it was going to be up front and I learned a ton! It was a great day!

I know that NO ONE should have to be told to stay off the cell phone and not go down to the cafeteria for random breaks for arbitrary lenghts of time. However, some of my fellow students had to be reminded and some were even put on contract (not a good thing) for repeated offenses. Just include that in your morning talk. "Texting while in the work area is not allowed. Please do not that until our scheduled break time." Students are used to being told what to do. I don't think it will be offensive if you just lay out the rules at the beginning of the day.

This is just a student perspective!

NurseKitten, MSN, RN · Aug 10, 2009

Students doing this need to be given 1 chance...discuss it with them first, then if it happens again, their clinical instructor needs to be told.

New nurses need to be reminded that they will be held responsible for this information/procedure/etc as soon as they are off orientation, and if they want to not drown in the weeds when that happens, they better get off their butt and snap to.

The new grads I've had to give that little schtick to have not traditionally been successful, sadly, BTW.

Either they come in wanting to know everything and are little sponges for you to pour your years of experience into, or they are just plain sorry. There isn't a lot of middle ground, in my experience.

Like the poster above me, though. Great ideas.

Good luck.

pH7.40, LPN · Aug 12, 2009

First off set very clear rules or expectations for them so they know what not to do and

dont hurt anyone, including themselves.

Secondly, critical care is really intense. There is so much to learn! Try to focus more

on keeping them safe and cultivating a love of critical thinking and pathophysiology rather

than splitting hairs over every detail. It takes years to learn and master the details.

Give them simple hands on tasks, like priming IV tubing. Break it down into simple steps.

Also the students who seem like slackers just simply might already know that they

do not want to be critical care nurses... and thats ok. Its not your fault, critical care

just isnt for them. In my nursing school during clinicals I was dying to get to the hospital

every day, even went the day before to pick out my patient and look up everything in advance

while other nursing students absolutely hated it and couldnt wait to leave.

Its an intense environment and some people can take it only in very small doses.

One fellow student of mine I remember passed out during a rather bloody insertion

of an ng or foley ( i wasn't there). She fell hit her head and got a black eye. It was

just too much for her. Just accept people for where they are in the process and try not

to scare them...because lets face..us ICU nurses can be intimidating.

hope that gives you some words of encouragement.

And its awesome that you are willing to share your knowledge by precepting.

pH7.40, LPN · Aug 12, 2009

"As a student it is sometimes hard to read your preceptor.... does she want me to jump in? Does she want me to wait to be asked? Does she want me to follow her every step or does she want me to back off????? All questions that we wrestle with in our heads. The absolute best day I EVER had was when I had a seasoned ICU nurse meet me eye to eye at the desk. She said "I'm glad you are here today. This is how I work. This is what I expect from you. I am here to teach you anything that you want to learn, but I will not beg you to follow me and get involved. I would love to have you right beside me all day long, but if you just want to sit at the desk, I'm not going to come and get you. I would love to show you how to do procedures, but if you don't want to try, I'm not going to beg you". She scared the crap out of me, but I knew exactly how it was going to be up front and I learned a ton! It was a great day! "

This is a great example of drawing very clear lines for expectations while allowing for the student to step back if they feel overstimulated or overwhelmed.

profstudent4life · Aug 19, 2009

Much of the behavior you described is appalling, but you also need to keep in mind that there are huge generational differences. Learning to work with and deal with the generational "gaps" are key to successful workplaces. Just as you think the student behavior is horrifying and disrespectful, they grew up in a different era. Keep this in mind before passing quick judgements.

TX RN · Sep 11, 2009

I feel it's totally up to the student to take advantage of their time in clinicals. I always ask my student to list 3 goals for me at the very start of their shift. If they can't list them I ask what they're covering in class and come up with 3 goals for them myself. Anything above and beyond those goals is made clear that it is totally up to them. The rules of the unit, cell phone use, breaks, etc., are made clear and apply to students just like they do to staff. It's those students that lack motivation and initiative that struggle as new grads. Oh well, they're grown ups....time to start acting like one.

BabyLady, BSN, RN · Sep 11, 2009

So, I've started precepting in my ICU. The students I've had thus far have been senior BSN students and new graduate RN's. When I was starting out in nursing, I would read the night before, ask "smart" questions, and make every effort to try new task and gain new experiences. I have been so disappointed with the ones who have come in to work with me. I understand that new grads will not know ICU drips and calculations, but not knowing what MAP is or means, not knowing that removing the patients o2 cannula can cause a patients o2 sats to drop, and text-ing at the desk, checking their e-mail, and taking random breaks at their convenience seems a little too much for me. I was never like this at a student. How can I get the new nurses or senior nursing students to take some initiative without "telling" their instructor or director, or making them feel dumb and like they can't hang a critical care unit??

Don't assume that they are all taught the same thing...seniors or not.

Students are not told at every school who they are going to get the next day in clinical. At our school, we weren't...we found out who our patient was when we showed up for clinical...many times they had a condition and we had not "got to that chapter yet" so I had no idea regarding the management of their care.

Not my fault..I can't help nor have a choice of who I am assigned to.

MAP...never covered at my school. I never knew what it was until I started working with patients on vents.

No nursing school can cover everything.

Texting or e-mailing is unprofessional...you should be able to put a stop to that yourself.

However...be careful about "complaining" to the instructor...you may start out trying to bash the student, but you may end up bashing the program instead.

CharlieT · Sep 11, 2009

"I'm glad you are here today. This is how I work. This is what I expect from you. I am here to teach you anything that you want to learn, but I will not beg you to follow me and get involved. I would love to have you right beside me all day long, but if you just want to sit at the desk, I'm not going to come and get you. I would love to show you how to do procedures, but if you don't want to try, I'm not going to beg you".

Where can I find this CI? This is the type of CI that I would love to find. I would be on her heels the entire time, like a puppy after its human. I would jump in and try to learn all I could. This is the type of nurse I hope to be some day when I have students.

allnurses Guide · Sep 11, 2009

Much of the behavior you described is appalling, but you also need to keep in mind that there are huge generational differences. Learning to work with and deal with the generational "gaps" are key to successful workplaces. Just as you think the student behavior is horrifying and disrespectful, they grew up in a different era. Keep this in mind before passing quick judgements.

So it's a slacker generation and we should just deal with it?

You don't think those behaviors are appalling? I think when the students are asking staff to donate their time, efforts and experience to help them learn, the onus is NOT on the preceptor to deal with their "generational" issues - it's on the preceptor to outline their requirements, and it's on the student to follow them.

Lolling around at the desk, texting or emailing during clinical is NEVER acceptable, no matter what generation the student is from.

PS: I agree though, many kids these days have a huge sense of entitlement and no respect for people in authority (sorry I know that makes me sound like an old bag, but I deal with many of them!).

allnurses Guide · Sep 11, 2009

So it's a slacker generation and we should just deal with it?
You don't think those behaviors are appalling? I think when the students are asking staff to donate their time, efforts and experience to help them learn, the onus is NOT on the preceptor to deal with their "generational" issues - it's on the preceptor to outline their requirements, and it's on the student to follow them.
Lolling around at the desk, texting or emailing during clinical is NEVER acceptable, no matter what generation the student is from.
PS: I agree though, many kids these days have a huge sense of entitlement and no respect for people in authority (sorry I know that makes me sound like an old bag, but I deal with many of them!).

:yeahthat:

llg, PhD, RN · Sep 11, 2009

We can't use "generational differences" as an excuse for bad behavior. I'm not saying we should crucify the younger students because no one has taught them appropriate professional behavior -- but we should use the situation as a teaching opportunity. I strongly agree with those who suggest clearly articulating the expectatons at the beginning of the shift, giving them a chance or 2 to learn the new behaviors, and then enforcing them. That's the only way the students will learn appropriate behavior.