How to support student nurse?

Specializes in Emergency Department.
How to support student nurse?

I recently was assigned a sophomore student nurse in the emergency department for the next month or so. I'm finding it difficult to teach as well as provide patient care in a busy trauma center. I'm doing my best to provide teaching as we go but sometimes we just don't have time. She wasn't given a clinical guideline nor was I. I'm getting increasingly frustrated and was looking for guidance on how to best support her. 

In the past (Step-Down Unit RN) I'd have students that were in their senior practicum, I was given guidelines to follow for their clinical practicum. It was easy to teach as well as take an assignment. I was able to make cheat sheets for my students because we had the time and usually the same patients throughout the shift. This isn't really feasible in the Emergency department due to our high rate of patient turnover. My management hasn't been particularly helpful in regard to resources for our students. Looking to see if anyone had a similar experience/how they handled it?

5 Answers

Specializes in ED, Tele, MedSurg, ADN, Outpatient, LTC, Peds.

Working as an ER nurse, I had a student  around 2005 shadow me in the ER for around 5-6 months. She was hired as a student tech and could do vitals, fingersticks, urines and EKG.

The first week she followed me around and watched what I did and I talked her through some of the cases. I also had her go to an empty ED bay and do a scavenger hunt for all equipments, supplies and learn the setup of each bay and where stuff was kept in the ED.

 During down time or if the pace was slow or sluggish we went over common case and the 5 tier triage system. We also went over critical thinking and anticipating protocols in codes.

She also had to go through the algorithms to learn and figure out meds especially while coding the patient although she was hands off and  observed in actual emergencies. She had a chance to question me about why we did what we did. She observed me doing NG,Foley's , heplocks, blood draws, conscious sedation protocols etc etc. I used our orientee checklist to guide her as the school protocols were very vague!

I basically taught her what I would teach an  ED RN orientee. She had to go back to school after the 6 months were done. I moved to a different ED within the system as a supervisor.

Years later, I met her in the ED while I was covering the hospital  as the house supervisor  (Assistant Director of Nursing). When I rounded in the ED I asked to speak to the charge Nurse, guess who showed up as charge! She took one look and ran and hugged me! She had joined the ED after I left and now ran the ED in a stellar manner! I couldn't have been more prouder!

Specializes in Critical Care, Capacity/Bed Management.

Having such a green nursing student in a high intensity specialty can definitely present some challenges, which you brought up.

If this placement is part of a course, reaching out to their professor for guidelines/goals might be beneficial. If they have been brought on as a nurse extern then the first point is moot.

Some of the things that might be helpful for a new nursing student is differentiating between normal and abnormal. For example, have them listen to lung sounds on a CHF exacerbation patient vs someone who came in with a broken bone. As you work up your sepsis patient talk through the 3 hour sepsis bundle. It is simple things like this that help them begin the process of critical thinking. 

Specializes in Psych, Addictions, SOL (Student of Life).
22 hours ago, ER.NurseJea said:

I recently was assigned a sophomore student nurse in the emergency department for the next month or so. I'm finding it difficult to teach as well as provide patient care in a busy trauma center. I'm doing my best to provide teaching as we go but sometimes we just don't have time. She wasn't given a clinical guideline nor was I. I'm getting increasingly frustrated and was looking for guidance on how to best support her. 

In the past (Step-Down Unit RN) I'd have students that were in their senior practicum, I was given guidelines to follow for their clinical practicum. It was easy to teach as well as take an assignment. I was able to make cheat sheets for my students because we had the time and usually the same patients throughout the shift. This isn't really feasible in the Emergency department due to our high rate of patient turnover. My management hasn't been particularly helpful in regard to resources for our students. Looking to see if anyone had a similar experience/how they handled it?

Without a clinical guideline you don’t know what the expectations are.Way back in the Stone Age when I was a student we were told to observe and jump in when the RN needed some assistance. We could not do any type of procedure without our instructor being present and an instructor would have given your student a clinical guideline. If this did not happen it’s on your student to go back to the instructor for this. In the mean gave them observe you can ask how they think certain illness present, let them know what has to happen before discharge and what meds are give for. It sounds like you care that your student has a good experience which speaks volumes. 

Specializes in oncology.
ER.NurseJea said:

a sophomore student nurse

ER.NurseJea said:

She wasn't given a clinical guideline nor was I.

Someone, somewhere is getting tuition dollars for supervision/teaching etc. You and the student are being had. Refuse this assignment in the future. 

ER.NurseJea said:

I'm getting increasingly frustrated and was looking for guidance on how to best support her. 

Yes, you can support her, but there is a limit. Is this one of the for-profit schools in Florida?

Let me guess...the clinical instructor isn't even on site. ?

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