Lazy Student Nurse Preceptors!

[jfpruitt]

I am furious over my most recent clinical experience. I'm in my last semester of school and graduating in May. Our school waits until 4th semester to learn IV's. Well, the "goals" for this semester is to get as much IV experience, practice on all other procedures/shots, and shadow a real RN. Well, my first clinical night with a new preceptor was a disaster. I was assigned a travel/agency RN from NY. This was her 2nd night in a new hospital and a new state. She is given specific instructions to let me do all IV's, meds, procedures etc on this patient. She happily agrees, but doesnt listen. Next thing I know, she's hanging IV's, giving heparin shots, and changing tubing. All these things were supposed to be done by me and checked by her. When asked, she kept saying, "Oh, I'm sorry, I forgot". It was as if she resented me being there and just wanted to get the job done without taking time to teach me. Next thing I know, she is volunteering me to give this hemiparetic, 250+ comatose man a bed bath and mouth care. Not that I think this is not a nursing role by no means, however, this is not something I need to learn again. How is it she forgets to teach me IV's, but suddenly remembers I can do a bed bath? I was furious. I learned how to do bed bath's 1st semester and certainly did not need the practice now. So, I essentially spent the whole evening doing "tech" stuff and learned nothing about IVs or the nursing role. Again, I'm not saying bed bath and oral care are not important, however, I need to be practicing procedures and IVs not bed baths. So, I guess my point was why are some RN's so reluctant to teach students and others so great? I felt she was using me to do the jobs she didnt want to do. The other students were doing caths, NG's, etc and I got stuck with a bed bath and oral care. Just wanted to get some input from the veteran RN's out there.

[delirium]

I am giving you advice not as a veteran RN but as a nursing student.

Go to your instructor. The last semester of your nursing program is supposed to be for developing management skills and maybe perfecting some advanced skills, like IVs.

You are *not* a tech, and you are not free labor.

I think it was a bad situation because you were paired with a travel nurse who wasn't properly oriented herself (or that's the way it sounds from your account).

I would have called her on it, which it sounds like you did, and pointed out that you are in the RN role and these are the experiences you need to have.

If that didn't work, I'd go straight to my instructor and let them fight it out. Either she'll become more understanding of your role on the unit (and it could be that she has little experience with students) and help you, or your instructor can assign you to a different preceptor.

You have precious little clinical time. Make it count.

Edited to add: The first time I floated to ICU (last semester), I was assigned to a nurse with a patient in DIC. The head nurse of the unit instructed me to hold pressure at the femoral a-line site. I did as I was told.... for almost 2 hours. True, I spoke with the nurse and found out about the patient but I was stuck there holding pressure.

My instructor did a walk through and was livid that they were placing me in the role of a tech or a nurse's assistant and not allowing me to have the best possible experience in the role of the RN (i.e. assessment, comparing blood orders, calculating gtts).

[llg, PhD, RN]

I agree with delirium. Talk with your instructor and ask her to help clarify your objectives with the unit staff. It was certainly inappropriate for them to buddy you with someone so new to the facility.

llg

[MEtheBabiesRN]

I agree with delirium. (lol love that name). You need to tell your nursing instructor. Otherwise what's going to happen is that you'll be finishing your rotation without the proper requisites to graduate and you'll have to repeat. I am a 12 year veteran of nursing and certainly feel as new as you do some days because we are always learning. That's the nice thing about it. You can't get bored. There's too many different areas you can go into. Hang in there.

[delirium]

I don't know about having to repeat. More likely is that you'll graduate and feel clueless once you're actually working as a GN or an RN on a unit.

You are paying to be trained, and you deserve appropriate, relevant training. You're not in a CNA class, and really its in everyone's best interest to train you to become a safe, competent nurse (and its my understanding that we will become safe, skillful, competent nurses in time).

Besides, this is good situational training to teach you to be assertive and ask for what you need. We'll need this as novice nurses.

[bossynurse]

Originally posted by delirium

I don't know about having to repeat. More likely is that you'll graduate and feel clueless once you're actually working as a GN or an RN on a unit.

Hey we're all clueless when we graduate. I remember thinking that I couldn't believe that stupid school graduated me I'm lost. But I learned more in my 10 week orientation on the floor than in nursing school. Not to say that your preceptor wasn't wrong. I always try to find new learning for students when they are on my floor.

[Nurse Ratched, RN]

(Precede this by saying my admiration of agency nurses is second to none, and this is not a slam against them.) I also agree that having an agency nurse - any nurse for that matter - who had worked that unit and that state only TWICE was a pizz-poor selection for a preceptor by whomever made the decision to place you with her. She should have been assertive enough to say that she didn't feel able to offer that experience to you. One of three things happened, I presume - either none of the regular staff "wanted" to precept a student, and dropped it on the agency nurse (who should have known better,) regular staff all already had students assigned to them, or she was the most qualified person to do it (!).

As others have suggested, this is a good opportunity to learn assertive communication. Unfortunately, this is not the last time you'll need it in your nursing career. Good luck :).

[delirium]

I was not suggesting that any nurse graduates feeling competent and secure in his or her abilities. If you'd read my post in its entirety, you'd know that.

I am suggesting that if you continue through all your clinical experiences only performing the role of a tech, you will be more clueless than those who had more relevant experience while in nursing school.

[sjoe]

"my first clinical night with a new preceptor was a disaster. I was assigned a travel/agency RN from NY. "

The problem is with whoever assigned this preceptor to you. It was a singularly inappropriate assignment for the travel nurse to be given for several reasons, and any competent person would know that.

You need to be firm and assertive about getting a preceptor that suits your leaning needs. This is a good opportunity to practice standing up for yourself WITHOUT blaming the agency nurse, who is not the problem.

[SmilingBluEyes]

I agree w/ALL Rebecca's posts. Especially when she says YOU ARE PAYING TO LEARN THE ROLE OF RN, not TECH. report this yesterday to your instructors and/or head of the nursing dept at your school. Lodge your complaint loudly and learn assertive behavior NOW...you will it need in the few short months that precede your becoming an RN. Good luck.:kiss

[emily_mom]

I'm probably the only one in disagreement here (I am also a last semester student and Student Nurse Intern). OK, true...you are to practice the higher difficulty things here, but that's not always possible. You need to take care of the whole patient as a nurse, not just chuck in IV's and such. You sound like you were upset that you were asked to do some aide duties. You said you "don't need to learn that again." It's not like you're "learning", you're doing. As I said above, you're caring for the whole person.

While I disagree with the nurse you were put with, who set this up? Did your instructor or the floor? I've had to shadow similar staff nurses and ended up doing TONS of aide things, but it really does help. You learn how to manage time and have a greater understanding of all that is required of a floor nurse.

While in clinical, I NEVER got to put in an IV, catheter, etc... It was only when I started working that the nurses specifically seek me out to do it. I had only given 1 IM injection before working...never hung a piggyback....

We also have senior students shadowing on my floor. Some of the nurses are apprehensive because they are unsure of their skills and such. When I float to other floors, not all of the nurses let me do things. I work as an aide then. It is their judgment and I respect that.

That was your first night. Most of the clinical students don't do a lot their first night as they are just orientating to the floor. Wait and see how the rest of your clinical experience goes. You will be a fine nurse whether you have started 150 IV's or 1.

Kristy

[EmeraldNYL, BSN, RN]

We aren't allowed to do IVs at all at my school so consider yourself lucky! It's frusturating though because I have already done so many bed baths it's not funny-- I want to be doing more skills like giving injections, changing dressings, etc.