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Discussion

My Preceptee concerns me

Preceptee concerns anyone??

I have this student nurse who I have been working with for the past 4 weeks now. I told him to draw 3 units of insulin. I went in to see how he was doing and saw him reach for the 5ml syringe-probably to draw up 3ml of insulin... yikes. Stopped him, and then proceeded to show him where the right syringe was. It's crazy bc I have seen this student draw up insulin from the appropriate syringe before and give the right dose. Maybe he had a brain fart. But now I'm wondering if should I notify his clinical instructor of the incidence?

Does anyone have some tips to guide student nurses and help them critically think before doing something? This is my first time precepting a student nurse btw.

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    I don't think that kind of error in a student warrants putting him/her on their instructor's radar if they were receptive to the correction. He should not have been drawing up insulin independently at his career phase for just this reason - these things that are basic tenets to us are still new to a not-yet nurse.

    I like to use questions to help foster critical thinking. In this case, I would have asked "Is that the syringe you want?" and then given him a chance to let his wheels turn and self correct.

    Thank you for precepting. It is not easy, but if it is in your heart, its a great experience.

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    No, I've seen experienced nurses grab tuberculin syringes for insulin. Hopefully this was a memorable learning experience for your student.

    You'll need to watch him like a hawk and observe everything he does. When he's about to make an error, stop him and ask him to walk you through what he is doing. Don't pounce on him like a cat on a mouse; he'll start anxiously second-guessing himself and critical thinking will be out the window.

    Just encourage him to be always thinking everything through. Pilots have auto-pilot; nurses don't get an auto-nurse.

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    10 hours ago, TriciaJ said:

    No, I've seen experienced nurses grab tuberculin syringes for insulin. Hopefully this was a memorable learning experience for your student.

    You'll need to watch him like a hawk and observe everything he does. When he's about to make an error, stop him and ask him to walk you through what he is doing. Don't pounce on him like a cat on a mouse; he'll start anxiously second-guessing himself and critical thinking will be out the window.

    Just encourage him to be always thinking everything through. Pilots have auto-pilot; nurses don't get an auto-nurse.

    Thank you and will do. I need to remind myself to always remain patient. This student nurse recently forgot how to prime and hang IV bags and even scan them in. I just try to keep in mind that everything will come in time for him.

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    On ‎5‎/‎12‎/‎2019 at 1:36 AM, RNZZ27 said:

    Thank you and will do. I need to remind myself to always remain patient. This student nurse recently forgot how to prime and hang IV bags and even scan them in. I just try to keep in mind that everything will come in time for him.

    Either it will or it won't....but this may be just the kind of situation when an Aha! moment happens and you both get the rush of feeling pieces coming together.

    If he is regularly forgetting things he has done successfully before, having him verbalize to you as he does things. It will help move things out of his memory and into the forefront of action.

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    I'm curious, what year student is he? To be forgetting things you already now could be a sign that you never really learned them. Student experiences jump around so much and each student's experience is not the same as another. Thanks for precepting them, we are always grateful for staff nurses who engage students.

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    I can't think of any medication preparation or administration (or a lot of other things) that I would have a student doing without direct observation.

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    On 5/12/2019 at 2:36 AM, RNZZ27 said:

    Thank you and will do. I need to remind myself to always remain patient. This student nurse recently forgot how to prime and hang IV bags and even scan them in. I just try to keep in mind that everything will come in time for him.

    "This student nurse recently forgot how to prime and hang IV bags and even scan them in." Just defending the slower learners over here in the cheap seats... ? This is a pretty advanced skill for a new student nurse. What is muscle memory to us is brand new to students.

    Clamping, back-priming, making sure all air bubbles are out, aligning it with the pump and programming the pump? and troubleshooting beeps?! and that slight manual gravity adjustment that can't really be taught to get a secondary in just the right spot -- to do that super quickly and correctly took me a while as a new RN. Doing all of that without repetition of the steps explained to me (yes, multiple times), as a student? No way.

    Also, experienced nurses have all forgotten to scan a 500cc saline prime bag before, no?

    +1 to patience

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    On 5/8/2019 at 8:30 PM, RNZZ27 said:

    But now I'm wondering if should I notify his clinical instructor of the incidence?

    First you let a student a student draw up a med unsupervised,then you are so concerned about his syringe selection you are thinking about reporting this to his instructor.

    While he needs correction and appropriate guidance,cutting the wood under him ,you would still be hurting his chances

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