Need to vent

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Specializes in ICU.

I had a student with me the other day. After report she sort of wandered off, that's ok, so I went in to assess my patient. We unfortunatly have two patient rooms, and while I was assessing patient 1, I heard someone talking to patient 2. At first I thought that it was one of the md's, but then i realized who it was as she kept talking. At this point I hadn't been over there to even introduce myself. Then I heard her ask this pt if they wanted some Tylenol, or if the Nubain and phenergan that they had had last night had worked better....No, I still had not even looked at the patient. I was alittle freaked out to say the least. I didn't want to say anything in front of either patient, so I waited and cought her in the nook where we keep the linens, and said (verbatum) "I appreciate that you are taking initiative and being a go-getter, but I would really prefer it if you didn't assess the patient without me or talk to them about medications. This is my liscense we're working with here. " she said ok, then asked if it was ok for her to change his linens, which I said sure, which she did. Then, as I was finishing with him, she left, and I didn't see her again, until I saw her, her professor, and my ncm going into the break room. I went t talk to my ncm about it the first chance I had, cause I knew I was gonna get called in. Turns out that she had had the pt the day before (didn't tell me that), and had been a LPN for many years ( didn't mention that to me either). I got a lecture about how I should be nicer to the students becausewe might want to hire them when the graduate, but they won't want to work here. Basically, me the person who is trained, is not as important as the person that they might hire in 6mo when she graduates. I even spoke with her professor who said she needed to get a thicker skin, and understood my point, and that some of the problem was because she was having problems at home. I'm just frustrated and agitated. Grrrrrrrrrrrrr.:angryfire

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Specializes in med-surg.

I'm a first year nursing student and one of the things that was stressed to us during our Med-Surg clinical is that we need to communicate as professionals. At our school, our instructors have privileges at the units we were on and served as our ultimate authority since we were practicing under her license (6- 7 of us). The patients and the assigned nurse had to approve being assigned to a student nurse. We were told from day 1 that we would be required to report off vitals by 7 AM to the assigned nurse and sit in on the shift report. For the following 5-6 hours, we administered meds under our instructor and performed basic nursing tasks (bed changes, baths, emptying Foley's, tracking I&O, etc). At the end of our time, we reported off to our nurse. As the clinical progressed, our instructor started directing us to the RN to consult with them what actions should be taken instead of just telling us what to do. We had terrific nurses that were willing to explain why things should or should not be done and the rationale behind it. They allowed us to participate in procedures that we could not perform without our instructor there. Any time there was something unusual on the floor, two or three of them (I love you Brad, Amber and Chester) would gather us up so we could catch it.

The point to all of this is that the students should be learning how to communicate professionally with everyone, not just her professor. I most certainly hope that her instructor urged her to communicate with the staff and not just to wander off and do what she thinks needs to be done. It isn't fair for the staff to have a nursing student thrust upon them with no knowledge of that student's skill level. For example, I had a nurse in my ob-gyn clinical this week. She hadn't worked with a student from our school before and was surprised to find out that I would be there all day. I shadowed at first, but as we conversed while the delivery dragged on, she began to understand that I was able and willing to do what was needed based on her comfort level (the 1.5 hours in the OR for the Cesarian--they didn't care--you just do what your told:idea: By lunch, she felt comfortable enough leaving me in charge (although I'm sure she had someone checking the FHR at the front desk).

You should be a little steamed...just remember that we are learning and some have different skill levels. Maybe take a few minutes to talk to the student and find out what the experience level is and what the clinical goal for that day is. A student that you can some faith in can be a big help on a really bad day

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Specializes in ICU;CCU;Telemetry;L&D;Hospice;ER/Trauma;.

she was out of bounds....

she should be your shadow....not going off and doing things on her own...whether verbal or any other way....that's practicing without a license...period.

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Specializes in Rural Nursing = Med/Surg, ER, OB, ICU.

Wow, I am sorry you had this experience with a student. I am a student and we were taught to respect the nursing staff and to follow them and only do what we were asked by our nurse. As the weeks progressed and our nurses got to know our abilities, more responsibility was given us. I hate it when a nurse has a bad time with a student because it makes it hard on the students that follow. I have worked in a hospital for years and am advanced in my knowledge but I would never do anything with a patient without my RN's permission. I am very thankful for the RN's that have put up with me!

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Specializes in ICU.

Thanks everyone for letting me vent. I have to say that I'm not really mad at the student (more like frustrated). I've had LPN students with me before, and not had any difficulty, and really enjoyed having them because i got to teach more unit-specific ideas v. general nursing ques (not to mention they're a great help if you're havinga rough day). Usually, they tell you before you get started that they are LPNs. I love having students with me. What's fluffing my biscuits is that my NCM not only didn't step up for me, but I got called into the principals office and LECTURED on how I need to be nicer to the students because "they talk to each other, and if one of them has bad experience, then they might not want to apply here". ***? (pardon the language). I didn't even get an "I see where you are coming from". I've been thinking about it since it hapened, and I just can't seem to get un-irritated. Humph.:angryfire

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Specializes in med-surg.
What's fluffing my biscuits is that my NCM not only didn't step up for me, but I got called into the principals office and LECTURED on how I need to be nicer to the students because "they talk to each other, and if one of them has bad experience, then they might not want to apply here". ***? (pardon the language). I didn't even get an "I see where you are coming from". I've been thinking about it since it hapened, and I just can't seem to get un-irritated. Humph.:angryfire

That is unfair...hopefully her instructor told her to toughen up. The last thing anyone wants in a coworker is someone that will not communicate on a lateral level and has to run to the NM everytime she doesn't get her way. If thats the way she behaves in clinical, then I doubt more than a few of her classmates take anything seriously from her because that behavior is probably present in class as well.:smilecoffeecup:

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Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.

It doesn't matter that she had the patient the night before OR how long she has been an LPN. When she is in clinical, she is the student and she needs to follow the same rules as everyone else. You corrected her on her behavior and you did it in a professional manner, so you did nothing wrong. I don't care what the supervisor says, if it happened again I would ask that she be removed from my patients care.

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