Newish grad. Dealing with students on the ward.

livefully · Sep 17, 2014

As a new nurse myself, I understand. But think how far you have come since your first day.

I always do my own assessments. I'll have the student doing his/her own along side me, and we can talk about what we each assessed. Anything else that they do, I am right there with them.

firstinfamily, RN · Sep 17, 2014

As far as I know student nurses are usually accompanied by their instructor and it is the instructor who has to check up on the students not the nurse who is working for the facility. When I have had students on my floor, I took my usual assignment and did my usual thing, assessment, medications, treatments etc. Unless the nursing instructor came to me and asked for me to not do something so the students could do it I did what I normally did. It should not be your license who is being responsible for these students, it is the responsibility of the school to provide an instructor. If there is no instructor, then they would not be doing hands-on anything!!

loveoutloud · Sep 17, 2014

There is an instructor, but it is a 6:1 ration so the will inevitably be asking me questions. In terms of assessments etc I want to complete everything to ensure changes are detected promptly.

LightMyFire · Sep 17, 2014

Let them know that you'll be happy to answer questions if they keep up. Otherwise they can forget it because you're responsible for your pts, not them. I'm not going to pursue them to teach them. With that said, I love students! At least the ones who want to learn!

BSNbeauty, BSN, RN · Sep 17, 2014

I perform and chart my own assessments. They are my patients at the end of the day. Students are just there to learn.

Nonyvole, BSN, RN · Sep 17, 2014

I'm in your situation, OP. Graduated in the spring, now working. However, if there are students on the unit they aren't assigned to a specific nurse unless they're doing a preceptorship.

My patients are just that. Mine. I am not comfortable letting students go in and assess the patient/give meds/do whatever without me physically there so that I can form my own impression and be a backup. I also listen to my instincts when it comes to skills - if a student says "I don't (whatever)" then they don't get to do. If a patient is sick, unless I know the student is quick on their feet and confident in their skills, then they also don't get to do.

I do love teaching. Students both hate it and love it because I ask them questions. Medication rights, what they think is going on, the medications that the patient is getting, whatever comes up. And then I'll pull up resources on the computer and talk over it all with them. I let them put a tourniquet on my arm and poke at my veins because the manikins are terrible. That's something that you can do, if you've the time, OP, and if they want to learn.

amzyRN · Sep 18, 2014

I still do a complete head to toe assessment and double check vitals if I feel that is necessary. I let the student chart their assessment and I double check it to make sure it is makes sense. If I heard crackles and the student says the lungs are clear, I will have them go back and listen again. I will ask them questions about medications to make sure they know what they are giving and will also make sure they know what labs to check and what not. I like to share what I have learned a long the way and have found that most of my interactions with students have been positive. If we never let students do anything their learning is impeded and then when they start work they don't know how to do anything. It's nice to get a new grad who actually can start an IV or insert a Foley properly.

RunBabyRN · Sep 18, 2014

Think of it as an opportunity to learn, yourself! You learn so much by teaching. As you develop a comfort level with the students, you can let them chart, but look over their charting before they leave for the day and sign off on it. I would have them do their assessments with you there, and double check their work. For example, you both listen to lung sounds, and THEN they tell you what they hear. Take in students anywhere you think they can learn something, and try to rope in more than one if possible (with the pt's permission). This is, of course, assuming they are the kind of students who WANT to learn.

sjalv · Sep 18, 2014

I'm a student so perhaps I can tell you what the nurses do on the unit where I have clinicals. First off, there's only 3 of us on the floor in one day, and our instructor double-checks the patients we have picked out so that the nurses working won't have more than 1 student each. So I'm guessing that makes it less stressful. We can perform procedures with the nurse's supervision, and usually the nurses will come get us if our patient needs a catheter or IV. We cannot give a medication without our instructor's supervision. We do all of the meds for our patient while we are there, and our instructor documents them in the MAR. We help the aides when needed, but we are basically a dedicated CNA/CMA for that patient.

Of course, we do things like assess the patient and ask them questions (smoking habits, support system, worries about ability to care for self, etc), because we have a case study to do which includes two care plans w/5 interventions, but our instructor is ultimately responsible for us, not the nurse.

LarkBea · Sep 18, 2014

Typically, if your experience was like mine, some students may approach you with questions. My advice is, be approachable. If you don't know the answer, don't be afraid to say so. If you do, don't be afraid to share your knowledge. I remember the kind and knowledgeable nurses who gave me guidance as a student (even the one who advised me to give up nursing and drive a truck...less stress and better pay...lol) and I also remember the cold and remote ones who gave me as much acknowledgement as an annoying gnat to be flicked away.

sjalv · Sep 18, 2014

Also, I wanted to add that you shouldn't worry about not knowing an answer a student might have. Any student who resides on the planet Earth knows that it's impossible to know everything, especially as a new nurse. During my last clinical, my patient's nurse was a new grad, and the patient was taking Depakene (valproic acid). Typically an anticonvulsant and sometimes a mood stabilizer, the patient didn't have a history of seizures or of any mood disorder. I asked the nurse if she knew why the patient was taking it, and she didn't. We asked the doctor later, and he told us that it can sometimes be used to treat phantom pain in amuptees (which the pt was). Basically my point is as students, we don't put nurses on a pedestal as paragons of knowledge. I respect what they know and look to them as a 2nd person to turn to for information (my instructor being my first), but I don't "judge" them for not knowing something.