This "us" vs "them" mentality....

[DL-SNUP]

I've been reading through the posts from the last few days, and I'm completely astonished by the "us" vs "them" mentality that is showing up between the nursing students and the staff nurses.

Maybe I'm idealistic, but shouldn't we be trying to work as cohesively as possible so that we can combine forces and provide the best care possible for our patients? It seems to me like we're both equally to blame for the issues that seem to be going on. On one hand, it seems like nursing students need to be more willing to contribute and gain some perspective, realizing that while the staff nurse should *try* to teach us, it isn't their main focus. On the other hand, it seems like a lot of staff nurses are going into clinical situations with a negative attitude about working with students, which I really think can only make matters worse.

Can we really care for patients effectively if we're not on the same page and being professional to each other? I personally don't think so. I think that in any customer service business, having issues behind the scenes like this WILL impact the patient. And I'm so tired of all the finger pointing, because both sides are making mistakes. As a student, I am more than willing to admit that I have been less than enthusiastic when asked to perform something I've done a million times. It happens, and when I realize I've done it I try to change my attitude and do better next time.

Instead of all this negativity, why can't we just try to learn from each other, and accept and navigate the limitations of the time together? Students can learn SO much from staff nurses, and (believe it or not) once in a while a staff nurse can learn a new thing from a student. If we can accept that we're all (hopefully) intelligent individuals united in the fact that we chose nursing to help the patients, and see each other as imperfect people who face constrictions based on our role, it seems like everything would go more smoothly.

I know that it's not all nurses and students that are acting this way....it's just incredibly discouraging to see such a lack of teamwork from the members of this community. At the end of the day, all the students of today will be your coworkers soon, staff nurses. And students, soon we'll all have students that stress us out and make more work for us. Can't we accept that and learn from each other?

Sorry for the ranting....I guess my point is this:

Let's meet halfway.

Students: The nurses are stressed out and busy. Try to help. Ask what THEY want you to do. Tell them that you understand they are busy, but that you would appreciate anything they can teach you. SAY THANK YOU. Realize that it's about the patient. If that means that you miss getting to d/c a central line, there is always next time. If it means that you have to help out what with ADLS, I/Os, etc...realize that you WILL learn from that as well. Be grateful for the opportunity to learn anything you can, and always try to be understanding.

Nurses: Realize that a lot of students *do* realize that you don't want us around. We know that it's not your choice to have a student, but realize that we're not there to ruin your day. Realize that most students want to learn from you and value/idolize how much you know. We're sorry that we're often thought of as an annoyance or an extra task, because all we want is to learn from you so that we can care for our pts as well as you do.

Communicate with us. Today, I worked with a nurse who had 2 pts and was getting her 3 admits all at once. All it took was her saying to me "hey, I'm super busy right now. Can you keep an eye on pt 1 and 2 while I admit these new pts? I'll come find you when it calms down or if there is something I think you could really learn from". Seriously, 3 sentences and I was able to feel like I was helping and not simply being ignored. I don't care how busy you are, but communicating with your team (and a student is a part of that team) is such a priority.

Like I said, maybe I'm just idealistic. But from my experience with other jobs and life in general, if we can just take a deep breath and do our best to make the "behind the scenes" dynamics positive, it will help our patients. Because at the end of the day, that's what ALL of us really want, right?

[Orange Tree]

I've been reading through the posts from the last few days, and I'm completely astonished by the "us" vs "them" mentality that is showing up between the nursing students and the staff nurses.

Maybe I'm idealistic, but shouldn't we be trying to work as cohesively as possible so that we can combine forces and provide the best care possible for our patients?

Yes, you're being idealistic. Students don't do much to contribute to the "best care possible" of patients. They're there to learn. I do try to make students feel welcome, but they are not a valuable part of the team just yet....they will be someday, but not just not quite yet.

[DL-SNUP]

Yes, you're being idealistic. Students don't do much to contribute to the "best care possible" of patients. They're there to learn. I do try to make students feel welcome, but they are not a valuable part of the team just yet....they will be someday, but not just not quite yet.

I do see what you're saying and can understand it, especially depending on where the student is in their education. However, it isn't really fair to punish students and write them off as useless simply because they are students. And my point was more that staff nurses should try to accept that we are students and they're simply trying to become RNs. And that students should understand that teaching us can't always be the staff nurse's primary concern. I've been on the "teacher" side of similar situations in other settings, so I can (to a point) see what it's like for the staff nurses. But I've also found that the units that function best and are known for their patient care are the units that attempt to be positive about the student/staff nurse relationship. I know it's impossible not to get frustrated--I'm not 12 years old, I get it. I know what it's like to work with new people who slow you down and drive you batty. But getting ourselves into this pointing fingers, negative mentally can't HELP patients. It's draining emotionally, and it doesn't really benefit anyone.

[Flo., BSN, RN]

I think the problem is that staff nurses are being over worked. When I went to nursing school we had a clinical instructor on the floor. We asked the CI all of our questions and disturbed the RN as little as possible. Now there is no CI on the floor and students are assigned to work with the RNs. We don't get a lighter assignment or extra money. I don't think this is fair to any party involved.

But to answer you question yes you are being idealistic. But I like it, I was idealistic once and according to older RNs I still am.

[JulieCVICURN, BSN, RN]

The nurses are stressed out and busy. Try to help. Ask what THEY want you to do. Tell them that you understand they are busy, but that you would appreciate anything they can teach you.

You said a lot of great things that really just boil down to the fact that a little common courtesy goes a long way. I do not recommend the quoted action, though, because on the surface it may seem like it's a really great way to show initiative and be helpful, but often the RN doesn't want to stop and think of what it's safe to have you do when she's in the middle of thinking of a thousand other things.

I'm not saying it's ok to be rude or to blow you off, but something that to you seems like a nice and helpful thing to say is actually asking the RN to stop her routine, think of things for you to do, and also trust someone she doesn't know to correctly carry out those things without supervision. It's never just busywork when you're working with students and patients, even if some of it seems like it is. Something as simple as giving a cup of coffee or water to a patient because you (the student) didn't think to check that the patient is NPO for a surgery and now you've set the surgery schedule back.

On the flip side, RN's really shoot themselves in the foot when they're rude to students. I was recruited by a facility where I had done clinicals. The RN's there were awful to the students. They wouldn't even look up and say good morning and pretended they didn't hear you when you talked to them. When I turned the job offer down, I told them it was because of the crap attitudes of the RN's in their facility and that I would NEVER consider working there. That facility has undoubtedly lost more than one potential great hire because of those kinds of things.

[NightOwl0624]

I think the problem is that staff nurses are being over worked. When I went to nursing school we had a clinical instructor on the floor. We asked the CI all of our questions and disturbed the RN as little as possible. Now there is no CI on the floor and students are assigned to work with the RNs. We don't get a lighter assignment or extra money. I don't think this is fair to any party involved.

But to answer you question yes you are being idealistic. But I like it, I was idealistic once and according to older RNs I still am.

Exactly. Same thing - when I was a student, our clinical instructor was in charge of us. SHE was getting paid to be the teacher. Where I worked, the nurse was in charge of the students, we were not given a choice in the matter, and no incentive for our time. AND we were still responsible for the patient. Very stressful, and really not fair.

I didn't mind that much working with students - unless I was very busy or had a patient crashing. Then, I really needed to concentrate on my job.

Where I work now, there are no students. And I really don't miss it that much. Being a new(er) nurse myself, it is hard enough to get through the night without having to "teach"!

That being said, there's no reason not to behave like professionals!

[DL-SNUP]

You said a lot of great things that really just boil down to the fact that a little common courtesy goes a long way. I do not recommend the quoted action, though, because on the surface it may seem like it's a really great way to show initiative and be helpful, but often the RN doesn't want to stop and think of what it's safe to have you do when she's in the middle of thinking of a thousand other things.

I'm not saying it's ok to be rude or to blow you off, but something that to you seems like a nice and helpful thing to say is actually asking the RN to stop her routine, think of things for you to do, and also trust someone she doesn't know to correctly carry out those things without supervision. It's never just busywork when you're working with students and patients, even if some of it seems like it is. Something as simple as giving a cup of coffee or water to a patient because you (the student) didn't think to check that the patient is NPO for a surgery and now you've set the surgery schedule back.

I can appreciate that, but I really do believe that nurses should try to help the students as much as they can. For example, today I got to do a pleural aspiration. Yes, it took my nurse a few extra minutes to explain it to me, but then she was able to delegate four more to me that day so that she could care for other patients. I do see what you're saying though. In clinical, we've been taught to just mention something along those lines at the start of the shift. As long as I'm polite, most of the nurses I've worked with are more than willing to come get me if the opportunity arises and they have a minute to spare. The nurses already know that they're expected to try to teach us, so I think being polite goes a long way.

I think it also helps that all the hospitals I've had clinical in tell their RNs when they apply that teaching students is a part of the gig. I don't think most get paid extra, but when that's the expectation and part of the job description, they seem to suck it up and be as positive about it as they can.

It's really a poor situation though. It doesn't benefit the nurses who can't stand students to have students, it doesn't benefit the students when they have an RN who won't teach them, and it doesn't benefit the patient to have all the poor communication (like you mentioned with the NPO thing) going on. And yet, students have to learn somewhere and we need to make the best of it. :/

[nursel56]

Part of it could be that when I was in school and probably for some years after the prevailing culture was that the student-staff nurse relationship was not 50-50. We were there to learn but we never thought or were told "it's their job to teach us" or threaten not to do a task because of a perceived attitude problem the student believes the nurse has.

The only attitude that mattered was ours, (as students). I would compare it to medical education or a military-like hierarchy. So what you may be seeing is a bit of culture shock from people such as myself who are appalled at the "what are you going to do for me?" attitude that seems to be very prevalent now.

I've never seen a staff nurse act in an abusive manner toward a student, and if they did - they should be disciplined for it. Being ignored, being asked to do the same task over and over, asked to do jobs that are often met now with "don't you have a tech for that?" would never have been questioned. We just did it.

[Flo., BSN, RN]

For example, today I got to do a pleural aspiration. Yes, it took my nurse a few extra minutes to explain it to me, but then she was able to delegate four more to me that day so that she could care for other patients. I do see what you're saying though. :/

Pleural aspiration other wise known as a thoracentesis?

[DL-SNUP]

Part of it could be that when I was in school and probably for some years after the prevailing culture was that the student-staff nurse relationship was not 50-50. We were there to learn but we never thought or were told "it's their job to teach us" or threaten not to do a task because of a perceived attitude problem the student believes the nurse has.

The only attitude that mattered was ours, (as students). I would compare it to medical education or a military-like hierarchy. So what you may be seeing is a bit of culture shock from people such as myself who are appalled at the "what are you going to do for me?" attitude that seems to be very prevalent now.

I've never seen a staff nurse act in an abusive manner toward a student, and if they did - they should be disciplined for it. Being ignored, being asked to do the same task over and over, asked to do jobs that are often met now with "don't you have a tech for that?" would never have been questioned. We just did it.

Hm...that's an interesting thought. I'm really hoping that's not how I'm coming off to nurses, and I don't think that my peers tend to behave that way. If I ever told ignored my nurse or told her to find a tech and my CI found out, I'm sure I'd be put through a disciplinary hearing at the absolute least. I'm truly sorry if that's coming from personal experiences of your's with students--that type of behavior is beyond unacceptable, and I really hope it's not common.

I do try stay out of the way when there is a lot going on. But it's hard sometimes, because this is my education. If I don't learn it in clinicals, I'll end up being a new grad who is vastly under qualified and who can end up seriously harming a patient because I was never shown something. At the end of the day, we literally depend on staff nurses. It might not be fair, but there isn't really a whole lot that the students can do about it.

So I guess what I'd like to know is what you'd suggest. If you had a student, what would be the best way for them to benefit from learning from you and gain skills as a nurse, while respecting your duties to your patient? I can't stand that to learn HOW to be a nurse, I have to be a burden to a nurse. Any advice you have on how to make the relationship go as smoothly and mutually beneficial as possible would be greatly appreciated :)

[anotherone, BSN, RN]

I've been reading through the posts from the last few days, and I'm completely astonished by the "us" vs "them" mentality that is showing up between the nursing students and the staff nurses.

Maybe I'm idealistic, but shouldn't we be trying to work as cohesively as possible so that we can combine forces and provide the best care possible for our patients? It seems to me like we're both equally to blame for the issues that seem to be going on. On one hand, it seems like nursing students need to be more willing to contribute and gain some perspective, realizing that while the staff nurse should *try* to teach us, it isn't their main focus. On the other hand, it seems like a lot of staff nurses are going into clinical situations with a negative attitude about working with students, which I really think can only make matters worse.

Can we really care for patients effectively if we're not on the same page and being professional to each other? I personally don't think so. I think that in any customer service business, having issues behind the scenes like this WILL impact the patient. And I'm so tired of all the finger pointing, because both sides are making mistakes. As a student, I am more than willing to admit that I have been less than enthusiastic when asked to perform something I've done a million times. It happens, and when I realize I've done it I try to change my attitude and do better next time.

Instead of all this negativity, why can't we just try to learn from each other, and accept and navigate the limitations of the time together? Students can learn SO much from staff nurses, and (believe it or not) once in a while a staff nurse can learn a new thing from a student. If we can accept that we're all (hopefully) intelligent individuals united in the fact that we chose nursing to help the patients, and see each other as imperfect people who face constrictions based on our role, it seems like everything would go more smoothly.

I know that it's not all nurses and students that are acting this way....it's just incredibly discouraging to see such a lack of teamwork from the members of this community. At the end of the day, all the students of today will be your coworkers soon, staff nurses. And students, soon we'll all have students that stress us out and make more work for us. Can't we accept that and learn from each other?

Sorry for the ranting....I guess my point is this:

Let's meet halfway.

Students: The nurses are stressed out and busy. Try to help. Ask what THEY want you to do. Tell them that you understand they are busy, but that you would appreciate anything they can teach you. SAY THANK YOU. Realize that it's about the patient. If that means that you miss getting to d/c a central line, there is always next time. If it means that you have to help out what with ADLS, I/Os, etc...realize that you WILL learn from that as well. Be grateful for the opportunity to learn anything you can, and always try to be understanding.

Nurses: Realize that a lot of students *do* realize that you don't want us around. We know that it's not your choice to have a student, but realize that we're there to ruin your day. Realize that most students want to learn from you and value/idolize how much you know. We're sorry that we're often thought of as an annoyance or an extra task, because all we want is to learn from you so that we can care for our pts as well as you do.

Communicate with us. Today, I worked with a nurse who had 2 pts and was getting her 3 admits all at once. All it took was her saying to me "hey, I'm super busy right now. Can you keep an eye on pt 1 and 2 while I admit these new pts? I'll come find you when it calms down or if there is something I think you could really learn from". Seriously, 3 sentences and I was able to feel like I was helping and not simply being ignored. I don't care how busy you are, but communicating with your team (and a student is a part of that team) is such a priority.

Like I said, maybe I'm just idealistic. But from my experience with other jobs and life in general, if we can just take a deep breath and do our best to make the "behind the scenes" dynamics positive, it will help our patients. Because at the end of the day, that's what ALL of us really want, right?

My last priority some days is communicating with the student. who is really not in my team. i don't have time to hunt down the students. and it is easier and faster sometimes for me to do it all or delegate to an aide than to ask a student to help, than supervise the student. etc.

[DL-SNUP]

Pleural aspiration other wise known as a thoracentesis?

No, but it was similar. The surgeon had placed a semi-permanent tube into the pt's pleura and out the skin that allowed us to use luer lock syringes to remove fluid from her pleura. They actually do it quite a bit on the peds floor I'm on right now. :) Super neat!