Nurses see us coming for clinical and RUN away from us. Irritating!

nursesunflower · Apr 24, 2012

I agree with pretty much everything stated above!!! I work at a hospital where we get students who randomly show up for varied time periods (some are there 3-4 hours, some 8-5, some all day!). The nurses generally decided which students to put with which nurses. Since it is an ICU, there are some high stress/high tension situations that we don't want to throw a student into. I personally like taking students. There are days when all you can do is hope that the student can spend the whole 12 hours jogging after you and hope that they have absorbed something worthwhile during the day. I always wish that nursing instructors would tell the students these things before they come.

1. They are practicing under my license, so please be aware of that.

2. The busier that I get, the less they are going to be able to do. It in no way reflects on them as a nurse or a student or a person in general.

3. Ask LOTS of questions, if you don't understand something I will do my best to explain it to you.

4. If you are not asking questions and acting interested, I am going to take less interest in you (I don't want to waste my time teaching someone who doesn't want to learn).

5. Things in the real world are very different from the scholastic world. That is why you are at clinicals. Don't be shocked if I am winging it some of the time.

6. Patients are people too, don't ever treat them as anything less. (Would you like it if someone repeatedly commented about how gross your bowel movements are?)

I have worked with some wonderful, intellegent, hard working students. I have even lobbied for some of the students I have precepted to get hired by the hospital. I have also worked with some students who scared me to death. One student was told (by me) not to leave the nurses station and not to go anywhere NEAR a patient for the rest of the shift (He decided he was competent enough to draw an ABG (without an order) out of an ART line because HE wanted to know the patients blood gas, he told me repeatedly "its okay, I used to be an RT" He didn't even call for help when the art line was backed up and leaking through an OPEN port on the floor!)

Merlyn · Apr 24, 2012

Maybe all the nurses have 'Post Traumatic Student Shock" Maybe the class ahead of you were all Brain Dead.

nurse_kirsten · Apr 24, 2012

I've had different experiences throughout all my clinicals!

My program seems to be set up very similar to the netherlands program, though. Throughout the school year, we have one theory term (4 months) that we spend at school doing papers, labs, exams, assignments, group work, etc. If we've successfully completed that, we go on to clinical for the next term, where we have 3 5-week rotations in a variety of settings. In year 2, I had a surgical, a mental health, and a medical placement. Coming up next term for year 3, I have a community, maternity, and acute care placement. By 4th year, we have one final clinical, and then our preceptorship. The only exception was in year 1, where we did 2 theory terms and a clinical 1day/week on top of that.

The way the clinicals are operated sound really similar, too.

We are expected to do at least 3-5 hours of patient research before our shift, we usually have at least 1 scholarly paper to write, 3-5 reflections, depending on the clinical, and anywhere from 1-5 care plans. All this on top of being prepared and confident in our patient care. It's not easy...

In most of my placements, we are buddied/shadow for the first 2-3 days. This is to learn the unit, get to know some people, etc. We can help out with minor things here and there, but for the most part are just observers. I try to help as much as I can. Then we are given our own patient assignments - one to start with, then more once we're ready. That first week, I find, is stressful for everyone, since we're still pretty new at the unit and practicing our skills (especially if this is the first clinical of the new term).

We are given our patient assignments the day before (if possible), and the nurse who would typically have that patient is told that a student has that patient that day. We then talk with the buddy nurse about what we can and can't do (which they get to know after we're been there for a week or so) and we make up a schedule of who does what. For the most part, we're pretty independent, and we've had good feedback from many of the nurses on the units we've been at.

The nurses will show us what they can, but in the end, it's our instructor's responsibility to watch our skills. However, after we've been signed off by our instructor as competent at the skill, we are left alone to do it without supervision. Usually this means that the staff nurses only show us things in the first week. They can supervise a skill, but again, it's better if our instructor does it. This gives the buddy nurse an "out" if things are too busy, too.

There are others (like in my mental health placement), where no matter what you did, you were a nuisance. We were segregated to a closet to chart (even though the charts weren't supposed to leave the nursing station), and the nurses literally bashed us while we were standing right in front of them, yet they acted like they didn't see us. When I went to do a skill in front of one nurse, he played with his iPhone instead of watching me (the patient was an RN - at least she helped me). All in all, it really sucked, because I looked really forward to that placement.

sponkynurse · Apr 24, 2012

I would talk with the dean of nursing at that school. I would be hesitant to bring it up to the clinical instructor (remembering how they can hold things against you). Or you could talk with your clinical instructor about feeling like you need her guidance during the day. She may like to feel needed. It depends on her personality. CI's are different. I once had one that liked to make all her students cry. She would pull you aside and drill into you about one thing or another. I got a clinical failure one time for touching an IV pump. I didn't even touch the buttons, I just touched it with my hand. I also on the same clinical day pushed a little of the insulin out of the syringe on the way to the room and got a clinical failure for the day. She sent me to the lounge where we kept our stuff and met before and after the day to sit. She then came back after about an hour and talked to me to see if I could "function" for the rest of the clinical day. I did not cry in front of her amazingly, but on my way home I let loose. All this to say, it is scary being a nursing student taking care of a patient(s). It depends on your clinical instructor how good of an experience you will have. They can make you or break you. They can make it a wonderful experience as well. I had a few CI's that were wonderful and loved teaching to make good nurses. They have to teach you by the book(NLN) and a lot of times the staff nurses are not always going perfectly by the book. Always rely on the instructor to have the best learning experience.

Also, the school and the CI is responsible for the teaching of the student and the results of that teaching. There is no way that a staff nurse can properly teach the student if they are doing all of their pt load and duties. It is a disservice to the student and is not fair to them.

They get to be with a preceptor at the end of their school when they have had most of their teaching of the different subjects of nursing and also the preceptor is trained in what the student needs and also reports to the school for the students progress.

Good luck!! I love nursing and could not see myself doing any other job.

tothepointeLVN, LVN · Apr 24, 2012

Oh that's kinda sad.

My last clinical rotation when we were receiving orientation from the clinical coordinator for the hospital she was very specific about one point. She said that because the school used to have its own nursing school they consider themselves a teaching hospital for nurses still. They don't have medical students they having nursing students. She encouraged us to come to her with any problems at let her know if the nurses were unpleasant.

The only nurse that was unpleasant to me was the one that made a huge med mistake with my patient ( she wouldn't have made that mistake if hadn't been giving the meds herself instead of letting me with my instructor give them ). The rapid response team needed to be called (she gave IM narcotics to the wrong patient) He was ok and I ended up looking like roses because I had held his BP meds earlier)

But I think thats why nurses don't want students. They think they are going to rat them out.

Rabid Response · Apr 24, 2012

Ugh. This post brings back bad memories of my own student clinicals. So few of the nurses wanted anything to do with us, and the ones who were forced to work with us either ignored us or hid from us. Some of the blame must fall to your clinical instructor. Our clinicals improved (slightly) when we got a clinical instructor who worked at the hospital where our clinicals were held. Apparently it's a little harder to be rude and condescending to someone who you will have to work around in the future.

Because of my own past experiences, I have gone out of my way to welcome students into our ICU and always offer to work with them when I can. I have rarely regretted agreeing to work with a student and only then because I had a really busy/crazy day and know that they didn't get to do much besides follow me around.

Some nurses are going to be less than welcoming no matter what you do, but there may be a few things students can do to make themselves more welcome on the floor. One student automatically started changing my patient's bed linen right after we had gotten him out of the bed after extubation. I remembered that thoughtful gesture and asked specifically to work with that student again. Also, while I like answering questions, there is a time and place. If I look super busy and distracted (probably more often than I wish I did) maybe that's not the time to ask a very detailed question. Write down questions to ask later during lulls in the workload. One student did that, and it worked really well for both of us.

While I understand that students are not placed in our unit to do scut work, my ICU has no nurses aids and so doing any of that sort of work for me (serving meals, helping to turn patients, toileting patients, emptying foleys) frees up time for me that I can spend helping them to learn some of the more interesting and challenging stuff.

This too shall pass! I once got YELLED at by a CNA when I was a student and just trying to help. I left clinicals that day on the verge of tears. I now work in the same hospital where that happened and I see that CNA often during my rapid response rounding on the med-surg floors. Now that I've had a chance to get to know her, I realize that she yelled at me because she is incompetent and stupid, and I was the only person lower than her that she could take out her frustrations on. She is lucky that I'm not a vindictive person.

Hang in there, students, and try to remember how crappy it felt not to be welcome so that you can change things when you are the nurses.

tothepointeLVN, LVN · Apr 24, 2012

1. They are practicing under my license, so please be aware of that.

This is a complete misnomer. Nursing students do not practice under your license. They do not practice under their instructors license. They practice under the license of the school and the authority given to the school by the Board to teach nursing students. Only if you sign to a task completed by as a student as if you yourself performed it are you liable and btw you shouldn't do this. The student should sign for anything performed by the student cosigned by their instructor (or nurse if appropriate)

I was fortunate to have both my schools PhD prepared DON as my clinical instructor and he always clarified this for the nurses since they were quick to use the above as an excuse for brushing us off. At least with my school there was a financial arrangement between the school and the hospital (in the form of donation in exchange for access to clinicals') so our DON didn't look upon that too favorably.

Oh and here's a study about this whole topic just because I happened to be reading it before I saw this thread

http://www.nova.edu/ssss/QR/QR14-2/hathorn.pdf

Personally I think the best solution would be to have clinical instructors that were formally associated with the hospital. The instructor could have a small handful of students take on a load of patients and then delegate them out to her students thus cutting out the middleman of the staff nurse.

Cynthia Wood, RN · Apr 24, 2012

I swear every week when we go to our floor for clinicals the nurses pratically run away from us. The charge nurse on the floor tell us to just get with someone and last week every nurse I went to said they didn't want a student. I ran out of people to ask and I went in the breakroom and sat down until finally a nurse who doesn't like students took me. It was horrible. I watched the clock all day. To me this is the worst part of nursing school to me.Its as if no one remembers when they were in nursing school and the way nurses either made you feel welcomed or like crap. Last semester the charge nurses had us assigned and had reports printed for us. It was great but this semester.. negative. 1 more semester after this, Cant wait to be done!!!!

Please know that not all nurses are like that. I've got nearly forty years of nursing completed, and I love working with nursing students. Nursing is an honorable profession, and I want to help students know they have chosen wisely.

MeliSNstudent · Apr 24, 2012

This is great! I have been interested in research on this phenomenon! Thank you! I will be sharing this with my classmates.

CrazierThanYou · Apr 24, 2012

In my nursing program, back in the Dark Ages, and in the programs I've taught in over the years as faculty, the students have been supervised by the school's clinical instructor; the students worked alongside the staff nurses, and the staff nurses were welcome to become involved as much as they wanted to, but nobody expected them to take full responsibility for one or more students. The trend I have seen more and more in recent years is for a clinical instructor to drop off a group of students on a floor and the staff nurses are expected to provide all, or nearly all, of the clinical instruction/supervision for the students. Keep in mind (students), that nobody asked any of these nurses whether they wanted to do this, they get no additional compensation for it, having students typically slows them down getting their work done during the day (despite many students' belief that they somehow make things easier or quicker for the staff nurses), it adds significantly to their stress level for the day, and, frankly, if they wanted to be teaching students, they would have gotten a teaching job instead of their current job.
It's also not fair or helpful for the students; they end up feeling demoralized, as the OP notes, by the apparent lack of interest and willingness on the part of the staff nurses (which I agree makes no sense at all if you don't understand "the big picture" here, as most students don't), and they are not getting a consistently high (or at least adequate) level of instruction/supervision.
I see this as a significant deterioration in the caliber/quality of nursing education in general; IMO, it's unfair to the students, it's unfair to the staff nurses, and it's a bad idea all around. If I were a student paying tuition to attend a nursing program, I would find this approach completely unacceptable. I'm amazed that schools find it acceptable to just take their chances on what kind of instruction and supervision their students are getting in clinical, but it seems like many programs and instructors just want to take the easiest route these days.

I'm sure all that is true, but wouldn't it be fair to say that many of today's nurses, including those who are so ugly to students, were those self-same students once upon a not so long ago time?

I might be wrong, but personally, I don't think I've caused my nurses any of the strife you describe above. I got report from them, reported anything important to them, and gave report at the end of my clinical day. The end. The rest of the day, I was providing care for my patients, not getting underfoot of the nurse.

ButterflyEffect06 · Apr 24, 2012

I haven't experienced this in my clinical rotations because we get assigned our patients prior to arrival, which causes us to naturally fall under whichever nurse has that patient for the day--whether they want us or not. However, the attitudes of some RNs we have to work with can sometimes be sickening.

I don't see why taking students under your wing is so hard to do let alone annoying UNLESS you aren't competent enough nor confident in yourself as an RN. I wouldn't mind it! But just to be optimistic, I stay prepared and ready to learn regardless.

Kill 'em with kindness and preparedness lol.

nerdtonurse?, BSN, RN · Apr 24, 2012

It's not a great experience, but I want you to fast forward 2 years:

You're working your 4th 12 hour shift in a row because you're running short handed. You've got a fresh MI on a heparin drip, an evolving CVA that wants to crawl out of bed and go home (but they can't use the L side, so they'll fall and the bed alarm's going off every 2 minutes), two people who are in with the flu (so you are in and out of droplet precautions) and a fresh post op that the OR says, "you can react them, can't you?" One of the flu patient's has a family who is calling you every 30 seconds for it being too hot, too cold, to much air coming out of the vent, not enough air coming out of the vent, turn her right, turn her left (patient can walk, talk and turn herself). You've got to complete some computer training TODAY that management just realized everyone was supposed to have completed 6 months ago. You get told you're getting a 6th admission, one of the frequent flyers who comes in the DTs about every 3 weeks. Who also has a seizure disorder, has Hep-C and likes to spit at people who don't keep him stoned enough to his liking (you can't give someone as much narcotic as he wants).

Now, imagine that into the middle of this, you get told, "we've got students." 1st year? 2 weeks from graduation? The student that nearly killed a patient last week, or the one that's been a CNA/LPN and knows what's going on? Or the CNA/LPN who thinks they knew everything and you wonder how they still have a job where ever it is they work? They want you to paint a rosy picture of nursing, and all you're doing is trying to figure out how you're going to manage heparin drips, the new onset chest pain in your MI patient, your DT patient stating he's going to walk out if you don't bring him dilaudid he can't have because he's started puking blood and his BP is 70/30, the flu family stating they're going to complain to the house supervisor that you're taking to long to answer their call bells and they've already told you they don't want a student, a CNA or a LPN providing care, they want what they "paid for."

I've had that day, that exact patient load. And then the students came in and weren't prepared, didn't know Diovan from Diprivan, and then complained when we weren't "welcoming" when all they did was stand in a huddle at the end of the hall and run from the GI bleed where we really could have used help. There's two sides to every situation. Did you ask anyone "what can I do to help?" rather than just go sit down somewhere?