Not impressed with clinical group and instructor

[1Tulip]

I work on a neuro floor. It is a GREAT learning environment for nursing students. Now, I know clinical education has changed since I was a student (Dr. Kildare taught us materia medica and I graduated with Cherry Ames...) but still, I don't think the gals who worked with us last week got nearly enough from their time on the unit.

These are final semester ADN students. One example: a student had a pt. who is severely brain injured, has a tracheostomy, a PEG, is hemiplegic, a compelling list of family and emotional needs and so forth.

In general, the student took the pt's vital signs, and gave him his AM meds via his PEG. She let me show her how to deep suction with sterile technique (which I was pleased to do... and she did a credible job.) But otherwise, they let the CNA's clean him, change his bed, turn him, position him, etc. They hung in the Nursing station and dithered with the computer and chit chatted with each other. That is my main gripe. But also, they didn't report off to me or let me know where they were leaving off his meds (he gets something almost hourly). I found later where they had updated his chart or not.

None of the students were really pushing themselves, either intellectually or in terms of hands-on care. (Here is where I sound like a real anti-deluvian...) When I was a student, I would have been worried about the instructor seeing me sitting down, let alone chit-chatting with my fellow students. Not unless my patient was in pristine shape, the room was tidy, restocked with suction catheters, new irrigant and piston syringe for the PEG, foley bag emptied, I and O calculated for the time I was there, all conceivable charting completed, and unless/until I'd offered to help my fellow students and other unit staff members. In short, there would have been no stopping until every opportunity to learn had been wrung from the few hours we had at the bedside.

I suppose this is a generational thing, nevertheless... what did the students really learn yesterday? They just scratched the surface, did the minimum. And that seemed fine with the instructor (though, obviously I don't know what the learning objectives were nor what she was trying to accomplish.)

It was sort of disappointing.

[oncnursemsn]

I've read most of the posts, and as both nursing faculty (clinical and theory) and work in my own practice on a BMT unit, I can say that there's nothing wrong with expecting nursing students to bathe, change and do vitals on their patients. Sure, when they graduate, they will delegate that. But as a new learner, there is so much they can gain from providing primary nursing care to their clients. In my own practice, if I have a total care patient, I ask my aid to get me, and we'll do the bath together. It fosters a good relationg ship with my tech (I'm not sticking them with cleaning the poop and the foley), it allows me to do a better assessment then if I didn't get in and see for myself and lets the patient know they matter enough to have my full attention. I learn a lot too, after 25 years of nursing to still see my patient first hand. As far as the students chit chatting and sitting around, my students know that this behavior is not acceptable. I'm not mean or unreasonable, but our unit is a busy 36 bed oncology floor, and there is nearly always someting going on. (Accessing a port, putting in a picc, etc.) They are to go around and ask the other nurses if they need help, or if there's a patient who could benefit from a pair of ears and hands. Sitting and writing isn't acceptable, they will have time at the end of the day. Clinical time should be spent absorbing as much as possible. I don't mean to sound so harsh, but this is a pet peeve of mine as our students have very little clinical time before they graduate and they need to learn as much as possible.

[Goodoldnurse]

Jess,

Thank you for keeping your students busy! In class I remind the students that the RN is responsible for finding abnormalities such as lymph node swelling and decubitus. The tech is there to help, NOT do the work! My students are usually apologizing when I find them at the nurses station. They know that the learning happens at the bedside and if they want to learn the most, they will ask other nurses if they can help in any way.

Then if they still have time on their hands, they get to pick up another patient! They have far too few clinicals to "waste" time sitting around.

:icon_razz:

[OneThunder, BSN, RN]

My mother was a diploma nurse and I heard horror stories about nursing school. However, at the end of her diploma program, Ma was a functional nurse. I have nothing against humanities or foreign languages, however I think nursing students would benefit from more clinical time and less BS.

AMEN! I taught first and second semester RN students. MY clinical group started IVs, inserted foleys, walked rounds with the physician....wrote workable care plans and they loved it! You should have seen their faces when the blood in the canual "back flashed" or when the yellow gold (urine) started flowing in the tubing... they would just look at me and smile from ear to ear. The kids knew my clinical was no slouch... to do a head to toe assessment, they needed to see the patient naked. As long as they were naked, they might as well give them a bath...LOL. At first I could see they didn't expect to be doing all this "manual" labor, but quickly realized that it was to their benefit. And talk about proud. Last summer when I visited the medsurg floor of a hospital, a nurse came up to me and said, "do you remember me? I was in your class"