Nursing School Patient Loads

Nurses General Nursing

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There is a discussion going on in the Nurse Educator forum related to clinical expectations. Anyway something that has come out of it is the amount of patients this student is responsible to take on.

In my ADN clinicals back in 2005ish in our last clinical rotation we were expected to have total care over two patients. We were on the same floor for 8 weeks, had two new patients per week with three days of 8 hour clinicals.

The student I am talking to is expected to ramp up to five patients by her last semester, do full care yet not have access to the PIXIS without the primary RN, and has to move to a new floor and learn a new stocking layout about every week.

Does this sound common? I have yet to ask where she goes to school, so this may be an outside of the US situation.

I am just curious as to what your degree is and what clinical expectations they had for you during school.

Tait

Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.

By the end of my ADN program we were expected to take 2 patients, do all meds, assessments, charting, etc. On and off throughout all of nursing school we'd occaisonally get two patients but that was the exception, not the norm.

Just have to add that recently there was a thread where a senior student had something like 5 patients and believed that was not appropriate.

Instead of being supportive, people were incredibly rude to the OP and told her to suck it up. I was upset and wrote a response back to those people. These are just students, they are not trained in anything. 99% of nursing I learned on the floor after graduation not during clinical. I just thought people were quite b!tchy to the OP.

Your situation sounds similar to the one we are discussing, though I am not sure how the RN factors into the other students day. Maybe, if you have time, you could pop over to this thread and offer some advice on managing that many patients. :)

https://allnurses.com/nursing-educators-faculty/reaching-dedicated-intelligent-825023.html#post7257692

Yes, I have lots of tips. I'm on my way to class now but will respond when I get home.

Just have to add that recently there was a thread where a senior student had something like 5 patients and believed that was not appropriate.

Instead of being supportive, people were incredibly rude to the OP and told her to suck it up. I was upset and wrote a response back to those people. These are just students, they are not trained in anything. 99% of nursing I learned on the floor after graduation not during clinical. I just thought people were quite b!tchy to the OP.

I agree. I think many (if not the majority) of the responses in that thread were ridiculous and inappropriate. I also agree that 99% of nursing I learned on the job.

Specializes in Neuro ICU and Med Surg.

In my last semester we had up to 4 patients. Our class was spread out over two adjoining units. We stayed on the same unit for the last 8 weeks of the semester. We had 2 6 hour days of clinical. We had the same pateints 2 days in a row usually with the exceptions of transfers or discharges.

Specializes in Acute Care Cardiac, Education, Prof Practice.
Just have to add that recently there was a thread where a senior student had something like 5 patients and believed that was not appropriate.

Instead of being supportive, people were incredibly rude to the OP and told her to suck it up. I was upset and wrote a response back to those people. These are just students, they are not trained in anything. 99% of nursing I learned on the floor after graduation not during clinical. I just thought people were quite b!tchy to the OP.

I didn't see the thread, but I am not surprised. It is interesting how people respond differently to students vs. nurses or just in how the OP phrases the comments. There is another thread over in Nursing Educators about the overuse of power point. After I read the OP I had to sit back and drop the frustration I had with how she phrased some of it, because it sounded like ANY use of ppt was lazy and boring and showed a lack of ability on the part of the instructor. However, after a bit, I was able to come back and make a meaningful post on how I love ppt but that ti is a tool to aid in teaching, not something designed to teach for you.

My last rotation, I had 5 pts and was able to pull from the Pyxis and give meds unsupervised. I was encouraged to delegate to the aides. I was not allowed to call the doctor or take off orders, but the floor nurse let me know to do a bladder scan or d/c a foley or whatever. We were expected to be as independent as possible, but be smart enough to know when to ask questions and seek help. I did okay, but I only managed it because I didn't have the full-on responsibility the floor nurse had.

A few of my peers never got more than three, one of my peers could hardly manage one and another one of my peers managed six.

Thank goodness we did not have to have someone with us to pull the meds! But sometimes it depended on the hospital. Another hospital we went to required the instructor, but fortunately, we only took 1-2 pts at that time.

I graduated in 2011, but apparently things have changed since I left school. In my last rotation, I was able to go to the ED and start five IV's. I know a student now who is at that same hospital and they are no longer able to start IV's-- anywhere.

That's a shame.

I graduated last year from a BSN program where we had 1-2 patients per clinical. During my final semester we did a transitions course where we shadowed a RN in our specialty of choosing for 40h a week for 6 weeks. We worked our way up to full patient assignments and did all charting, meds, etc on each patient.

I went through an ADN program in Northern California. In our last semester we were responsible for full care of 4 patients under the supervision of an RN. We had full pyxis access, but were required to double check medications and verify patient identification with an RN. We were responsible for all charting, although our nurses were usually happy to help. We spent the majority of the semester on the same unit, but had brief rotations (1-2 shifts) to ICU, OR, ED, and Cath lab. We rotated out to OB for 6 shifts. We did not have a preceptorship in my program, and I have been told by other nurses and interviewers that my school "screwed me over" in that regard. They have since reintroduced a preceptorship to my school. In our 1st semester we had to complete a detailed 8 page careplan on our 1 patient load. In our final semester we had to complete a brief one page careplan on only 1 of our 4 patients, until our clinical instructor decided we were competent enough to not have to write it out and turn it in (of course we still had to make a verbal report/care plan if asked).

Specializes in Acute Care Cardiac, Education, Prof Practice.

So it definitely looks like there is a lot of variation in the programs.

Specializes in Acute Care, Rehab, Palliative.

In my last placement I started with one and had worked my way up to full care of 5 by the end.

Specializes in Perinatal.

I was in an ADN program in Northern California and we had 1 patient 1st semester, 2 the 2nd, 3 the 3rd, and 4 the 4th. By the time we completed our preceptorship we were expected to be doing the entire nurse's assignment (usually 4-5 patients) except for having Pyxis access and calling MD's/receiving orders. Usually my preceptor was glad to have SOMETHING to do ;)

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