I had a nursing student assigned to one of my patients yesterday. I had a very busy day with several issues coming up, and this student was not exactly helpful. She definately was in the chapter of the book to never let the patient be in pain, because the patient that she actually had could have IV pain med every 2 hours, which I was trying to keep on top of the best I could, but I had some other pressing issues with my other patients. I was trying to include the student in what was happening with my other patients too, since she had expressed interest in this. But, she seemed very annoyed with me when I didn't get back into that room soon enough to get him his pain med. The patient was NPO and had a lot of IV BP meds due contantly, in addition to abx and IV Dilaudid, so this was all very timeconsuming, and this student couldn't give anything IV.
The patient was scheduled for a follow up CT scan and had to take oral contrast, and was supposed to go down in an hour after taking it. This student was acting like an annoyingly pro-active family member and became very annoyed when radiology got delayed in by other patients. She insisted I call them even though I told her that they would call when they were ready for the patient, then she was very put out when they didn't come when she expected them, as if they were making her poor patient suffer. The student acted as if I was neglecting her patient. I know she was trying to be an advocate for him, but I needed to prioritize care and had several more pressing issues with other patients. The patient was fine with everything, he'd been in the hospital 15 days and was finally starting to feel a little better.
I told the student that we could change the sheets when he went to CT, but she said that she would be going with him there. She never did let me know that she was taking him, but just took off. She definately wasn't into doing any personal care for this patient. Basically, this student was a thorn in my side all day, I felt. I kept trying to explain some other issues that were going on with patients, but she was disinterested.
Basically, this student was clueless still about the big picture of caring for several patients, and was pushy with me in advocating for her patient, and she definately annoyed me.
I don't know why this person can't do IV meds because with only about seven weeks into my clinicals I have given IV meds, done a foley cath, trach care, bed bath, ect., either on my own, or with the help of my instructor.
What the student is allowed to do at clinicals may vary with their NS program. In mine, we aren't allowed to give IV meds until 2nd year. Yeah, I know...but that's how it is.
I also was wondering where the instructor was, if the patient was in pain, couldn't the instructor have given the med?
The instructor may have been tied up with another student. I feel a ratio of 8 students to one instructor is not effective. This instructor may have been like the instructor I had my last semester- no where to be found. Sometimes she was down eating in the cafeteria, in another part of the hospital talking to her friends (she worked in education per diem at this hospital), or helping out RN's at this facility who were her previous students. I had a situation where one of the patients I was assigned to was in a lot of pain, another patient needed his morning insulin, and my third patient was a sweet little old lady who was a fall risk and kept jumping out of her chair. The RN I was with was so swamped that she could not help me. In between trying to get my numerous meds ready for one of my patients I had to keep running into the patient's room who was a fall risk because her alarm was goiing off. I could not find my instructor anywhere and it was extremely stressful as I could not help any of my patients that day without my instructor or the nurse. I ended up almost making a med error that day and almost getting bounced out of the program. I should not have let myself become overwhelmed so I take full responsibility for my almost error but the instructor should have been more supportive of me and her other students. The RN's at this hospital were also frustrated with this instructor.
The instructor may have been tied up with another student. I feel a ratio of 8 students to one instructor is not effective. This instructor may have been like the instructor I had my last semester- no where to be found. Sometimes she was down eating in the cafeteria, in another part of the hospital talking to her friends (she worked in education per diem at this hospital), or helping out RN's at this facility who were her previous students. I had a situation where one of the patients I was assigned to was in a lot of pain, another patient needed his morning insulin, and my third patient was a sweet little old lady who was a fall risk and kept jumping out of her chair. The RN I was with was so swamped that she could not help me. In between trying to get my numerous meds ready for one of my patients I had to keep running into the patient's room who was a fall risk because her alarm was goiing off. I could not find my instructor anywhere and it was extremely stressful as I could not help any of my patients that day without my instructor or the nurse. I ended up almost making a med error that day and almost getting bounced out of the program. I should not have let myself become overwhelmed so I take full responsibility for my almost error but the instructor should have been more supportive of me and her other students. The RN's at this hospital were also frustrated with this instructor.
Ouch! What a terrible teacher! I'm so sorry, but that was very unprofessional. Student nurses are responsible for their practice, but as an instructor, they are still working under my licsense, so you can BET I'm not leaving the floor. Besides, how can you teach your students from the cafeteria or other department?!?!?! During an 8 hour clinical, I even bring my lunch and don't leave the floor (students split lunches) so I am always there for my students.
This type of instructor behaviors shouldn't be common practice in a nursing program, and we don't tolerate that kind of junk where I work.
Anyway, the origonal student will one day figure out that you can't be everywhere at the same time. It just hasn't happened to her yet. Still, VERY frustrating for the staff nurse!
Squirtie, your instructor wants you to call a charge nurse when a nurse is having trouble juggling all her patients? Wow.
I know I was that PITA student once when a pt's NGT wasn't working well and he believed he had fecal material going up into his nose. The nurse adjusted it without success and kept saying "What do you want me to do?" and I kept saying "what are we supposed to do? He says he has "s--- coming out of his nose." He's getting pretty mad in there."
She got an order to d/c the NGT, and the pt turned into a sweetheart, ended up making her day easier. He would have been a surly hostile pt to deal with all shift otherwise.
It's a balance, and jlsRN, now that I'm so close to the other side, I get your vent.
I just needed to vent. It was an extremely busy day. I know it's hard to be a student. I didn't like the way this student acted judgmental and pushy with me, however. She was an older student, btw, probably close to my age. I actually think she'll make a decent nurse one day once she gets a clue.
She must be first semester (at least) since she couldn't touch the IV. I imagine reality will hit her in the face after enough clinicals, and she will . But yes, that sure must have been irritating.
What the student is allowed to do at clinicals may vary with their NS program. In mine, we aren't allowed to give IV meds until 2nd year. Yeah, I know...but that's how it is.
Students here don't give IV pushes at all ever. They can hang piggybacks.
More than once I've received "the look of judgement" from a student when they've informed me a patient needed pain medicine and I didn't jump. I understand they are the one's that have to listen to the patient complain, and contrary to all they learn in the books it's hard to make a patient wait, but that's when I say "practice the non-narcotic pain relieving techniques you're learning in school, and I'll medicate him when it's time".
Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.
Oh, I've had a few students like this too. It is unfortunate because the majority of nursing students are a big help. One time I had a nursing student almost reduce me to tears (and that takes a while with me) with her very frustrating behavior. She didn't want to do any of the cares for the patient, or the assessment, or anything. All she wanted to do was give him his medications. And she was so, so slow about it that the patient received all his medications late. And she only had one patient! I kept telling her "go assess the patient before you do anything else." She just sat there on the computer and said, "okay." I walked back 15 minutes later and she was still on the computer. I repeat what I said more firmly this time. Come back later and she is still on the computer. I was ready to pull out all my hair. Some nursing students just cannot see the big picture.
When I was a student, in the early stages we were assigned only one patient. We were not to focus on other patients...our assigned patient was to get all of our attention. Like the other poster said, our instructors were very big on patients getting their meds on time. However, we did not give meds with the nurse who had that pt, we gave them with the instructor. Actually, we didn't tag along with the RN who had the pt at all. We'd get report from them, and talk to them during the day, but most of our procedures and such happened under the eyes of our clinical instructor. Most of the time, once the nurses and CNA found out a particular pt had a student, you actually had to hunt them down to talk to them.
To me, it sounds like this student's heart was in the right place..at least she cared about her patient. I do think she could have communicated with you better ie letting you know she was going with the patient, her school's med policy etc.
It can be hard to have the big picture as a student, IMO. That usually comes after working for a while.
The instructor may have been tied up with another student. I feel a ratio of 8 students to one instructor is not effective. This instructor may have been like the instructor I had my last semester- no where to be found. Sometimes she was down eating in the cafeteria, in another part of the hospital talking to her friends (she worked in education per diem at this hospital), or helping out RN's at this facility who were her previous students. I had a situation where one of the patients I was assigned to was in a lot of pain, another patient needed his morning insulin, and my third patient was a sweet little old lady who was a fall risk and kept jumping out of her chair. The RN I was with was so swamped that she could not help me. In between trying to get my numerous meds ready for one of my patients I had to keep running into the patient's room who was a fall risk because her alarm was goiing off. I could not find my instructor anywhere and it was extremely stressful as I could not help any of my patients that day without my instructor or the nurse. I ended up almost making a med error that day and almost getting bounced out of the program. I should not have let myself become overwhelmed so I take full responsibility for my almost error but the instructor should have been more supportive of me and her other students. The RN's at this hospital were also frustrated with this instructor.
Thank God, I ended up with very good clinical instructors. The way most of them did meds with students was this..there were usually 8 of us students in a group. We'd alternate days giving meds so on any given day, you had 4 students giving meds. If it wasn't your day, you simply told the nurse that had your patient that you weren't doing meds that day, so the nurse would do them. We'd do everything else, meals, baths, ambulating, procedures.
I know my school had the instructor watching over us because they said they didn't want us picking up bad habits from some nurses..in other words, our instructor's way of doing things was to be law. I suppose this was fine if you had good teachers, like I did, I can't imagine an instructor just leaving his/her students out in the wind like that. Bad for patients, bad for the students, bad for the staff!
That would irritate me, too. I remember being a student with one patient, and all I had to do was PO meds and ADLs. You really do not see the big picture of what the nurse has to juggle at that stage as a student. She'll be smacked upside the head by reality when she's a nurse.
It wasn't your student. It was just your responsibility to show her the actual nursing process and she got that i'm sure. Some days are better than others, am i right??! Don't feel so bad, you did a good thing by showing her a little of the "dark side". What's going to happen when she's on a floor alone and things get a little "hairy"....??!:chuckle
i was assigned 3 students at the same time! this was absolutley hilarious to me because as a new nurse, it was like the blind leading the blind. i had a lot of "ummm, ok, that sounds good."
i was also so jealous of them because i remember the days of being able to focus on one patient, not have that much responsibility, chatting in the nurses station carefree, taking hour long lunches, and only staying for a few hours and then leaving. ahhh, i miss nursing school!
. But yes, that sure must have been irritating.
Meriwhen, ASN, BSN, MSN, RN
4 Articles; 7,907 Posts
What the student is allowed to do at clinicals may vary with their NS program. In mine, we aren't allowed to give IV meds until 2nd year. Yeah, I know...but that's how it is.