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.
Squirtie, your instructor wants you to call a charge nurse when a nurse is having trouble juggling all her patients? Wow.
most of them did when I was in school... the reason for calling the charge nurse was not to get the nurse in trouble, but it was more of a back up method of us getting what we needed for the pt. The instructors always tried to go right by the book, it didn't matter that real world nursing is quite different. I feel that some of the reason this happens is because instructors who are no longer bedside nurses seem to forget how things really are.
Specializes in Infusion Nursing, Home Health Infusion.
You sound so kind and caring and BUSY but the bottom line is that you were responsible for caring for all those patients that day and the SN should have followed your lead and your instructions and you should not have had to dance around him or her. Lets face it having one or two patients to take care of in medical surgical areas is what students need to do to learn but the real world is quite different and I would have told her so the minute the student got pushy with me!!!! Of course this can be done in a polite but assertive way. If the student did not back down and failed to see the bigger picture I would have paged her instructor for a little chat. I have taken hundreds of nursing students and trained and oriented just as many in my 27 year career and no matter what way you cut it is a demanding draining job on top of all the other duties and responsibilities for the day....and the students need to know that and respect that as well.
She'll be smacked upside the head by reality when she's a nurse.
and this is exactly what happened to me when i was a nsg student.
kept on pestering a nurse about a certain pt (one of my assigned 2).
(no, i now know it wasn't critical)
anyways, this nurse professionally but firmly put me in my place, strongly cautioning me that i was missing the big picture, about priorities and perhaps i should just observe and keep my mouth shut until i know what i'm talking about.
and, this nurse repeated her conversation w/me, to my instructor.
my instructor whole-heartedly supported this nurse (as she should have!)
and it was probably one of the most important lessons i learned in school.
maybe it's not such a bad thing, for us to be educating the students about these type situations?
I also was wondering where the instructor was, if the patient was in pain, couldn't the instructor have given the med?
The instructor appeared to be merely a resource person who showed up now and then. I don't know how many students she had, but perhaps they were on several units. She didn't interact with us nurses at all.
It seems to me that there should be more communication with the nurses who have the students' patients, but the whole thing seemed very unorganized.
One thing this student did was give a heparin SQ injection. She did it differently than I had been taught in that she went in the patient's abdomin straight in at a right angle instead of sideways like I had been taught. This wasn't an obese patient with a huge roll of fat.
I asked some of my fellow nurses if the teaching on this had changed. I wanted to make sure before I mentioned it to the student. One of them thought maybe it had. I never did get a chance to bring that up with the student.
One thing this student did was give a heparin SQ injection. She did it differently than I had been taught in that she went in the patient's abdomin straight in at a right angle instead of sideways like I had been taught. This wasn't an obese patient with a huge roll of fat.
I asked some of my fellow nurses if the teaching on this had changed. I wanted to make sure before I mentioned it to the student. One of them thought maybe it had. I never did get a chance to bring that up with the student.
i think that's a matter of nsg judgment.
unless there's a substantial roll of adipose, i go in at an angle.
to go in at a 90 deg angle in a thin pt, is showing poor judgment, imo.
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!
Sweet Lord Above! I hated nursing school and really don't look forward to going back. I'm in an EMT class right now, and it's like nursing school all over again. Intimidating, wicked-experienced instructors with a "do it perfect or you're dead in the water" attitude. Now that I'm comfortable as a nurse, I've been totally shoved outside my comfort zone in the EMS realm. Oy.
I tend to get assigned a lot of students as well. (I'm apparently known for being receptive and welcoming to the newbies.) Last year, it was not uncommon for 5 of my 6 tele patients to have students attached to them. They drove me bonkers, but it's a learning process they have very little control over. Between some of my HAs, who don't understand nursing prioritization, who approach me 4 times for the same inane nonsense while I'm dealing with a CP or respiratory distress or hypoglycemic episode; and the poor students, whose instructor makes them report every piece of inane nonsense they find, I was so frustrated I'd laugh.
I'm just wondering, what is our responsiblity with these students? The instructor was not asking us for feedback, they are thrust upon us, we don't know anything about the student, the instructor makes no attempt to interact with the nursing staff, doesn't ask for any feedback about how the student did. There seems to be a huge disconnect with this set up.
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.
She told me she was in her third quarter of her ADN program, which would be the same a second semester, so still pretty early in her program.
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".
Ha ha, "the look of judgement" :chuckle That's exactly what it was like.
I was complaining in the med room about my student to my co-workers. One of them later in the day told me "I saw your student in the supply room complaining to her instructor all about you!" . She was just pulling my leg, but she had me going there.
I think there is a significant disconnect and dissonance between what we students have drilled into us in lecture v. what we see in clinicals. And we don't know how to reconcile it yet, as students. We don't know what to push and what not to.
For example, I had a patient who would cry in pain when the wound care team came by and tended to her pressure ulcers. So prior to the wound care team rounding the next day, I tried to get PRN pain meds from the RN for the patient. The RN seemed exasperated, acted like I was a fussy and demanding nursing student, and said with "quick pain" like with the wound care team, we don't give PRN pain meds.
So I watched my pt. cry again and I tried not to cry as the tears rolled down her face and she started doing that fish-mouth breathing thing.
I think there is a significant disconnect between what we students have drilled into us in lecture v. what we see in clinicals. And we don't know how to reconcile it yet, as students. We don't know what to push and what not to.
For example, I had a patient who would cry in pain when the wound care team came by and tended to her pressure ulcers. So prior to the wound care team rounding the next day, I tried to get PRN pain meds from the RN for the patient. The RN seemed exasperated, acted like I was a fussy and demanding nursing student, and said with "quick pain" like with the wound care team, we don't give PRN pain meds.
So I watched my pt. cry again and I tried not to cry as the tears rolled down her face and she started doing that fish-mouth breathing thing.
wow...
even when i went to school, nurses gave prn pain meds pre-dsg change.
i have to admit, practically all of my clinicals involved top notch nurses.
If the patient is on PO pain meds and the nurse isn't sure exactly when the wound team will show up, then it would be very difficult to time the pain meds to kick in at the right time. What's good in theory sometimes doesn't work very well in the midst of a busy shift.
. But yes, that sure must have been irritating.
. She was just pulling my leg, but she had me going there. 
squirtle
138 Posts
most of them did when I was in school... the reason for calling the charge nurse was not to get the nurse in trouble, but it was more of a back up method of us getting what we needed for the pt. The instructors always tried to go right by the book, it didn't matter that real world nursing is quite different. I feel that some of the reason this happens is because instructors who are no longer bedside nurses seem to forget how things really are.