Nursing student asks nurses the question..

kskarzin91 · Jun 16, 2016

Ok so what was the point? If you've understood the history or diagnoses of a patient and it is an abnormal finding so you reported it to your instructor. You have done your due diligence. The responsibility falls on the primary nurse. The S3 you have as an example is not an urgent finding. It's not a OMG I have to call the doctor now thank you so much for saving that patients life finding. It's a oh hey that's cool to hear and pick up on finding.

Were you there the extent of the shift? Were you present during every interaction the nurse had with the doctor? This is what I was talking about regarding students making a mountain out of a mole hill in the grand scheme of things. That finding while interesting is a small expected finding in a lot of people with different condition. It seems you are alarmed that that finding didn't set off an alarm in the nurses mind and honestly it wouldn't in mine.

I can only speculate but considering you were not in that nurses shoes or following her entire patient load you had no grasp at that point in time where her priorities were or should have been.

Wait until you graduate and are working to judge.

Here.I.Stand, BSN, RN · Jun 16, 2016

But my instructor, well she's not very reliable.

but if I just come to you with something that I and myinstructor agree is important and you say to me "well that stinks" or "I don't remember what the normal is" that is crazy.

I don't disagree that the nurse should know the responses to simple questions like the K+ level. I wonder though if they could be taking their frustration out on you (if in fact they are acting rude as you interpret), due to having to do your CI's job for her. As PPs have said (and I did in those threads linked in an earlier reply), this really is the responsibility of your CI -- NOT the floor RN.

Scrubs_n_sirens, MSN, RN · Jun 16, 2016

Sorry, it's difficult to respond to each comment. But my instructor, well she's not very reliable. She tells us to be at clinical at 0600 and we get there at that time, and she strolls in around 0630 usually, she's not shown up on time even once. The other day, she worked the night before, came down at 0630 to tell us she had to give report and would be back down in 30 minutes. 2 hours went by before she came down. But that's besides the point, when we're on the unit she is usually difficult to find or off the unit doing whatever it is she does. I'm not new to Healthcare, as I've worked as a tech in the ICU for the past 4 years at the largest teaching hospital in my city. I guess I'm so used to being able to ask a simple question to my nurses at work without an issue or without rude remarks. I don't expect a nurse to explain everything to me, or anything for that matter, and I usually keep my questions to a minimum because I like to research it myself. But when I ask the nurse a question that has something to do with the patient's health that I find concerning, I'd like just a little reassurance or something to ease my misunderstanding of the situation. I'm not one who hounds the nurse about every little thing, because I feel that I am pretty knowledgeable in regards to patient care and disease processes. I don't understand some of the rude comments here, I didn't say anything out of line or not true for what I have encountered. I go to clinical, do my assessment, analyze my findings, come up with a few goals for my patient and mostly stick to myself, unless I find stuff that is abnormal or concerns me or the patient. I look into the patient's history and diagnosis before I start assuming things that will make me look silly. It's not necessarily fair to the patient to get the short end of the stick when I tell a nurse something I've found and they're too busy or whatever the case may be to go follow up. I understand most of the reasons why you all don't necessarily like to have a student, but when the student really isn't bad and is just there to learn and care for the patient, why blow them off? I don't mind being told "wait a few minutes and I'll explain" or "could you ask your instructor, I'm busy right now" but if I just come to you with something that I and myinstructor agree is important and you say to me "well that stinks" or "I don't remember what the normal is" that is crazy. Thank you all for your responses, I will try not to be in the way so much and will keep what you all have said in mind.

Wow. No. This doesn't get to fall back on the staff nurses. Your clinical instructor is obviously inept and if you're having these issues, it's not because of the nurses. Your clinical instructor is PAID to teach you.

Also... I really wanted to be helpful to you, but your superiority complex as a student is unsettling. I owe students nothing and my patients everything. You're not paying me to teach you and if I'm trying to coordinate the care of four patients, I don't need to be answering some of these questions but rather focusing on the care you somehow feel the nurses "neglect".

Ruby Vee, BSN · Jun 16, 2016

I agree, and see where that could be a problem. But it's not my fault or my classmates fault that we get paired with them, after all we don't get to choose and we're just trying to learn a thing or two. I just would like to be able to ask a question about mine and the nurses patient that we're sharing without being looked at as a burden or as an idiot. It can be quite discouraging for some students.

It isn't the nurse's fault they got paired with you; they don't get to choose. They don't get to choose which student they're paired with, they don't get to choose if they get a student. They're not asked if they mind taking a student.

The patient isn't a "shared" patient. The NURSE is responsible for the patient. The idea that you are just trying to learn a thing or two has nothing to do with the outcomes. . . The patient comes first. IF there's time to answer questions and/or teach, most nurses are happy to do so, but teaching you comes after the patient's welfare, after the welfare of my other patients, after teaching the family, after discussing the patient with the medical staff, the RT, OT, PT and any consulting services, after talking to lab, central services and radiology about equipment or tests the patient may need and after emptying my own bladder. Too many students assume that they and their learning are the priority for the bedside nurse. That is not the case. It is, however, the priority of your clinical instructor.

The tone of your first (and subsequent) posts tells me volumes about how a nurse could possibly see you as a burden, a pain in the posterior or even an idiot. How about toning it down a little and showing some respect for the nursing staff you're making so much extra work for.

NotYourMamasRN · Jun 16, 2016

I have never been rude to a student. But I definitely will say it can be a lot of work to be responsible for the nursing student AND my heavy patient load. But the worst part is I have never gotten not even an extra dollar for orienting anyone. That kind of ticks me off. I mean even just a letter of appreciation for my portfolio would be nice. But as always, I am always expected to do more work for nothing. This is totally not your fault, which is why I would never take it out on you. It is just the nature of the beast.

2bNurseDR.T · Jun 16, 2016

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The tone of your first (and subsequent) posts tells me volumes about how a nurse could possibly see you as a burden, a pain in the posterior or even an idiot. How about toning it down a little and showing some respect for the nursing staff you're making so much extra work for.

Excuse me, but I'm not sure where I have been out of tone at all. Furthermore, I am far from being an idiot. You don't know me at all, and I've done nothing but ask a simple question. I apologize you took my post the wrong way. I show respect for everyone, no matter who it is.

ItsThatJenGirl, CNA · Jun 16, 2016

Obligatory "I'm not a nurse (yet)".

Maybe you need a new frame of reference for the nurses you're watching. Perhaps viewing their participation in your education as a favor to you, rather than something they owe you because you're entering the same profession might help?

Just my two cents :)

psu_213, BSN, RN · Jun 16, 2016

Sorry, it's difficult to respond to each comment. But my instructor, well she's not very reliable. She tells us to be at clinical at 0600 and we get there at that time, and she strolls in around 0630 usually, she's not shown up on time even once.

You raise an interesting issue here. With really good nursing instructors, a floor nurse knows in advance which patients "have" students and what exactly those students are going to do for their patients (Meds, assessments, charting, etc.).

I have seen some instructors who don't offer a clear patient list, they don't tell their students what to do, you have no idea what students will actually do (if not given clear directions, most students end up standing or sitting around). For example, I find out after the fact that "oh, students aren't passing meds today" (after the instructor asked me how to get into the med drawers). :angrybird1: Assessments are often not charted correctly or completely, yet the instructor signs them off as complete. Even after nursing eduction talked to this instructor, the issue persisted. I could go on, but you get the point. It is unfortunate that this ruins nurses attitudes toward students--it is not the students' fault; however, when dealing with instructor issues like this, it puts a bad taste in nurses mouths.

RNrhythm, BSN, RN · Jun 16, 2016

At the time, I thought all of my preceptors were pretty awesome. Now that I am a working RN, I see that, holy %$#!, they were AMAZINGLY generous and patient.

We don't have students where I work now. We are too short-staffed and over-worked.

Tenebrae, BSN, RN · Jun 16, 2016

...
It does go both ways. I got to work, got report on my patients. Started the routine of assessing/medicating my patients. A group of students strolled onto the unit at 0755..... .

Gadzooks. When I was a student (only four years ago for anyone tempted to make a quip about age:cheeky:) we were expected to be on the ward for handover at 0645 not rock in over an hour later

chacha82, ADN, BSN · Jun 16, 2016

If you report something you think is abnormal and the floor nurse doesn't jump on it right away, keep in mind you are just seeing a snapshot of a very large picture. As a night nurse we have certain float MDs that don't act immediately on blood pressures YOU as a student might see as high. Again you are not seeing the whole picture. We do not slam metop into everyone whose BP is 151/80. Some other levels are expected, not great but expected due to hx or other meds going on with the patient. THANK YOU for your input but you don't know what is going on behind the scenes. Some MDs say "Let this ride for now, we will recheck xyz."

2bNurseDR.T · Jun 16, 2016

Wow. No. This doesn't get to fall back on the staff nurses. Your clinical instructor is obviously inept and if you're having these issues, it's not because of the nurses. Your clinical instructor is PAID to teach you.
Also... I really wanted to be helpful to you, but your superiority complex as a student is unsettling. I owe students nothing and my patients everything. You're not paying me to teach you and if I'm trying to coordinate the care of four patients, I don't need to be answering some of these questions but rather focusing on the care you somehow feel the nurses "neglect".

How is it that I have a superiority complex as a student? I don't believe that I am better than anyone, just as I don't believe a nurse is any better than I am. I believe in equality. Also, I can't help that my instructor is unreliable and is a poor instructor. I don't expect the nurses to owe me anything, I would just appreciate if I weren't looked at as a burden when I stick to myself mostly or when I ask a question about something that I've been taught is concerning.