Nursing Student From Hell

twinmommy+2, ADN, BSN, MSN · Mar 12, 2017

Why do I need to be evaluated? I tried to give her the benefit of the doubt and be a good preceptor. I'm not her school. I'm not her program. I bent over backwards teaching her. I know I have to fail her but I know it's going to suck. Thanks making me feel even worse.
DWelly, I'm not trying to make you feel bad, you're doing that for yourself. I'm not also trying to be harsh re your student but you simply have to pay more attention. We cannot afford to ever not be vigilant. You of all people should know this being in L&D. I find it impossible to understand that people can't understand that when our patients suffer from our mistakes, multiple entities are involved and not just physically but also psychologically and emotionally. You have to be prescient, vigilant, always!! We all make mistakes but if it involves myself, I can live with the consequences hopefully, but to through carelessness or inattentiveness cause harm, appears criminal. Your primary priority is to advocate for the patient and that means reasonable standards of care. And grow a set if you are to be effective at your job. The better the nurses you educate, the better they represent us effectively.

I have to disagree. It was not like she was giving her patient assignments and the student was taking care of everything while the preceptor was no where to be found. The patient assigned was not attended to by the student and could not be found. If that were me I would expect to fail.

DisneyNurseGal, BSN, RN · Mar 12, 2017

I find it odd that they put a student in Labor and Delivery. I don't think that is fair to the student in preparation for the NCLEX. Maybe she doesn't like L&D and maybe just let it go.

TriciaJ, RN · Mar 12, 2017

I find it odd that they put a student in Labor and Delivery. I don't think that is fair to the student in preparation for the NCLEX. Maybe she doesn't like L&D and maybe just let it go.

It doesn't matter what she likes. Since when do you just get to do what you like? It is still a valuable experience to learn skills, time-management and gain confidence before your first job throws you to the wolves. This is a time-limited opportunity and any student should be making the most of it.

There is absolutely no excuse to be hiding, shirking and "laughing off" concerns from your preceptor. Is she really clueless and arrogant enough to think she can skate by on this behaviour? Four shifts is not enough to pull a very bad attitude out of the toilet.

It's really not about the student. It's about the patients. Who deserves a nurse who's MIA?

icuRN2srna · Mar 12, 2017

I find it odd that they put a student in Labor and Delivery. I don't think that is fair to the student in preparation for the NCLEX. Maybe she doesn't like L&D and maybe just let it go.

L&D is taught thoroughly in nursing programs and tested extensively on the NCLEX. OB and Pediatrics was a large section of my NCLEX. I was placed in the OR and had to learn an entire environment that was not taught about at my program, and I was expected to be able to run an OR room by myself including set-up, consents, pre-op issues, etc, etc.

I think regardless of the placement, it's not fair to the student or her cohort. If I were in her class working my tail off during my practicum and knew that someone passed by hiding and refusing tasks, I'd be up in arms.

LuKeeU · Mar 12, 2017

Would you trust her as your nurse? I wouldn't.

She could cause problems.

LuKeeU · Mar 12, 2017

Right is right. Well said.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Mar 12, 2017

She's a student, not a nurse in orientation yet. I could get your frustration if she were a new grad that was an employee, but she is a student, of course she's nervous and scared.
I'm surprised she's allowed to do as much as you are saying she is. When I was in school, we did nothing with the nurses, only our instructors. And when I have a student, they do nothing with us.
I just think that expecting her to be a full on trainee nurse at this point is a little much. If she ends up graduating and passing NCLEX, then finding a job, let it be up to her employer to handle laziness.
I was scared to death of IVs as a student and I still stink at putting them in!!!
Now, if she's late, not following you around, not doing what you ask, that's a reason to fail. But not nerves.

If you re-read the OP's post, Alice was told by her instructors at the midterm meeting that she was to take on the primary role and that the OP was to back off. Apparently, Alice has other plans. :no:

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Mar 12, 2017

The only part of your post that I have just SOME issue with... before
you went into the room with Alice to admit that patient, did she know
what was expected of her? Did she know she would be doing the
entire admit? Starting the IV? Was she okay with it? Did you make
sure she would be comfortable?
I mean, I understand the whole gist of your post, but... shew I'm
with a couple of other posters... after 13 years, this girl still HATES
starting IV's on most patients, and if put on the spot about starting
one, there are times when I will STILL shrink like a violet.
Other than that, I get what you are saying, I do. I vote to let
her do the rest of her preceptorship, make her fully aware that
her passing grade is on the line, and see how she does. Maybe
she will redeem herself?

At midterm, the faculty said Alice was to take on the primary role. 'Primary' is all-inclusive.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Mar 12, 2017

So I need help. I've been a nurse for 6 years now. I have a BSN & an MSN and am also a CNM. I've worked 4 years in critical care and the past two years in labor and deliver at a large suburban hospital. I've precepted several students and have always had positive experiences with them. I was not planning on taking another student this semester as I finally am transitioning into full scope midwifery practice but the local nursing school was desperate so they talked me into taking one last student. So in January, this student, let's call her Alice, started with me. When Alice first started she seemed very unsure of herself. She's a student though so not unexpected, even though this is her last rotation before graduation. But I got my teach on. We discussed anatomy and physiology of pregnancy and labor, walked through procedures at least 10 times, I stayed after every single shift to work with her, and she always went home with printed out policies and articles to read up on so we could discuss on our next shift. I felt like I was seeing improvement but I was always right there with her helping with her during the first 6 weeks of her rotation. When we had her midterm evaluation with her faculty member, Alice was told she was to take the primary role and I was to back off. So that's what I've been doing. Unless safety is in jeopardy, I've kept my hands off. And Alice is crashing and burning. To the point where I'm not sure how she's made it this far in her program. She is lazy, refuses to do basic nursing tasks such as starting IVs, and will just go hide to get out of things. We admit a patient. I go in to the room with Alice, she just stands there. I say "Ok, go ahead and get started." She says (in front of the patient mind you) "well, I haven't done many IVs so why don't I watch you one more time?" I say " you only have 2 weeks left, you only have so many chances left ... " Patient chimes in "I want you to start my IV please DWelly14!" .... opportunity lost. Fast forward to when the patient is complete. Alice is nowhere to be found. I'm in pushing with her and the charge nurse has to find her. Several of my coworkers have commented on her behavior to me, I've confronted her on it and she always makes excuses, and I've now emailed her faculty.
My question to all of you is do you have any tips for what to do? I feel bad just recommending that she not pass but at this point she only has 3-4 shifts left with me and I'm getting really frustrated with her. I'm really not willing to take her for any longer than the originally assigned amount of time because of the behavior I've observed. I feel like she's skated by through her whole program somehow and now she's finally having to actually do it and she can't. Help!

I think everyone is overlooking this one statement.

Wuzzie · Mar 12, 2017

I find it odd that they put a student in Labor and Delivery. I don't think that is fair to the student in preparation for the NCLEX. Maybe she doesn't like L&D and maybe just let it go.

Please expand on this.

Editorial Team / Admin · Mar 12, 2017

I find it odd that they put a student in Labor and Delivery. I don't think that is fair to the student in preparation for the NCLEX. Maybe she doesn't like L&D and maybe just let it go.

Why wouldn't it be fair? All types of nursing are fair game when it comes to NCLEX, and there is much more to preparing for NCLEX than simply completing required nursing school courses.

In my capstone, we were told to list our top 3 choices- many put L&D as their number one choice. Not all who wanted it could have it, and those who didn't have the best grades were the first to not be considered for L&D placement. I'd bet this student wanted to be in L&D and wasn't just randomly assigned. Capstone is an opportunity for a student to get an in-depth experience with a specialty he or she may wish to work in once licensed.

kbrn2002, ADN, RN · Mar 12, 2017

First a rant about the state of nursing programs in general: Why is it even up to a preceptor to make the decision to pass/fail a student in any stage of their schooling? Capstone, preceptorship or whatever it's called in this program should not mean that the actual nursing program instructors have little to no contact with the student. Are these instructors not being paid for that semester? Is the precepting nurse being paid by the school of nursing to finish this students education? I bet not.

Rant over. Now to this particular situation. First thank you for taking on this role. I get the impression you've done everything you can to impress upon "Alice" the importance of at least being present during patient care and she just doesn't seem to care. At this point I don't see how anybody could fault you for failing her for inability or plain unwillingness to demonstrate her competency and ability to safely practice.