Nursing Student From Hell

DTWriter · Mar 12, 2017

OP,

First, I would like to commend you for what did for that the ingrate.

Finding preceptors is so~ hard :unsure: , especially for women's health, so thank you very much for taking the time out of your schedule to help students out.

The ingrate does not realize how good she is getting it - not many preceptors are willing to stay after time, provide materials, teach the basics, etc. You did that and so much more. People like "Alice" do not seem to get it until something bad happens to them :no: .

Based on your posts, you did more than enough for her, and you gave her chances, even warned her (which not many preceptors do in a timely manner.) Maybe failing clinical will be the wake up call she needs. Yeah, failing clinicial will postpone her graduation and she will have to spend more money on her program but that is not your problem. You warned her, right? And within enough time to make improvements, right?

Then, fair game.

Please, please, please~ do not be discourage from precepting in the future

tfharms · Mar 12, 2017

I can't say this strongly enough so forgive the caps. FAIL HER!!!! Believe me you will be doing any future patients of this lazy twit a very big favor. Her school needs to be taken to task for allowing someone with these poor characteristics to have advanced as far as she has. You would think these traits must have surfaced in other clinical situations before she got to you. You remind me of my preceptor. She took her job as seriously as you take yours and I'm a better nurse for it. I'm sorry your last experience was such a bad one but you shouldn't feel bad about doing something that is 100% Necessary. This child has no business being a nurse

tfharms · Mar 12, 2017

This is not something that you let go. Laziness and passing the buck are serious character flaws in any profession but they can be lethal in nursing. I've worked with more than my fair share of nurses like this, ones that were very possibly "let go" because someone felt they got a bad break

tfharms · Mar 12, 2017

Amen!!

pixierose, 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.

Why is this odd?

And how is it unfair in relation to the NCLEX? She can schedule the NCLEX any gosh darn time she wants, and, while clinical rotations help reinforce your learning, it's usually studying your orifice off that prepares you for the NCLEX.

Doesn't matter if she *loathes* L&D; you get what you get. I didn't like my L&D rotation either because I found it boring as heck and not my cup of tea; however, the charge nurse never had to hunt me down. Do I even need to explain why not?

**NICU Guy, 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.

We were given a choice of Capstone/Practicum. We gave the school our top 3 units that we have an interest in. My top choice was NICU. Practicum is designed to give you exposure to a specialty that you have an interest in post-graduation. Nursing school didn't prepare me for the Capstone and NCLEX doesn't cover NICU type patients. Was that placement not fair to me? I guess it was fair to me, I passed NCLEX at 75 questions and I got my job in the NICU due to having a NICU Capstone placement in nursing school.

Skippingtowork · 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!

When I was in nursing school, my practicum preceptor was very interested in me as a student, teaching me, guiding me, allowing me to practice skills without pressure. Like you, she was dedicated and took the job seriously. I remember her to this day.

All that being said, failing the student is probably not a good idea. If she applies to your unit, you will most likely be asked to give input. You can put on her evaluation that L&D may not be the place for her at this time. Also, as a CNM, you may be evaluating her from a different perspective and you really should not have been her preceptor. Just so you know, starting IVs is not a requirement for nursing school. Most hospitals do not let you do that. All hospitals I have worked in have you train with your preceptor after you are hired and then validate you. Even now, I work with nurses who have rarely started an IV. The requirements for passing clinicals in nursing school are very basic. It would be unfair for a school to allow a student to fail based solely on a preceptor's evaluation.

I once precepted a student who behaved similarly. I didn't understand it and told her professor that I didn't think she was going to make it. The professor agreed that there was a problem. After investigation, I found out she was sick. After her surgery, she felt much better. I then discussed expectations and evaluated her from that day forward. She performed much better after that. I also found out that she had not had much useful clinical experience prior and was about to graduate. Professor said program was going to change. That young lady is now successfully working.

There is a chance that your student is very anxious or intimidated and hides in response to those emotions. Sit with her and try to find out the root of her avoidance behavior. If indeed it is related to fear, back off a little and have a short do-over. Be careful what you say to her in front of patient. Let her go in without you and then report findings to you. She is a student without nursing experience, being trained by the equivalent of a doctor.

I think you should be precepting graduate students. They may benefit more from all your efforts. Staying over and providing materials shows that you take this role seriously and there aren't enough of you around for other CNM or new employees. Please don't abondon teaching because of this experience. There is a place for you and you are desparately needed. Contact graduate programs for CNMs and FNPs who need first trimester clincals. They will be eternally grateful to you.

Ruby Vee, BSN · Mar 12, 2017

Would you trust her as your nurse? I wouldn't.
She could cause problems.

Would you trust her as a colleague? I wouldn't.

Skippingtowork · Mar 12, 2017

I think everyone is overlooking this one statement.

A CNM is not doing the work of a bedside nurse and the primary role is different. A fully seasoned nurse transferring to an L&D would not be able to do a whole lot. I see it all the time. Most of learning occurs on the job and over a period of time. Many people talk as if they know more than they actually do, sometimes so they aren't criticized. It takes time to become comfortable and proficient. What primary role could a student take with a woman in labor? Repeat after me "NONE." This is a high risk area and there are enough nurses in L&D who aren't proficient without adding high expectations on a poor student. Even as an experienced nurse I would quake if I had to go to L&D. When I had my last child, I welcomed the student in the post partum unit, but a student during my labor would have only been useful as a helper.

pixierose, BSN, RN · Mar 12, 2017

"The biggest issue is that she just laughs it off when you call her out on disappearing."

This is what stands out to me. Nervous student aside, RESPECT is a component of the instructor-student and patient relationship. This student, by laughing it off and by saying she is in one location (i.e. the bathroom) but somewhere else entirely (so that the charge nurse herself had to hunt her down at one point), is exhibiting unprofessionalism and disrespect to a degree that no student at her level should be demonstrating.

Ruby Vee, BSN · Mar 12, 2017

"The biggest issue is that she just laughs it off when you call her out on disappearing."
This is what stands out to me. Nervous student aside, RESPECT is a component of the instructor-student and patient relationship. This student, by laughing it off and by saying she is in one location (i.e. the bathroom) but somewhere else entirely (so that the charge nurse herself had to hunt her down at one point), is exhibiting unprofessionalism and disrespect to a degree that no student at her level should be demonstrating.

This stands out to me as well. The only question I have, is at what level is this level of unprofessionalism and disrespect OK?

kakamegamama · Mar 12, 2017

This stands out to me as well. The only question I have, is at what level is this level of unprofessionalism and disrespect OK?

Exactly! I remember working with a L&D nurse who would disappear when emergency situations arose because of various excuses. I was always amazed why she was kept on board. Her excuses ranged from needing to make ID bracelets for mom/baby, to being "off the unit". Either way, it wasn't good. Thankfully, the L&D staff were good team mates and made sure the patients were safe.