Nursing Student From Hell

Horseshoe, BSN, RN · Mar 12, 2017

I'm a little surprised at all the fail her posts. She's a student. A student. I feel like some of you have way high expectations of students.

And perhaps some have exceedingly LOW expectations of SENIOR capstone students, who at this point should be integrating their entire education and seeking out every last opportunity to learn. Being scared and insecure is okay; hiding out, disappearing, without letting her preceptor know, skills avoidance tactics, etc. are NOT okay.

If she hasn't met the objectives of the course, yes, she should fail. I would hope someone who has made it that far would be given the opportunity to repeat, however.

Horseshoe, BSN, 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?

We can't require students to meet certain objectives unless they decide they are "okay with it"? Wow! Talk about the tail wagging the dog. :nailbiting:

Jasel, BSN, RN · Mar 12, 2017

It sounds like she's being required to do ALOT more than I ever had to in nursing school for clinical and I went through 3 separate programs. But that still doesn't excuse poor work ethic, laziness, and purposeful ignorance.

Once I had a not so great evaluation from a nurse I was shadowing for a clinical day, which I disagreed with as I wasn't impressed with her either throughout the day. But I made sure the nurse I was assigned to the following day would have a glowing report about my performance which she did. It just sounds like this student is trying to skate by. I went to school with an RN like that and guess what? She's been called before the BON, fired at least twice, has switched jobs multiple times because she's never able to handle the job wherever she's at, etc. And that's just in the last 4 years.

I doubt anything you say is going to derail the student from the program. If this is how she's been behaving with you and she's nearing the end then her instructors are most likely aware of what she's like by now. If she does graduate and passes the NCLEX, she's not going to make it wherever she goes if her attitude stays the same. Most nurses I work with are mediocre to amazing. But every now and then I run into nurses who are lazy or just outright bad. Sounds like your student is going to be part of the latter. Not your fault or responsibility. The best thing you can do for her or any future patients who are unfortunate enough to be under her care is to be honest in your evaluation. But besides that, not much else you can do.

pixierose, BSN, RN · Mar 12, 2017

We can't require students to meet certain objectives unless they decide they are "okay with it"? Wow! Talk about the tail wagging the dog.

Pixierose's Adv. Med-Surgical Rotation, December 2016:

Clinical Instructor: "Ok, Pixie, the patient in bed 2 needs to have his trach dressing change this morning. *Are you *OK* with this*?"

Uh, Pixie??? Has anyone seen pixie?

(((searches for pixie)))

Yeah. Trach care was my kryptonite. Gah. If I could have run off to hide, I totally would have!

SmilingBluEyes · Mar 12, 2017

Pixierose's Adv. Med-Surgical Rotation, December 2016:
Clinical Instructor: "Ok, Pixie, the patient in bed 2 needs to have his trach dressing change this morning. *Are you *OK* with this*?"
Uh, Pixie??? Has anyone seen pixie?
(((searches for pixie)))
Yeah. Trach care was my kryptonite. Gah. If I could have run off to hide, I totally would have!

But did you? I doubt it. There was a lot of "kryptonite" for me......trach, eyeballs, projectile bloody emesis/vomit, cleaning up GI bleed poop, and changing colostomy dressings/bags all come to mind. But I did not run away. I leaned INTO it and got through it.

That is how we succeed.

pixierose, BSN, RN · Mar 13, 2017

But did you? I doubt it. There was a lot of "kryptonite" for me......trach, eyeballs, projectile bloody emesis/vomit, cleaning up GI bleed poop, and changing colostomy dressings/bags all come to mind. But I did not run away. I leaned INTO it and got through it.

That is how we succeed.

Nope. Didn't hide.

I earned that PASS.

In fact, I became quite good at trach care BECAUSE it was my kryptonite.

LadysSolo · Mar 13, 2017

As a nursing instructor, I expect my students to SEEK OUT experiences during clinicals, and ESPECIALLY during preceptorship. If she is hiding and not trying, I would expect you to notify me (you say you notified her program so done,) they should have talked to her (I would have,) and then if she doesn't improve I would expect you to fail her and give detailed reasons why. And at least in the program I teach in, she would just have to repeat preceptorship, and then she could graduate in the next semester (if she improves.)

ICU_UcMe, BSN, RN · Mar 13, 2017

But she's NOT doing what she's being asked. She's NOT following the OP around; rather, the charge nurse had to search for her on an occasion. Major no no.
I'm a brand, spanking new nurse, graduated in December. IV's are still terrifying to me. But when my instructor/the nurse/my preceptor tells me to try it ... I tried/try it. Same with foleys, dressing changes, trach care, etc. When you're a nursing student, you grab on to those opportunities because that's what's expected -- as evidenced by this particular nursing students' faculty members' midterm statement.
Acquiring nursing skills can be really scary -- this I can certainly agree on. Still doing it. But this student is wasting the OP's time and doesn't appear to be meeting her school's set standards for this particular semester. Sorry kid = fail. That's the consequence.

I agree with you for the most part. However, of the preceptor hasn't first told her what she's doing wrong and attempted to help her correct said behavior then she is also failing Alice herself.

She's a student. Students are used to hand holding and are scared of doing anything without being told to because they've been conditioned that way. Unless OP has talked to Alice about the behavior and still hasn't seen a change, then I think it's wrong to expect any improvements to miraculously be made.

TriciaJ, RN · Mar 13, 2017

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.

She probably would not have been useful as a hider.

mrisquet · Mar 13, 2017

Fail her. She is a liability. I've had to work with nurses who hide and nursing assistants because they are lazy. It's very stressful when all the workload is on you and you've no help. Send her to an IV class with a clinical instructor since she's so "nervous" which really is a cover-up. She seems to be passive-aggressive making up excuses all the time. Inform your supervisor and document everything. Maybe, she's only doing nursing for the good pay and benefits. What if a patients is crying out for help for example with chest pain or they fell on the floor and she's hiding, expecting someone else to deal with it. She doesn't deserve to pass because she hasn't pulled her weight and doesn't seem interested in learning. If she has other problems, send her to the employee assistance program (EAP). There may be issues at home or elsewhere in her life but you can't just pass everyone because you feel bad for them. Sorry, you have to be cruel to be kind.

BookishBelle · Mar 13, 2017

In the immortal words of Bonnie Raitt,"l can't make you love me if you won't..." You also can't make anyone learn if they won't. You can definitely have an unequivocal talk about what will happen if they won't, and perhaps put the expectations on paper. (Which it sounds like you did?) But other than that, you sound like the kind of preceptor I really, really hope I get!

Skippingtowork · Mar 13, 2017

She probably would not have been useful as a hider.

No, probably not, but that's what some people do when they can't cope. We don't this young lady's background or thoughts. I've had students stare at patients with the look of terror in their eyes.