Quick question - I've been working on my current unit for 6 years now, and I have never seen this happen before. We have a group of nursing students now who are early in their education and stay for the whole shift. But they come up to us about half an hour after we get out of report and want us to stop what we are doing to give them report. I can't believe that! We just got there and haven't even seen the pts yet and they want us to stop what we are doing to give them report! Every other group I have ever seen either listened to report with us and then asked questions later, or else their instructor listened to report and then talked to them about it. I understand that this is a young group who might not be able to catch everything in our real report, but that's why they can ask questons later, IMHO. I think they read the charts and stuff too, but they do that at the beginning of the shfit right when we get there. And since we don't have the luxury of having time to read charts, I'm sure they already know way more about the pts than I do at that point! When I was in school, we had to go the day before clinical and read out pts chart, and then got a brief report from the instructor. What do they do on your unit? Oh, and I'm not talking about precepted senior level students, but clinical groups.
I've said it a million times before - I love teaching! I love being a preceptor for new grads, too! But not at the expense of pt care. The last time they were there, I had a pt who was tanking, and the instructor got mad at me because I told the student I couln't talk to her just then...of sorry, this I'll just have the guy with the O2 sat of 68 wait while I tell the student about the guy down the hall!!!!!
Just finished my first year of nursing school. I did not like getting report from nurses sometimes because I felt like it was never a good time. My instructor would say wait awhile to get report from the nurse because the nurse has to get report and get settled in. I think that I would have liked it if the nurse I was getting report from would just be honest and say whens a good time for him or her to give report. So I guess the best thing to do is be honest and respectful and say "Right now I busy come back in about a half hour or something."
When I was in school, the instuctor got report and gave it to us beforehand. Although in senior year, one instuctor did tell us to ask for report from the nurses, and they were never very happy about having students around.
Still, when a pt was crapping out, the students all tried to be in the vicinity to see, but our instructors made sure we were not in the way. We'd get something, if asked to. I'm suprised the instructor didn't see that as an opportunity to see an emergency.
Specializes in Emergency Nursing, CPEN, Pediatrics, Obstetric.
I work in ob and we seem to have students every day. I love it, and their instructors for the most part make them very helpful to us as they bathe new babies, get things for our laboring moms, and help with vital signs. All these things and all they ask in exchange is to share nursing with them. I remember what it was like as a student and like to believe that as an RN I have a good rapport with the ones in our department. It mainly involves the instructor if a particular group seems disrespectful or unappreciative. I know that we were told the students would report to us before "signing off", but one group would just leave. And the instructor for that group would make the students take lunch two at a time, but the problem was that while the whole group was lunching, the instructor would join each group in the breakroom, and we wouldn't see her for hours. That, to me, is not the students fault. So I think the instuctor should be asked about this.
I would speak to the instructor just to get an idea of the logic behind the scheduling. Our clinicals were set up as follows:
CI would usually arrive around 1200, we were on the 1400-2200 shift. By the time we were done with pre-conference, during which our CI would usually give us a rough report on our pts, the RNs were giving report and we would listen in. When we were moved up to having 3/5 pts this became more difficult as we had to get report from the other RNs if we hadn't heard it the first time. Kind of difficult to get report on 3 different pts if you have 3 different RNs, KWIM? Our CIs also INSISTED that we get report before even stepping foot in a pt's room - doing anything otherwise resulted in a Clinical Warning.
I know in my case the school set up the clinical times, not the instructor. Maybe you could work something out with this particular instructor so that the flow is a little better.
I just had my last clinical day today! When I was part of a clinical group we were still assigned a specific patient, would go in the night before and gather our information about them so we could look up anything we did not know and all of the medications, and we showed up the next morning to attend report with the nurse. So many things have to happen when you hit the floor in the morning, I can't imagine trying to pull my nurse aside and expect her to give me that much time!
Yep, that's what they made us do, too. But, I found a way around it. Now, keep in mind the way I found was not kosher with the instructor, but she didn't have to know. We were told the same thing, "You must take report before anything." Well, to me, that seemed ridiculous since out of my 3 pts, each had a different nurse who were each off to various parts of the hallway with others getting report. So, being that I could not be in three places at once to hear report, I would just go and take vitals and do assessments while the nurses were doing report. Then afterwards, I would seek out each nurse to hear report. I did it this way for two reasons mainly. One, it saved time and gave my nurses time to regroup. And two, since we students had already studied the charts the night before, I figured I had enough info to go by to be able to get vitals and do assessments. I could always go back if I missed anything. My instructor would not have seen this as an okay thing to do, I'm sure, and as an RN, I would never do something like that. But since I was just a student, I don't figure it really mattered what I did in the mornings, cuz all the nurses wanted was for us to get out of the way initially and approach them later. Also, it was easy to do this because my instructor had students on two different hallways, so she floated around. I guess she just assumed that I had already gotten report since I was never up there when she got back. :wink2: It's just another one of the byways I had to create during school to be able to get things done in an orderly fashion. Some students, though, will follow their instructors directions to the letter for fear of their wrath. I was one to always find an alternative route if something my instructors said didn't make since in the real world. For example, We were given about 30 minutes in the morning to: obtain vitals, change linens, straighten room up, give bed baths, empty foleys/drains, do assessments, accuchecks, pass any early morning meds, feed pt if necessary, AND have it all charted in the computer. In 30 minutes?! That's just plain stupid. Not to mention physically impossible. I understand they want us to learn to be quick and efficient, but don't give me stupid crap like that. Just say, "You need to accomplish these tasks as soon as possible." Tadaah, how hard was that? Ridiculous. The instructors would hand out Unsats left and right if they asked about these tasks and you said they weren't done yet. Soooooo...I just lied every time and said, "Oh yeah, check that off my list." I always sounded so confident that I guess they never figured to go check on these things, which I did get done, but in a more real-time fashion. :chuckle Whatever, I'm just glad to be done with that place.
It is a bit difficult for clinical instructors and students when hospitals use SBAR. When the hospital we use switched to SBAR, the group report was done away with and each oncoming nurse is responsible for finding each offgoing nurse who has his or her patients and listening to a report out in the hall. One instructor cannot listen to four nurses out in various areas of the hall at the same time, and if a student has patients with more than one nurse, it's hard as well. It was much easier when there was a group taped report by offgoing nurses. But the nurses themselves ruined that, because there was too much monkey business and wasted time during shift report. The clinical groups haven't found a good way to deal with the SBAR reporting. We try to be unobtrusive and not bother the nurses, but it is unsafe for students and instructors to be performing patient care without a report of any kind, even if the students do look up everything the night before.
During our clinical days, we are not allowed onto the floor until 8 AM.. we are not given assignments the night before; patients are assigned that day. We are told that when we get onto the floor, we should get report, check for new medication orders, and do a head-to-toe, in that order. I've always introduced myself to the primary nurse, asked him/her if he/she had a moment to give me a quick report, and if he/she is busy told him/her that I would check the chart, take vitals, and come back in ten minutes so that the nurse has a moment to finish what he/she is doing. I try not to be a nudge, but some professors have gotten PO'd at me for not getting report right away.. just my experience.
It is a bit difficult for clinical instructors and students when hospitals use SBAR. When the hospital we use switched to SBAR, the group report was done away with and each oncoming nurse is responsible for finding each offgoing nurse who has his or her patients and listening to a report out in the hall. One instructor cannot listen to four nurses out in various areas of the hall at the same time, and if a student has patients with more than one nurse, it's hard as well. It was much easier when there was a group taped report by offgoing nurses. But the nurses themselves ruined that, because there was too much monkey business and wasted time during shift report. The clinical groups haven't found a good way to deal with the SBAR reporting. We try to be unobtrusive and not bother the nurses, but it is unsafe for students and instructors to be performing patient care without a report of any kind, even if the students do look up everything the night before.
That is understandable, but not an excuse for this CI. We do a taped report. If she doesn't want to listen with the nurses, the tapes are right there for them whenever they want to listen. All I ask is that, if I am busy when the students are ready for report, that they come back to me later and get it. I resent being scolded as if I were a child who won't play nice with others. Once I was in full isolation gear in a room waiting for a fall risk to finish in the bathroom, and she stood outside the door and glared at me until I got out and cornered me and demanded a report right then and there. I was like "hey, I'd like to wash my hands first!" Like I said, yay students, but I'm not going to drop what I'm doing to give you report.
I don't mean to dig on this one CI too much, but I don't see any way to reason out of the way they are doing this. They are all there when I get there at the beginning of my shift, and like I said, they sit in the break room while we get report, plus the tapes are all there for them to listen to! Sorry but I feel like it is disruptive to us and to the pts and that they should be doing it the way they would do it if they were RNs. Like you said, it's not really possible with SBAR, but in this situation, it is!
When I was in school, we were expected to show up early enough to listen to report at change of shift...showing up after report and expecting the nurses to stop what they're doing to give report again to a student sounds wacky to me...
You all make it sound like these kids are doing this on purpose... They are undoubtedly doing exactly what they are told. Don't take it out on the kids, don't you remember your own clinicals as a nursing student? I agree that they should be in report with you, not look you up afterwards, but someone needs to go to the CI and bring this up. I have a daughter who just finished her first year and she has an endless number of stories about how rudely she is treated by floor staff. How quickly we forget..........
We had to be at the clinical site by 630, we had already recieved our pt assignments the night before and our CI checked off our prep sheets and were usually on the floor just before 700 and we listened to report with our assigned nurse, if you were lucky your pt wasn't discharged and you wrote up a mini care plan that night for the next morning, if your pt was discharged you recieved a new assignment and stayed after clinicals to research the new pt and be ready to go in the am all over plus the mini care plan on the discharged pt which I found alot easier to do the teaching topics on it since you did teaching at time of discharge.
lizzyberry
440 Posts
Just finished my first year of nursing school. I did not like getting report from nurses sometimes because I felt like it was never a good time. My instructor would say wait awhile to get report from the nurse because the nurse has to get report and get settled in. I think that I would have liked it if the nurse I was getting report from would just be honest and say whens a good time for him or her to give report. So I guess the best thing to do is be honest and respectful and say "Right now I busy come back in about a half hour or something."