Opinion vs. legality -- a rant

[PetiteOpRN]

This is prompted by another thread in which a student was admonished for actively participating in patient care during surgery.

One member responded that it is illegal for unlicensed personnel to pass instruments, and was a patient safety issue.

Fact: Some states require certification for people who pass instruments in surgery (surgical technologists). But MANY states (mine included) require no license or certification whatsoever.

This member posted, ad nauseum, that this was illegal: "It NOT legal! Period! The unliscenced people present pose a risk to patient safety."

I understand that you are of the opinion that it is not in the best interest of the patient to have students participate in their care, but it is legal. It is not necessary for you to try and convince us that your opinion is the law for us to respect it as a valid opinion. Many of the other members of this forum are thrilled to have students who are enthusiastic enough to want to actively participate in patient care.

/rant

[kakamegamama]

dthfytr:

"other countries may not realize that, for instance, everybody drives in the middle of the road in Lower Slobovia (a trauma nurses dream!)."

Although I didn't live in Lower Slobovia, I lived pretty close. Your comment makes me glad that I lived part of a trauma nurses dream, and survived :). Thanks for the chuckle.

As to the OP--I wish I too, knew where the poster you refer to is from in the States. I cannot imagine any nursing school nor healthcare facility in ANY state in the U.S. that has students not allowing students to participate. How else can they learn? I guess I've broken the lawaccording to her more than once, both as a student and as faculty!!

It sounds as though you are willing to have students learn alongside you. Thank you!

[merlee]

Back in the Jurassic Era, as a student I was allowed to scrub in and pass instruments, and to circulate. I loved it! And when I was in the OR during my 'leadership' rotation, my surg instructor saw me and asked if I would be willing to scrub in on an emergency case! What fun - a facial injury with plastics and opthy guys. They all knew I was a student, and stopped to show me things and explain stuff.

If you never gets hands on, how can you possibly know if this is truly what you want to do? Hooray for hands on!!!!

[klone, MSN, RN]

I agree with the OP and Jolie - I read that thread, and I found the poster's authoritative tone to be very annoying, especially the last post in the thread.

Yes, it IS perfectly legal for students to practice under appropriate supervision - including in the OR.

When I was a student, one of the OBs let me scrub in and stand directly at his side during a C-section. I handed him tools, and even held the tissue together as he stapled the incision closed.

[BabyLady, BSN, RN]

This is prompted by another thread in which a student was admonished for actively participating in patient care during surgery.

One member responded that it is illegal for unlicensed personnel to pass instruments, and was a patient safety issue.

Fact: Some states require certification for people who pass instruments in surgery (surgical technologists). But MANY states (mine included) require no license or certification whatsoever.

This member posted, ad nauseum, that this was illegal: "It NOT legal! Period! The unliscenced people present pose a risk to patient safety."

I understand that you are of the opinion that it is not in the best interest of the patient to have students participate in their care, but it is legal. It is not necessary for you to try and convince us that your opinion is the law for us to respect it as a valid opinion. Many of the other members of this forum are thrilled to have students who are enthusiastic enough to want to actively participate in patient care.

/rant

Just because it doesn't require a license, doesn't mean the state doesn't require the facility to do bare-minimum training. No license doesn't give the facility an allowance to do a free-for-all.

So yes, it was wrong for the student to participate.

[Jolie, BSN]

Just because it doesn't require a license, doesn't mean the state doesn't require the facility to do bare-minimum training. No license doesn't give the facility an allowance to do a free-for-all.

So yes, it was wrong for the student to participate.

How so? Unless I missed something, there is nothing in the original post to indicate that this student was engaging in a "free-for-all."

I highly doubt that she showed up at a random hospital on a Saturday afternoon and wormed her way into an OR to scrub for the fun of it.

As best I can tell, she was participating in an OR assignment which was part of the clinical training in her nursing education program, arranged and supervised by both her program and the participating clinical site.

So again I ask, how was her participation wrong or illegal?

In my last hospital job, I precepted senior nursing students in, of all places, the NICU (gasp)! It was my responsibility to design a clinical course of study to meet the student's educational goals within the framework of their nursing education program objectives for the independent senior rotation. The few students who qualified for this NICU program had demonstrated clinical excellence in their basic maternal-child rotation, had the recommendation of faculty and staff and passed an interview. In exchange for their commitment, we provided a unique opportunity to attend C-sections, lady partsl deliveries, and learn hands-on assessment and care of critically-ill neonates. They were able to learn aspects of care that few seasoned nurses ever experience. All under the direct supervision of myself, their clinical instructor, a designated cooperating staff nurse or a physician.

The program described in the original post sounds much like our NICU preceptorship, which I assure you was perfectly legal and proper.

I'm shocked at the number of nurses who believe that hands-on training is somehow wrong, and that nursing students should simply observe their way thru clinicals. I encurage those posters to read their nurse practice act, especially the sections pertaining to education of student nurses.

[blondy2061h, MSN, RN]

It's so easy to get caught up with what's legal/illegal in your state and forget it's not the same everywhere. I've been guilty of that at times.

[idahostudent2011]

As a student, I want all the hands on that I can get, how else am I going to be able to care for patients when I graduate? I am also a scrub tech,(certified but unlicensed :) ) and I would be more than happy to have students scrub with me. Its not as if I am going to leave the room and just let them at it. I am always there to jump in if there is a problem. Hey, if I got to scrub as a nursing student I would be in heaven. Since my school lets us go into to OR for one day only, we get to sit in a corner with our hands crossed, far away from the field and line of sight of the actual surgery that is going on.

I am finally going into the fourth semester, so that is very exciting, and by the end of this semester will have a full load of patients(precepting) and the nurse will only be there for backup and to watch us give meds.

[canesdukegirl, BSN, RN]

This is news to me. I have never heard of a nursing student's involvement in patient care as being illegal. As far as I know, nursing students work under the license of their instructors while in clinicals. Nursing schools are required to carry malpractice insurance for their students...at least that was the case at my nursing school. It was part of my tuition fees.

I am curious as to who thinks it is illegal for nursing students to participate in patient care. This is kinda shocking to me. I train nursing students all the time in the OR. Being as hospitals are deathly afraid (excuse the pun) of bad press and have an entire risk management department to cover them, I am confused as to why someone thinks that involving students in patient care is illegal.

[klone, MSN, RN]

So yes, it was wrong for the student to participate.

Why do you say that? How do you know that?