I'm a new grad (graduated in December) and have been working as a nurse now for 2 months. I just wanted to post some my thoughts on some of the students who come into my unit for clinicals
Please answer call lights, even if it's not 'your' patient. It may not be a big deal to you but it makes a big deal to me and may save me a few minutes.
Don't 'sit' at the computers if you're not working on them. If you're looking things up on the patients, that's one thing but to sit there because you don't have anything to do and take up a computer I need to use is not cool.
Try looking up answers to your questions before asking us. Google is your friend at times. I recently had a 1st year student ask me what "full code" meant then didn't understand what CPR was and when you use it. I also had a student recently ask me for a "rundown" on why my patients were here. I don't have time for a "rundown". I'm really happy to answer questions if you can't find the info but please do your homework first.
Don't sit at the nurses station and gossip. Especially if you're sitting in front of a computer.
Ask me if there is something you can do. I will almost always say yes :) and I will be more willing to show you things, grab you when something interesting is going on, etc if you actually want to be there
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
To those mentioning new nurses having students, this is becoming a common practice, actually. The thinking is that these nurses can teach things in a way that a brand new nurse needs, one that is still fresh, that was recently a student, etc. They can offer a different (not necessarily better or worse) perspective than a nurse who's been in practice for 20 years. It's great working with a variety of nurses, because you learn something different from each one, including the newer ones.
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Or it could be that all of the experienced nurses are already precepting new grads, and there's no one BUT a new nurse to work with the students.
students in the past have been quick to run into a room with a call bell going off and unintentionally caused harm to the pt: giving water to a pt with an NG tube, assisting a pt to the restroom without using a gait belt and resulting in a fall, removing an abductor pillow from a fresh post op and resulting in the pts fresh hip to pop out of place... these situations are unfortunate and it's easy for someone to be quick and blame the student but again they are 1st semester students who only get 1 classroom day per week and the ratio of students to instructors is 16:1.
A lot of that could be mitigated by requiring nursing students to be CNAs first. They would already be familiar with things like NPO for NG tubes, abductor pillows and their purposes, and the importance of not getting a patient up until you are more familiar with their stability and ability to bear weight. They would also be thoroughly steeped in the idea that you need to check with the nurse first before doing a lot of things. I know the idea of requiring CNA experience before nursing school is unpopular, but it would definitely reduce problems like the ones you describe. They would also know what call lights usually sound like, and what CPR is before getting onto a floor as a student. That one really made me go .
Not a thought in the world is given to who the nurse caring for the patient will be when the clinical instructor chooses the patient for their students. They pick patients who are willing to have a student and who they think will be interesting for the student. When I worked in the hospital, the instructors often came in the day before and selected the patients for their students, way before the patient had been assigned to the nurse on the floor for that shift. And the charge nurse didn't assign the nurse based on if that patient would have a student, she assigned the nurse who was most appropriate for that patient. I had students working with my patients when I was still on orientation.
I've been at three different clinical sites in my state, small community hospitals and large teaching hospitals, and this is not at all we've experienced. Our instructors pick patients that they think will be good for us... Then ask the nurse assigned to them how they feel about/if it's a good patient for a student ect. And at all three locations new nurses were on orientation for at least three months and the charge nurse would absolutely not allow a new nurse she's still basically supervising to have a student. Maybe I've been to three utopia hospitals.
About the answering call lights thing, at work and clinical I answer call lights even if I don't know what is going on to the patient. If they ask for something and I can't figure out what is appropriate I will find the nurse or tech working with the patient and ask them how I am supposed to help the patient. I hear a lot of people say that they don't want to answer call lights because they don't know the patient but that seems like a simple solution to me.
That's great that you can do that. But again, we can't. It's not that I don't want to, it's that I can't.
I remembered an interesting event that occured during my clinical this semester that has relevance to the concern of answering call lights or assisting with other patients besides your own. In my clinical the students were supposed to go the day before to pick patient assignments and do all required research on said patients condition, meds, etc. We were fully aware about our patient but due to HIPPA our teacher made it a point to stress that patient information is only on a need to know basis and if it wasn't your patient you were violating HIPPA by looking at their chart or seeking information on them.
With that said, we were asked to help pass out lunch trays which we were glad to help. A classmate took a tray that was assigned to a specific patient that stated a "general diet." She knew nothing about this patient and did as she was instructed. Turns out the patient was NPO and our classmate took the fall for this error which in my opinion she had no way of knowing! Thus answering call bells, assisting patients other than your own without a bit of a rundown from the nurse is dangerous! Our instructor made our classmate sign an incident report for the hospital. It was a pretty big deal.
A lot of that could be mitigated by requiring nursing students to be CNAs first. They would already be familiar with things like NPO for NG tubes, abductor pillows and their purposes, and the importance of not getting a patient up until you are more familiar with their stability and ability to bear weight. They would also be thoroughly steeped in the idea that you need to check with the nurse first before doing a lot of things. I know the idea of requiring CNA experience before nursing school is unpopular, but it would definitely reduce problems like the ones you describe. They would also know what call lights usually sound like, and what CPR is before getting onto a floor as a student. That one really made me go .
I remembered an interesting event that occured during my clinical this semester that has relevance to the concern of answering call lights or assisting with other patients besides your own. In my clinical the students were supposed to go the day before to pick patient assignments and do all required research on said patients condition, meds, etc. We were fully aware about our patient but due to HIPPA our teacher made it a point to stress that patient information is only on a need to know basis and if it wasn't your patient you were violating HIPPA by looking at their chart or seeking information on them.
With that said, we were asked to help pass out lunch trays which we were glad to help. A classmate took a tray that was assigned to a specific patient that stated a "general diet." She knew nothing about this patient and did as she was instructed. Turns out the patient was NPO and our classmate took the fall for this error which in my opinion she had no way of knowing! Thus answering call bells, assisting patients other than your own without a bit of a rundown from the nurse is dangerous! Our instructor made our classmate sign an incident report for the hospital. It was a pretty big deal.
Food for thought!
That is quite the story; I feel bad for your classmate.
That story highlights what our nursing instructors told us about HIPAA violations and the possibility of doing something wrong with a patient who is not your patient. You don't have to be a CNA prior to nursing school to know that some patients will be NPO. We didn't have clinical the first semester. That was spent learning to do patient care (aka CNA skills). We weren't allowed on the floor until after that. (Off topic but the advice I was given prior to starting school in the Fall was do not take a CNA course in the summer. Because I was a returning student at the age of 38, my mentor told me to simply enjoy the summer off with my family because I was about to start a tough two years trying to commute 70 miles to a nursing program with 3 young children at home. Plus she said I'd be learning all the CNA skills the first semester anyway. So I took her advise - but that's another thread).
This is all on the nursing schools and the lack of instructors. I don't blame the nurses but the hospitals could be more careful about what nursing schools they allow in for clinicals.
Or it could be that all of the experienced nurses are already precepting new grads, and there's no one BUT a new nurse to work with the students.
There has actually been discussion about this with management, and what I wrote is based on those conversations. Fortunately, in our clinicals, the nurse that is assigned to the patient IS a consideration (because we all know some nurses are better with students than others!). There have definitely been times where there are no nurses without a student, but our instructor would sometimes get us to other units if there wasn't a particularly good nurse with whom to work for that day.
That is quite the story; I feel bad for your classmate.
It happens, cause if you try to defend yourself, it makes you look...defensive. I won't get into specifics cause who knows if my clinical instructor is one of ya'lls, but I had something happen in clinical that wasn't my fault and my clinical instructor brought it up with me, and I defended myself. Water down a duck's back, right? In my clinical year end evaluation, that same scenario was brought up and my jaw fell to the ground. I couldn't believe I was being chastised for defending myself. I had no idea that something seemingly so innocuous was haunting me again. And this is why floor nurse's shouldn't assume student nurses are lazy or don't want to help - there are serious consequences at hand for us.
I agree with most of what the OP says. But I have to get a "rundown" from nurses. Sometimes I'm not even able to touch the patient's chart because the nurse misplaced it in the med-room. Or is taking the chart with them. So I have to follow the nurse around while they do report with the other nurses. Where is the thanks for helping with the blood sugar level, or thank you for taking the patient's, b/p again right before their blood pressure med. Or thank you for the checking on my patient and helping me with the extra few minutes we give you to rest your feet a little. I'm happy that most of the nurses I worked with had patience with me being a nursing student. I never sat down to take a break but constantly was doing or asking to do something.
Congrats on the job straight out of nursing school:up:
Our charts are 100% computerized so that is never an issue. they sat in the break room during report (we do bedside reporting). the people she was asking about, she wasn't assigned to, however if she wanted a 'run down' she had full ability to look them up. IF they do help out (which some do) I absolutely thank them, sorry that wasn't in my post, however only a small handful of them has done that so far :/
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Ruby Vee, BSN
17 Articles; 14,051 Posts
Or it could be that all of the experienced nurses are already precepting new grads, and there's no one BUT a new nurse to work with the students.