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Discussion

precepting nursing students?

I have a confession...I hate to be followed by a nursing student.

I work ER and yesterday was from hell. Started my day with a code/death. (lots of family issues, lots of paperwork) I swear I had every nursing home pt with "change in neuro status" in the valley...I was really getting my butt kicked. My charge nurse is pretty good, but she just kept loading my rooms. I had charts from one end of the dept to the other...and then she gives me a nursing student:confused: :chair: Usually one of the more experienced nurses has the students. I'm not sure why she gave me this particular student. This student had only been in the ER for a brief show and tell of where everything was. I was very nice and told her that I was going to need to catch up on paper work, but I could probably come up with some procedures for her. She said "thats ok, I will just watch you do the paper work" and proceded to sit by my side actually watching everything I wrote or typed. One of our pt's was using a commode chair every 5 minutes (or so it seemed) and the student would not help pt by herself. She would go in the room, get started and then come find me to help her. She had already had a orientation to our unit and knew where the basics were. I asked one of our tech's to let her follow her and do ekg's and blood sugars. She watched one ekg and came back to stand over my shoulder. She told me that she needed "nursing experience" not "tech" experience.

Give me some tips on how to be a better preceptor.

or...Can I ask my director that I not be used as a preceptor to nursing students? I know some nurses LOVE to have a student. I remember nursing school very well, and I remember having some wonderful preceptor nurses with me...But I am new enough in the ER that having one makes me nervous!

thoughts???

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Seems to me you should have been approached by your NM before 'here's a student, have fun.' Also sounds like the student is a bit on the immature side.

I have had several students, but was asked about it prior to being thrown into the situation. My students were all very mature, self-starting and willing to jump in without going beyond their abilities. Again, I was given a heads up and able to discuss with them what their skill level and comfort levels were first.

I have precepted several students (in my short nursing career) and enjoy it greatly. BUT I asked my CN to ask me before plopping a student next to me. There are days that I just want nothing to do with it. If you get thrown into the situation again - I always have a talk with my students. "I will find as many procedures, IV, and other interesting experiences for you as possible. But please remember you're working under my license, and I take that very seriously. If you have questions, please ask me instead of assuming. If I ask you to leave the room or do something, please do it without questioning. Don't question me/MD in front of the patient. And if you need to take a break or grab some food, let me know!"

I enjoy taking students, but all it took was 4 great kids and 1 immature one to make me start with that little speech. I say it with a smile and don't come off intimidating at all (I hope).

It may be that your student was really unsure of her skills and needed constant reassurement. Either way, don't be afraid to tell your charge you'd like to be asked before having a student.

You may not really be that confident in your job in the first place yet. Thats why it was bothering you that she watched your documentation.

You should have told her yes she did need tech experience too because thats part of nursing period. Remind them of Maslow next time that comes up.

I started to take students before my first year was up, but i also worked in the facility for years prior to my Rn completion so it was no big deal to me. If you arent quite comfortable in your position yet,, let your NM know you would prefer to wait a while longer before you take on a student.

haveing a nursing student is a big responsability- your charge should def. have asked you first (or at least given you a heads up!) and filled you in on the student's experience/competencies. that happens all the time on my floor- good morning, and btw- here's your student, have fun! personally, i see it as a sign of nurse manager disconnect when nursing students are assigned w/o warning. the manager had to have ok'd it, so clearly SHE knew ahead of time. it is just not respectful of the job that you do to add this responsability without telling you first!

hope your relationship with your student improves, maybe she'll be a little more independent once she feels comfortable in your environment, a new place can be intimidating for some.

I would ask not to have students. There were plenty of nurses where we did clinicals that didn't take students. Personally I wouldn't want to be a nurse who doesn't want to be a preceptor. I was with a preceptor during my first nursing job that hated it, hated me and it made the whole expereince horrific, I quit after 2 weeks!!

I have had a few of these, and I don't let them watch me chart unless I have something specific I wish for them to learn about charting. I can't write well with someone over my shoulder.

I take some time after getting my assignments (hard to do in ER), and make up a list of things to have my preceptor work on that day. Like, today is lung assessement day...so I wish for you to listen to as many lungs as you can (ask the other nurses and pts please before hand, and introduce yourself), and come back to me with the best set, and worse set you have heard. Then we will go over the whys and hows.

The other day it was "one on one pt care" day...I had the preceptor do more ADL type work for a patient including lotioning and what not in order to make pts feel good. Good learning experience...but at the same time I had them do a head to toe assessment during that...no steth, no machines...a head to toe assessment by using their eyes and touch on a pt! WOW did she appreciate that one! She was like "wow, I could tell so much by just observing when they talked, or moved!" The lesson I wanted her to know worked, and we discussed it afterwards! That is a great one :)!

Doppler day was fun (had to find pedal pulses on all pts), Tube and wire day (IV's/PCA's/NG/G or J tubes...you name it all were the students to do!).

I would pick something you wish for them to learn and make a day of it!

  • Author

I just spoke with my director and asked that I not be assigned students.

apparently my nursing student requested to have me as her regular preceptor for the 2 weeks she is on ER rotation. I certainly do NOT want to hurt her feelings, but I am just not comfortable teaching. Like I said, I only have a year under my belt in the ER. The student told my instructor that I was one of the first nurses who didn't just pass her off to do the grunt work...

I just accepted the compliment and declined. For some reason the thought of someone over my shoulder every shift for two weeks really makes me anxious!

Knowing that you are uncomfortable and standing by that is excellent...for the student and yourself! Hard thing to admit, but you seem to know yourself well...and I say stick with the declination!

I just spoke with my director and asked that I not be assigned students.

apparently my nursing student requested to have me as her regular preceptor for the 2 weeks she is on ER rotation. I certainly do NOT want to hurt her feelings, but I am just not comfortable teaching. Like I said, I only have a year under my belt in the ER. The student told my instructor that I was one of the first nurses who didn't just pass her off to do the grunt work...

I just accepted the compliment and declined. For some reason the thought of someone over my shoulder every shift for two weeks really makes me anxious!

give it some thought though- the fact that the student said you did things differently than all the other nurses she was with sticks out for me, maybe you are better at teaching than you think...

the first time i had an orientee i was nervous as heck. just something to consider. by all means wait until you're ready- it's great that your management allows you to do so.

I would ask not to have students. There were plenty of nurses where we did clinicals that didn't take students. Personally I wouldn't want to be a nurse who doesn't want to be a preceptor. I was with a preceptor during my first nursing job that hated it, hated me and it made the whole expereince horrific, I quit after 2 weeks!!

I respect the nurse who will say that she doesn't want a nursing student today more than the nurse who rolls her eyes and huffs as she take me and then ignores me all day. Have the guts to say "no thanks"-we'd all feel better.

Knowing that you are uncomfortable and standing by that is excellent...for the student and yourself! Hard thing to admit, but you seem to know yourself well...and I say stick with the declination!
I agree.

I absolutely LOVED my preceptor - couldn't have asked for a better one :)

And I love to teach - as a Senior, we had days when we were supposed to 'teach' the Juniors. I loved that, my Juniors loved me, and my professor said I had a definite 'knack' for it - heck, I might go back and teach as faculty someday :p

I have been in L&D for a little over a year now and when a request went up for preceptors for the summer nurse externs, I signed up and was turned down:uhoh3:

So when we were told at staff meeting last week that we are getting 17 new grads between now and July I spoke up and asked who would be their preceptors. Only some of us have gone to coach class (I was not asked).

I was frank and told my NM that while I could have handled an extern with my years of experience in Med/Surg etc. and could cover all the basics of all kinds of nursing care with students I was absolutely not interested in trying to train new employees. I still have to hit the P&P's at least once a week for myself.

Her response was that everyone would be expected to pick up a new employee for a day or two here or there when assigned preceptors might not be available.

What a load of crap. Not just a new grad to teach, but a new grad with whom you are unfamiliar and you don't know what their experience is.

In my 12 hour shift, how will I have enough time to plumb the depths of what I can expect from a new grad? And pick up a full pt load of high risk antepartum/labors too?

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