precepting nursing students?

collegemomrn · May 28, 2006

Remember someone was your preceptor too. If we ever want to retire we need to get new blood into the practice. I always take the students when I am doing patient care. Some of the nurses I work with are not always friendly with the students and there have been complaints. I hate to see that happen. We teach everyday, patients, family members, other coworkers, why not students. They need to know that everything that we do is not perfect and does not always work the way it should. I like to teach to get over the fear of teaching.

DusktilDawn · May 28, 2006

I don't understand all the discussion. The unit has a workload. Managers and charges have to assign that work. I have never refused legitimate work assigned me by a superior and I never will. I don't go to work and expect to get paid for picking and choosing activities according to my own tastes. BTW, students have a job themselves. It's to learn. They aren't aides. They are paying for the experience. They aren't getting paid.

Being assigned a student is above and beyond what you are assigned to work. It also needs to taken into consideration the nurse's workload when a student is assigned to them, because it does increase/impact their job. The student was dumped on the OP, unfair to both the OP and the student. I don't agree with assigning students to just anybody, they need to be assigned to someone that shows the capacity of being a good mentor along with experience.

Your right, the student has a job to do and it is to learn. The role of aide/tech should also be included in their learning. They may have a job where there are no aides/techs. They can also learn a lot from an aide/tech when it comes to providing basic care.

She watched one ekg and came back to stand over my shoulder. She told me that she needed "nursing experience" not "tech" experience.

This hardly demonstrates an interest on the student's part to learn. She should know how to do an EKG, she should have been receptive enough to learn how to do an EKG, a tech may not always be around to do it. It would have been interesting to know what her definition of "nursing experience" is. In order to understand, as a nurse, what is appropriate to delegate to others requires and understanding of another's role.

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...

Dang right she requested the OP as a preceptor. She sat and watched the OP do paper work. Sounds like the student wants to pick and choose not to do "grunt work." The student didn't even want to help the one patient that need to use the commode chair, unless the OP did it with her, any guesses as to who had the honors of cleaning the poop? Sorry, from the OP's post I'm getting the impression that this student does not think nurses do "grunt work," boy, will she be in for a rude awakening.

Put a student with someone who enjoys the precepting role, and it will be a good experience for both. Put an eager to learn student with someone who enjoys mentoring and it will be an awesome experience.

anonymurse · May 28, 2006

I guess we'll have to agree to disagree.

If the hospital that pays me has committed to doing something and has passed a piece of that down to the manager who assigns a piece of that to me, then that's part of my job by definition.

It may well be that the manager has put more on me than I can handle, in which case I have a duty to communicate that fact to her as early as possible.

But as a matter of maintaining perspective, I leave it up to my boss as to exactly what aspects of my work she'll reduce to make things workable, including her option to leave the original work assignment as is.

Just my 2 cents.

cardiacRN2006, ADN, RN · May 28, 2006

I don't understand all the discussion. The unit has a workload. Managers and charges have to assign that work. I have never refused legitimate work assigned me by a superior and I never will. I don't go to work and expect to get paid for picking and choosing activities according to my own tastes. BTW, students have a job themselves. It's to learn. They aren't aides. They are paying for the experience. They aren't getting paid.

I agree with this. I know all too well that tech work is part of nurisng work. But I am paying to get my best nursing experience that I can get. I can get all the tech experience in the world at work, or if I wasn't a tech, then I could get a job as a extern. But I only can get one chance to do nursing experiences, at that is at clinical. Plus, I hated having to learn things from techs that had 9 years less experience than me and did the procedures wrong.

smk1, LPN · May 28, 2006

I agree with this. I know all too well that tech work is part of nurisng work. But I am paying to get my best nursing experience that I can get. I can get all the tech experience in the world at work, or if I wasn't a tech, then I could get a job as a extern. But I only can get one chance to do nursing experiences, at that is at clinical. Plus, I hated having to learn things from techs that had 9 years less experience than me and did the procedures wrong.

:yeahthat: Again, it isn't about getting out of "grunt" work (for most of us at least). It is about learning and getting familiar with higher level nursing functions and skills. Seeing how the nurse's day is spent, because that is the role that we are hoping to attain. There isn't any problem with doing ADL's sometimes during the day, but you can't spend all day running after call lights and missing out on observing and participating in other RN/LPN functions. The student in question was in an ER rotation, so they have certainly done LTC and med surg and done lots and lots of basic care already. There is precious little time to see and learn new things in clinical, maybe she just didn't want to miss out on anything new. - just another student perspective.

imenid37 · May 28, 2006

I hope you will consider orienting a student in the future. I can understand that you feel that you're not ready at the moment. Some of us older nurses (those who have been at it awhile-some new grads are younger than me) forget how it is to be brand new. You guys who are in your first couple of years of practice can really remember being a student, being new, etc. I think a newer nurse is often a very good fit w/ a student. There is nothing wrong w/ learning from techs, Cna's, LPN's, and other healthcare/ nursing staff. These folks do not necesarily do all of the procedures wrong. When you work as a tech, I am sure you do not do them wrong and can show others what to do correctly. As a nursing student, you can look w/ more of an eye to assesment and converse w/ pt'sduring procedures like ambulating or toileting pts. to observe them and gather data that you need. True, you are paying for a learning experience perhaps (our externs are paid) but you can make the most of the experience you find yourself in. Does this mean you should put pts. on the potty all day long? No. You can use it to gather data, assess, and make it known you'd like to see specific things, ex. central line insertion, etc.

clee1 · May 29, 2006

I don't understand all the discussion. The unit has a workload. Managers and charges have to assign that work. I have never refused legitimate work assigned me by a superior and I never will. I don't go to work and expect to get paid for picking and choosing activities according to my own tastes. BTW, students have a job themselves. It's to learn. They aren't aides. They are paying for the experience. They aren't getting paid.

Bingo! Exactly right. My NS instructors took/take great pains to point out that we are their to learn as much as we can about being a nurse; we are NOT there as unpaid facility staff. We are expected to learn as much as we can about every aspect of Nursing that we encounter and not spend VALUABLE clinical time that WE are paying for doing endless repetitions of skills we have previously mastered. Having said all of that, NO patient-care task is "below" me, and I'll do my dead-level best to help out anyway that I can any time that I can. I am currently half-way through a LPN program.

I make it a point to take a minute to talk with a newly-assigned preceptor. I tell them that "I have alot of pre-hospital experience, am a currently certified CNA and CMA, and work as a CMA at an Urgent Care Clinic where my duties exactly match those of the LPNs on staff." I go on to say that "My personal goal here today/this week is to do whatever I can to help you out with anything you need me for while simultaneously staying out of your hair; I'd appreciate it if you'd let me know if something comes up that you think I need to see/learn. I realize that the real world is totally different from nursing school. I CANNOT push IV meds under any circumstances. I am not bashful and will let you know if there is something I don't understand or don't know how to do. How can I be a help to you and not a hinderance?"

This gets three things perfectly clear from jump street: a) I am there to learn whatever they are willing to teach me; b) they don't have to worry about shepherding a nervous-nelly; and c) I really want them to be happy to have me as their assigned student, and not worried that I am going to critically judge their practice against the "perfection model" that NS teaches.

It seems to work. Of all the various units/facilities I have rotated through, most have had supervisors tell me to "come talk to me when you get your license".

I am loving this. I think I'm going to love being a nurse. Instead of being nervous about the NCLEX and being a "new" nurse, I can hardly wait!

meownsmile, BSN, RN · May 29, 2006

Somehow this thread moved to someone not wanting to do "grunt" work.

Well im sorry but if your preceptor is in there cleaning and transferring to commodes ,, so should you. You should be your preceptors shadow on a sunny afternoon. Period.

Ill go get who im precepting so i can have them help me transfer a patient. In the meantime, please dont think your clinical experiences will just be those heavy duty "nursing" issues until your graduation. Whether your a new young freshman, or a seasoned (and i say that lightly) senior you never ever get beyond "grunt" work. So lets not call it that and call it what it is,, NURSING. Remember your heirarchy of needs folks. No patient cant get well without their most BASIC needs met first.

imenid37 · May 29, 2006

I agree w/ you meowsmile. I remember working w/ a young tech about 17-18 years ago. It was on a tele floor and techs were just starting to do things beyond basic nursing care. Ours drew blood and read monitorstrips, etc. in addition to bathing, vs, and all of the basic nursing assistant duties. This guy and I were probably about the same age, but I had been a nurse for a year or two and he was still in school. We had a really heavy load of pts. and we were working together. He was making beds and ambulating pts for me. We had a monitor tech at the desk ,so he wasn't needed to read strips. About half way through the day, he complained that he would like to do some "real nursing stuff", not just washing and walking pts. Guess what I told him... That is real nursing stuff! I wonder if he became a nurse and what he does now.

bladensburg,OHrn · May 29, 2006

I am frequently in the position to work with nursing students: during their clinical rotations, for their preceptorships, and then as new graduate nurses for their orientation period. I consider this assignment as an honor, and welcome every opportunity to share nursing experiences with these folks. I provide the preceptorships and orientations as part of my position as my unit's "educator", as well as providing staff members with other education pieces. Does this mean that I know it all? By all means no. Does this mean that it is always a comfortable experience? No. But, I do believe that as nurses we are called upon to teach all the time: patients, families, stna's, the general public, etc.. So why then, is it so hard to take on a student? Here is someone, another soul, whose life and livlihood we have the chance to impact in positive ways. Someone, who one day soon, will be taking care of someone's family member, and today I have the opportunity to show them how to do it! What better way to do our part to ensure there's quality nursing care out there. Sure my day could be a little less hectic, a little more organized, or I could do a lot less talking and explaining without them. But this will pass. The rewards and fuzzy feel good feelings of sharing of oneself and our profession will last a very long time (hopefully until I get my next student!)

mandana · May 29, 2006

I am frequently in the position to work with nursing students: during their clinical rotations, for their preceptorships, and then as new graduate nurses for their orientation period. I consider this assignment as an honor, and welcome every opportunity to share nursing experiences with these folks. I provide the preceptorships and orientations as part of my position as my unit's "educator", as well as providing staff members with other education pieces. Does this mean that I know it all? By all means no. Does this mean that it is always a comfortable experience? No. But, I do believe that as nurses we are called upon to teach all the time: patients, families, stna's, the general public, etc.. So why then, is it so hard to take on a student? Here is someone, another soul, whose life and livlihood we have the chance to impact in positive ways. Someone, who one day soon, will be taking care of someone's family member, and today I have the opportunity to show them how to do it! What better way to do our part to ensure there's quality nursing care out there. Sure my day could be a little less hectic, a little more organized, or I could do a lot less talking and explaining without them. But this will pass. The rewards and fuzzy feel good feelings of sharing of oneself and our profession will last a very long time (hopefully until I get my next student!)

Well, I think I'm in love!

Preceptors with attitudes like yours just breed learning.

Thank you.

Amanda

smk1, LPN · May 29, 2006

Somehow this thread moved to someone not wanting to do "grunt" work.
Well im sorry but if your preceptor is in there cleaning and transferring to commodes ,, so should you. You should be your preceptors shadow on a sunny afternoon. Period.
Ill go get who im precepting so i can have them help me transfer a patient. In the meantime, please dont think your clinical experiences will just be those heavy duty "nursing" issues until your graduation. Whether your a new young freshman, or a seasoned (and i say that lightly) senior you never ever get beyond "grunt" work. So lets not call it that and call it what it is,, NURSING. Remember your heirarchy of needs folks. No patient cant get well without their most BASIC needs met first.

Meow, i can appreciate what you are saying, but the original example wasn't saying that the preceptor was in cleaning transferring patients to the commode. The student wanted to stay with the nurse instead of the tech. That seems reasonable as a "general" rule. As students we have precious little time to get comfortable with equipment and skills. Everybody in the RN schools out this way has to already be a CNA to be selected into the program. 1st quarter is a long term care type facility with an emphasis on a lot of assessment and ADL's. We are quite comfortable and proficient in this role at this point however when we are learning new skills in lab, we have to seek out the opportunities to practice these skills in the clinical setting. All too often the CNA's or techs on the floor think that if you are there then you always should be the one to change briefs, answer lights etc... A student is always going to get plenty of experience with baths, toileting etc... The issue is that when you have done a lot of that, you really do need to be able to spend a good portion of the day learning and practicing new skills. Doesn't mean we don't expect to "have" to answer lights anymore, just means we can't come out of these rotations having done little more than basic ADL work either. If i could be drawing up a med and giving and injection Learning how to chart a PRN narc pass, or inserting a foley observing a wound vac instead of changing 3briefs in a row...well that just really is a better use of my time and a better learning experience. The patient has to have their needs met, but there are techs that are paid for this and nursing students' primary responsibility is to learn as much as they can...not to function as an unpaid CNA. I hope people don't take this the wrong way because I can't stress enough that I don't feel "above" basic care and I am a team player, but I also have to make this clinical experience benefit me in my growth as a student nurse. Prioritization and delegation are also skills that we have to learn.