Preceptorship: My Nursing Student Didn't Take Me Seriously Because of My Age

[HalfBoiled, BSN, RN]

I graduated and became a licensed RN at the age of 21. I started working a med/surg floor just a few months later. I'll post detail of my student pathway in the comments.

After I just reached my one year mark working in my unit, I was given a student to assist caring for a patient with a small bowel obstruction.

The issues with my student follows (no particular order)...

1) Pt had a mediport and MD allowed to access because of multiple electrolyte infusions. I informed student what I was going to do. He thought a mediport was a brand name needle for a peripheral IV and wanted to insert himself for more practice. I explained the difference between a central and peripheral IV, but he insisted to insert. I asked the instructor if it was in his scope of practice and, of course, it wasn't

2) I inserted an NGT for my patient. I called for xray to verify placement prior to leaving for lunch. I returned, did rounds for my other 4 patients and came back to my students and patient. During this time, my break relief informed that the student walked the patient around the hallway. When they returned, the NGT was out and I ask why I wasn't informed immediately. His response was, "She sneezed it out. You weren't here. I told my instructor. I figured she would have told you."

3) My patient was pain management around the clock and my student attempted to advocate for pain medications. I praised for his assessment. I asked him to take vital signs and report the respiratory rate and O2 sat. IT WAS 9 and 87% I rechecked and it was still 9. I questioned the student what was a common clinical side effect of opioids. He confidentially said "Addiction." I corrected that it was not pertinent to the current situation and I explained respiratory depression. He was adamant that addiction was correct and went to his instructor to validate. I was right.

4) I tried to explain that an IVF Normal Saline bolus and IVPB of anything does not infuse simultaneously and we would require a second IV pump. He still didn't understand and asked for clarification with his instructor. The instructor said verbatim of what I said including the use of a y-port.

5) Student saw my patient's K+ 3.3 and immediately gave orange juice. I explained it wouldn't bring up the K level compared to IVF and I asked if he was mixing it up with blood glucose levels. He didn't understand went straight to his instructor before I could explain.

6) The clinical instructor wanted the student to practice hanging IVPBs. I informed the student that we will be hanging K+ replacements. We met in the patient's room and I sat the supplies down on the clean bedside table. Before I could verify/scan patient identity, my student started opening IV tubes from the packages and was about to pike the potassium back and I firmly told him to stop. He dropped everything and said "fine." I explained, that I need to perform the 5 rights (there are probably more) of medication administration. We completed the task and he stormed off.

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The instructor found out that the student (while walking to his car) openly admitted to his classmates he couldn't take someone who was younger than him seriously. He got wind of my age from his classmates. Per the instructor, this student had a health care work history (non-nursing) and the program was just a filler until he can apply to medical school.

In the end, no patient harm was done. I understand what it was like to be a nursing student and I stayed patient. I always educate and make sure my students are always safe in any patient interaction. I took theses small circumstances as teaching points for any nursing student having a rotation for my unit.

[HalfBoiled, BSN, RN]

I was two years ahead in high school graduating at the age of 16.

I finished my nursing pre-reqs within two years and got accepted to a local state college nursing program (BSN) at 18.

I graduated nursing school, passed my NCLEX, and was hired at 21. (Very emotional year).

[mmc51264, BSN, MSN, RN]

You did all the right things and sound very professional in all that you did. You are to be commended. I have the opposite problem. I was a new nurse at 48 so on the unit, there are pts that think because I am old, I have been a nurse for a long time and pts don't take some of the 25 year-old nurses very seriously when there isn't a whole lot of difference in experience level.

I'm glad the instructor validated your concerns. It was probably a rough pill for your student (no pun intended) to have a younger, and a female, person more experienced than he and he was not able to bully you into letting him make a huge mistake (several, it sounds like!)

[FolksBtrippin, BSN, RN]

You did great. Students were lucky to have you.

I was 40 years old and in clinicals. If I didn't take people seriously who were younger than me.... Well I would have taken few people seriously.

I love that he got busted and apologized.

You win.

[pixierose, BSN, RN]

I was 39 when I went back to school.

I would have been lucky to have you. You sound like an incredible nurse, both as a nurse to shadow and as a coworker now.

What an orifice.

[nursel56]

You did great, as did his instructor. He sounds scary. For the sake of his future patients, I hope he had a major attitude adjustment. :-[

[BSNbeauty, BSN, RN]

How would anyone know your age if you didn't tell them ?

[NightNerd, MSN, RN]

Wow, does THAT guy have a bright future ahead of him. You did a great job, OP; it's a shame the student didn't take advantage of this opportunity to learn from you. His loss.

[iluvivt, BSN, RN]

Although you were younger than he was he was more immature. His poor little ego could not handle the fact that a younger person and a female knew more than he did. He did not know his place and was out of line and behaved badly!

[Jory, MSN, APRN, CNM]

I was in my 30's when I started nursing school. I didn't give a rat's behind about the age of my preceptors. He has the wrong attitude. My attitude is if someone had something to teach me, my job was to learn it.

One of the best preceptors I had at my first job was only two years out of school herself, but she could work circles around many senior nurses. She had some mad skills. Anytime I had the opportunity to work with her I did.

If he is going to keep playing tattletale I would see if you can refuse to have him back as a student. He has a chip on his shoulder and the most unsafe student is the one that thinks they already know everything and they'll carry that attitude into their work if they ever get a job and start practicing.

[Horseshoe, BSN, RN]

FolksBtrippin said:

You did great. Students were lucky to have you.

I was 40 years old and in clinicals. If I didn't take people seriously who were younger than me.... Well I would have taken few people seriously.

I love that he got busted and apologized.

You win.

It doesn't sound like the student apologized; the clinical instructor apologized for the behavior of her student. At least that's how I read it.

[tara07733]

Horseshoe said:

It doesn't sound like the student apologized; the clinical instructor apologized for the behavior of her student. At least that's how I read it.

Yes, that's exactly what happened.

I mean, can you imagine going to a department as a student nurse and actually debating with the practicing nurse about MULTIPLE treatments?!! One of the craziest things I've ever heard . Just last week I was shadowing a nurse that I'm sure I had a good 10+ years on (age) and I was all ears and deferred to her on EVERYTHING.