Preceptorship: My Nursing Student Didn't Take Me Seriously Because of My Age
I wasn't planning on posting my encounter with this student I had a semester ago. Until the student's clinical instructor returned to my unit the following semester. I was pulled aside and was given a formal apology for the behavior of said student.
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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.
