Problems with Rn's in clinicals

VanillaPalamino · Mar 25, 2005

I guess my biggest problem with the RNs we had to deal with this semester is the disappearing act.

This doesn't apply to me ~ I am going off when the students are coming on.

We do not get separate reports, that would be senseless.

I agree with you ~ it IS senseless. That's why, if it happens AGAIN, I am going to POLITELY answer any GENERAL questions the student nurse may have and then ask them to wait until I give report.

I am glad to see students on the floor. Unfortunately, they are on day shift, so I don't get to interact with them. I wish I DID. I just found it annoying the other morning, because it was already chaotic on the floor, and all these students wanting to know how so-and-so was doing (in essence, wanting report), was distracting and irritating because I couldn't answer their questions. I had patients to take care of.

Yes I know students need to learn, but can't they SEE when someone is very, very BUSY?

Evidently I am going to have to tell them to wait for report. But I do like them being there, I just don't want to have to report off twice!!

LPN1974, LPN · Mar 25, 2005

This doesn't apply to me ~ I am going off when the students are coming on.
I agree with you ~ it IS senseless. That's why, if it happens AGAIN, I am going to POLITELY answer any GENERAL questions the student nurse may have and then ask them to wait until I give report.
I am glad to see students on the floor. Unfortunately, they are on day shift, so I don't get to interact with them. I wish I DID. I just found it annoying the other morning, because it was already chaotic on the floor, and all these students wanting to know how so-and-so was doing (in essence, wanting report), was distracting and irritating because I couldn't answer their questions. I had patients to take care of.
Yes I know students need to learn, but can't they SEE when someone is very, very BUSY?
Evidently I am going to have to tell them to wait for report. But I do like them being there, I just don't want to have to report off twice!!

I don't understand why the students are not there to get report when YOU do, or at shift change, whenever that is. Wouldn't that take care of some of their questions?

VanillaPalamino · Mar 25, 2005

They are coming in BEFORE the day shift RNs are even on the floor.

They come on before we even give report and start asking questions while I am trying to give 7 a.m. insulins and such.

I am busy enough trying to get everything together to give a prompt report.

Their questions just throw me further behind.

LPN1974, LPN · Mar 25, 2005

They are coming in BEFORE the day shift RNs are even on the floor.
They come on before we even give report and start asking questions while I am trying to give 7 a.m. insulins and such.
I am busy enough trying to get everything together to give a prompt report.
Their questions just throw me further behind.

I see now what you mean.

That is a very busy time of morning.

I worked in a LTC on the nightshift and had to do all the early am ac breakfast meds, and the insulins. Very busy time.

VanillaPalamino · Mar 25, 2005

And this particular morning, there were some unexpected things that came up that threw me further behind.

I don't condone RNs being nasty to students; on the other hand, I think STUDENTS need to use some tact and sensitivity.

If a nurse is PLAINLY VERY BUSY, please wait until she is giving report to pepper her with questions!

RN4ustat, BSN, RN · Mar 25, 2005

I can sympathize. When I was a student, there was a seasoned nurse who complained to our instructor that we asked too many questions. And my very own preceptor had the same attitude. We sat down to take report on my first day on the floor with her, she looked at me and said "I promised myself I'd be nice to you today".

I am usually very happy to have students on our unit but I was pretty disgusted with one we had the other day. I walked up to the desk to check for orders to note and she was sitting on the desk with her shoes off text messaging her friends on her cell phone. We asked her to get down and informed her that wasn't appropriate or professional. If I had seen her instructor, I would have visited with her about it as well, but she never came to the floor. Do instructors still go to the clinical settings with students??

KrisRNwannabe · Mar 25, 2005

We come on the floor at 6:30. report starts at 7:05. we go to report with everyone else. I agree that students shouldn't be bugging nurses while they are busy. they should go to report with everyone else. it is a good place to learn. we usually start pulling meds until report starts, since the med room get very busy with nurses and students trying to pull 8:00 meds. I would notify the instructor and let them know the students need to come to report with everyone. tell them it is disruptive and repetitive to give it twice.

Haunted · Mar 25, 2005

I am really sorry to hear that you are being treated like an indentured servant while you are in clinicals. As an RN, I am happy to have students and here in So Cal we have ratios in place which affords me more time to spend with my patients, and with the students.

You are on my unit to observe, learn and practice your nursing modules under the supervision primarily of your instructor and ultimately by the nurse you are working with, hopefully it's me! You are not there to fetch coffee for me, do me "favors" or "keep an eye on X,Y or Z" while I run to the bathroom. If you can grab a set of vitals for me on our patient, or pull up a lab and review it before we give that potassium chloride, it saves us both a lot of time, and you are also placed in a position to delegate to the nurses aid a task if you see something else as a higher priority.

You are learning a lot about everyone's job descriptions, responsibilities and obligations to the operation of the unit. Some of us do jump in and help the nurse aid with their task, some of us don't. I don't question them, I just know I like to be there to assist with a bed bath or when the CNA is ambulating the patient. It's not that I don't trust the CNA's observations, but I can add my own perspective to what I see and how the patient tolerates these treatments.

Keep a thick skin sweety, if I am ever lucky enough to work with students, I always assure them that I will never, ever ask them to do anything to a patient that would put any of us in jeopardy. Learning is an ongoing process, and some students can be overwhelmed with the expectations thrust upon them.

dazzle256 · Mar 25, 2005

Could you be more specific?
I personally have been rather annoyed at the latest crop of nursing students.

I've noticed the same thing. I wasn't going to say anything because I'm sure all aren't that way but lately the new grads I personally have had to work with and nursing students haven't been like they were just a few years ago. New grads and students were always my favorite to work with......always so willing to learn and helpful. Not this last year I don't know what it is.

LPNer · Mar 25, 2005

I've noticed the same thing. I wasn't going to say anything because I'm sure all aren't that way but lately the new grads I personally have had to work with and nursing students haven't been like they were just a few years ago. New grads and students were always my favorite to work with......always so willing to learn and helpful. Not this last year I don't know what it is.

What really irritates me is the way the young ones slaughter the English language, and this includes the BSN students, not just the LPN students. (We get both from different schools.)

flashpoint · Mar 25, 2005

When I was an LPN student, we were assigned between 1 and 3 patients depending on where we were in our rotation. We total care for our patients...everything from bed and baths to meds to assessments and everything in between. CNAs were not allowed to do our patients' beds, baths, vitals, etc. We did all documentation (after writing it in our notebooks for instructor approval). We had to write a one page report on each patient's three most pertinent diagnosis. We had to do a med card on all medications that each patient was on. If we didn't understand a diagnosis, procedure, or whatever, our school had a library of books that we could pour through until we did understand it.

In report, we were not given the preprinted report sheets that the staff nurses were...we had to listen carefully and learned to quickly sort out what we needed to write down and what was just FYI. If there were not enough chairs for everyone, the students stood...our instructor did not allow us to lean against a wall or counter while we stood in report.

Now...students at the school I went to print their med information off the internet...a lot of them turn in a printout from the internet for their patient's diagnosis as well. They are allowed to use computer generated care plans...those didn't even exist when I was in school! :) In report, they are given the preprinted report sheets and there will be hell to pay from the instructor if we don't make enough copies for them! Students come in 45 minutes before staff gets there and sits around the report table before most of our staff arrives...staff who don't fit at the table stand around the room or sit on the floor to take report.

What a change from 15 years ago! It scares me to think that they are getting so much information from the internet and are simply allowed to print it out. Hopefully they are reading everything...they could learn and retain so much more if they actually had to look it up and write it out. And taking the chairs at the table in report...that just burns my biscuits! I am amazed that there are not enough chairs in the first place, but more than that, I am angry that students who are going to be there for 4 hours less than the staff are being allowed to sit comfortably while staff either stands, sits on the floor, or crowds two people onto one folding chair. I don't think the students should be abused or picked on, but I honestly do beleive that staff should come first.

On a positive note...from what I have seen, most of our students do give very good care...their patients are always clean and dry, rooms are neat, etc...

Tony35NYC · Mar 26, 2005

I am an RN student and nurse intern so I can see this issue from both sides. If I were the RN I would probably be annoyed, too, if a different student is coming up to me every few minutes with questions. Its not easy for the nurse to keep up with taking care of the patients, charting, plus putting up with the physician's bad attitudes, b*tchy relatives, and the constant changes that are going on with pharmacy, new orders, respiratory, discharges, new admits, etc., and its worse if morale at the hospital is low.

I try to get a good handle on what's going on with my patient assignments when I go the day before to pick them up at the hospital. I read as much of the chart as I reasonably can, and I look up all the diagnoses, complications, meds, recent surgeries, etc before I even come to clinical. That way when I approach the nurse for report I'm not asking a lot of questions about things that are already clearly stated in the chart. I don't have problems with the RNs in clinical because I always approach them with the attitude that I am there to help THEM, even moreso than the patient, and most of the ones I've worked with really appreciate the help. Even the few nurses who start out with an attitude soften up once they realize that you are really there to work and to gain experience. Besides, what you're doing for their patients easily cuts at least 1/3 off their work load.

We are expected to do total patient care on every patient assignment we get in clinical and I always say this to the nurse during report: "Hi, I'm Tony, and I'll be assisting you today with care of patient so-and-so in room so-and-so. I'll be doing vital signs, meds, basic head-to-toe assessment, grooming, toileting, and hygiene, and assistance with meals. If there's anything else that I can assist with please let me know." How can they not LOVE you after a line like that? Works like a charm for me every single time!

As for the blood pressure issue, we were taught to always use a manual one if it is available because it is more accurate.