Problems with Rn's in clinicals

caroladybelle, BSN, RN · Mar 26, 2005

Why that sounds just like the externship that I had.....and it is still called a job...and still limits what you do...and your purpose is to work, with a secondary goal of "valuable job experience".

You know "valuable job experience" , like every other career/profession generally requires.

Tech work does teach you a great deal about Nursing....if you are willing to learn it.

mariedoreen · Mar 26, 2005

Well, let's see. Did you pay tuition money for this "externship" and was there a clinical instructor present while you were performing it? Or did you get paid for doing this "externship"?
If you got paid for this "externship" then it is called a JOB and if you do not have a license, then guess what! The work that you will be doing will probably be that of an aide.
Now, if you paid money and your clinical instructor was there to legally cover you with her license, then you have a grievance.
Because until you have a license in your hand, you cannot perform the actions of a nurse. And any nurse that lets you do more than tech work is violating the patient's rights. Not to mention, taking a big risk with her license.
And, in addition, WHAT IS WRONG WITH TECH WORK? If you are a good and caring nurse, you are going to be doing a heck of a lot of tech work in your career. If you have a problem with that, then Nursing is probably not going to be very satisfying to you.

Lol, I don't disagree with your message (or any of the others that you posted on this thread) but in defense of those you're responding to I have to say that your tone is continually a tad HOSTILE. You almost sound like one of the nurses to whom the OP is referring

(Time to duck and cover now..............)

webblarsk · Mar 26, 2005

Last week I assesed my patient, took vitals, got my meds ready and then got my instructor. My patients b/p med was dependent on one med and I got 90/62. The machine was used by the Aide just after me and it showed 82/60. The patients med was to be held if the sbp was below 90. My instructor told me that because 'my' reading was so close we'd take it again but my nurse had told me to hold the med. We took it again and I read 90/58 and my instructor told me I should be giving that med. My instructor (who works full time as an educator at this particular hospital and just part time teaching clinicals for the school) went and asked the nurse again and she said No..hold the medication. The machine read the pressure too low. I can tell you that my instructor returned to me, muttering under her breath and told me we were holding it because of the nurse and to note exactly what the pressure was. She repeated to me what I had already knew from working as an aide myself.....manuals are much more accurate!

I think I would have held the med myself, JMO. If it was 90/62 and your giving a BP med, man I would think it would bottom out and I wouldn't want to be responsible for that.

mysticalwaters1 · Mar 26, 2005

Why that sounds just like the externship that I had.....and it is still called a job...and still limits what you do...and your purpose is to work, with a secondary goal of "valuable job experience".
You know "valuable job experience" , like every other career/profession generally requires.
Tech work does teach you a great deal about Nursing....if you are willing to learn it.

Why are you snapping back like i offened you when I have done nothing wrong or said anything that puts down techs or experience? Ok YES internships/externships are JOBS. Yeah your point? It seems you think i'm being snotty is that it? That I feel it's a "higher" position? It isn't. It's just a SPECIFIC job that allows you to work ONE TO ONE with a nurse and learn from that nurse. You do tech work but just not all tech work as my experience ended up being since they were too short staff to even show me ANY nursing procedures at all! In a real externship you are paired with a nurse. My point was informing others about externship programs to become more efficient with school and trying to learn the full range of nursing for a summer as promised but was just mislead and not offered the full scope as indicated in their recruitment process. You're telling me you'd take it as it is and that's the end of it or such a program isn't good? I don't understand where you're coming from.

I don't want to offend anyone I really am just talking about different experiences for students. I took the experience and am grateful I got some experience but I am just stating I was mislead and didn't get what was promised (which I guess happens a lot) and warning others if they need an externship make sure it specifically states it and make sure it is one to one with a nurse. Make sure it's designed for you to be one to one with someone the entire time. As a result of me telling the recruiters this their brochure was changed and less indicative of an externship. It was more specific. Oh and externs/interns work under the liscence of that preceptor. So maybe where you're from it's different requirments and you are ONE to one with a RN so I don't understand the negativity toward trying to learn more experience that is not offered fully in some nursing programs instead of thrown on the unit. My internship helped me pull everything together and gain more experiece at the bedside and an externship would have helped as well.

mysticalwaters1 · Mar 26, 2005

The externship at the hosptal i work at DOES have an externship program that is designed for experience as the primary goal. The idea is they want to recruit that student when they graduate which happens. As a result of working for school credits through an internship i did obtain a position at the hospital. See my hosptial is a small community hospital although expanding the hospital i chose to do a program that explained working with a nurse at a specific "teaching hospital." I thought i'd get more clinical experience of Tech actions and nursing actions. It wasn't so I'm warning others to ask questions and really investigate what each program is.

lee1 · Mar 26, 2005

Just a question??? Did you know that in some hospitals, including mine, that the techs are not taught how to take a manual B/P and rely exclusively on a Dinemap machine or whatever your unit calls it. Also the trend in some hospitals is for the patients to have their own disposable B/P cuff that is used exclusively for them while they are a patient.

Now, hopefully the "machines" are checked periodically by biomed and those that seem to be functioning poorly are gotten rid of.

I can only say that as a critical care nurse we always checked a machine B/P that was abnormal with a manual B/P machine, but now it seems they are becoming harder to find.

What trends have you found in your hospitals??

What ratios are you seeing also-----ratio of RN/pt, techs/pt, etc.?

Are they telemetry patients or strictly med/surg without telemetry? Some states have mandates on telemetry patients as to ratios that cannot be exceeded.

LPNer · Mar 26, 2005

Just a question??? Did you know that in some hospitals, including mine, that the techs are not taught how to take a manual B/P and rely exclusively on a Dinemap machine or whatever your unit calls it. Also the trend in some hospitals is for the patients to have their own disposable B/P cuff that is used exclusively for them while they are a patient.
Now, hopefully the "machines" are checked periodically by biomed and those that seem to be functioning poorly are gotten rid of.
I can only say that as a critical care nurse we always checked a machine B/P that was abnormal with a manual B/P machine, but now it seems they are becoming harder to find.
What trends have you found in your hospitals??
What ratios are you seeing also-----ratio of RN/pt, techs/pt, etc.?
Are they telemetry patients or strictly med/surg without telemetry? Some states have mandates on telemetry patients as to ratios that cannot be exceeded.

To tell you the truth, I don't know if our Aides know how o take a manual B/P. If I don't think what they gave me is accurate, I go take it manually. I also take it manually if it is very high or low for what I expected, or just to double check.

Makes ya kind of wonder. None of our aides have stethescopes, so s/he would need one to take a B/P manually, I don't let anybody use my ears!

mysticalwaters1 · Mar 26, 2005

Here this is a better description of an externship and what I thought i bought into and was not. I can't remember if they passed meds I think not but i know there was charting. If anything they practice and the preceptor oversees I'm telling you it is not illegal stuff going on and only helps train nursing students. I'm telling people I was preparing a summer to prepare for med surg nursing and this program was reccomended and you are paid but many expect you to work for them: http://www.sleh.com/sleh/Section004/index.cfm?pagename=Nursing+-+Education&PageMD=CAREERS&objectid=D2058B57-D2CC-11D5-A7D400B0D06875AD

caroladybelle, BSN, RN · Mar 26, 2005

My issue is with the complaints with your "valuable job experience".

As long as your are not doing specified Nursing tasks, then it is okay. But you really shouldn't go into a paid job, thinking that it is just part of school and not expecting that "Tech work" is not going to be the main part of it. Because that is what you are legally qualified to do.

You got a valuable reference, money and hopefully have learned how to balance your time and do many of the tasks, that you can legally do. What more did you expect from the facility?

LPNer · Mar 26, 2005

My issue is with the complaints with your "valuable job experience".
As long as your are not doing specified Nursing tasks, then it is okay. But you really shouldn't go into a paid job, thinking that it is just part of school and not expecting that "Tech work" is not going to be the main part of it. Because that is what you are legally qualified to do.
You got a valuable reference, money and hopefully have learned how to balance your time and do many of the tasks, that you can legally do. What more did you expect from the facility?

I can't help but add that just becuase your responsibility is for "tech work" it does not mean that you can not continue your education concerning nursing duties. Just because you are not hanging that IV or regulating it, does not mean that you can not study up on why this particular pt is getting that solution at that rate, etc. Take this time to learn, not just perform tasks.

mysticalwaters1 · Mar 27, 2005

My issue is with the complaints with your "valuable job experience".
As long as your are not doing specified Nursing tasks, then it is okay. But you really shouldn't go into a paid job, thinking that it is just part of school and not expecting that "Tech work" is not going to be the main part of it. Because that is what you are legally qualified to do.
You got a valuable reference, money and hopefully have learned how to balance your time and do many of the tasks, that you can legally do. What more did you expect from the facility?

Well I went into it as an educational experience which i did get but not as I felt described as my duties. I meant it for learning specifically how a nurse acts and thinks hence why i wanted one to one preceptor and if you look at the link i provided before that's EXACTLY what an externship is and what I expected from the facility and I found out that the other hospitals i looked into had it. I went witht he teaching hospital thinking that is exactly the type of atmosphere and it wasn't because that was not the program. And the nurses were too busy to tell me things ok I helped with 2 wound care pts and that was alright but not as if it was setup like the link I provided. It's more of a teaching precepting program that's all i'm getting. I selected the wrong thing it was not exactly like this but very similiar which is what upset me because it was a trick THAT is why i'm upset. Not with the tech work it was great experience i got to do blood draws but that it was designed to bring you in and made it sound as an externship when it wasn't that's all. I'm more upset at being mislead. Really i won't mention the hospital but the link I applied in previous post competes with several hospitals in the area and is treated as a very respected hosptal that they aren't setting up to the standards of other hospitals to help teach students. It's not the hospitals responsibility but if you can find a program and get PAID it's awesome experience. Please! I don't shove all the dirty work away if anything i take on too much which is another issue altogether which seems to be what some thought from my statement. NOt at all. Ok I'll stop now i keep the thread going ok bye.

KrisRNwannabe · Mar 27, 2005

Mystical, I understand what you are saying. I too would be upset if I had applied to be an extern and ended up missing out on that portion of the job. WHile i don't disagree that the CNA portion of the job is critical to learn, we spend enormous amounts of time in school doing this job. The purpose of an externship is to give the nursing student more practice doing nursing procedures such as wound dressings and the like. around here externs even get to pass meds. being an extern and being a CNA are two different jobs and i don't blame you for being upset if you didn't get what you signed up for.

Kris