Problems with Rn's in clinicals

mysticalwaters1 · 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

Thanks! That's it EXACTLY!

:)

caye · Mar 27, 2005

Bonnie HANG IN THERE! Not all RN's are like that. I am not. Try to remember that the nurses are shortstaffed and many are working 12 to 16 hours a day and are exausted and overly stressed.

I see all nurses as a team. Once you are a nurse I hope you will feel differently. I had one student of mine call all nurses part of a "cult". :rotfl:

:balloons: I have found a common bond and made many friends with other nurses through the years just from the fact that we are nurses and try to help each other. We want everyone to succeed.

:cheers: I wish every student out there good luck and that they be very successful with their careers. FOLLOW YOUR DREAMS!

HAPPY EASTER! :balloons:

Caye

:rotfl: Does any one else have problems with Rn's in the hospitals when attending clinicals? I guess they forget they were students once, or they think they were born a nurse. I do not understand this type of treatment. We are all in this profession to help people, and it seems like they would welcome the help. Our instruction has been a RN for 27 years and is a GREAT!! instructor. And she can not understand this either. We have all approached the nurses with great respect, and this does not work at all.
HELP :uhoh21:

irishnurse67 · Mar 29, 2005

I'm

BETSRN · Mar 29, 2005

I'm a new RN and even I can't believe the gall of some of the students. Granted, most are ABSOLUTELY WONDERFUL, but some are rude, illiterate, and lazy. I've had four-year students tell me to give them another patient b/c the patient that their instructor gave them had a colostomy and they didn't like colostomies. Who does?! I was once sitting at the nurse's station w/charts on the chair next to me and a student came up to me and very snottily said, "Would your charts mind letting me sit in that chair?" You could have just asked me to move them, honey. We have a back rm right off of the nurse's station for students, yet they insist on sitting at the nurse's station, right in front of the computers, then get pissed when we ask them POLITELY to move when we need the computers. They also frequently want a separate report and ask things that can easily be looked up. I had one student stand outside a patient's rm and yell down the hall to me that the patient was about to throw up. God forbid she hand the patient an emesis basin! I also love how some students flat out refuse to answer call lights. Or they go God knows where w/the med sheets and charts that still have orders that need to be taken off, then don't want to hand them over when we need them and then get pissed when we insist that they do.
I've had many students that I'd love to come work w/me, though. Those arethe ones that I love to help and that I know will be a great asset to their patients. Actually, this is true of the majority of students.

This gave me a huge laugh! Thanks for the chuckle!!

earthflower · Mar 29, 2005

I'll remember that the next time a BSN student sticks her nose up at me, when she finds that I "merely" have an ADN, and doesn't think that she should be assigned to any of my patients.

OMG that is completely outrageous! She will get a rude awakening when she gets out of school and treats co-workers like that. I wonder where that leaves me... I'm graduating with my LPN and plan on working in a hospital while I'm going to school for my RN. I wonder what the RN students will say about me? :rolleyes:

rach_nc_03 · Mar 29, 2005

Could you be more specific?
I personally have been rather annoyed at the latest crop of nursing students.
They want a separate report, instead of waiting to get report with their preceptor. This is completely out of line, not to mention time-consuming - time I do not have.
Sorry, I do not have time to give two separate reports in the A.M. after a 12-hour shift on a busy Med/Surg unit. Especially when it's 6:45, and I'm running around, trying to get ready to give report anyway! :angryfire
Plus, some of them have an "attitude" ~ pointing things out to me. Well, hey, if I had the luxury of being a student again and not having five other ACUTE patients, maybe I could sit around and theorize about why Patient A. acted this way...blah, blah...but thanks for pointing it out to me!

On our clinical unit this semester, half the nurses work 8- hour shifts, half work 12's. We come in at the end of an 8-hour shift. Instead of the 12-hour nurses keeping their patients, they often switch out with someone else- but this information isn't available on the assignment board, from the charge nurse- nowhere! It often takes 2 hours after shift change for anyone- students OR nurses- to get report, and I don't feel comfortable providing care when I haven't received report.

Also, there's a crop of less advanced students from another school who have clinical right before us, and they frequently leave things undone (dressing changes, meds, you name it). Many of the RN's don't check to see if these things have been done, so we come in and discover that many of the interventions that are charted as complete actually haven't been done at all. It's a communication nightmare.

It's clear to us that these nurses aren't happy where they are, have poor management, and certainly don't want students there. Sucks for them, and sucks for us, too.

dazzle256 · Mar 29, 2005

I'm a new RN and even I can't believe the gall of some of the students. Granted, most are ABSOLUTELY WONDERFUL, but some are rude, illiterate, and lazy. I've had four-year students tell me to give them another patient b/c the patient that their instructor gave them had a colostomy and they didn't like colostomies. Who does?! I was once sitting at the nurse's station w/charts on the chair next to me and a student came up to me and very snottily said, "Would your charts mind letting me sit in that chair?" You could have just asked me to move them, honey. We have a back rm right off of the nurse's station for students, yet they insist on sitting at the nurse's station, right in front of the computers, then get pissed when we ask them POLITELY to move when we need the computers. They also frequently want a separate report and ask things that can easily be looked up. I had one student stand outside a patient's rm and yell down the hall to me that the patient was about to throw up. God forbid she hand the patient an emesis basin! I also love how some students flat out refuse to answer call lights. Or they go God knows where w/the med sheets and charts that still have orders that need to be taken off, then don't want to hand them over when we need them and then get pissed when we insist that they do.
I've had many students that I'd love to come work w/me, though. Those arethe ones that I love to help and that I know will be a great asset to their patients. Actually, this is true of the majority of students.

The new grads I've had the most trouble with were the ones that went through the excellerated BSN programs.... and some of the new BSN nurses also. So what do you do when they get snotty.... sit back and watch them sink? I know thats not right either.

The ADN new grads didn't give me as much problems and to be honest I think the the ADN grads had better critical thinking skills then the new BSN nurses. Just my observation. I will say however right after posting my last post about rude new grads , I went to work and had a very pleasant helpful new grad from the accelerated program.

With all that said it still does not exuse the more experienced nurses to be rude to the new nurses.

rach_nc_03 · Mar 29, 2005

Why do you need a BP machine?
I have been a nurse for 11 years, and have generally done manual BPs. They are more accurate, and less of an infection risk.

The nurses on our clinical floor insist that we use the machines- also, there aren't any portable thermometers on the floor, so we have to lug the big dynamaps into the room, just to get a temp.

I usually take a manual BP anyway, if the cuff in the room actually works (which it usually doesn't). If not, I use my own cuff and disinfect it.

earthflower · Mar 29, 2005

I was amazed when I started readig some of the posts here (ON other threads) and then started paying more attention to what the students do when at my hospital. They do this or that but don't seem to ever be responsible for all of a pts care.

Yes, that's true. I can really see both sides of this issue. This can also be very, very frustrating to students as well. I finished up my last clinical rotation at a hospital a couple of months ago, and our clinical instructor had each of us divided into "teams" which comprised of treatment team, med team, and patient care team. So instead of getting the benefits of providing total care to a select group of patients, we had tons of different students going into and out of the poor patients' rooms all day, along with the RN who had to do anything IV since we were only LPN students. What you get is a patient care provider who only gets to give baths, toilet, and answer call lights all day long, and other people giving meds and doing treatments on a whole hall of patients they don't know anything about. Of course the nurses were getting frustrated with us since there were so many different students assigned to each patient. It really was awful. Nurses were constantly coming up to us asking simple questions that we should have been able to give a quick answer to, like "how much urine output did so-n-so have?" or "what did the drainage look like on so-n-so's dressing?" and we would have to say, "Um, I'm just the med nurse for that patient today" or "I really don't know but I can go find out for you" when of course they don't have time for you to go hunting for all the other people taking care of this one patient. Being the med nurse, we had to get the vitals ourselves for any meds that we passed, which is fine, but the patient care team were expected to get their own vitals too. I got yelled at by 2 patients who complained that someone had just gotten their vitals moments ago, and I had to calmly try to explain "Yes, but we're students, and I'm supposed to take them again because I'm giving your meds, blah blah blah".:stone Nobody likes that many people going into and out of their rooms constantly. And we finally did complain after a couple weeks of this, but were told it's "part of the 4th quarter program" and that we needed to do it that way to learn "team nursing". I'm so glad to be done with that school and out of the program! I ended up learning a lot at my preceptorship, and that taught me more about team nursing than anything at clinical did, lol.

rach_nc_03 · Mar 29, 2005

You are the first student I have "read" in a long time that is being educated the way we were way back when. I was amazed when I started readig some of the posts here (ON other threads) and then started paying more attention to what the students do when at my hospital. They do this or that but don't seem to ever be responsible for all of a pts care.
I am so glad some schools are doing it how, IMHO, is the best way!
Thank you! Glad to have heard from you.

our program is exactly the same way- we do total care for our patients. We have the choice now (our last semester) to take on 2 or 3 patients. I choose to take 2 sicker patients, some students want 3 less acute patients. We do everything needed for those patients, from shift assessments, meds and dressing changes to toileting, ambulating, etc. Sometimes this works well with the staff, but you have to learn to be assertive- some CNA's will try to make things difficult for the students; some of the RN's will send students off the floor repeatedly to hunt down dietary, linen carts, pick up blood (which is against policy), etc....even for patients to which the student isn't assigned. A few of my classmates have learned about assertiveness and prioritizing care from these types of experiences.

There was one nurse on my L&D rotation who would go around the unit and look for dirty (empty) rooms, then order the students to clean them- in a hospital with adequate housekeeping staff, and when the rooms weren't needed. (obviously, we didn't comply, and she was reprimanded by her manager.) She hated having students around, and made it miserable for everyone. But when we did our clinical evaluations, this nurse was mentioned by every student who worked with her as being rude and hostile. I found out later that her coworkers saw her the same way. When I finally got to work with one of her patients in labor and *truly* did total care, she stopped being hostile toward me.

rebeccainlv · Mar 29, 2005

From the postings, it sounds like there are a lot of issues with students in clinicals. I'm a 2nd semester BSN student doing clinicals on an IMC step down unit. My instructor is with us the entire time except the day prior when we get our patient's info for the next day. We have a team leader each week that goes to the unit and chooses the patients for each student in our group. We usually have 2 patients on IMC and we do EVERYTHING for those 2 patients. We consult the nurse or instructor when we need to, but if it's something that is easily found or can be thought out using critical thinking skills then we will be told to think about it longer. We aren't 'given' answers.

The paperwork we do for each patient consists of looking up H&P, course of treatment thus far, all meds (and know pathophys for each one as well as normal doses, classification, contraindications, side effects, nursing care, etc for each med), pathophysiology in detail for the main admission diagnosis, full head to toe assessments, all vitals, all meds, and all ADLs/personal care. I would never attempt to turn in a care plan, pathophys or med cards that I didnt' personally do. We actually have to document where we get our info.

The hospital I'm at now is 1 year old and state of the art. They don't have manual BP cuffs in the rooms and I haven't seen any portable O2 sat or thermometers. We must use the machines. No choice in the matter. We know how to do manual BPs, though.

We hang out in the dr computer room and that is where we do all of our charting. Our instructor looks at everything that we do and will ask us to re-do something if it's not spelled correctly, etc. I have had nothing but excellent, helpful instructors so far.

I have run into 1 or 2 nasty CNAs. The worst being a fiftyish lady that would cut down every student for no reason. I'm not at that hospital this rotation! I haven't really experienced nasty nurses. Not so good nurses, yes!!!

I'm just letting you all know that there are good students and good instructors out there. I always have to know 'why' and drive myself nuts until I find the answer, but rarely do I have to ask someone else. I use the education I've paid dearly for to figure it out myself. Some students think the school is too hard on us, but I know they are teaching us to be independent, thinking nurses and that is what is needed in health care.

SmilingBluEyes · Mar 29, 2005

I'm a new RN and even I can't believe the gall of some of the students. Granted, most are ABSOLUTELY WONDERFUL, but some are rude, illiterate, and lazy. I've had four-year students tell me to give them another patient b/c the patient that their instructor gave them had a colostomy and they didn't like colostomies. Who does?! I was once sitting at the nurse's station w/charts on the chair next to me and a student came up to me and very snottily said, "Would your charts mind letting me sit in that chair?" You could have just asked me to move them, honey. We have a back rm right off of the nurse's station for students, yet they insist on sitting at the nurse's station, right in front of the computers, then get pissed when we ask them POLITELY to move when we need the computers. They also frequently want a separate report and ask things that can easily be looked up. I had one student stand outside a patient's rm and yell down the hall to me that the patient was about to throw up. God forbid she hand the patient an emesis basin! I also love how some students flat out refuse to answer call lights. Or they go God knows where w/the med sheets and charts that still have orders that need to be taken off, then don't want to hand them over when we need them and then get pissed when we insist that they do.
I've had many students that I'd love to come work w/me, though. Those arethe ones that I love to help and that I know will be a great asset to their patients. Actually, this is true of the majority of students.

so what do their instructors say when you tell them these things? I would put the smackdown on anyone acting this way in the clinical area, myself. and the instructors WOULD be hearing from me.