karenbear

I worked in the ICU float pool while I was pregnant with my first. I signed up for FMLA pretty much as soon as I found out. That was I could call in sick if I needed to and the facility couldn't hold it against me. That being said, I did not use it all that much. I did ok for the first 33 weeks or so and then I started getting a lot more tired so I cut back to 8 hr shifts for the rest of my time. A couple things that I did that helped were drinking vast quantities of water each day (3-5 liters), I brought along a small portable snack (cheese cubes, peanut butter, etc) to eat a couple hours after my shift started and a few hours after lunch. I found keeping my blood glucose stable made my night easier. And I took breaks. I don't know what state you are in but you should be allowed some breaks. I had a couple nights where the unit I was on used and abused me for the night (i.e. 700 lb woman with a K of 7 and they gave her KayExalate at 1815. No help available per charge nurse). The nights I had like that I would usually call in the next night so I could keep my feet up. My second pregnancy I had breast cancer and went through six rounds of chemo before delivery so it was obviously a little different. I still worked some shifts in the units. Both my boys are healthy, mostly happy and the light of my life!

According to what I've been able to decipher from the legal speak that is our nurse practice act, a student nurse is held to the same standards of care as any other licensed person. The critical part if the equation is in the delegation of tasks. The student is responsible for saying, "I'm not experienced enough to do this" and the nurse or instructor has to only delegate tasks that the student is competent to perform. I agree that students need to learn, but not at the expense of the patient. My husband is an airline pilot and I was with him the first time he flew and landed his new airplane. I bet the other 75 passengers would have been a little nervous if they had known their captain had never flown the plane for real (just in the simulator). My point is that everyone has to learn but we have to have some systems in place to ensure that our patients don't suffer because some nursing student (and this is the exception not the rule) isn't willing to say they don't know how to do something. I also think that our patients expect, when they are introduced to a student nurse, to see an instructor or preceptor. If you knew a new pilot was flying your plane I bet you'd want someone watching over what he's doing!! I think that as students progress through their clinicals they should be allowed more responsibility but until you have your own license mine is the one responsible for the patient. I know I'll offend someone with this statement...this is just my experience. I have worked with a lot of nursing students and new graduates who have a lot of, let's call it confidence. Some times it's a little misplaced. I really was joking about not being able to breathe on the patient without an instructor but we did have to write out out assessment on a piece of paper and have the instructor check it before we wrote on the permanent record. There are a lot of factors in play and it's been interesting ready what other hospitals allow/don't allow

I understand the need to learn and want to facilitate that as much as possible, but I also want to make sure the hospital is protected from a legal stand-point. I've been doing some researching on the BON site but haven't found a lot of specifics yet. We have a variety of ways we could allow student nurses to see the information in our system. Right now they have the same access as an RN and just have "NS" at the end of the name to designate they are students. They currently each get their own login for pyxis so they could pull out meds but we are trying to determine if they should each get a badge for scanning/documenting meds given or not. If your instructor is scanning her badge and then leaving and allowing you to administer meds is she/he not in essence saying that they gave the medications? I'm not sure I'd want that on my license. I agree that the setup and education of all students is A LOT of work that most people probably don't understand. At our facility the spreadsheet with names first goes to someone who creates unique id's for all of them and then goes to my team for access to online documentation. It can take quite a bit of time to set everyone up. We also have to set up residents, nurse aide students, pharmacy students, etc. The taking people OUT of our system is actually the bigger issue from a security stand-point. We also see errors created in our system due to lack of training for the students. Not sure what all the answers are but I appreciate all the comments and feedback!

I just started working with Information Services at my hospital. We've been using computer charting for most units and will be going live for the rest in a few weeks. We have just (in the past 6 months) moved to a scan medication/patient/nurse system for medication administration. So, I am on a group that is trying to figure out a good policy for nursing students (in light of our "new" computer systems)-should they be allowed full access to all charting (which is what they get right now-just have NS at the end of their name) and the medication administration system? What is your hospital policy on this subject? I remember when I was in nursing school I wasn't allowed to breathe in the same room as a patient unless my instructor or another RN was around but I'm old so maybe times have changed! Thanks!

We use coin envelopes for passing meds and it has worked well for us for the past few summers. The outside of the envelope is labeled with the campers name, cabin number, counselor name and medications that are in the envelope (we use a different envelope for each med time) and then clip it shut with a paper clip. We can use the same envelope all week. You can get a big box of them at any office supply store.