konstantine

I think it's less about being dismissive than about not adapting what you say to what it seems like the patient is actually worried about. "It doesn't bother me at all" is good for a patient cringing at the smell of a BM. The other two are pretty trite, but might have a place somewhere. If the patient seems bothered about taking your time, "This is just part of taking care of all of you. It helps me see what's going on." might work. Since you're a student, it's easy to lay that on thick. "I'm only taking care of you/I only have 2 patients! I'd be bored otherwise!" If I get a vibe that the patient likes helping be a part of teaching, I'll say something like, "Would you like to be my guinea pig so I can learn how to help out a patient without getting all of us and the floor soaking wet?" which usually makes them laugh. Sometimes just validating the patient is helpful for topicals. Just commenting on the breakdown, "Oh man that looks like it hurts, let me put this on, it'll help," takes it from embarrassing to the patient to addressing a valid medical concern, which makes it more medical and keeps the privacy boundary. A lot of the times I find I need to step back and help the patient help themselves or at least make a choice, saying something like, "Would you like me to get you some warm water and a washcloth so you can clean the front, and I'll get the back? That way I can check out the skin on your back and make sure everything looks okay." It sounds like you just need to show that you really don't mind instead of worrying about the "proper" way to say it. I'm sure that attitude will show.

I don't judge nurses assessment skills, because I certainly don't have the knowledge and experience to do so. I do feel somewhat confident that a student who can't adequately go through the motions of the listed steps on our check of sheet of a head to toe, or even help to clean an incontinent patient, is someone I would consider mediocre at best. I do admit, I have a strong bias against nursing students who are unwilling to do the "dirty work" of nursing. My definition of good for now, for me, is getting As in theory and getting good evaluations from my clinical instructors and positive comments from the nurses I work with. The only criteria I claim as mandatory are being able to go through the motions of nursing to eventually learn enough to be a good nurse, which I so far define as knowing what is and is not appropriate and necessary to the situation. Really, my goal is to NOT get into a mess of what I don't know. My original question was, what is the novice nursing student with good grades and no experience missing. I did make the title click-baity, because I wanted the perspective of everyone.

I got in as an alternate in January while missing ethics and speech with a 4.0, if that helps. For Level 1, the basic textbook is Kozier and Erb's Fundamentals of Nursing. It's difficult to recommend what to read ahead, as the reading is bits and pieces of chapters. You start with the nursing history, nursing theorists, SPC's nursing theory, and safety (infection prevention/legal and ethical issues in nursing). The best tip I have is to do lots and lots or NCLEX style questions, and study the material of whichever question you missed. Honestly, you'd do better just to enjoy your time not in the nursing program and follow the readings as assigned once in the program. Level 1 gives enough time for reading and understanding the material. I had Mrs. Morris and Dr. Clem mostly for lecture, and they were really really great at lecturing. Reading supplemented the lecture, not the other way around. Mrs. Morris's powerpoints in particular are worth saving for subsequent levels. They are really excellent at giving you the material you need to pass exams. You rank your placement in clinical sites/times in orientation, once you've already accepted your place in the program. This is where you pick day or evening and which hospital company you'll be in. It's based on your admission group rank and your ranking of choices. I was alternate 24, and got my 2nd choice, which was evenings, as I wanted. Level 1 is Monday 2-4, Tuesday and Wednesday 2-11, and Thursday 2-5 with content cafe (general review) 5-6. I spent at least an hour a day, more when assignments were due, on studying or assignments. The clinical assignments are pass/fail and takes hours and hours. It's true that evening students go through summer. I'm doing it now, and my advice for summer session would be to quit your job if at all possible, say goodbye to your family and devote everything to nursing school . In summer, the schedule is M-F, Monday is 1-10, Tuesday-Thurday is 2-11 for clinicals, and Friday is 1-4, plus a content cafe (test review ish) of 4-5. Pharmacology also requires an additional 3 hours on campus at a time of your choice on M-Th between 7-7 and F from 7-3. I spend an additional 2 hours a day AT LEAST on studying or assignments. For the weekend before a test in both semesters it's been about 5 hours just on test review each weekend day, minimum. I would say I spend the average or less amount of time studying, and I have some of the best grades in my class. It sounds dramatic, but summer in nursing school is REALLY intense and time consuming. Lots of students who got As in all their pre-reqs and in Level 1, really, truly intelligent students, have failed level 2 tests in summer. Right now, I'm wasting time before dealing with studying. Overall, the nursing program at SPC so far has been difficult, disorganized, and really, really awesome. The teachers can be frustrating, but seem to really care that you become a good nurse. Really, they can be maddening in the lack of organization, but overall, I think I'm being prepared to be a good nurse. The reviews I get from the nurses in my hospital back this up. I'm in HCA for the program and so far all of my clinicals have been at St. Pete General. I have loved every minute there. The nurses we follow are INCREDIBLE and teach us so much!!! I can't use enough exclamation points to describe how much I love SPG.

My school has us rank sites in level 1, and we're assigned sites based on rank and preference. This means that the preference between day or evening programs influences which hospital system you are in. Once we select the initial site, we remain in that hospital system for the remainder of the program. As in, you are assigned a particular HCA hospital, you stay HCA, but may rotate through the various HCA hospitals in the area. If you were initially VA, you stay VA. The hospitals in our area requested this.

This is so, so late, but I wanted to thank you all for your comments. I continued to hear the same sentiments throughout the semester, and it was discouraging. However, I also got to see lots of students and their theory grades. I saw students with good grades and good clinical practice or mediocre clinical practice, and the same with students with mediocre grades. I also saw students with good grades and an inability to perform reasonably acceptable head to toe assessments. In my totally complete expertise of experiencing level 1 and half of level 2, I think y'all are completely right. My new clinical instructors are much more balanced, and I'm feeling a little more intrinsically competent, aside from the numerous opportunities I've had to completely screw everything up :). I'll keep working on getting As in theory and getting better clinically, because if I've learned anything in the first parts of nursing school, it's that I have SO MUCH to learn. Thank y'all for giving me a huge confidence boost when I needed it, and also a reminder that grades are not all it takes to make a good nurse.

This was so helpful. Thank you for tying your personal experience in with general nursing practice. It made it easy to understand for someone with no experience!

I really do know what you mean, and that's why I feel so much guilt at the idea of not helping as much. I really am trying to be a positive presence for her, and I encourage her at every opportunity. At some point though, an honest appraisal suggests that someone who is already on academic probation and is continuing to turn in late assignments will likely not continue with me in this program. I don't think it's mean to assume someone with those characteristics is unlikely to pass this course.

This is the refrain I keep hearing from my clinical instructor and others in and around my program. What's your experience? I'm a Level 1 student. I know very well I have all of it to learn, but I don't think I'm a complete lost cause. I make good grades in class, but at every turn I hear someone telling me that good grades mean absolutely nothing to being a good nurse. Just to validate myself. I always finish my head to toe assessment by the time it's due while establishing a good rapport with my one patient (so far). I have found things during my assessment the actual nurse missed (due to the fact that I have one patient and half an hour to assess them, while the nurse has at least 5 and significantly less time to hover over the same lung spot). I've gotten feedback from the CNAs and nurses on the floor I have clinical on that I'm the one who jumps in to do anything, while many of my classmates huddle and just answer call lights. My clinical instructor has me go in the room with other students to help them with their assessments. I'm the only person in my clinical group she's let do a glucose check and lovenox injection unobserved. I'm not blind to my faults. Most obviously, I don't have experience. I still very much need someone to validate what I observe, because I'm really not sure I'm what I think I'm observing is correct, or if I'm missing something altogether. And I am most definitely missing assessment findings a real nurse catches. In addition, I struggle with time management. That's why I make the effort to get all my patient work and paper work done as early as I can to shadow a nurse as long as I can. I want to see how they organize their shift and how they deal with all the random stuff I'm not going to see with my one patient. I don't know what all goes in to being an actual nurse on a med-surg floor. Mostly, I don't know WHAT I don't know, but I really try to be aware of that and observe the nurses and ask what clues they got that made them do what they did. Really, though, I just don't see how getting good grades is going to make me a ****** nurse. Is this something people say to make people who are earning grades they wish were better feel better, or is there truth to it? I'm trying to keep my confidence up, but I hear this sentiment several times a week, and I'm really wondering what I don't even know I'm missing. In your experience, are the nurses with the highest grades in their class bad nurses when it comes to caring for real patients? If they are, what are their weaknesses, and what can those class-smart but patient-stupid do to improve?

Thank you all for giving me the validation to stop helping her so much. You've all given me a lot to think about, especially thecommuter, i think, who mentioned how giving help excessively can hinder actual nursing practice. A couple of you mentioned that she won't last, which is probably true, as she was late, again, for our test today. I'm going to try to reconcile my poor bleeding heart to setting better boundaries. Again, thank you for giving a clear, yet kind, picture of what's going on and what I need to do about it.

Hi everybody, I'm looking for some advice on dealing with another student in my class. She's a really sweet lady, and since class has started I've been helping her figure out assignments and such. She seems to really want to succeed, but really just can't seem to manage. It's not that she isn't spending time trying, but that she can't really figure anything out. As in, helping her today, she admitted she hadn't scrolled down all the way in our online course manager software (Angel, MyCourses, Blackboard, etc). She'd been working on the project for hours already. I've spent more hours helping her sort out how to do care plans, other assignments, head to toe assessments, therapeutic conversation assignments, etc. She frequently complains that she needs someone to walk her through everything so she can do it herself next time. She can't manage to get anything turned in on time. As in, we had a project due 3 weeks ago and she just now got it done, and she's just starting the project due last week. She's trying to get with Disability Resources to try and work things out. I feel very badly for her, as she seems to have very poorly managed disabilities that are impairing her ability to succeed in school. I don't mind helping, but honestly, I would never in a million years want this woman as my nurse. Maybe as a social worker or something? She's great with talking to people and has a level of compassion that's rare. I would feel very badly about abandoning her to her fate, but in all honestly I do not think she will pass the program without significant help (if at all), and I'm finding myself dreading her texts and calls. I know it'll be an hour of going over exactly what the teachers went over, again, and again, and in different words, and sending my own project so she can have an example. In addition, I'm getting the feeling that she wants to blame her failure to succeed on everything but her, which really frustrates me. We all have our different burdens to bear, and I'm dealing with a learning disability myself. Am I wrong to help eek her along? I think it'd be better if I found some way to tactfully stop being a crutch. But how do I do that tactfully, anyway? I've already identified myself as her hero (her words), unintentionally. It's not anything but really annoying to keep helping her figure out that A comes before B, so I feel bad abandoning her, but I don't think I should. Am I being ****** in wanting to stop giving her so much help? I would appreciate any advice y'all can give!