Question about student nurses

[shortNsweetRN]

Is it a rule/law that as an RN you must deal with student nurses taking part of your assignment?

Are the students working under my license or their instructors?

If the patients are still assigned to me as an employee of the facility, in the end is the patient still my responsibility, including everything the student does/does not do?

Don't get me wrong, I normally love students and love to teach motivated students. But as an RN assigned to 14+ patients on a rehabilitation unit, It is all I can do to get my own work done. When I have to oversee the 4-6 student nurses that are assigned to my patients and the instructor it is more then overwhelming. The instructor doesn't know anything about passing medications or doing dressing changes, and its concerning to me thinking that all of this is going on under my license/as my responsibility. Someone please help

[JBudd, MSN]

Triquee, I got that :)

What I was trying to say, is that the CI has that many students there, and since the OP has 14+ patients, there is no way to not have multiple students assigned amoung them. She should not have to be supervising that many giving meds, in fact, the CI should be the only one supervising students giving meds. Which would IMO only be 1 or 2 per shift. The OP would then be able to pass the rest of her meds as efficiently as on non-student shifts. Instead she is having to stop to teach the CI how to do things. Again, red flags!

[Whispera, MSN, RN]

Theoretically, a student works under his or her instructor's license and the instructor should co-sign everything that's done, as well as observe and instruct each new skill that happens. Then the student can be more helpful to the RN on duty, AFTER a skill has been completed competently at least once, with the instructor. Some things should never be done by a student without supervision.

In reality, patients are always the nurse-on-duty's responsibility, whether there are students, instructors, or Martians helping.

If something went wrong, it would fall on the RN on duty, the instructor, the student, the school, and the medical facility.

[classicdame, MSN, EdD]

you might want to review your Nurse Practice Act for some of the answers you are seeking. I have been a student, hospital staff nurse, instructor and now coordinate all students in a hospital (along with other duties). So I know students are incovenient, but how did you learn? They need that experience. If a nurse is not willing to work with a student then I do not assign them, but I also do not recommend them for clinical ladder because that attitude is not conducive to nursing education. The primary (staff) nurse is always responsible for the patient, and should be in communication with the student.

In my state you are never responsible for someone else's license. Since they do not have a license you are responsible for supervising what they do. If they are with an instructor, the instructor has that responsibility. Again, better check your own state's NPA for clarification.

I also recommend you talk to the person who coordinates students in your facility.

[AgentBeast, BSN, RN]

The only one who works on or under your license is you.

[Whispera, MSN, RN]

When I said students work under an instructor's license, I meant the instructor is responsible for everything the students do, and if it's incorrect, it falls on her as much as it falls on them...

[Meriwhen, ASN, BSN, MSN, RN]

That's a common misconception about students and licenses.

In reality, the only person who works under my license is ME. Not a student nurse, not the CNA, not the LVN...just me. It's in my name alone, not in my name and student nurse's name.

Should something happen to a patient, as the RN I am ultimately held accountable for my patient's care because I am responsible for supervising those personnel who I delegate care to. But that doesn't meant that the LVN, CNA and yes, the student nurse are to get off blame-free because they can also be held accountable for their own actions even if they're not licensed personnel.

After all, most if not all schools require that student nurses carry Liability Insurance...I mean, if student nurses couldn't be held liable because they were "working under someone else's license," they wouldn't need insurance, right?

[llg, PhD, RN]

We are all accountable for our own decisions and actions. If an instructor makes a bad judgment call and allows a student to do something that the student is not able to do ... then the instructor is held accountable for for her bad decision/poor supervision. The student would also be held accountable if she knowingly endangered the patient by doing something she was not qualified to do. The staff nurse would be held accountable if she knew about it and didn't do anything to stop it. (But she would not be held accountable if there was no way she could have known about it or stopped it.) Each person is held accountable for their own decisions and actions.