Scary story I heard from some nursing students

[NurseyPoo7]

We had some nursing students on my unit a few weeks ago and I overheard their instructor and the students discussing an incident that happened with another clinical group at another hospital.

They said this group of nursing students had pts on a med surg floor.. and one nursing student was assigned to be the "charge nurse" of the group and was supposed to help with FSBS. Apparently, this student informed the other students of their patients' FSBS results. Well, long story short, at the end they couldnt find the documented FSBS in the computer and when the instructor asked the "charge" student about it ,he fessed up he had "made up" the numbers because he didnt know how to do a fingerstick and didnt want to ask someone

[tvccrn, ASN, RN]

Hopefully the instructor or the school have policies in place, including issues on integrity. I agree the student should be out, but you can't do it unless students know up front the disciplinary actions that could be imposed. The student could bring a law suit, and....well, it could get ugly.

Bottom line, the school should have something in place that would make this an automatic failure!

If the student is enrolled in the school, they have a responsiblity to know the policies of the school and I am willing to bet a chunk of money that there is a policy on integrity somewhere.

[NurseHopefulInOH]

I have heard nursing aids doing this which a bit more understandable. They have not been trained on the significance of these numbers. A nursing student however, if they have reached the level in their program that they are allowed to go do them by themselves they definitely should know the significance of FSBS. If they know what it is and why its important and still proceeded to just make up number then I agree they shouldn't be a nurse or student nurse. What else would they just fake?

[TiffyRN, BSN, PhD]

I guess I'm the biggest cynic in the world.

First of all, I always question stories like this. You heard some students discussing this with their instructor. Did the the instructor confirm this did happen, and if so why was he/she discussing this in a group? Was it another school? Was the student in question already dismissed and the instructor was having a "teaching" moment? If discipline had not happened (or was pending) I would find it inappropriate for the instructor to be discussing it with the students beyond perhaps a general warning of not taking on tasks one didn't know how to do. If this student's instructor allowed him to be assigned a task he/she hadn't personally verified he knew how to do, I would say that instructor may need discipline.

Secondly, everywhere I've worked in the last 10 years, one cannot do fingersticks until they are checked off by the lab and assigned a number code or bar code to use with the machines. I know not everywhere may be that advanced, but still. For the sake of argument, I could concede that a person could make up the numbers and even give them the other students or nurses, but very soon it would be apparent when the numbers couldn't be found in the machine or as it does at my hospital, transferred to the electronic record.

I'm not questioning the OP heard this story, I'm just saying, question such things, I think we can all agree that such an action is unpardonable. The manager of the unit where it happened needs to refuse to have that student there again. At that point, the school would have some 'splaining to do if they kept this student in their program.

[traumalover, RN]

I have a hard time buying this. So essentially the nursing students didn't notice, the clinical instructor didn't notice, and the primary nurses weren't at least keeping an eye on the students? I'm telling you, it's a little hard for me to buy all these people just believed this kid was getting them....and there was no family when nurses came in with insulin going they didn't check Mama's sugar yet! really?

[~Mi Vida Loca~RN, ASN, RN]

I have heard nursing aids doing this which a bit more understandable. They have not been trained on the significance of these numbers. A nursing student however, if they have reached the level in their program that they are allowed to go do them by themselves they definitely should know the significance of FSBS. If they know what it is and why its important and still proceeded to just make up number then I agree they shouldn't be a nurse or student nurse. What else would they just fake?

Actually, I don't see how Aides should have a leeway here either. If the facility allows the CNA's to do this, their should have been training on when things need to be reported. When I did clinicals at the nursing home, the aides were not allowed to do the blood sugars, but at the hospital they can and although the machines when put back on the dock download all the numbers to the Pt. charts, the CNA's though were given a range that they need to report to the nurse immediately. Our machine even tells you if the FSBS comes back at an usafe range. But being an aide is not an excuse, just like they should be reporting abnormal VS's as well. Infact, they do so many of them since they do 90% of them at our hospital, that they should be well aware of normal ranges and abnormal ranges and even if they are not well versed on the ins and outs of blood sugars in their significance, they do know the difference between abnormal and normal with standard ranges.

[cherrybreeze, ADN, RN]

I have heard nursing aids doing this which a bit more understandable. They have not been trained on the significance of these numbers. A nursing student however, if they have reached the level in their program that they are allowed to go do them by themselves they definitely should know the significance of FSBS. If they know what it is and why its important and still proceeded to just make up number then I agree they shouldn't be a nurse or student nurse. What else would they just fake?

I don't think it's "more understandable" at all, if a CNA does it. They are trained what to report. Part of our yearly glucose competency includes the numbers! Plus, any CNA that's not completely wet behind the ears has been around glucose-testing, seeing insulin given (or juice...I will usually ask my CNA to give a person juice, order them an early meal tray, etc, when they report a low sugar to me), hearing it discussed to know what's low, what's high, and that it's a big deal. Or at least they should (and I believe most do).

[cherrybreeze, ADN, RN]

I have a hard time buying this. So essentially the nursing students didn't notice, the clinical instructor didn't notice, and the primary nurses weren't at least keeping an eye on the students? I'm telling you, it's a little hard for me to buy all these people just believed this kid was getting them....and there was no family when nurses came in with insulin going they didn't check Mama's sugar yet! really?

While I concur that it could be more of a story than truth, I can see how it COULD happen. Once a student is past the point of having been checked off on blood sugars as a skill, the instructor wouldn't be watching them do them anymore, necessarily. Why would the other students have any reason to know whether or not this one had done their sugars? They don't go with each other to perform simple tasks. A blood sugar would be something considered a basic, mastered skill by an early point, so I don't think the instructor or primary nurse would have any reason to think they'd have to observe it...if the student had said previously that he knew how, that's enough. So, to say it's hard to buy that all these people just believed he was getting them...that would be the natural thought. You wouldn't think OTHERWISE. Lastly, plenty of patients don't have visitors, some EVER, so that doesn't matter, either.

[traumalover, RN]

I said I had a hard time believing it. I still find it highly unlikely it happened in a hospital setting where most glucometers upload to a lab results. long term care, maybe. And obviously he hadn't been checked off if he hadn't done one.

[traumalover, RN]

Also, I don't let nursing students give meds, draw blood, or stick them for even a glucose if I/m not there, as well as get them up, or zero lines, or anything I consider it would be easy to mistake. Mentoring students is part of our job too.

[cherrybreeze, ADN, RN]

Also, I don't let nursing students give meds, draw blood, or stick them for even a glucose if I/m not there, as well as get them up, or zero lines, or anything I consider it would be easy to mistake. Mentoring students is part of our job too.

Yes, mentoring students is part of our job. Thanks for pointing that out?

I don't equate mentoring with breathing down their necks, though. It doesn't sound like you let them do ANYTHING on their own...I don't think people learn that way. I think it does zero for a students confidence when they aren't allowed to do anything.

The student in the OP is the exception to the rule, IMO. No, obviously he wasn't checked off on the skill (maybe it was the machine he wasn't familiar with, I don't know) but that falls on the instructor, not the primary nurse. That's the CI's job, I couldn't possibly be in the room with each student every time they do something, nor do I/should I have to be. Some nights, when we have a group of students doing a rotation, 2 to 4 of my patients might have a student working with them. It's not in my ability (nor my responsibility) to watch each of them do everything....I just can't.

[traumalover, RN]

Perhaps we feel differently, to each their own, but no pt will receive meds, IV starts, blood draws, dressing changes, accuchecks without me or their instructor there. Can they do their assessment, their bath, help them to the commode without me? Sure. But I don't let nursing students do what I listed without me. It is my personal perogative. So I will say I'm sorry if what I said offended you or you felt insulted, but that is the way I do it and it isn't "breathing" down their neck. Those tasks don't take hours and hours, but they're important to me. So let's agree to disagree.

[Cindy-san]

I have a hard time buying this. So essentially the nursing students didn't notice, the clinical instructor didn't notice, and the primary nurses weren't at least keeping an eye on the students? I'm telling you, it's a little hard for me to buy all these people just believed this kid was getting them....and there was no family when nurses came in with insulin going they didn't check Mama's sugar yet! really?

WORD

I guess I'm the biggest cynic in the world.

First of all, I always question stories like this. You heard some students discussing this with their instructor. Did the the instructor confirm this did happen, and if so why was he/she discussing this in a group? Was it another school? Was the student in question already dismissed and the instructor was having a "teaching" moment? If discipline had not happened (or was pending) I would find it inappropriate for the instructor to be discussing it with the students beyond perhaps a general warning of not taking on tasks one didn't know how to do. If this student's instructor allowed him to be assigned a task he/she hadn't personally verified he knew how to do, I would say that instructor may need discipline.

Secondly, everywhere I've worked in the last 10 years, one cannot do fingersticks until they are checked off by the lab and assigned a number code or bar code to use with the machines. I know not everywhere may be that advanced, but still. For the sake of argument, I could concede that a person could make up the numbers and even give them the other students or nurses, but very soon it would be apparent when the numbers couldn't be found in the machine or as it does at my hospital, transferred to the electronic record.

I'm not questioning the OP heard this story, I'm just saying, question such things, I think we can all agree that such an action is unpardonable. The manager of the unit where it happened needs to refuse to have that student there again. At that point, the school would have some 'splaining to do if they kept this student in their program.

And more WORD.

Nursing school was several years ago now and even then, I couldn't get into the FSBSG machine without one of the nurses putting in their passcode. And none of them left without making sure I knew what I was doing since I was working on their passcode.

I think we have a game of exaggeration dramatics filling in for lack details here.