Seriously?

decembergrad2011, BSN, RN · Jul 26, 2011

Did you tell the student herself that she should inform the nurse before performing a physical assessment next time? I can't tell from your posts, but it seems a little harsh to go over the head of the clinical instructor and student and talk to the team leader over ONE incident with ONE student. This was my problem with the majority of the nurses I did not get along with in clinicals - they would talk to everyone besides ME about what I did wrong. I loved it when a nurse would tell me what I did wrong to my face in a respectful way and made it a teachable moment. And I made plenty of mistakes - people are lying if they say they did not/do not.

Re: some of the attitudes in this thread - Students are there to learn and should not be expected to be perfect. This threat of us getting in major trouble over every little mistake increases anxiety and leads to pitting of nurses against each other rather than collaborating. Lack of communication at shift-change is a problem, but it's not something wholly unexpected from someone unfamiliar with the hospital setting. There are some mistakes that need a punishment, and some that really just need guidance.

Jenni811, RN · Jul 26, 2011

So if the student got on at 0630 and you didn't find out you had a student till 0900, then what the heck was the student doing from 0630 til 0900??

dudette10, MSN, RN · Jul 26, 2011

Is it common for students to just show up and work without talking to the primary nurse?

In a word, no. At least not where I went to school.

Joining the primary nurse in morning report has two purposes: patient safety and professional courtesy.

Jenni811, RN · Jul 26, 2011

Cut her some slack. She was probably nervous as heck and had a clinical instructor breathing down her back to look up 20 medications, write down and analyze all lab work, and get a physical assessment done and charted before 9 am.

Cut student some slack?? I wouldn't. And i remember what it is like being a student, i graduated in 2010 so just last year. I'm working as an RN now and i've had students with me a few times. I remember one time the student gave the patient his medications, with her clinical instructor of course, and did not inform me that he was given his medications. Im diligent with medications and very cautious, so i checked everything and saw they were given. Had i not looked back on time i would have not seen it and double dosed the patient. Making it MY fault.

So, I don't really cut students slack when i have a patients life in my hands. there is no room for error that can be prevented when you have a life in your hand.

Not that this student did anything seriously wrong, but what if something serious like that happend? This patient would have been doubled dosed on medications and it occured because the student didn't approach the RN to check in.

Just my two cents, but i am very cautious when i have students. in fact it makes me nervous. I review their charting and do everything im supposed to but i just ask that they don't do anything with the patient without me there.

dudette10, MSN, RN · Jul 26, 2011

Cut her some slack. She was probably nervous as heck and had a clinical instructor breathing down her back to look up 20 medications, write down and analyze all lab work, and get a physical assessment done and charted before 9 am.

No. This is not about the student and her busy schedule. This is about the real live patient, the RN ultimately responsible for that patient's care, and reducing miscommunication during care.

xtxrn, ASN, RN · Jul 26, 2011

Around 0900 I go into my patient's room and there's a student doing a head-to-toe. I've seen students since 0630 this AM so I knew they were here. Is it my responsibility ot check and see if a student has anyone in my assignment? Or perhaps shouldn't students check in with the nurse for report/plan of care/share of information/questions??
Weird. I'd already passed meds, and was about to do a treatment, but I let her do it.
Is it common for students to just show up and work without talking to the primary nurse? Befuddled.
This is not my floor. I floated today......having a great day, all walkie talk patients. w00t!

This was a pet peeve of mine when I worked nights, and an LVN student showed up one day, around 6 a.m. (report started at 6:45- when the students usually listened in). She started asking questions (I was going through labs that were coming in, checking orders from rounding docs, and winding down the shift). I answered some questions, and she seemed ok...she asked some more, and I answered a lot, but it was interfering with getting my work done, so I told her that report was at the same time as usual, and we'd go over more details then. She asked if she could see the chart- sure, no problem. Then she disappears into the patient room. That was NOT ok. She was not on the assigned shift, and I was not her keeper. I love students when they are on the proper shift, with their instructor responsible for them (even if I'm there !! :)), and not just plowing into things unattended and without any information on what they're supposed to do or not do. So, I asked her to step out (the patient had just fallen asleep after being confused and agitated all night) and explained to her that at report she could get information with the rest of her class. Period. :uhoh3:

She balked, and I gave her instructions to the supervisors' office- and phoned the sup to tell her a student may be coming to complain. She started to argue with me about having to see "her" patient. I informed her that the patient was mine until after report. (I was in charge, and not directly doing patient care, but I was still responsible- and the patient wasn't able to give consent for someone they didn't know coming in to do some assessment without supervision). My supervisor backed me up.

Had I been working days, and involved in what the students could and couldn't do, no problem- I like students, and taught several CNA classes and had a ball. I've worked other places with both ADN and BSN students (on neuro) and loved when they were there- they were inquisitive, and eager, but knew their limits- and the instructor was there as their primary supervisor. But this twit stepped over some major boundaries by coming onto a shift that was not a participant in the school's teaching rotation. :cool: Not gonna happen! Had there been arrangements for the other work to get done, and communication from her instructor about what she was allowed to do (couldn't trust her- she tried sneaking back into the sleeping patients' room), then fine- I'd be pleased to be there to watch her. (she was like a first semester student- so really new. And, the only problem- in the years I'd worked there, none of the others had ever pulled that.

As a patient (several times, and for extended periods, over the last 7 years), I love students. Whenever a nurse asked if I minded a student coming in, I always welcomed them. I've been dumbfounded at how little they were allowed to do, and never saw an instructor, which mortified me. Nobody in my class went near a patient without the instructor coming in briefly, at least once. And we did everything as soon as we covered it in class, and the instructor was with us the first time (at least) for anything- including pills, ear drops, and making the stupid beds :) One of my 'regular' nurses asked if I minded if a student did a blood sugar on me (knowing I was a nurse, and having talked with several of the nurses about feeling free to bring students in)- no problem, but I think it was on the 'down low', since the most the other students had done was bring in a lunch tray.... :confused:

When the shift and staffing permit, and it's part of the accepted part of that floor's relationship with the school, I'm all in- but if I have to watch someone who is that green and not 'scheduled' , AND get my work done, it's not going to work. :)

xtxrn, ASN, RN · Jul 26, 2011

Re: some of the attitudes in this thread - Students are there to learn and should not be expected to be perfect. This threat of us getting in major trouble over every little mistake increases anxiety and leads to pitting of nurses against each other rather than collaborating. Lack of communication at shift-change is a problem, but it's not something wholly unexpected from someone unfamiliar with the hospital setting. There are some mistakes that need a punishment, and some that really just need guidance.

IMHO- the floor nurse is not there for the primary benefit of the student. They are responsible for a lot of patients (and their families, the docs, the RTs, the radiology transports, the volunteers, the boss, etc)...

Yes- students absolutely have to learn, and on real live patients- but their instructors are their primary teachers. :)

Always like having students, when it's handled professionally, and with communication. :) The instructor is that first line. :)

linearthinker, DNP, RN · Jul 26, 2011

Sounds like a systems problem to me. I have never worked anyplace where students so much as breathed without a by-your-leave, nevermind laid a hand on a patient without direct permission. Ever. This needs to be addressed at an administrative level as a matter of safety.

Tait, MSN, RN · Jul 26, 2011

Nice to see you Tweety :)

Carry on.

xtxrn, ASN, RN · Jul 26, 2011

Re: some of the attitudes in this thread - Students are there to learn and should not be expected to be perfect. This threat of us getting in major trouble over every little mistake increases anxiety and leads to pitting of nurses against each other rather than collaborating. Lack of communication at shift-change is a problem, but it's not something wholly unexpected from someone unfamiliar with the hospital setting. There are some mistakes that need a punishment, and some that really just need guidance.

TRUE :) They aren't perfect !! (nor is any nurse- and the ones who think they are are just plain scary:eek:) That's why they need their instructors :).

You should not be made to feel that you'll get in trouble for 'every little mistake'- that's sad.... little mistakes can be fixed- or aren't that big of a deal... it's the BIG mistakes that are at issue :)

Just something that may help with knowing some of the perspective of those who are already nurses- whether a couple of years, or a couple of decades- we've seen those who couldn't get through nursing school, and those who got through by the skin of their teeth and were a nightmare to work with. Thankfully, those are few and far between- but it doesn't take too long to know they're best kept at a distance. :eek:

Students don't have the full benefit of 1) all of their education, and 2) having to deal with others who work under them. You will... In the meantime, know that most of us have worked with students, and really like them. We 'remember' ... and we want you to do well...just in the proper way, and through the proper channels :)

:twocents: