Snapped at a nurse student last night, she had a bad case of Nursitis

[Tony1790]

I hate nursing students that haven't been an aid before, nursitis was running rampant. I had a 350 lb that needed a hibiclense prior to heart surgery. I asked if the nursing student extern, could help me with the bath as the patient said she was dizzy and unsteady. The nurse extern said that baths were the aides job and why was I asking for help. So, I reminded her that I was a nursing assistant....that all jobs from head to toe were Nursing duties and that it was my job to help with those duties. You could tell she had never been an aide, I believe that she felt that she was a nurse after all and above helping to do an aides job.

I did tell her that:

1. As a CNA I already realize I'm at the bottom of the healthcare ladder, no point in being blatant about pointing it out.

2. Catch me on a bad day and you may be doing the baths anyway as aides can and often do quit, making low wages at Walmart is a lot easier than making it as an aide.

I did complain to the charge nurse and nurse manager, of course that is a total overreaction on my part, I guess it's just that I hate nursing students and being reminded of my lowly status as an aide, especially by a student nurse.

Tony

[pagandeva2000, LPN]

I'm not sure the situation, but many times nursing students are not allowed to do certain tasks. At times, nursing students are "in training" to not only be a provider of patient care, but also, to delegate. There are questions on the NCLEX (the test you take to get your nursing license) about what you would delegate to the CNAs or if you are going to get your RN then to the LPNs. Also, clinical times for the nursing student is very VERY valuable. Nursing students have a very limited time in clinicals; and so, The professor may tell the students, "you are here as nurses today, not cna's. You will do wound care, insert foleys, and give meds. You are expected to show your organization and delegation skills. After you graduate there will be many times that you will have to provide total care, as the patient is YOUR responsibility; however, today we have to work on more advanced nursing skills." I would not want to be the student to ignore my professor's order. Now, I've been in clinical and was told that WE were to provide total patient care. All adl's were our responsibility. My professor also divided us up, some of us were "cna's" and some were the nurses. My program also taught us the importance of the cna. As someone that worked as a cna before nursing school and during, I already knew how important the cna is!!!

I'm not sure what to say about this Tony. Lumping all nursing students in with the bad ones in kind of like lumping all cna's in with the bad ones!!! Also, you should never hate anyone for "reminding you of your lowly status..." Additionally, you should not feel that your position is "lowly." If this is how you feel about being a cna, maybe that is where the problem is!!! CNAs are extremely important; and yes, they are "entry level," but not unimportant. You need to know that. Yes, there are nursing students that look down on CNAs. There are Nurses that look down on CNAs, Doctors that look down on Nurses, RNs that look down on LPNs, BSNs that look down on ASNs, CNAs that look down on house keeping, etc. etc. It's life. Some people have to lift themselves up in order to feel important. I would hope that you learn the importance of being a CNA and think of the nursing students as "just people that chose nursing as a career, as oppose to being lawyers, doctors, or mechanics." No need for resentment or hatred, really. Be proud to be a CNA. I know you do not get credit for what you do. As a nurse, I don't always get it either. Nursing does not make one famous. Nurses are among the most trusted professions year after year. We rate above Doctor's, but many people think we are there to just follow "doctor's orders" which we are not. Anyway, I wish you all the best!!!

Sincerely,

Jay

That was one of the points I wanted to stress...the nursing student was wrong, for sure! However, there are phases in the nursing program where we do have to go on and learn how to administer medications, and other skills and each clinical is supposed to be designed within a certain time frame. The clinical instructor has to mark her students off on these skills before the end of the semester, and some will not allow their students to go off and do other things independently, because ultimately, the CI is responsible for their actions. And, I am sure that many CIs have been burned in the past behind students working independently and harm has come to patients. One of my classmates almost got thrown out of the program because she helped a nurse by administering medications without the instructor's knowledge. It was a BIG deal...she was told to do fingersticks, read about the medications and report back to the instructor, nothing else.

I do hate when good CNAs are mistreated by others, because without their skills and observations, we would be nowhere. Just the other day, a PCA came and told us that she could not get a blood pressure from a patient in our clinic. The RN tried, could not get it, either, and then did a palp and it was 60. Finally, got a machine to take the BP and it was 60/20, and the lady was about to crash. We initiated an IV line and got fluids in her just in time to get her to the ER. That woman could have died had it not been for the PCAs observations.

Like I said, she'll see how it goes down when she gets her license and snubs her nose, then...believe me.

[Melinurse]

I just have to point out that Tony had told the nursing student about the pt. not feeling right with the dizziness and about to faint. Regardless of where you are in your clinicals she/he could have said, " Lets not do the bath right now, I'd like to get the staff RN to assess the patient first since there is a change in condition or whatever the case may be." Although these other posts are correct, sometimes nurse students are not allowed to perform certain tasks/skills if instructor has not cleared them to do so.

[dancechica]

As a nursing student, I feel embarrassed for that student that had the audacity to say 'that's the nurse aid's job'. I appreciate someone like you who is about caring for the patient. My hospital has CNAs that automatically avoid the rooms the students are assigned to, even if we take up half their patients that they would have to care for had we not been there; it's like pulling teeth getting them to help, especially if it's a total-care patient.

Unfortunately no place is immune from nursitis...

I feel your pain.

[Tweety, BSN, RN]

I just have to point out that Tony had told the nursing student about the pt. not feeling right with the dizziness and about to faint. Regardless of where you are in your clinicals she/he could have said, " Lets not do the bath right now, I'd like to get the staff RN to assess the patient first since there is a change in condition or whatever the case may be." Although these other posts are correct, sometimes nurse students are not allowed to perform certain tasks/skills if instructor has not cleared them to do so.

If that was the case, then this student has a lot to learn about communication. The scenerio you describe doesn't sound like this case. This student clearly said that baths were not her job, instead of that she was uncomfortable with a change in patient condition.

This student has some hard lessons to learn about getting along with co-workers. You alienate your tech by not helping them with heavy patients and your life is going to be miserable. Getting on the right foot and learning how to play well with others is imperitive when a student hits the floor.

[bmoregirl]

I just graduated from nursing school in may and I was a CNA for over 10 years and I have to agree with tony Some nurses do treat CNA like they are on the lowest level of nursing. Even some NS do it, the idea is placed from almost day 1 in nursing school. You delegate that task that require skill not so much knowledge. This can give the NS who's never been a CNA the idea that" I don't have to do bedpans or baths the tech will do that". It gives them a wrong sense of reality. Trust me Tony there will be many,many,many days when that NS will have to bite her words and come to realize that contrary to popular opinion going to school doesn't make you superior and guess what they don't teach common sense in nursing school.

[gutcheck]

this has been my experience also. I have been a tech for 3 years, two of those while in nursing school which I just completed. I remember during our clinical skills tests at school our instructors encouraging us to put the call light on and have the aide/tech bring an item/s if we had forgot to bring something to the bedside. it was our "out" so to speak. in terms of teaching us prioritizing an instructor during lecture would say "have the tech do that". it just amazed me.

I agree with everyone else. the student should have rechecked the patients status. and if the patient was "okay" helped you or if she wasn't allowed found someone that was able to help you. you are right, ultimately the nurse is responsible for the pt. she is delegating that task to you. if you are unable to perform the task, as you gave notice to such, she is responsible for assisting you to complete the task or delegating the task to someone who can.

[cuppa_tea]

I will be a first year nursing student this fall. I have my CNA certification. We are required to pass our CNA exams before we can apply to the nursing programme. I did 16 weeks of CNA clinicals at our local hospital. Only once or twice in those 16 weeks was I thanked or even acknowledged as being helpful to the nurses on Med/Surg. Shameful! Now, as I prepare for nursing school, it is pounded into our heads that we should be thanking our CNAs and treating them like gold. They do all the hard work. They do a lot of the patient care basics. They handle the tough jobs so that we NSs can do our assignments. God Bless 'em! I am going to remember to thank my CNAs because I've been there. I've cleaned up diarrhea and vomit. I've had patient's throw their suppers at me. I've been slapped. I know what they go through. They are a valuable part of the nursing team and they deserve better wages and better treatment. Believe me, if they need some assistance, I'll help them if I can. Treasure your CNAs! They are worth their weight in GOLD!!

[DLS_PMHNP, MSN, RN, NP]

I'm a nursing student and worked as a PCA in a hospital while going to school.

It is backbreaking (and sometimes) thankless work but it needs to be done in order to provide good patient care.

Nothing irritates me more than hearing some of the younger students during clincials reply "Isn't that the PCA's job to get the vitals?"

Gee, Ms. Student Nurse, you are only assigned two patients. I'll bet you can handle it. If not, I feel sorry for your future patients, if you make it that far.

Ok, I'm done :)

[Melinurse]

Diane-RN-Student, you said it very well. If they can't handle 1-2 patients what are they going to do with 5-6 or more? If they can't multi-task, how are you going to manage your patient care? If you think you are " above " your co-workers, why should they go the extra mile for you?

I am so fortunate & privilaged to work with a fantastic team of equals, we all work together and no one thinks they are " too good " to do " CNA " work. For us, there is no such thing, we all do all patient care regardless of what it is. I understand some nursing students in first and second semesters may only be allowed to do certain tasks/skills but, there is no need to be rude and most of all, patient care comes first. Alot of people have written in some great responses to this. However, it shows we have a long way to go in teaching future nurses not only patient care but also people care.

[cardiacRN2006, ADN, RN]

Diane-RN-Student, you said it very well. If they can't handle 1-2 patients what are they going to do with 5-6 or more?

I dunno... I was awfully stressed out in nursing school, and in the beginning I had a hard time with 2 pts too. I seem to be doing just fine as a charge nurse in my busy ICU.

Also, something else to think about. I only had 12 hrs of clinical time a week to practice my skills. So if an opportunity came up for me to do a set of vitals or place an IV, the emphasis would have been on the IV. I did PCT work during weekends and already knew how to do that.

I think it's understood that students shouldnt' be rude to anyone, and that pt care comes first. But some students really need to focus on the nursing skills.

Also, when I was a tech, I remember hearing the other techs say, "Oh good, nursing students are on the floor today. That means I don't have to do anything with the pt all day."

No, not all techs are that way (but they sure were at my hospital). And I have to admit that I felt the same way about students before I started nursing school.

Just my thoughts from both sides of the fence.....

[kstec, LPN]

As a LPN, I've experienced the hierarchy crap too. I think it goes all the way up. If your a CNA, then why aren't you a nurse, if your a LPN, than why aren't you a RN, then it's when are you going to get your BSN, then your master and on and on. We are all equal (housekeeping, laundry, CNA, LPNs, RN, MD, lab and so on) we all contribute to patient care, but at different levels because of different educational experiences. Noone knows everything and everyone can be taught something. I work in a LTC/rehab facility and the CNA's are my eyes and ears. I can't be with 28 residents at one time or for a long amount of time each shift, so I look to them for a lot. I worked as a CNA and I know what you are made to feel like sometimes, because I felt it as a CNA and now on ocassion as a LPN. I just look at it this way, the people who are rude or judge, are insecure and need that ego trip to make themselves feel good. I, on the other hand feel good being a LPN and don't need to cut anyone down to make myself feel better. You should be proud of being a CNA and realize the SN has the issues, not you. I couldn't do my job alone, I need everyone as I listed above. We all have a special role, without one of these departments, healthcare would not be what it is. No housekeeping, dirty facility, no laundry, no clean linin, no CNA's, noone to be the frontline caretakers of the patients, no nurse, noone get meds, or assessed, etc., you get the picture. I believe in Karma and one day that SN will get hers. Hopefully sooner than better, before her head gets so big it explodes. CNA's ROCK!!!!

[SuesquatchRN, BSN, RN]

I did well in clinical by my assignment usually took an hours at most. I spent the ret of the time helping anyone I could. I spent one day changing beds with the aide. I spent another running errands for the nurses. Every asignment left me time to help.