I very often read posts on this board which complain about the staff nurses. I was a nursing student, too, and I know that such criticisms can be valid but you should know that a lot of us really dig having students around and look for opportunities for you to learn.
I work mid-shift (which means that my shift overlaps both days and nights) and I recently was helping out a colleague who had a student assigned to her. We had just intubated a patient and were tending to our post-tube tasks (e.g. OG tube, Foley, etc).
The student was just standing at the end of the bed so I looked at him and said, "Alright, time to do an OG tube."
He responded, "Um, I don't know if I'm allowed to when my instructor isn't around."
I replied, "Well, I don't know either. Please close the curtain and either come in or step out."
He closed the curtain and tentatively stepped inside at which point my colleague handed him the OG kit. He stepped up to the HOB and we talked a bit about NG vs OG, indications and contraindications, followed by guidance as to what to do.
A couple of minutes later, he'd dropped his first OG on an intubated patient.
I still don't know if he was or was not allowed by his program to drop the tube but those opportunities are relatively rare and I figured he should take advantage of it when it presented itself...
So, young Padawans, know that some of us staff nurses are actually invested in your learning... not because we have to but because we like to.
Exactly this. Telling the student to close the curtain "come in or step out" is rude as hell, and the insertion of a feeding tube not urgent enough to warrant being so short. Like I said before, is that also how the OP talks to patients? Or to complete strangers? I doubt it. Well, if you wouldn't talk that way to a complete stranger, then you shouldn't talk that way to students or coworkers or anyone else. There's a power differential between the staff nurse and the student, which the OP is integrating when they talk that way to the student. The whole original post of this thread is dripping with it, by the way the OP is referring to the audience as "young padawans" and making reference to the idea that he doesn't have to be vested in the learning of students.
OG placement in an emergently intubated patient is not for feeding -- it is to prevent airway complications related to vomiting. And, as another poster has pointed out, the OG requires xray confirmation of correct placement and so should be completed before the CXR shot after intubation.
I have read nothing about the OP's interaction with the student that appears inappropriate. A lack of superfluous conversation and attention to the task at hand does not equal rudeness, disrespect, nor the power struggle that you seem to be inferring. There is definitely a delineation of roles - and the student is not the leader - but that does not mean that there is struggle or that the interaction is negative. Unless you make it so.
Disagree all you like; it isn't your job to teach students. I'm going to assume you are a bedside staff nurse. Reread your employer's job description for your position, and if you please, can you quote the passage where it states that your role includes teaching nursing students?
Maybe be where you work you are not required to teach students and have the option to not care if they learn. If that how you're facility is set up then that's fine. But not all facilities are like that. My clinicals are at a teaching hospital where my clinical instructor actually was employed for a long time. She said that part of their employment contract states, at the charge nurses discretion, they could be working with a student and are required to teach them to the best of their ability throughout the day. She said by teach it meant that during down time they go over anything the student witnessed earlier. When their is a skill they offer it to the student if the patient consents and it is in the student scope of practice. The nurses can't just brush off students as the instructors problem. I think that is where the disconnect is with you. You aren't required to teach, so if you don't care to, that is within your rights and ok per p and p at your facility. But at many others, it IS the staff nurses responsibility to teach and if they don't want to, they can work elsewhere. I have never had a nurse that just flat out doesn't take any responsibility for my learning for the times my instructor can't be present. But instructor does try to observe/assist with any skill offered to us if she can.
OG placement in an emergently intubated patient is not for feeding -- it is to prevent airway complications related to vomiting. And, as another poster has pointed out, the OG requires xray confirmation of correct placement and so should be completed before the CXR shot after intubation.
Yes, yes, no argument.
I have read nothing about the OP's interaction with the student that appears inappropriate. A lack of superfluous conversation and attention to the task at hand does not equal rudeness, disrespect, nor the power struggle that you seem to be inferring. There is definitely a delineation of roles - and the student is not the leader - but that does not mean that there is struggle or that the interaction is negative. Unless you make it so.
And again, I interpreted the OP's written word much differently than you did. Neither of us were there, and what is missing is the student's perspective.
I am willing to give Song in my Heart the benefit of the doubt that his intentions were honorable- I like Song in my Heart and want to believe that this is true.
But the language used in the OP came across to me very differently than it came across to you, apparently. And, neither of us were there.
As I've stated before, I think this is a very interesting discussion and I think it's been worthwhile. :-)
Disagree all you like; it isn't your job to teach students. I'm going to assume you are a bedside staff nurse. Reread your employer's job description for your position, and if you please, can you quote the passage where it states that your role includes teaching nursing students?
Sorry to disagree but a teaching facility does indeed consider teaching part of the job. It's not limited to hospitals either. I work in a SNF and we are about overrun with students right now. Two clinical groups at different points in their educations are with us and it is really fascinating to see how much students progress in just a semester. We also have a first semester group in for observation rotations, they are assigned to an RN 1:1 to shadow for a full day and boy do they ask the questions!
I do wish some clinical instructors would chime in here, I don't know how one person can manage a group that size while allowing each student to do and learn everything they can to obtain the maximum benefit from that clinical rotation.
I am a student and did not take offense to anything the OP stated. At my clinical site, there are 5 different schools with students in both ASN and BSN programs along with an LPN class. It is the student's responsibility to know what they are/are not allowed to do. How are the nurses to keep track of the different school's regulations in addition to what year and level of nursing a student is in? That seems to be unrealistic. With that being said, none of these have a "do not observe" clause that I am aware of. I am thankful for nurses like the OP that want to teach us. Most of the nurses at the clinical site are like OP, maybe some more/less direct, but all have been willing to teach. My take on the post was 1. this needs done, do you want to do it. Need an answer now. 2. If you either are not allowed to do it or do not wish to do it, go to #2. make a decision to either observe or not, but please close the curtain and pick a side you are going to stand on. This is only my perspective and no more right or wrong than anyone else's.
I've always had great experiences with staff nurses on the floors we've done clinicals, barring one or two moody individuals. For the most part, I've been so lucky to have worked with such experienced nurses. I've learned a LOT that I would've never learned in school. For that, I'm super grateful.
You should try and be a Clinical Instructor. Many times on the unit, those of us who are students do not get exposed to much opportunity like that. I had the opportunity to try and start an IV - I missed twice (but it was my first time trying it - and it was on a patient with cancer and skin lesions - it was really difficult to find a vein).
When you are on the unit, Clinical instructors do not want to "overload" nurses with being responsible for a student's mistakes. I have heard that a lot.... but if a nurse OFFERS you to get experience, then that is on the nurse.
If I was in that situation, I would ask if I could confer with my instructor first to do it...that way, the instructor knows that I am performing an invasive procedure under the guidance of an RN. I am assuming this was not an ER situation, so it probably could have waited a little bit. I would assume things would be different in an ER rotation - where the HCPs decisions could mean life or death (ie, hypersensitivity to opoids may lead to opiod toxicity --> naloxone as antidote).
I am a student and did not take offense to anything the OP stated. At my clinical site, there are 5 different schools with students in both ASN and BSN programs along with an LPN class. It is the student's responsibility to know what they are/are not allowed to do. How are the nurses to keep track of the different school's regulations in addition to what year and level of nursing a student is in? That seems to be unrealistic. With that being said, none of these have a "do not observe" clause that I am aware of. I am thankful for nurses like the OP that want to teach us. Most of the nurses at the clinical site are like OP, maybe some more/less direct, but all have been willing to teach. My take on the post was 1. this needs done, do you want to do it. Need an answer now. 2. If you either are not allowed to do it or do not wish to do it, go to #2. make a decision to either observe or not, but please close the curtain and pick a side you are going to stand on. This is only my perspective and no more right or wrong than anyone else's.
Just so that I clear things up, perhaps a little more... the "never list" is simply a list of things/procedures that students are not allowed to do, but they can certainly observe any skill or procedure. I've seen a PICC placed many times but I wasn't allowed to place one. I'm separately licensed to perform endotracheal intubation by nasal or oral routes. When I'm in a student nurse role, I can't do it myself but I can observe someone else do it... Same with defibrillation/synch cardioversion. I've done that too, many times... but I wasn't allowed to in my student role.
Sorry to disagree but a teaching facility does indeed consider teaching part of the job. It's not limited to hospitals either. I work in a SNF and we are about overrun with students right now. Two clinical groups at different points in their educations are with us and it is really fascinating to see how much students progress in just a semester. We also have a first semester group in for observation rotations, they are assigned to an RN 1:1 to shadow for a full day and boy do they ask the questions!
I do wish some clinical instructors would chime in here, I don't know how one person can manage a group that size while allowing each student to do and learn everything they can to obtain the maximum benefit from that clinical rotation.
Do you even know what a teaching facility means? A "teaching hospital" only refers to the teaching of medical students. It has nothing to do with the teaching of nursing.
I work in a large university medical "teaching facility" too. It isn't called that because nurses have clinicals there. The tiniest of hospitals have nursing clinicals; they aren't "teaching facilities." Do you really not know this?
Do you even know what a teaching facility means? A "teaching hospital" only refers to the teaching of medical students. It has nothing to do with the teaching of nursing.
I work in a large university medical "teaching facility" too. It isn't called that because nurses have clinicals there. The tiniest of hospitals have nursing clinicals; they aren't "teaching facilities." Do you really not know this?
If your hospital is associated with a nursing school, as well as a med school, i am thinking you are off base. And if your hospital has a contract with a nursing school to provide nursing clinicals , that would include the nurses teaching the students. I am not sure what your problem is.
Do you even know what a teaching facility means? A "teaching hospital" only refers to the teaching of medical students. It has nothing to do with the teaching of nursing.
I work in a large university medical "teaching facility" too. It isn't called that because nurses have clinicals there. The tiniest of hospitals have nursing clinicals; they aren't "teaching facilities." Do you really not know this?
Altra, BSN, RN
6,255 Posts
OG placement in an emergently intubated patient is not for feeding -- it is to prevent airway complications related to vomiting. And, as another poster has pointed out, the OG requires xray confirmation of correct placement and so should be completed before the CXR shot after intubation.
I have read nothing about the OP's interaction with the student that appears inappropriate. A lack of superfluous conversation and attention to the task at hand does not equal rudeness, disrespect, nor the power struggle that you seem to be inferring. There is definitely a delineation of roles - and the student is not the leader - but that does not mean that there is struggle or that the interaction is negative. Unless you make it so.