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.
I look forward to every learning opportunity in the future, but what you did is ******** And you should never put another student in that position again. Can you guys feel that!
No, no I can't feel that. He didn't make the student do squat! The OP decided the pt needed the OG right then--which was the right decision for the pt--but the student was free to leave if he wasn't able to do the skill w/ the RN present. And the OP was very clear with the student that he was free to leave. So no, I can't "feel" the idea that the OP was jeopardizing the student's future in the program.
What I can always "feel" is personal accountability, which as adults and future nurses, the student needs to have.
Specializes in public health, women's health, reproductive health.
My last med-surge rotation was interesting in that my instructor was well known in the hospital. Because of that, nurses went to her with opportunities for the students. We got to do A LOT of things that way because our instructor would bring us around to watch us do the skills that needed to be done and there was quite a lot on any given day. It was a win-win situation. We got many things done for the nurses and never had to worry about scope of practice. True, we didn't do things that came up suddenly, but most interventions were not urgent, this minute, type things.
It's a shame, that what the OP allowed the student to do is controversial.
That rules have inhibited learning and growth. That we're afraid to let our newbies learn how to be nurses when the opportunity presents itself.
Unfortunately that's the way it is.
I wouldn't have done what the OP did, but I find nothing wrong with it either. I wish it were safe, for a staff nurse and student to make either choice.
I won't admit to what staff nurses let their nursing students do 20 years ago.
If a nursing student risks losing his/her diploma, then the student is an idiot. Students are all over this board whining about how nurses in clinicals won't pay attention to them and don't want them around, then we have a well respected member of this board tell a story about a teaching moment, and there are nurses and students getting their panties in a bunch over it.
If you're a nursing student in a hospital, and you don't know exactly what you're allowed to do, just go ahead and drop out. And if you're so afraid to tell someone no that you're willing to risk expulsion, then you should drop out then, too.
I'm lucky that I'm in a unit where we get to hand pick which students we have. We end up with bright, enthusiastic, and hard working people who can't believe they're getting to hang out in the CVICU.
I just can't believe people are getting so upset over a nurse offering to teach a student at clinicals!
No thanks, nobody should "drop out" and nobody should be pressured in any way to go against their comfort zone student or not. & especially with an attitude that says "close the curtain and get out if no", how about "thats totally okay if youre not comfortable or your school doesnt allow this, come watch me instead and I'll talk about each step."
It is up to the NURSING STUDENT to KNOW their scope of practice.
It is up to the nursing student to be PROACTIVE and seek out learning opportunitieswithin their scope of practice.
It is admirable when RNs support the learning and education of nursing students and future co-workers.
Throughout our nursing careers, we undoubtedly face many difficult situations. If a NS feels pressured to do something they are not comfortable with, they need to learn how to gracefully decline! A simple "I haven't learned that yet" or "I haven't been check off on that" and "could I observe instead?" would be more than enough for me.
AGAIN: It is the nursing student that needs to know their scope, educational institution's rules & hospital's rules. (Of course the RN needs to know the medical facility's rules too). In my region there are at least 4-5 BSN and 5-6 ADN programs rotating through the hospitals; each with different rules!
Haven't read through the thread to see what the controversy is about, but wanted to mention that one of the most valuable and appreciated incidents that happened in my entire nursing school career came about when my preceptor one time pulled me aside and pulled the curtain around us and explained to me that she was aware that my school did not allow a lot of things, but that she felt I needed to be exposed to what I needed to know or have experience doing for myself before I graduated. So it was her position to do those things with me, but she realized that it was against school policy for her to do so. Another time, a nurse at the LTC facility where I worked as a CNA did the same thing. Those nurses were both the kind of nurse I wanted to become.
After just reading a few posts I am really surprised at the existence of this "never list." I get that students shouldn't be allowed to actively participate in procedures that haven't been covered in class yet, but to have a list of procedures they can never participate in seems counterproductive to learning it before graduation.
After just reading a few posts I am really surprised at the existence of this "never list." I get that students shouldn't be allowed to actively participate in procedures that haven't been covered in class yet, but to have a list of procedures they can never participate in seems counterproductive to learning it before graduation.
The so-called "never" list is simply a short list of procedures that a school does not want their students performing. For instance, my program would have been OK with me placing a Salem Sump tube but not OK with me placing a Dobhoff. That would NOT mean that I couldn't observe the procedure, but I just couldn't actively place the tube.
While I am a Paramedic and currently licensed, my program prohibited me from actively defibrillating or cardioverting patients while I was doing clinicals. They also prohibited me from pushing code meds in my student nurse role, even though I have done exactly that, on my own, under my other license more than a few times.
So the reality is that the "never" list isn't to stop participation, it's to keep the school's liability to a minimum by preventing students from performing a certain set of high-risk procedures. I was absolutely free to observe anything but there were just a few things I wasn't allowed to actually do.
I don't think it's a bad thing to offer the student an opportunity to practice a hands on skill, and I do agree that the student needs to be aware of what they are allowed and not allowed to do in the clinical setting.
What I find inappropriate about this situation was that there was no consideration given to the student's experience here. We don't know if the student had ever even seen an intubated patient before, let alone what their level of experience was. The student was described as "just standing there", almost in a derogatory way- but this is what students often do- stand there and observe, because it would be inappropriate and dangerous to just jump in and do things that they have no experience with, or to pull up a chair and just sit there (a little attempt at humor here). The student was told, in a nutshell "you're going to do this, or go away", and the tube placed into their hand. Basically, they were pressured, or, if you will, even (brace yourself) bullied (yes, I actually used that word) into doing this procedure.
While I can appreciate offering the learning opportunity to the student, I don't feel the manner in which it was offered was appropriate. If the patient needed the OGT immediately and there wasn't time to find out whether or not the student was allowed to place it, and the student was showing some hesitance, then the RN should have just placed the OGT her/himself and allowed the student to observe. Saying "Hey, come over here where you can see better" and explaining the purpose and function of the OGT and the steps the RN is following to ensure safe placement would have been a far more appropriate and respectful learning experience, IMO.
It's true that the student should not allow himself to be pressured into something he is not comfortable with, and it's not incorrect to point that out. But this post wasn't made by the student- it was made by the RN who did the pressuring, and I don't think it's incorrect to point that out either.
It's also true that as an RN, you're going to be put into lots of uncomfortable situations and you need to learn to navigate them, and that students need to be aware of this fact. However, I don't think that absolves the RN in this situation from their part.
Again, I really like you, Song In My Heart, and I enjoy your posts and often agree with you, but on this one, I don't see eye to eye. I hope I'm stating my case respectfully here.
Look you don't have all day to wait between rapid sequence intubation, placing an OGT and getting a PCXR to confirm placement. Placing an OGT during an ER nursing clinical sounds entirely appropriate and if you are limited to just watching well that's not getting clinical experience now is it?
Back when I was a nursing student in the ER, the Dr numbed the pt who had a pneumo, cut a hole in between the 4 and 5 ribs told me to put my sterile gloved finger in it, handed me the tube and told me to push it in. As a student. That is getting clinical experience.
If you are a student in my unit I am going to assume that you are there to learn hands on skills not just observe. I am going to put you to work. You are going to perform skilled nursing tasks and assist with procedures under my direct supervision all day long.
Students: If your instructor or school has an issue with that speak up. Bring your clinical guidelines so that we're all on the same page. We are not mind readers. Don't wait until the nurse is dealing with an unstable patient to mention your restrictions. Thank you.
The so-called "never" list is simply a short list of procedures that a school does not want their students performing. For instance, my program would have been OK with me placing a Salem Sump tube but not OK with me placing a Dobhoff. That would NOT mean that I couldn't observe the procedure, but I just couldn't actively place the tube.
While I am a Paramedic and currently licensed, my program prohibited me from actively defibrillating or cardioverting patients while I was doing clinicals. They also prohibited me from pushing code meds in my student nurse role, even though I have done exactly that, on my own, under my other license more than a few times.
So the reality is that the "never" list isn't to stop participation, it's to keep the school's liability to a minimum by preventing students from performing a certain set of high-risk procedures. I was absolutely free to observe anything but there were just a few things I wasn't allowed to actually do.
I guess things have really changed since I was a student...not quite back when dinosaurs roamed, but close enough! I really think that's unfortunate for the modern students. I learned a lot more doing than just observing, and I can't really think of anything that we couldn't do, or at least assist with, as students.
to seattlejess and soldiernurse : thanks for your well written posts.
to the others who made snarky remarks and attacked the OP: your comments to the OP were truly unprofessional and you have been added to my account's the ignore user list.
Here.I.Stand, BSN, RN
5,047 Posts
No, no I can't feel that. He didn't make the student do squat! The OP decided the pt needed the OG right then--which was the right decision for the pt--but the student was free to leave if he wasn't able to do the skill w/ the RN present. And the OP was very clear with the student that he was free to leave. So no, I can't "feel" the idea that the OP was jeopardizing the student's future in the program.
What I can always "feel" is personal accountability, which as adults and future nurses, the student needs to have.