student nurse precepting in ED...advice?

TrevyRN, BSN, RN · Mar 28, 2014

I've tutored lots of RN students that still didn't know their vital signs going into NCLEX! Know those! I know one nurse that still carries around a small laminated card of all pediatric vital signs so she doesn't have to memorize them. Also, some people are still weak in med math... ! Bring a drug book with you and stash it somewhere too.

I did my preceptorship in the ER as a student RN. I loved it! You do lots of assessments, vitals, meds, and IV stuff. And it's cool if they let you follow pt's to some of their tests (CT, x rays, pulmonary scans etc). You won't seem like a bumbling fool if you let your preceptor know what you need to practice and ask lots of questions.

Here is a list of some drugs I use all the time in the ER. Might want to be familiar with them... and know your IM, subq injection sites :-)

aspirin

zofran

tylenol

advil

dilaudid

morphine

phenergan

normal saline

lasix

epinephrine

solumedrol

toradol

clonidine

rocephin

lidocaine

nitroglycerin

zosyn

ativan

lovenox

regular insulin

tetorifice shot

What else... I don't know - be friendly and show initiative - ask questions, learn by doing, play with the equipment, help where you can and have fun. Good luck!

RunnerRN2015, ASN, RN · Mar 28, 2014

TrevyRN, THANK YOU! I'm currently an NA on a pediatric floor so I'm good with peds vitals from neonates on up (I have a laminated card already on my badge LOL). We have a peds ED attached to the adult ED so I don't know how many kids I'll see. Thanks for listing common meds; that is extremely helpful. We're a level 1 trauma center so I'm sure I'll see some amazing cases.

Thanks again for your help!

DayDreamin ER CRNP · Mar 28, 2014

I agree! I had a clinical student for one day that couldn't tell me why she was giving Zofran and Protonix. I even lead her down the primrose path by telling her to look at what the patient is doing and then tell me what these drugs are given for.

Sadly, she told me that the puking patient was getting the Protonix for an "antibiotic." When I told her what it was for she got all airhead on me and was like, "Oh! We give that on the floor I precept on all the time!"

:no:

When I have a student, I really hate it when she (or he) acts like she knows everything already. Even if you do have EMS or previous tech / LPN experience, you are a NEW nurse in my eyes until proven otherwise. Know your place and know your limits.

Ask questions. Don't assume you know everything and can do everything. We work at a very different pace and we often do things differently than they do on the floor. I get that and don't need you to tell me every single time we do something that "we do it on the floor like this" in a condescending way.

Ask questions.

Know your top meds and why we are giving it. Learn to anticipate what we are going to do with our patients we are seeing. What are we going to do for that patient that comes in with chest pain? I hope you have a pretty good idea of where to start with that pt. EKG? Labs? Xray?

Don't get hung up on starting IVs. It isn't the end of the world if you don't get em. Consistent practice is what you need and that WILL come with time. I promise.

Take notes. Ask more questions at the end of your day.

Be helpful and don't be lazy and don't butt into our conversations unless you are part of it. Don't be late. Not ever. I had a student that was late 3-4 times in a row - like 20 mins late. I told her instructor to find her another spot. I can understand once or twice while you are precepting but 3 times in a row?

Use some common sense and be proactive and don't be lazy! See a trend here?

Good luck!

**edit**

I re-read that and it sounds kinda harsh! It is! But I can promise you that if you can't cut in the ED there are 250 other students / applicants that would KILL to have that spot. The ED is not for the weak!!!

RunnerRN2015, ASN, RN · Mar 28, 2014

KeeperMom,

Thank you! I'm an older student (47) and don't expect to be given anything I didn't earn. In my opinion, this preceptorship is a 90 hour job interview. I appreciate your honest (not harsh!) advice.

DayDreamin ER CRNP · Mar 28, 2014

I was an older student too. I've seen some pretty entitled older students too but not so many really.

Honestly, life experience can go a long way in the ER preceptorship! You'll probably do great!!

good luck!

m

Altra, BSN, RN · Mar 29, 2014

* Be a sponge. Every single clinician in every single discipline that you encounter will teach you something.

* Observe/listen ... and withhold judgement. Ask your preceptor if you can carve out some time every other day or so to discuss the tough stuff - maybe over lunch.

* Totally agree with the comment above that having more life experience can be an asset in the ER as you will probably have an easier time grasping a patient's psychosocial "big picture" ... but realize right now, before you even start, that you cannot apply your life's journey/lessons to others.

Congratulations on getting this experience lined up, and good luck to you! :)

emtb2rn, BSN, RN, EMT-B · Mar 30, 2014

*...maybe over lunch.

What is this "lunch" you speak of?

ChuckeRN, BSN, RN · Mar 30, 2014

What is this "lunch" you speak of?

+1

I've lost 30 lbs since I starting working in our ED last year.

Altra, BSN, RN · Mar 30, 2014

What is this "lunch" you speak of?

I eat lunch 9.5 days out of 10. True story. :)

emtb2rn, BSN, RN, EMT-B · Mar 30, 2014

Oh, you mean eating. Yeah, I get to eat pretty much every shift. Chart, chew, chart, chew.

Altra, BSN, RN · Mar 31, 2014

Nope - I mean lunch. Away from the unit. Really.