Students ahead of the game!

[NursinOrBust]

I am not sure how to approach this situation, but I feel I need to get it off my chest and request some advice. I am not one to lose sleep, but stuff like this gets me thinking. I am a first semester student and my CI seems to have a couple of favorites. I have just recently gotten tired of biting my tongue. I am fine with the fact that my CI finds these certain student more advanced in their knowledge and skill, but my biggest concern is that our CI is allowing them to do procedures that we have not even covered at all. In fact, these are procedures that we will be learning in our second semester.

We are only suppose to pass oral medications w/ supervision and most of the time the CI is never to be found to do so. Second, we can observe but we have not been instructed on flushing/pushing ANYTHING through an IV and/or PICC line. The reason why I am so concerned is that one of the students did push dilantin with the CI through a Picc line. At our meeting however, that same student admitted to not having done an injection or even a gluco check since the semester started 3 mos ago. Ummk!

I do not feel that we have been taught and observed effectively being first semester students, and we should be on the same page by performing what is covered in class. It has been very frustrating and I have been afraid to speak up. Is this something I should just slough off?

Please share any thoughts and stories.

[TheCommuter, BSN, RN]

Is this something I should just slough off?

To be very blunt with you, my advice is to keep your mouth shut on this issue. Nursing school can be very political, and you'll become a likely target if you report the clinical instructor for the aforementioned infractions. The lack of observation by the clinical instructor is dangerous and very wrong, as well as his/her obvious favoritism for certain students. However, these things will occur in the real world of nursing, as well as in other aspects of life.

We all must learn to wisely pick and choose our battles. I have seen other nursing students fight this specific battle, only to be harassed by school administration, written up for petty infractions, and ultimately kicked out of school for bogus issues. Save yourself, and keep your mouth shut.

[shanyone]

Just ask yourself this question...What good will it do me if I report what is going on? And then you'll see that no real good can come of it. If the student were without supervision and the CI didn't know that the student did these things then the patient would be in danger and the CI should be notified, but since the CI is present when these things are happening, that means he/she condones the actions. Let it be. Study hard and overcome anything you need to in order to reach your goal. The nursing school games are just something you have to get through to reach your goal. Try to look at it like that.

Shanyone

[MikeyJ, RN]

I agree with the other poster -- nursing school (academics in general) is very political in nature. If you decide to report this, I would worry about your clinical instructor finding something fail you on or making your life a living hell. I have learned that when it comes to a clinical instructor, you need to play their game and just get through the semester.

My clinical instructor during my first semester was letting student's do many tasks outside of our scope of practice; however, I was not concerned about this. The clinical instructor was always there by the bedside, thus if something went wrong (which nothing ever did) she was there to intervene. To be honest, I enjoy those clinical instructors that like to push the line and allow students to do things that are not presented in that semester. And you say that she is only allowing certain students to do it, but have you approached her and asked if you could try? She may let you try.

[squirtle]

I like having the opportunity to do "extra" things in clinicals... I think that you should make the most out of your clinical experience and if you are focusing so much attention on and worrying about what everyone else is doing then you are going to miss out on your own experiences. I would just let them be... If there is something that you want to try, know the policies and procedures and then talk to your instructor.

[NursinOrBust]

Sad but true, but snitching is of no interest to me unless it involved definite harm to the patient. Guess I just needed to hear or be reminded that stuff like this does happen. Thanks for the wake up calls and I will keep my own head focused on the goal.

[llg, PhD, RN]

I applaud the clinical instructor for giving the students as much clinical experience as they can safely provide. We need more instructors who take the initiative to do such things so that students get a chance to see and do as much as possble.

The mentality that you have to attend a formal class on something and/or be officially "checked off" on clinical skills holds nurses back and is just plain wrong. Good old-fashioned "apprentice style" learning SHOULD be a part of a nursing education. As long as there is an experienced, competent RN directly involved with the task and taking legal responsibility for it -- and the student's limitations are being accounted for -- a nusing student should be able to participate in any and all aspects of nursing care.

In the real world of practice, there is rarely the opportunity for fancy classes as new equipment and procedures and introduced. Nurses need to be prepared to get a quick demonstration or read the handout and move quickly into the performance mode. The instructor in this case seems to be doing a good job of promoting a healthy "spirit of adventure" as part of the learning experience that will serve her students well in the future. I see nothing wrong with how she is teaching.

llg, PhD, RN

[MQ Edna]

Yeah... in the work environment it may be different... but when you're in school you all end up with the same degree, so don't cause any more stress than you need to. Just ignore it, get good grades and good luck! If anything were to happen to a pt. because of this situation who would it fall on? I know it's frustrating... but things will work out in the end you'll see.

[NursinOrBust]

I applaud the clinical instructor for giving the students as much clinical experience as they can safely provide. We need more instructors who take the initiative to do such things so that students get a chance to see and do as much as possble.

I agree, when it is for the students not student!

[AprilRNhere]

I hate to say it..but ditto everyone else. Clinicals are not fair...sometimes they really stink. Remember they are not your friends..and it is just a period in your life. If you cause waves now..it could affect the rest of your life. Unless there's really a patient safety problem....just focus on YOUR experience. If you want to do more skills...discuss it with the instructor...and ask to do them. Otherwise don't worry about what everyone else is doing.

My clinical experience was often negative. So much so that 2 other girls in my clinicals...turned in my CI after we were done about their treatment to me. I just let it go every week and focused on learning...and patient care.

[NursinOrBust]

Thanks for the replies. There were a lot of things said here today that I really needed to hear and I appreciate it.

[justme1972]

I applaud the clinical instructor for giving the students as much clinical experience as they can safely provide. We need more instructors who take the initiative to do such things so that students get a chance to see and do as much as possble.

I disagree with this...with first semester students (of which I am one) I see this as a very dangerous practice.

To me, there is a difference between a fully trained, licensed RN being handed a sheet to learn a procedure and seeing a video, etc. vs new students that have no such training.

If the clinical instructor isn't around, and no instruction is given...HOW can you call this practice safe?

To me, it isn't safe just b/c someone didn't get injured.