this morning after giving report, i was walking towards the lounge and noticed a call light on. i go in there, and ask the mom "may i help you with something?" and she and the bsn nursing student answer "the iv is beeping"
so i go and look at it, and the student mentions to me "the iv bag is empty" so i said "ok no problem" and i go to the iv pump to go and put in the new bag next to it. then the student says "oh, i was gonna do it"
so i said it was ok, i would be there to watch him do it.
he took the bag, and looked at it, like as if he's never seen an empty ivf bag before...... and i said "ok, i do it like this..." showing him how to do it, and he asked me "wont the fluid come out (of the chamber)?" and i said "no, it won't it's ok".... then he did it the way i showed him.
and i think to myself that this is a bsn student, and they have already done medsurg before and he didn't even know how to spike a new iv bag.
i was spiking iv bags, priming, giving piggyback megs, flushing iv's the first semester of nursing school. and mind you, i went thru an asn program.
i don't understand why a bsn student from a state school would not know how to do this by the peds semester.
anyways, i heard their instructor telling the charge nurse "the students are doing everything but meds"
so back to the student, isn't spiking an iv a skill that they should know by the peds semester?
btw that school-bsn- has a 78% pass rate on nclex-rn exam, and my school has a 98%-asn-)
Every student who arrives on the floor should take 3 minutes with the nurse they are assigned to, to address what they are allowed to do and cannot under any circumstances do. What they can do as long as the RN is in the room, and what they can do on their own independently. Also this is the time to say what you are uncomfortable doing on your own and will need help with. (in my case as a GN, I have never gotten to deal with a trach patient, so you can bet your bottom dollar I will want and need a watchful eye if I am cleaning a trach or suctioning one for the first time etc...) This allows everyone to be on the same page, and allows the nurse the opportunity to decide if he/she wants to watch the student do certain tasks and assess what the students plan for the day is and tweak the plan if need be. I did this with pretty much every nurse with whom I was paired and only had one or two nurses who still were "problem" nurses throughout my student clinical experience.
In the program I graduated from, EVERYTHING depended on who you had for a clinical instructor. Some would just dump you off on the RN, and sit in the lounge and read or watch TV for the entire clinical. Others were very hands-on and right there with you....you know....teaching! If you had an RN who was very busy, or resentful about having a student foisted upon them, you spent the day looking for anything to do...and honing your bed-making skills.
By the time I was a junior, I felt very behind some of my classmates due to the luck of the draw. Of course, I was a PRO at making beds. :)
One of the things about our lab, at least, is that it's not like we start with brand new equipment and supplies. Most of it has been used by many students before. So, even if you had never seen something before, the holes/marks pretty much told you how it worked.
Take the same stuff and park it in a room with a frustrated patient, beeping alarms and no "road map" to follow, and it's easy to get stumped momentarily. Sometimes being in the hospital is like information overload. Not to mention that many of the supplies in the hospital are very different from lab, or even the next hospital. When I first started working, the IV bags were totally different. I remember thinking, "Uhhhh....this one has 3 holes and 2 rubber thingies. Poke which??" I'm SO glad I had a great preceptor.
And...IMO....good/strong nurses come from all types of programs....just like poor/weak nurses.
We have a running joke on our unit between the adn/bsn nurses. If a bsn rn doesn't know something we (adns) say something along the lines of "Didn't you write a paper on that in apa format?" The other night two bsn's came up to two of us adn's and asked how to get a ng unplugged. We both said, "Did you try Coke?" What? Where did you learn that? "Community college, go write a paper on it" If I am stumped on something they poke right back, "We learned that at University" All said in a snooty, funny, 3 o'clock in the morning manner. It is never mean, it is just funny. I want my BSN too, someday. Like previous posts, it doesn't matter, there are good and bad nurses from both programs.
We have a running joke on our unit between the adn/bsn nurses. If a bsn rn doesn't know something we (adns) say something along the lines of "Didn't you write a paper on that in apa format?" The other night two bsn's came up to two of us adn's and asked how to get a ng unplugged. We both said, "Did you try Coke?" What? Where did you learn that? "Community college, go write a paper on it" If I am stumped on something they poke right back, "We learned that at University" All said in a snooty, funny, 3 o'clock in the morning manner. It is never mean, it is just funny. I want my BSN too, someday. Like previous posts, it doesn't matter, there are good and bad nurses from both programs.
LOL that is so funny. but the BSN is a lot of writing, and in my ASN degree it was all nursing theory and clinical. but I love it.
I know all the nurses in my floor are great nurses who went to a university for nursing. and they are wonderful.
I never meant to say 'oh the ASN is better than BSN' because that is not true.
I just know that the school where the student was from, is where I wanted to go to school originally (BSN) and peds is after medsurg, and fundamentals. so spiking IV's is something very simple that the student should have known, since he stated "oh I was gonna do it" (assuming that he already knew how to it) and if he wasn't sure he should of told me. If I would of left him alone.... since I was on my way to clock out after giving my report, all the IVF would of been ON THE FLOOR!!'
If I don't know something i ask.... and often I have my co-workers looking at me like I am a big dummy or they laugh at me... but I just brush it off, learn and move on that's all.
As you can see in the first part of my post, I showed the student how to spike the IV. and I did it in a kind way without looking down on him....(he was such a cute, tall, handsome nursing student BTW)
and he thanked me after it was done, and asked me if I was the nurse for the patient, and I said "I am gone!" and he said "oh you are night shift" .....
Every student who arrives on the floor should take 3 minutes with the nurse they are assigned to, to address what they are allowed to do and cannot under any circumstances do. What they can do as long as the RN is in the room, and what they can do on their own independently. Also this is the time to say what you are uncomfortable doing on your own and will need help with. (in my case as a GN, I have never gotten to deal with a trach patient, so you can bet your bottom dollar I will want and need a watchful eye if I am cleaning a trach or suctioning one for the first time etc...) This allows everyone to be on the same page, and allows the nurse the opportunity to decide if he/she wants to watch the student do certain tasks and assess what the students plan for the day is and tweak the plan if need be. I did this with pretty much every nurse with whom I was paired and only had one or two nurses who still were "problem" nurses throughout my student clinical experience.
my point exactly, my student should of told me to walk him thru it! but I noticed and ended up doing it anyways.
I managed to get through nursing school and my time as a graduate nurse without ever having given an IM shot. I have been a "real" RN for about 2 months now, and the other day when I was passing meds, one of my pts had an order for an IM abx. I got all of my supplies ready, quickly reviewed landmarks in my pocket nursing guide, and asked the charge nurse to come "hold my hand" while I gave the shot.
As we walked down the hallway, he reviewed the basics with me. When we got to the patient's room, he watched while I found my landmarks and everything. Now I have the confidence to do it by myself - in fact, I'm an old pro by now.
Had he said "Oh my god! Shouldn't you know that by now?!?", I don't know how I would have reacted. And I'm not a student ~ I am a full fledged RN.
We were all new once. We haven't always known how to spike a bag, give a shot, or even give a patient a bath. There is a first time for everything. And to those that have the patience and willingness to share their knowledge and "hold our hands", I for one say THANK YOU! And for those that wonder if we shouldn't know that by now, try to think back. Unless you were born with an IV bag in one hand and a tubing set in the other, there was a first time for you, too!
:nuke:
:twocents:I am very new myself! just off orientation for 2 weeks, and never have I said nor did I say to the student "you should know that by now" because I wouldn't like that to be said to me.
there are tons of things that I haven't done. but I admit to them, and ask before doing anything. I always go by "better be safe than sorry" attitude. I have people laugh at me, makes me feel like a dummy......but I don't care, I still ask, and if they laugh at me, I laugh back!
I am currently a nursing student, however, have been raised in nursing. As a student, I have observed other students beening fearful to ask staff nurses questions d/t being preceed as stupid. I think that it is very unfortunate and sad that ones that are so eager to teach, can treat others this way. Sure, we might be in your way or ask to many questions, but this is our time to learn.
Personally, I learned to spike a bag first semester of lab, however, if I did not review the steps for a specific prodcedure, I would be nervous too. I have never, not once, spiked a bag on clinicals, so my only experience has been one day in lab. Sure I have mastered other skills, caths, gtube feedings, ng placements, etc. I have even been a CNA for many years however if you dont use it, you lose it.
My two is, be nice, if you like to teach, then try instead of judging the student.
if the student tells me 'oh I was gonna do that' that is telling me that he knows how to do the skill in the first place.
if the student tells me, "oh I wanted to do it, will you just show me how because I have not used this kind of bag before" that is telling me that he knows how to, but has not seen the type of bag or equipment.
see the difference?
I love teaching, and I love learning.
My first day of orientation, I told my preceptor that "I don't know how to do anything"........ so she showed me how to do everything. how to use the IV pumps that I never used in clinicals, how to prime the IV line, since I didn't use that in clinicals, how to mix my morphine with my NS in clinicals.... I never told her "OH I WAS GONNA DO THAT"
when you tell people that, that is assuming that you already know it. that was my point.
I get your point..I will also freely admit that I tend to be a bit critical, in my mind only, of the students on the floor from the university which turned me away. I know it isn't right, I just am envious that they got in there and I didn't.
This school has one term of "med surg rotation". I mean one term only. My adn school was two years of med surg. Some students were picked to have a peds, ob or pysch roation for one term, however. I'll never forget that I gave Narcan on my very first day of clinical! We had a lot of great experience and I am grateful I went to that community college. Well let's be honest, I'm grateful I got in anywhere!
While working as a CNA at the hospital I had a new grad from the BSN program follow me (his idea) for the day. He confided in me that he had never emptied a foley! Talk about "Shouldn't you know this by now?" He and I talked at length about the differences in our programs. I didn't judge him or talk behind his back to our coworkers, I was just amazed. He said, "Nope, but I've written a paper on it." There are different ways of learning I guess.
I admit that I was scared to do things infront of my instructors, but I did it regardless. And I am happy there!
I actually got into a BSN program, but the first semester is theory, writing and advanced A&P
+ I have no loans (just the $2K left over from the BSN program I was in one semester), and now I am working on my BSN and the hospital is paying for it!!!
As a student I was scared to do things, and I understand what is like to be a student and scared.
but if you are supposed to know something and you don't, then admit it, learn and next time you will do it without any help!
While working as a CNA at the hospital I had a new grad from the BSN program follow me (his idea) for the day. He confided in me that he had never emptied a foley! Talk about "Shouldn't you know this by now?" He and I talked at length about the differences in our programs. I didn't judge him or talk behind his back to our coworkers, I was just amazed. He said, "Nope, but I've written a paper on it." There are different ways of learning I guess.
LOL, OMG that is too funny.
But even ASN students don't know some simple things, like the trach's moisturizer of air tube- I was working as a CNA and I asked the 2 ASN students if they new what it was, and they didn't!
My program was an hour away, I was rejected 5x from that ASN school (the one with the 2 students above), but when they would talk about it, and I would compare it with mine... I think mine was a lot more tougher on the students. can you imagine? NO CALCULATORS on a math test?! it's 2005-2007, the 21st century and NO Calculators?!
I know I can do my math, it's not rocket science math or calculus or anything like that.... but we are the only school in s.FL that doesnt' let you use calculators.
Now, at work, I have to use pen and paper to check my med, if I have to do a calculation..... in the NCLEX I had 3 math, and I think that I did the 3rd one right because it stopped after that.
Anyways, I am happy I went thru my ADN program, and I wanted an ADN program anyways, because I hate doing research and writing papers! but I know I have to get my BSN, but at least I will be able to focus just on the BSN part, and not do clinicals anymore since I am an RN already........
anyone gone thru the RN-BSN program? is it what I mentioned above?
we learned about trachs the first semester! they had the trachs already on the manequins at school. and God bless her heart, the lab instructor wanted to teach us everything the first semester. I wasn't even in OB semester yet, and she taugh us OB things, and ortho things.......... so I think that we learne a lot because of her.
:nuke:
:yeah:
smk1, LPN
2,195 Posts
Every student who arrives on the floor should take 3 minutes with the nurse they are assigned to, to address what they are allowed to do and cannot under any circumstances do. What they can do as long as the RN is in the room, and what they can do on their own independently. Also this is the time to say what you are uncomfortable doing on your own and will need help with. (in my case as a GN, I have never gotten to deal with a trach patient, so you can bet your bottom dollar I will want and need a watchful eye if I am cleaning a trach or suctioning one for the first time etc...) This allows everyone to be on the same page, and allows the nurse the opportunity to decide if he/she wants to watch the student do certain tasks and assess what the students plan for the day is and tweak the plan if need be. I did this with pretty much every nurse with whom I was paired and only had one or two nurses who still were "problem" nurses throughout my student clinical experience.