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-)
Is it more important to know how to spike a big or know the pathophysiology of the patient's condition and know what to do? Well, both are equally important as they ultimately contribute to the overall well-being of the patient...
I agree! The whole educational philosophy that anyone can quickly learn basic skills so students don't need to be taught them before they start working is counterproductive. There is so much for new nurses to assimilate already without being slowed down by having to learn how to perform a bunch of basic skills as well.
I am a senior nursing BSN student and I will graduate this May. I definitely lack some basic clinical skills. My instructors say that they focus on the theory and critical thinking skills more than the clinical skills. I guess they figure that I'll learn more clinical skills on I'm working on the floor. Which is true because finished my preceptorship on Telemetry floor about 2 weeks ago. I learned a lot of skills that I hadn't learned since the first semester of nursing school such as spiking an IV bag. We are taught these skills in the very first semester in a crash course over a few weeks for about 6 to 8 hours a day. We went to the hospital a few times a week and practiced some skills but spent most of the time working on the clinical paperwork (long) that was due that day or the next. Also, how am I supposed to learn a skill if I did it once in first semester and maybe one or 2 times in 5 semesters?
Honestly who cares if he did not know how to spike the bag. My instructor told us you could teach a monkey how to spike a bag, hang a piggy back, give a shot, etc. Not to mention as a student he is obviously a little nervous and insecure. Big deal after 2 weeks on the job he will be spiking with his eyes closed. Over time that theory he learns will transfer into practice while connecting the dots and pay much bigger dividends. Just my take...
Honestly who cares if he did not know how to spike the bag. My instructor told us you could teach a monkey how to spike a bag, hang a piggy back, give a shot, etc. Not to mention as a student he is obviously a little nervous and insecure. Big deal after 2 weeks on the job he will be spiking with his eyes closed. Over time that theory he learns will transfer into practice while connecting the dots and pay much bigger dividends. Just my take...
Yeah, yeah, that's what all the faculty say nowadays -- if it's so !@#$% easy to teach those skills, why don't they !@#$% teach them?? (And I say that as someone who has been in and out of nursing education, in both ADN and BSN for over 15 years -- I'm not mad at you, I'm mad at my fellow nurse educators ...) And there plenty of basic skills much more complicated and risky than spiking an IV bag that students aren't getting taught, also.
In my experience, the best *teaching* nurses are the ones who are eager to show or talk me through a skill they can see that I'm clumsy with. Instead of expressing shock about what the student doesn't know (how does that attitude help the situation?), try looking for ways to come along side to help them improve. IMHO your attitude of shock that the student isn't up to your expectation is a real barrier to you being an effective teacher. If they sense you're disgusted with them (and I'm sure they do), the last person they'll want to turn to for help and instruction is you.
It really doesn't matter when their nursing program teaches a particular skill or what you learned by their stage in school. There's an old saying that goes, "No one cares how much you know until they know how much you care."
My gut response to your original question, "Are they supposed to know this by now?" is does that really matter? They're at where they're at. The next time you see a student struggling like that, you might want to try, "I can see you're having difficulty remembering how to do this. Can I help walk you through it?"
now you would make a great teacher.
Teaching is a gift that sadly many nurses do not have. I for one would rather teach a student something rather than say work in the Icu and say hey my pt was on these drips and this and that and Yup you can tell I will never work in a ICU it just does not speak to me at all as my teachers would say
Yeah, yeah, that's what all the faculty say nowadays -- if it's so !@#$% easy to teach those skills, why don't they !@#$% teach them?? (And I say that as someone who has been in and out of nursing education, in both ADN and BSN for over 15 years -- I'm not mad at you, I'm mad at my fellow nurse educators ...) And there plenty of basic skills much more complicated and risky than spiking an IV bag that students aren't getting taught, also.
Well maybe some skills came easier because I was an aide in my last year of school and had more hospital exposure. Someone completely new to the environment may be more intimidated by spiking an iv bag. I too wish we had more clinical time in school. Unfortunately my clinicals consisted of me doing mostly aide work which was frusterating. It just seems that nursing is learned on the job. I'm not sure how much school can prepare a person besides mostly theory. I always thought role playing and the use of more case studies during classroom time would be most beneficial. To be honest my instructors reguritated power point slides that I could read on my own time. I don't know, after rereading my above post it sounded a little insulting. Although, I was quoting my instructor. Well I have my own fears such as all the multi tasking, being assertive with delegation, taking orders, constantly rechecking myself etc....but I am new and hope this improves with time - I have lots to learn. Additionally as a student nurse you really never know your role so I empathised with the BSN student you first mentioned. To me it seems all of those skills come with repition. Have a great weekend!!!
in reading a handful of the replies to the original question, i have to say that i am really feeling sorry for the one asking the question. it was just a question, after all. i feel as though she handled the situation with the student very professionally. what she thought were her own private thoughts. it is how she handled the situation that mattered and she handled it very well. it sounds to me as if she was patient and kind to the student and offered him a learning opportunity.
as for my own experiences with different programs and the feedback that i have heard, adn nurses are pushed through faster, thus having no choice but to learn the skills and get on the floor and do them, whereas bsn students learn more history and theory of nursing and go at a slower pace. this could explain why this particular bsn student did not know how to spike the iv bag yet.
on another note, at the risk of getting a lot of critcism-most nurses that you talk to will tell you that the nursing students that are in the faster paced programs are better workers as they are taught to get out there and do it as a way of learning, whether it be emptying bedpans or starting ivs.
thank you for actually reading and understanding what i wrote!
alot of people just write responses without actually grasping what i was writing and are so quick to judge in their responses! lol:chuckle
i know i am very helpful with my co-workers and the students as best as i could be.
i take my job very seriously and hopefully one day i will be a preceptor to someone else, and will do a better job than the people who precepted me.
Yeah, yeah, that's what all the faculty say nowadays -- if it's so !@#$% easy to teach those skills, why don't they !@#$% teach them?? (And I say that as someone who has been in and out of nursing education, in both ADN and BSN for over 15 years -- I'm not mad at you, I'm mad at my fellow nurse educators ...) And there plenty of basic skills much more complicated and risky than spiking an IV bag that students aren't getting taught, also.
I never spiked bags on "real" patients until I got started working on my floor. But I can tell you that I did not have a struggle with it or have my preceptor show me how to do it, because I had done it a MILION TIMES AND OVER at my school's practice labs.
So I suppose that in so many words to answer my question and most 'hostile' and 'unfriendly' threads: are they supposed to know this by now? is "NO"
the students nowadays are not supposed to do anything, because their schools, I have to assume, that they don't have labs to practice at, they don't have manequins as practice patients and practice IV tubings, and practice IV bags, and they don't have syringes to practice giving IM shots or SQ injections...... and they don't have practice return demonstration exams.......
so I don't understand then why we have to go to clinicals if everything we have to learn on the job. we can just go to therory classes.
"the students nowadays are not supposed to do anything, because their schools, I have to assume, that they don't have labs to practice at, they don't have manequins as practice patients and practice IV tubings, and practice IV bags, and they don't have syringes to practice giving IM shots or SQ injections...... and they don't have practice return demonstration exams......."
With all due respect, practicing on plastic people is MUCH different than doing it on real patients. The lab can only simulate to a certain extent how it will be in real life. There is no substitute for doing the skills on real patients, in a real setting, with real complications that cannot and do not come up in a perfect lab with perfect plastic people who have perfectly proportioned body parts, that don't bleed or void or occlude or feel pain.
All I'm saying is..............sometimes, lab practice just does not translate well in real life.
Example........... I had to do a foley cath last night during preceptorship. I had practiced dozens of times in lab, had 2 successful attempts at the real thing over the last couple semesters (both women)........ but I had to do it on an older gentleman. His parts were not like those on my perfect plastic lab guy. I struggled mightily, so much that my nurse had to step in. I was embarrassed........ kept telling myself that I should be able do it right the first time. Afterwards she gave me tips on what to do differently the next time. I was so grateful she didn't belittle me.
Patience towards students can go a long way. I think the seasoned nurses can learn a thing or two from the newbies, too. :nuke:
Specializes in Trauma ICU, Surgical ICU, Medical ICU.
I recently graduated in Aug 07 with a FOUR YEAR and went to work right out of school in the ICU. As a student I had SEVERE anxiety during clinical rotations and there were many times my mind completely went blank during simple things like spiking a bag. I even had panic attacks during tests where you were supposed to act out interventions such as putting an NG tube in, suctioning pt's trach's, foley insertion, etc. I was NEVER fully comfortable with working an IV pump until I became an RN and messed with them EVERY day! As students, we were scared poopless of doing something wrong and getting failed because of it. I mean, if we did this simple thing WRONG we (in our minds) thought we would be done in our nursing career. People who arent so cautious scare me to death. I'd rather have a student come to me now and say "can you help me" than do it wrong! You can really hurt people with an over-zealous "know it all" attitude when you may not know some simple things. If you have this attitude, I really hope it doesnt show, for the sake of people you precept and for the sake of nursing students around you.
thank you for actually reading and understanding what i wrote!
alot of people just write responses without actually grasping what i was writing and are so quick to judge in their responses! lol:chuckle
i know i am very helpful with my co-workers and the students as best as i could be.
i take my job very seriously and hopefully one day i will be a preceptor to someone else, and will do a better job than the people who precepted me.
it bears repeating that it's a little hard to read a post on the internet and take in all the "between the lines" stuff. you have no body language to put the words in perspective. i think maybe a lot of people are relating the op to comments they've heard or overheard in the real world. saying what you said to another nurse on your unit might qualify as a bit snide, but on these boards, it's probably less likely to get back to the student, or to color the perceptions of others he needs to work around. (not that it's wise to assume we're completely anonymous--that student might have read that post and know exactly who is talking about whom.)
is it wrong, on principle, to be "shocked" by a student's lack of preparation? well...maybe in a way. there are those who'd say your true feelings are bound to come through. certainly, it would be wrong to try to compensate for one's own insecurities by being hypercritical of others. is being privately shocked a precursor to that? it could be. on the other hand, are we nurses the perfect little angels of mercy the world seems to think we should be? do we always have perfect empathy for our patients, their families, or our co-workers? or do we try to put up a civil front and go cuss that pita up one side and down the other in the med room? does any nurse with more than six months' experience--heck, six weeks' experience, have to ask what pita stands for?
let's face it. few, if any, of us are as invariably sweet and kind as we're supposed to be, so in the face of all the sweetest and kindness we are supposed to pretend to, we probably need some outlets for the streak of evil we nearly all have. just one of the many benefits of allnurses.com.
Well maybe some skills came easier because I was an aide in my last year of school and had more hospital exposure. Someone completely new to the environment may be more intimidated by spiking an iv bag. I too wish we had more clinical time in school. Unfortunately my clinicals consisted of me doing mostly aide work which was frusterating. It just seems that nursing is learned on the job. I'm not sure how much school can prepare a person besides mostly theory. I always thought role playing and the use of more case studies during classroom time would be most beneficial. To be honest my instructors reguritated power point slides that I could read on my own time. I don't know, after rereading my above post it sounded a little insulting. Although, I was quoting my instructor. Well I have my own fears such as all the multi tasking, being assertive with delegation, taking orders, constantly rechecking myself etc....but I am new and hope this improves with time - I have lots to learn. Additionally as a student nurse you really never know your role so I empathised with the BSN student you first mentioned. To me it seems all of those skills come with repition. Have a great weekend!!!
I see by your username that you are a thoughtful, intelligent, and perceptive person, and undoubtedly handsome, too, so I'm glad to see you back away a bit from your intstructor's statement. I also see from your profile that you are a student. May I say in all kindness that the day will come, in the not too distant future, when you will think to yourself, "That must be one smart monkey!" Nursing school is no picnic, but there are many who would tell you, including me, that the first year of nursing practice is just about the hardest thing they've ever done. Which is all the more reason to be as gentle as one can be with those going through it. But it's also reason enough to wish schools--at least some of them--would do a better job of preparing us for the ordeal.
jjjoy, LPN
2,801 Posts
I agree! The whole educational philosophy that anyone can quickly learn basic skills so students don't need to be taught them before they start working is counterproductive. There is so much for new nurses to assimilate already without being slowed down by having to learn how to perform a bunch of basic skills as well.