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-)
OP... that student isn't uncommon. My BSN program that has a 97% pass rate didn't teach us sticks about real nursing practice. We had labs where we watched the instructor prime tubing for an IV. That's it. Clinicals consisted of us choosing a patient the day before and writing up everything about the meds, patho of the disease processes, and nursing diagnoses for that patient. Very, very little of our clinical time was spent assessing or learning anything practical.
Once I asked a nurse if she would show me how to start an IV med... she let me follow her and observe as she (quickly) did it without any instruction whatsoever. She left the room without a word.
Many days of our clinicals were spent rotating throughout specialty areas such as OR, IV therapy, dialysis, etc... I never felt like I was learning anything in clinicals.
Every school is different in their approach. I do my best nowadays to be kind to students, stay with them when there is something to do and learn, and take every opportunity to teach (or make them teach me) something new. I will not perpetuate the misery that was nursing school and never look down upon students if they don't know something.
Now that I'm a grad student, I realize that the same will go when I'm an NP. My current preceptor is hot/cold. I never know when she'll be nice to me or make fun of my shoes like she did the other day. Some people simply don't know how to treat others with respect.
Well, um, how hard would it be to show a new BSN nurse how to spike a bag? It's pretty darn easy. Pull off that cap, point the sharp thingy in that little hole, and SPIKE IT.
May take 3, maybe 4 seconds to teach it. It's just not that complicated.
(of course, you want to make sure your bag isn't leaking, fluid isn't expired, it's the RIGHT fluid, right volume, rt. pt, etc.)
This is what gets me about precptors/nurses sometimes...they blow everything up out of such proportion. They, as well as nursing school professors -- make such simple things so complicated -- then berate us for flubbing up the 15 steps someone has written to to "teach" this skill -- when one COULD SAY:
Yeah, just pull of that cap thingy and spike it with the sharp part -- DONE.
Oh, and hang it on the hook up there. DONE
Oh, you want to "prime" it? squeeze that little tube, open up your valve thing there, and let the fluid run about. Flick away all the bubbles. Then use one of those orange things to hook it up to the pt.
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.
Mike-
You're posts are ALWAYS my favorites, you are so darn funny.
This is what gets me about precptors/nurses sometimes...they blow everything up out of such proportion. They, as well as nursing school professors -- make such simple things so complicated -- then berate us for flubbing up the 15 steps someone has written to to "teach" this skill
Ha! So it's not just me?! How about every time you write a care plan having to reference a text that notes the importance of hand-washing or the like?! Sigh!
My experience was that the nursing instructors would make simple tasks out to be these VERY IMPORTANT, MUST DO IT JUST THE RIGHT WAY tasks... and like you said, break it down into so many smaller steps that it was sometimes ridiculous... and then reprimand you for not doing it JUST SO, even while it's safe and often how it's done in the real world. And then, if students were concerned about getting enough hands on experience with such tasks, the instructors would dismiss those same tasks as easy enough for a monkey to learn and easily & quickly picked up on the job. Ugh!
My experience with nurses/preceptors is that many have their own way of doing things. So if they saw a student/new grad doing it differently, they'd seem to assume the student/new grad didn't have a clue and would immediately jump in to do it "right" - often without explanation. After all, if working with a student or preceptee the patient is still THEIR responsibility. And also, they haven't had the luxury of taking the time to reflect on what and how they do their work... having to get things done ASAP & always having more to do next. Stopping to explain, even for a few minutes, is so out of their usual pattern, that they just don't know where to start - and so they roll their eyes at the inconvenience and do it themselves.
Meanwhile, other experienced nurses would be doing whatever it was that other way, but since they had already earned their stripes, the same nurse/instructor wouldn't tell the other nurse that they were doing it wrong.
Well I am about to complete my first year of a BSN program and we aren't allowed to do anything with IVs. I'm pretty sure we learn that next semester, but I could be wrong. We do all of the other meds without a hitch, sometimes without the instructor present (if she is okay with it). We don't have our Peds rotation until the beginning of our Senior year, so I still have another year before that.
There are a few of my classmates who have difficulty performing clinical tasks that we were taught, but even when someone is confident in it it is always better to ask and learn than to mess it up and make a huge ordeal out of it. Doesn't take too long to teach and you will have gained a lot of respect from that student/nurse's eyes because there are so many people that want to harass them for asking questions, but get ****** if something isn't done perfectly.
Well I am about to complete my first year of a BSN program and we aren't allowed to do anything with IVs. I'm pretty sure we learn that next semester, but I could be wrong. We do all of the other meds without a hitch, sometimes without the instructor present (if she is okay with it). We don't have our Peds rotation until the beginning of our Senior year, so I still have another year before that.
There are a few of my classmates who have difficulty performing clinical tasks that we were taught, but even when someone is confident in it it is always better to ask and learn than to mess it up and make a huge ordeal out of it. Doesn't take too long to teach and you will have gained a lot of respect from that student/nurse's eyes because there are so many people that want to harass them for asking questions, but get ****** if something isn't done perfectly.
All the programs are very different. but I know that in my school and in that school, medsurg comes first before peds.
and in the first clinical class we are taught the basics. how to spike a bag, how to crush pills, how to give insulin, how to do piggybacks etc etc
and mind you when we come to clinicals we have to do everything infront of the instructor, we are never left alone with the nurse...... GOD FORBID if we are seen with the RN during clinicals (we are with RN during our last semester)
I know I was very nice to the student who was not sure how to spike the bag........... he didn't voice he wasn't sure, or that he didn't know how to work with the bag and the spike..... but I know as a nursing student if you want to try something you ask. and he voiced "I WAS GOING TO DO IT" so therefore, I let him do it, I noticed he struggled with it, so I showed him what to do, he had questions and I answered them and he did it... and he thanked me and asked me if I was going to be the patient's nurse for the day.
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-)
all the programs are very different. but i know that in my school and in that school, medsurg comes first before peds.
and in the first clinical class we are taught the basics. how to spike a bag, how to crush pills, how to give insulin, how to do piggybacks etc etc
and mind you when we come to clinicals we have to do everything infront of the instructor, we are never left alone with the nurse...... god forbid if we are seen with the rn during clinicals (we are with rn during our last semester)
i know i was very nice to the student who was not sure how to spike the bag........... he didn't voice he wasn't sure, or that he didn't know how to work with the bag and the spike..... but i know as a nursing student if you want to try something you ask. and he voiced "i was going to do it" so therefore, i let him do it, i noticed he struggled with it, so i showed him what to do, he had questions and i answered them and he did it... and he thanked me and asked me if i was going to be the patient's nurse for the day.
I think we all feel you've made your point: the student shouldn't have said that he knew how to spike the bag when he didn't, in fact, know how. Feel better?
Well, I still have trouble UNspking a bag, without either spilling fluids on the floor (or my shoes, or the pt's bed or the tech's hair which she just had done...), or causing the chamber to overfill, or getting the line full of air - particularly frustrating when the fluid involved is PRBC's.
I think we all feel you've made your point: the student shouldn't have said that he knew how to spike the bag when he didn't, in fact, know how. Feel better?
I agree. Her point wasn't against bsn/asn students. It wasn't that she was a poor teacher. She came to vent and this post has gone on long enough. As a student and as a nurse don't say you know how to do something when you don't..Let's all move on?
yellow finch, BSN, RN
468 Posts
OP... that student isn't uncommon. My BSN program that has a 97% pass rate didn't teach us sticks about real nursing practice. We had labs where we watched the instructor prime tubing for an IV. That's it. Clinicals consisted of us choosing a patient the day before and writing up everything about the meds, patho of the disease processes, and nursing diagnoses for that patient. Very, very little of our clinical time was spent assessing or learning anything practical.
Once I asked a nurse if she would show me how to start an IV med... she let me follow her and observe as she (quickly) did it without any instruction whatsoever. She left the room without a word.
Many days of our clinicals were spent rotating throughout specialty areas such as OR, IV therapy, dialysis, etc... I never felt like I was learning anything in clinicals.
Every school is different in their approach. I do my best nowadays to be kind to students, stay with them when there is something to do and learn, and take every opportunity to teach (or make them teach me) something new. I will not perpetuate the misery that was nursing school and never look down upon students if they don't know something.
Now that I'm a grad student, I realize that the same will go when I'm an NP. My current preceptor is hot/cold. I never know when she'll be nice to me or make fun of my shoes like she did the other day. Some people simply don't know how to treat others with respect.