taking students, precepting

Thunderwolf, MSN, RN · Nov 4, 2005

Excellent posts, folks.

blueiwahine · Nov 4, 2005

Agnus,

I understand where your coming from but there is also a flip side. I am an older student about to graduate. Our instructors tell us we can not do a skill the first time until they are there with us. Needless to say I missed alot of skill opportunities waiting on her. I also feel that I am in the nurses way, because what school says we can do or can't do without them around or do not say at all. I know my experience in nursing school has not been the greatest. I feel from day one they have just let us out in clinicals on our on and feel we are suppose to jump into running. Some days I wouldn't see my instructor until post conference that afternoon. I don't know if they felt like I was older and thought I had it all under control or what (Yeah right!)...My instructor this last semester was awesome to take the time with us all and make sure to see us during clinical days to explain, etc needed info. I love nursing and enjoy caring for patients.. Again, I understand you are use to your routine and don't have time to deal with teaching a student and your workload...but experienced nurses is where we learn most of our real world nursing experiences...it's not from our teachers or the books...If we don't have nurses willing to be inconvenienced and put out...we won't have new graduate nurses coming into the field...which will lead to more nurse's having to work long hours and getting burned out. So all you nurses's out there...we need you guys to teach us your experiences...I know I appreciate every thing I learn from the nurse I am with that day.

Deb

lisamc1RN, LPN · Nov 4, 2005

My own experience has been that there are a couple of nurses on the floor I'm on now who grin and bear it when working with students. I take the attitude that I am going to be the least amount of burden on them as I can possibly be. I don't blame them for not wanting to work with students, no matter what their reasoning may be. Not everyone wants to do that. It's ok. I think it is the responsibility of the student to have their ducks in a row as much as possible. Go in prepared and informed! Seek out information from more than one source. We have an instructor, books, the computer, and many more resources at our disposal. Also, I think it's a good idea to let the nurse know that you know she is very busy and you do not want to be a burden to her and ask how best you can be of help. Where I am, if there is an invasive procedure such as an IV or foley, I have to get my instructor to observe, which can be frustrating if she is busy with another student. Sometimes that foley can't go in right away if it is dependant upon me. We can ask the nurse how much time leeway do we have for the procedure. If it has to be done asap and the instructor is not available, I just offer to observe or assist.

Kudos and many thanks to all those wonderful preceptors out there who are willing to teach students. It is much appreciated. For those who find themselves stuck in the position but would rather not be there, thank you too. You all deserve extra praise (and pay) for your efforts!

kim0190 · Nov 4, 2005

I am a student, and wondering--where is the clinical instructor in these cases when the nurse is bombarded with questions from the students? In my clinicals, I have been lucky so far with the nurses on the floor. However, we generally notify them in the morning that the students are assigned to these certain patients, and will be passing meds, doing am care, etc... and then we basically just report off to the nurse at the end of our time there. We may ask a question about something, or report something sooner that we feel the nurse should know, but we use our clinical instructor for the bulk of our questions. I would also get very frustrated if I was told to take someone under my wing for a day and then had to babysit them the whole time. I thought that was the purpose of the clinical instructor, to be there on the floor with the students, helping and assisting with procedures that we are unsure of. I will also say that I do tell the other nurses that if any patient needs anything else, please let me know and I'd love the experience of doing whatever I can. The hospital I am at now-Fairview-has been exceptional. The nurses on the acute rehab floor were actually so glad to have students, they came looking for us to show us all sorts of new things as they came up, that was wonderful. It is very nice to have nurses glad to see students-and also nice when the student lives up to the nurses expectations of them.

Fgr8Out · Nov 4, 2005

Hi Agnus,
I am just curious to know, when you were fresh out of school, did anyone precept you? And if someone did... imagine if they had your same attitude.

Thank you, badkids. I was wondering who everyone performed their clinicals with during nursing school as well...nad I'm leaning towards the idea that they trained with nurses who were equally sour. But the postings do prove a point; not everyone has the right aptitude to nurture our nursing students. I won't allow my CNA students to come near such nurses, as my CNA students are future RNs and don't need such negativity so early in their education. I've seen the tides change at our facility, however, as fewer CNAs and Nurses refuse to accept a student. We understand the value of these opportunities to educate one another, and are proud to share our expertise.

Raspberries to those of you pickle suckers... life is too sweet.

SoniaNurseRep · Nov 4, 2005

I agree that being a Preceptor can be difficult and must be voluntary, but have you ever wondered what would happen if we all shared your feelings.

Another aspect is that it is the responsibility of the employer to ensure that the working conditions are condusive to teaching/learning. Maybe then, we would be willing to bite the bullet, for the future of nursing!

crb613, BSN, RN · Nov 4, 2005

I am a student & I love clinicals. I also know I have the responsibilty of being prepared. I look up my meds, read up on the dx, have a plan of care ready when I get there. I pray for guidence, knowledge, & please Lord don't let my inexperience harm anyone. I work my butt off & I want to learn so badly....I don't care what it is just give me a chance to do it. I am scared to death & what I know you could put in a thimble & what I need to know could fill the bottomless pit! I will graduate in May & have been doing full care of 2-3 pts. & I run my legs off....I don't know how you care for 6 or more plus having students. My hat is off to you, I would just like to say thank you for helping us learn because without you we would be more lost than we already are. :wink2:

GrnHonu99, RN · Nov 4, 2005

Unless you were told you HAVE TO precept students as a condition of being hired then no one should have to do it if they don't want to. Why would anyone want to be with a preceptor that doesn't want a student?

I can feel how annoying I probably am at times. Running after my nurse, asking questions that must seem silly to her...getting in the way sometimes...I can definetly see how taxing that could be!

JohnBearPA · Nov 4, 2005

Seems to me that too many nurses forget that they too were students once. Fortunately, you seem to recognise that you don't have the patience to take on a student, and I'm sure your supervisors also recognise that. I haven't been in the real world that long, having just graduated in June, but have already participated in precepting a new nurse in my facility, and have had a student for a day watching and helping me do several procedures. I can see where the perception that "Nurses eat their young" originated, and refuse to perpetuate it. Also, remember that students get "graded" on procedures they perform, and their instructor must be present while they do the procedure. However, if the instructor isn't available, by all means move on and do the procedure yourself.

I'm sure my post will anger some of you, but again, remember, we've all been students. No one gave us a license and degree without all the hard work we put into getting where we all are today. Remember how scared and unsure you all were when you did your first cath? Let's give the students their due for choosing a profession where they are underpaid and underappreciated, and help mold them into the great nurses they can be instead of making them bitter and resentful of senior nurses that don't want to take the time to do anything but ***** about their ineptness.

weezledawg · Nov 4, 2005

I do not precept and I do not take students. At one time I thought I would never say this. However, students deserve better. I want you to learn and do well and have good experiences.
Taking students is very taxing and time consuming and frankly at times frustrating, when we are not on the same sheet of music.
It takes a lot of energy and patience and teaching to take on a student. I don't have it. And when I have a day when the demands are already high I do not need to spend extra time and energy with a student.
I will accept a student occasionally but not as a matter of routine. Ask me first. Perferably ask me after I know what I am up against for the day. If I have a patient go real sour very fast I need people I can rely on around me not a student.
I will galdly allow you to do proceedures on my patients when you are with another nurse. However, if I say this patient needs cathed and you waite several hours until you get around to it don't bother. I saw this done when anouther nurse offered to let a student do a cath. The student was with a diffrent nurse and both accepted the offer. Yet more than 2 hours passed and they made no move toward doing it. The patient was suffering. The student with her nurse was not that busy. The nurse who had the patient continued to waite after reminding the student because another hour passed. Finally she did it herself. I am not here to waite until it suits the student to do a procedure. If you want the experience take it now or not at all. Life moves fast in a hospital. Be pro active.
Be willing to jump on an oportunity when it presents itself. Waiting does not cut it. True you may not be able to jump on every oportunity if you can't because you are taking advantage of another opertunity say so. Say when you will be free and keep that commitment or at least tell the nurse you will not be able to keep it.
I found myself a few weeks ago trying to explain something to a student and I realized that because it is so ingrained in me by now I do it automatically and could not explain it. For many of us it gets to be that way. I do not want to go back to where I have to think about every detail so I can explain to a student. I want to just do it and be done with it.
Because you deserve better than what I am willing to offer I will not accept you on. If you are a pia (pain in the tush) for what ever reason I don't want to react to that in an unkind or unfriendly way. You deserve better. I deserve to choose to just do my job without the added stress and challenge of teaching, and being a textbook example because that is what you need right now.
I did have a student last week for one day. He was within 2 months of graduating. I tried to get him to do the meds. He told me he, "has the procedure down and does not need to do it." He watched me. HELLO. I am not the student. I really do have it down. Either you are here to practice your clinical skills or you are not. I did not respond it was his loss. He watched me do assessments. I had to push him to do assessments and they were incomplete. Why was he even there. What a waste of both my time and his.
I guess he had that down too. So why tell me why did he even show up if he had everything so down pat that he did not need to do anything. He lef tsaying he would ask to work with me again. I think not. I know this is not every student. But no matter how good you are you take energy that I am not willing to give as mine has become limited as I age.
You may find that unfriendly but I can assure you you will see more unfriendly if I take you on. You need and deserve much more than I have to give.

I would just like to say that not all students adopt this type of attitude. As a first semester RN student, I can honestly say that a clinical experience, while already frightening, can only be compounded by a nurse who clearly does not want to assist in the learning process of a future nurse. As a student, I try to align myself with nurses that have the skills and the desire to teach, because not all nurses that are adept at their jobs can teach as well as they work.

I am sorry that you have had such discouraging experiences with students - our program really wouldn't tolerate a student just watching the nurse do procedures. The other students in the program wouldn't swallow it either. We are all highly motivated to get in there, keep up and hone our skills so that someday we can be as proficient as our role models. Nurses on the floor are role models. I understand that you are busy, but how can you ever expect more help if you aren't willing to train us babies? Overall, the preceptor/student relationship can ultimately benefit all involved, if given a chance.

I didn't mean for this post to sound negative - this is not my goal - but as a nursing babe, I already feel like I am in the way of the nurses. Maybe some of the nurses who have been there and done that with students can suggest ways that we as students can facilitate learning while not being pias.

weezledawg · Nov 4, 2005

Seems to me that too many nurses forget that they too were students once. Fortunately, you seem to recognise that you don't have the patience to take on a student, and I'm sure your supervisors also recognise that. I haven't been in the real world that long, having just graduated in June, but have already participated in precepting a new nurse in my facility, and have had a student for a day watching and helping me do several procedures. I can see where the perception that "Nurses eat their young" originated, and refuse to perpetuate it. Also, remember that students get "graded" on procedures they perform, and their instructor must be present while they do the procedure. However, if the instructor isn't available, by all means move on and do the procedure yourself.
I'm sure my post will anger some of you, but again, remember, we've all been students. No one gave us a license and degree without all the hard work we put into getting where we all are today. Remember how scared and unsure you all were when you did your first cath? Let's give the students their due for choosing a profession where they are underpaid and underappreciated, and help mold them into the great nurses they can be instead of making them bitter and resentful of senior nurses that don't want to take the time to do anything but ***** about their ineptness.

I couldn't have said this better myself.

ceecel.dee, MSN, RN · Nov 4, 2005

Are you referring to the nurse that does not like to precept or.... the student that is difficult or those that are upset that a nurse admits that she does not like to precept?

Great questions!