The struggling student continues, will she actually pass?

[MaraG.]

So, I have had an LPN student for the last four almost 5 weeks. I have spoken with her and her teachers about my concerns regarding her ability to perform assessments and relay important information, decide what assessments need to be preformed based on the patients condition, lab work or disease as well as ability to safely administer medications. She was put probation with her last evaluation and had specific criteria to meet. On her next shift she did not meet any of the criteria. She did not look up the reasons why pt were on the medications ordered she missed 3 medications for 2 different patients as well she did not report her assessment findings, which included a pt with a low grade temp that several hours later when she told me about it progressed to a high fever.

She admits that she does not look up the uses, how to administer or the monitoring required for medications.

I have worked closely with her and tried to help her understand the medications and diseases she works with. I have allowed her significant time at work to do her research and prepare her self for safely caring for her pt's

Her immediate teacher was very supportive of my findings and assured me if at any time I felt the student was unsafe I could send her home. At the end of our last shift, I told the teacher that I did not feel the student was safe. With only 5 shifts left, I felt that there was too much improvement needed for her to be safe at the end and that I did not think she could finish her preceptorship working at the level she was currently functioning.

Here is the kicker! I got a call last night, the student will be back on my next shift prepared to work and take on a full load. that all she needs to do is come in the day before and do her research and she will be prepared. Did I mention she only has 5 more shifts until she can work independently on an interim license? I said NO! You will have to find someone else to help this student. What is going on here? How can they try and push someone through that can does not demonstrate safe practice?

[MedSurgeMess]

That is way to scary. I think you need to talk to your director, and the instructor's director. This is just a bad situation waiting to happen. Make sure to keep notes as well

[Pepper The Cat, BSN, RN]

That is scary.

We had a student on our floor that couldn't cope if she more than 1 pt. Her preceptor tried and tried but 1/2 way through she finally had to tell the teacher that this girl would be dangerous. The student was taken off our unit. I believe that she was going to be asked to repeat her final semester before trying the pre-grad experience again.

The scariest part though, is that everyone was saying she was an A+ student!

Good for you for refusing to take her back. its difficult to fail someone, but pt safety comes first!

[XYcsccSN]

Okay...I have to ask. What was the low grade fever she failed to report? If it was less than 100.4F, it wasn't a fever and it wasn't that important to report. She should have monitored the temp if it was a raise in baseline and recheck in an hour or so.

[Chapis]

the fever issue is not the only issue this nurse is dealing with. the lpn student has had many talks with this nurse that is willing and going beyond what she is supposed to do. she doesn't look up meds, and other things that i cannot remember since the last thread about this student was like a week or two ago.

[everyday6/12]

I am coming in pretty late on the thread,but didn't you tell the student that they are not prioritizing and/or assessing within the scope of the methodology?? What seems to be the "lack of connecting the dots" for the student?? The student may feel pretty threatened and could it possibly be a personality conflict?? I read an article about a Nursing student that actually had her instructor as a patient in the ER and in the end the instructor was at the "mercy of her student" and indeed she had her doubts but in the end the nurse came through and gave good care. I can honestly see your side, but in time do you think that the student will overcome and gain the confidence and competence??

Nursing

Student Advocate

[CrufflerJJ, BSN, RN, EMT-P]

So, I have had an LPN student for the last four almost 5 weeks. I have spoken with her and her teachers about my concerns regarding her ability to perform assessments and relay important information, decide what assessments need to be preformed based on the patients condition, lab work or disease as well as ability to safely administer medications. She was put probation with her last evaluation and had specific criteria to meet. On her next shift she did not meet any of the criteria. She did not look up the reasons why pt were on the medications ordered she missed 3 medications for 2 different patients as well she did not report her assessment findings, which included a pt with a low grade temp that several hours later when she told me about it progressed to a high fever.

She admits that she does not look up the uses, how to administer or the monitoring required for medications.

I have worked closely with her and tried to help her understand the medications and diseases she works with. I have allowed her significant time at work to do her research and prepare her self for safely caring for her pt's

Her immediate teacher was very supportive of my findings and assured me if at any time I felt the student was unsafe I could send her home. At the end of our last shift, I told the teacher that I did not feel the student was safe.

First of all, THANK YOU :yeah:for being willing to precept students (that takes some bravery, as I told my role transition preceptor!), and for being willing to make the tough decision regarding this student's safety (or lack thereof). It seems like you've gone the extra mile with the student, offering detailed help. It seems like the student either doesn't care or doesn't WANT to do some important tasks properly & safely.

I hope that the "powers that be" don't try to slide the student past, and instead, support your decision.

[roser13, ASN, RN]

"What was the low grade fever she failed to report? If it was less than 100.4F, it wasn’t a fever and it wasn’t that important to report"

Picking a single factor out of the whole report to comment on is not really helpful. You must view the student's progress as reported, as a whole.

[everyday6/12]

Why won't she look up meds?? Isn't she an A student. She couldn't possibly be too lazy if she is an A student. What a stressful situation! I suppose I would have another nurse(Advanced) observe her and see what they think......and so you get another perspective that is fair and neutral. Also, think about discussing your concerns with the school so that they can learn from this situation and better teach future students. I taught public education for 12 years and this is another learning example for everyone to gain from......Good Luck woth your decision...and Thank you for being a teacher/guider to nurses....

JLnewnurse

[caliotter3]

Gee, I didn't see anyone trying to push me through, or help me through, or even help me period. What a shame this is happening. I am glad that you decided that you will not participate in this any further. Either way, nursing students need preceptors who will stand up for what is right for both the student and the patients. Good for you.

[MaraG.]

Turns out that the instructor asked my co-worker to take over this student, she declined. Apparently one of the higher ups asked that the student not come back to our floor.

I feel bad, I wish I could have done better, but you can only do so much with what you are given. I really wanted her to succeed and get hired. My understanding is that she can now redo a portion of her schooling and try again, I am sure she will be a much stronger nurse for it.

[MaraG.]

Thanks for all the support.