Yeah, you're probably reading the title and are thinking: *eye roll* "Another Nursing student who thinks they deserve a better grade than they earned." I promise you, it's not that.
I am at a clinical site for clinicals, and the evaluations I am getting are absolutely nit-picky and I am wondering if this potentially could constitute as harassment. Why? Because it is negatively affecting my grades. I have gotten written up for the following:
-"Student takes too many notes."
-"Student carries around notebook everywhere. This shows the student is 'carrying around notebook excessively to avoid patient-care encounters'". WTH???
-"Student asked about the IV procedures regarding another clinical site." (They didn't like that I asked that).
-"Student doesn't show initiative." Even though I do! I ask to do things. I insert IVs in patients, I do vitals, I perform tests, I put ECG 12 leads on, assessments, etc. My previous clinical site gave me great evaluations, and this site it's ridiculous.
-"Student made nurses appear stupid to patient by asking to retrieve a warm compress on a patient with difficult veins (Yes, you read that correctly). Additionally, student suggested looking on different areas of an arm before proceeding with contacting an I.V. team, making the nurse appear as though she did not know what she was doing." I was trying to be helpful, and as you can see, taking initiative at this point gets me in trouble (again!)
I've had it with my clinical site, and my director is not helping me whatsoever and I'm tired of it all. I've had so much anxiety around these people it's not even funny. Damned if you do, damned if you don't. I can't take it anymore! Please, anyone have any advice? I ask my director, she says, "Learn to be adaptable." I AM. Some Nurses let me do things, some don't, and the ones that don't write me up for not doing anything. And the worst part is: it's going to drop my average :(.
Yeah, just remember the classic saying: those who can, do; those who can't, teach/coach.
Feed everyone's ego and just do what they tell you. Ask questions, but don't advise. You're the bottom of the totem pole. Even if you're 100% correct and the nurse is an idiot doing something wrong, unless you stopped a major safety issue, they're too far above you to take that advice. You're almost done, then you'll have your license, and be working, and never have to deal with these people ever again.
And thank you so much for painting all educators as people who cannot do the job. Very helpful advice ?
I’m gonna guess it wasn’t what you said as much as how you said it and probably other things that have been perceived in a similar way that weren’t written down. Some people are easy to teach, others need to be taken down a peg before they start accepting that they still have a lot to learn. I think the lesson you should be learning from this clinical is that you need to be more teachable. Just a guess because I’m not there and we only have one side of this story.
Specializes in Psych (25 years), Medical (15 years).
On 8/31/2019 at 10:09 PM, Scorio said:
This shows the student is 'carrying around notebook excessively to avoid patient-care encounters
Student made nurses appear stupid
Scorio has been critiqued quite a bit and responds to them by coming back and answering others' posts. I appreciate and admire that.
These quoted statement portions caught my eye the first time I read Scorio's opening post. They are written as conclusively subjective interpretations of situations documenting them as fact when, in fact, they are merely opinions.
If indeed these were the exact words used to critique Scorio's behavior, then the instructors are involved in wrongdoing. Like feelings, no one but the one experiencing the situation firsthand can determine motivation or rationales.
Unless, of course, Scorio made statements like, "I'm carrying around this notebook excessively to avoid patient-care encounters!" or "My goal was to make the nurses appear stupid!" Only then are the situations objectively factual.
As I noted previously, I can empathize with Scorio's situation.
Specializes in 26 yrs ER, Dialysis, HH, Education.
I've read the original post and all the comments and I can see both sides. First, if the interactions went verbatim, then the instructor needs to go to preceptors and see if there is an underlying factor. As an instructor, I've noticed nurses will put down "doing great", when that's not necessarily the case. I will be told other things when I ask directly how students are doing. It does a disservice to the students because they think they are doing a great job, when in actually they have area for improvement, and fortunately, now the student may be hearing things correctly. IDK, wasn't there.
If the original post was the student's take on the situation, then maybe you do need to look at how your overall body language. It's as I've told my own students, it's not always what you say, but how you say it and the other person's perception.
To the poster that said...those that can do and those that cannot teach/coach...yeah okay - most of the instructors I know can do both, myself included and that's what makes us good at what we do. I got into teaching because I got tired of seeing a good bit of students not developing the right skills; not because I couldn't do anything else.
It's typically the lower class places that don't care to further their education, that have a problem with learning, thinking outside of the box, picking on people. You are aware that none of us were present to see the body language and situation exactly as presented, so only generalities can be offered.
Yes, a warm compress would be an excellent idea in a pinch. Maybe we can't afford to use resources unless absolutely necessary here, maybe the "warm compress" is either wasting an entire warm blanket or an instant hotpack, maybe the person directly involved knows that the IV team can handle these veins easily. Maybe that's just what we do around here.
You whispering "maybe a warm compress would help" once would elicit an award on your paperwork but let's look at it from the room/patient perspective. I have a nurse about to do an invasive, painful, stigmatized, risky procedure on my arm. The patient sees the nurse has difficulty, patient thinks, "I know the nurse has difficulty because they always do on my veins, why is it so cold in here if it messes up IVs," etc. Then someone dressed like a student, obviously a student because their ID says it, offers valid advice. Now the nurse has to decline advice that is valid because the facility is too poor to provide this accommodation, it will probably be futile, I'm not comfortable with doing IVs, etc. Patient wonders if the people this place hires even knows what they're doing.
All I can say is use your own judgement at that point. When you're an RN, you should offer a warm compress to another RN. It's accountability, it's a helpful reminder, it's working as a team. As a student, at this facility, it seems you need to evaluate who you're around before you speak up. Some people are type A and some people are type B personality and they may see anything you offer as a student is a student opinion and be upset just because you're a student and wear a thinking cap.
But yeah I don't think we ever would use a warm compress for an IV, lol. I think they had a problem with the notebook because they're not used on the job realistically.
OP, we can't really offer an unbiased take on the situation because we weren't there, so it's hard to say unequivocally if the evaluations are unfair.
From your posts, you come across as a conscientious student trying to do your best, and that's not a bad thing. I'd much rather have someone like you on my floor than the type who sits around unless specifically asked to do something. However, some people find that eager-beaver attitude grating. It's personal preference and unit culture. It sounds like you really clicked with the nurses at your previous clinical site, but on this floor you're perceived as a bit of a know-it-all or book-smart at the expense of clinically effective. That impression might be erroneous, but it seems to be your current reputation, and, unfortunately, that's probably the lens through which they're viewing you right now.
At this point, it doesn't matter if you're right or wrong. You are a student and you need to survive this rotation. If you were a RN, you could look around for a job that's a better fit, but as a student, you're stuck.
Like others have suggested, right now your best bet is to fly under the radar and just pass this semester. If they give feedback about the notebook, lose the notebook. Don't suggest anything when the RN is with a patient. So if a nurse is having difficulty with an IV, keep quiet, or at most you might ask, "is there anything I can do to help?" rather than "do you want me to get a warm pack?" Make sure you're answering call lights and doing patient care whenever you can - never let them see you sitting around or looking at your phone (not suggesting that you're doing that, but you want to combat the impression that you are uncomfortable with or "avoid patient-care encounters").
Some units aren't student-nurse friendly, and at best want the students to blend in rather than stand out. It might be politically expedient for you to be as bland as possible. If there are other students who seem to be getting along better, see if you can figure out what they're doing, and model your behavior on theirs. I sympathize with your situation, but you need to keep your eyes on the prize and just pass.
My response will probably different than others, but I just wanted to let you know that almost everyone goes through some BS in school, as you've pointed out. Once you're in a new grad program, the "rules" become way more relaxed as long as you are providing the best, safe patient care. Everyone "nurses" differently. Some take more notes than others, it's all a personal preference. Once you're working with a preceptor, you will find your work flow and there is more trust and mutual respect (on my unit anyway), and there is no time for petty complaints. Keep your head down and get through nursing school. The grass is actually greener on the other side and you'll soon forget the misery of nursing school!
OP, you remind me of my current orientee when she first graduated nursing school. Our first shift together, she looked at me and said, That’s not how they do it in nursing school and on NCLEX!!!!
When we left the room, I looked at her and said, Look, I want to you to remember what you learned in nursing school and on NCLEX right up until you pass NCLEX, once you pass that test, I want you to forget it because it’s not real world. I explained that even our hospital policies don’t match up with nclex. And nursing school simply prepares you to take nclex, not to be a nurse. She learned quickly how right I was.
You are a student. You have zero nursing judgement yet. As a student, you are there to learn, not offer suggestions.
I’m terrible with IVs. And since I know I’m terrible, I don’t have much confidence when I have to stick, and it worse when I have people watching me. I stick twice and if I don’t get it, I find someone else. I’m embarrassed that I’m not good at it but I honestly don’t do it often. Most of my patients have PICCS or central lines. So, if I was already frustrated, and a student was trying to “suggest” to me what I need to do, I would be upset as well. Every nurse knows about using hot packs.
Taking initiative is, asking what you can do to be of help. Turns, baths, Foley care, those kinds of things.
I truly think you mean well. But I also think you may come across as overconfident. You are still a student. You don’t know anything about nursing yet. That will come in time.
I really feel for you here. I was lucky to work with some really exceptional nurses while doing clinicals in school. I had the opportunity to learn from people that really wanted to teach nursing students. But I also had the opposite experiences and just had to keep my head down and try to get through the day.
At some facilities nurses are simply told they will have a student assigned to them, they don't volunteer for this and they are not asked. I think that this practice leads to some nurses feeling resentment towards the student that they are assigned to work with. I can totally understand it from their perspective, having a student is one more thing to keep track of and watch over, it is extra work and slows down their flow.
Reading through your post I didn't see anything overtly egregious, maybe your timing could have been better when asking questions or making comments but I have been in similar situations and was able to ask questions which lead to great discussions and learning opportunities.
Lastly, even if you were totally inappropriate in your actions, the nurses you work with should talk with you directly about what is going on well before they ever write it in a review. As nurses we are professionals trained in navigating difficult and uncomfortable conversations, if they are not discussing these areas of improvement with you directly and instead passive aggressively writing them in your evaluation I think its cowardice and shows a lack of professionalism on their part.
Specializes in 26 yrs ER, Dialysis, HH, Education.
MotoMonkey, I completely agree. Some facilities do not have an actual preceptorship program and just assign students to nurses without ever telling them first. I've often run into nurses that are not looking forward to working with students, merely for that reason and because it does slow down the flow of their work. I truly wish there was some form of communication across the board to help alleviate this, thereby alleviating resent towards students. I have also had my fare share of "know it all students and new grads". These students make it very hard to precept them, without knocking them back a step or two. As I tell students, there is the book world and the real world of doing things. The book world works well for passing the NCLEX, but not as much for actually working with the patients.
Specializes in OR, Nursing Professional Development.
54 minutes ago, DoneMostAll said:
Some facilities do not have an actual preceptorship program and just assign students to nurses without ever telling them first.
That would be because the schools are often sending students to the facility and the instructor is "somewhere in the building". When I went to nursing school, we were the responsibility of our instructor- that was who we went to with questions, that was who was at our side to pass meds, that was who was at our side to perform a procedure. Schools need to go back to that model instead of dumping students on the nurses who are getting zero compensation for being a de facto clinical instructor. The only exception was our senior capstone, and that was set up specifically with nurses who volunteered for the preceptorship.
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sweetumsRN
24 Posts
And thank you so much for painting all educators as people who cannot do the job. Very helpful advice ?