What does the floor really think of nursing students?

[superduper]

Hi everyone.

I am a third semester nursing student and just recently started working as a PCA/PCT in the same hospital system as my clinical site.

I have noticed during my PCA orientation that the hospital that I work at isn't "nursing student friendly" or "new nurse friendly". There have been a couple of instances like.. there have been comments by PCAs and nurses about new grad nurses not knowing something, or I have noticed nursing students having a hard time being paired with a preceptor because no one wanted a nursing student.

The following is rant.. I don't mention that I am in school however, during my last shift on orientation my PCA preceptor asked me if I was in school and I told her I was. She began to congratulate me on being a PCA before becoming a nurse because some nurses have no idea what they are doing. I responded that I just want to be a good nurse and appreciate the opportunity. Before the shift ended the entire floor knew I was in nursing school and when giving report to the oncoming pca she basically was telling me to not work on that floor because new nurses usually sink than swim on that floor and that there were too many cardiac drips for a new nurse to handle. Maybe it was just advice but it just felt like she was trying to intimidate me because the floor was no different than the other med-surg floors I had been training on (I am a PCA in float pool). There's more to it but rant over.

Just to say, I have been a CNA for two years before getting this job. I am not scared of hard work and always try my best. I am a pretty good student I try to study as much as I can to be a bad *** nurse one day lol. I feel confident in doing my job as a PCA but feel like I would be judged if I mentioned that I was in nursing school. People/professors have told me that when you work as a pca while in nursing school the nurses are nicer and let you do more things but it doesn't seem like that's the case in that hospital. To be honest, now when I get asked I say that I am not in school : (

I just feel like there's a bad connotation about nursing students/new grads at that hospitals. I am just curious is this normal feeling on the floors and I have been oblivious to it? Maybe my particular hospital has had bad experiences with nursing students?

Sorry if this was long or didn't make sense... just curious.

[SilverBells, BSN]

From my experience--and I'm guessing most people's experience--some nurses love students, some are neutral, some would rather not be bothered, and others' moods change depending on the day. Mainly what nurses are looking for are that you are willing to participate in some way, not just stand around, watch, or even worse, do nothing at all. I remember one time when I was assigned to "shadow" a nurse in the cardiac ICU being strongly encouraged to perform a skill I really didn't feel comfortable doing. In my opinion, I found the nurse intimidating, especially since she remarked, "if something goes wrong, you're telling the doctor." Fortunately, nothing went wrong, but at the time I didn't appreciate her approach. I am now starting to wonder if perhaps she was like that because it appeared that I wasn't actively engaged in learning the way she wanted. I was ready to learn, but I can be a very quiet person around those I'm not familiar with, and rarely ask many questions anyway, so I'm wondering if she was like that based on how I presented myself. So, just be mindful of that.

Anyway, I currently work in a rehab center, not a hospital, but must say I do really enjoy having students whenever they happen to drop by. I have always liked teaching and am hoping to formally educate at one point in my career. I am currently an interim nursing manager and enjoy training others. At the same time, not all nurses are like that--they would rather do. Each one has their own personality, of course. But, if a student is eager to learn, most of them won't turn them away, or at least won't go out of their way to make it a negative experience. If a nurse does that, the student, of course, has the right to a new nurse...but those people are typically few.

[organichombre, ADN, BSN, MSN, LPN, RN]

On 11/28/2019 at 9:10 AM, JadedCPN said:

THIS.

I totally get this and appreciate the feedback. I am an educator in a Trauma 1 facility with ADN students who are about to gradate. Too often over the years I have heard that instructors drop off the students and don't see them until the end of the day. Not only is this wrong from the staff's point of view but it is usually in stark contrast to what our job descriptions are. Instructors anywhere are required to make rounds, assist with meds, procedures and generally be available anytime during the shift. Faculty vs. preceptor led clinicals are the standard and with drastically reduced numbers of true "preceptors", instructors need to maintain close contact with students while on the floor. More and more we are assigned to more than one unit which is logistically challenging but we are responsible none the less. I encourage staff to address this discrepancy and for instructors to do right by staff and students! Merry Christmas!

[KarenMS]

On 12/2/2019 at 6:27 PM, emmjayy said:

This student was on their very final clinical placement, for which this school of nursing does not require a clinical instructor's physical presence. They come up periodically during the week to see how the student has been doing, but it's an experience where the student is assigned to a nurse, follows their schedules/assignments, and perform nursing skills under the one nurse's direction. It's seen as a stepping stone to new grad orientation.

Many students complain that they need their phones to look up information, but all the computers have Micromedex, UptoDate, and Google very easily available.... not sure what your phone can offer that's better than all of that. Also, I constantly see them scrolling through Instagram, which is not going to give them any trustworthy information about pathophysiology, medications, how to manage lines, compatibility of drips, etc. and have literally never seen a student using Epocrates or any other medical education app. So the "Oh, I need it to look things up" excuse is a crock IMO. I got through school without my phone with no issues, graduated in 2018 so it wasn't that long ago!

Like I said... I absolutely love a receptive student. I had one a few months ago who helped me tremendously with my very unstable patient whose belly surgery had gone bad and she had more questions for me than I knew how to keep up with. My day went more slowly than I'm used to but it was okay because I could see her learning. Be that student ?

To the phone point: I graduated in 2017, and it was made very clear to us that we *had* to have a phone or other handheld device with us at clinical, with the app they gave us (I can’t for the life of me remember what it was called!) to look up meds and procedures.

I’d much rather students look stuff up on their phone than monopolize one of the precious computers that were already fighting specialists, PT, speech, and social work for.

[gere7404, BSN, RN]

Same way that I think of patients... unless there was something that really stood out, forget about them as soon as I've clocked out.

[myoglobin, ASN, BSN, MSN]

I find it ironic that the hospital constantly harasses me about not using my hospital IPhone (or portable fomite device as I like to call it) ever since they eliminated unit secretaries while other nurses and schools are so against students using phones. I can hardly give a med, or complete an assessment without being interrupted by an inane text about sending tubes to pharmacy or helping to move patients out of ER faster. I would think to function effectively in modern hospitals that schools might want to require that students actually use their phones (albeit for learning related matters) while in clinical.

[wanderlustnurse88, RN]

For the most part I enjoy having nursing students on my floor. We usually have first or second placement so they are doing vitals and personal care. It is helpful as long as they are willing to help out and learn. It does get frustrating when they all stand in the nursing station and shift change when we are trying to get our report first.

[organichombre, ADN, BSN, MSN, LPN, RN]

On 12/5/2019 at 11:08 AM, nursej22 said:

"It could be different. If nursing schools would stop dumping students on the already over-burdened staff nurses expecting them to be de-facto (not to mention gratis) clinical instructors and instead place smaller groups of students with an instructor who was both present and engaged then we wouldn't be having this discussion over and over."

Disregard the name attached I quoted the wrong person I think. To whomever I quoted, the fact is that there are insufficient instructors to supervise the students. I have 7 students and we are assigned to 6 different units. Rarely does an instructor have just one floor where they can concentrate their time. Just as in the bedside nursing arena, educators are few and far between because of the difference in money. More students means more clinical sites which leads to nurse/student burnout. I think, and this is a big leap, pay nurses who want to precept students, require they attend preceptor classes, require that they document student performance and behaviors and maybe things will adjust a little. I try to be on the floor enough that the student and nurse feel that I know what's going on with the student's primary patients. A nurse should never allow a student to be "dropped off" unless that is the what has been agreed on and satisfies the Board of Nursing in their state.

[Wuzzie]

6 minutes ago, organichombre said:

A nurse should never allow a student to be "dropped off" unless that is the what has been agreed on and satisfies the Board of Nursing in their state.

The affected nurses have no say in it. We are voluntold to take students.

[organichombre, ADN, BSN, MSN, LPN, RN]

So what happens if you refuse? Is this a standard of practice for your floor? Are you designated a preceptor? Have you been trained to precept students. Does the instructor have any contact with you aside form the initial "drop off"? Are you being compensated? And even more importantly, do you have a problem with students in general? Or just the lack of communication?

[MunoRN, RN]

I've always understood that teaching nursing students is an integral part of the professional duties of a nurse. If you took a staff nurse job in a hospital and then announced "I don't administer medications, that's just not my thing" would that be reasonable?

[Wuzzie]

17 hours ago, organichombre said:

So what happens if you refuse? It's considered insubordination. Is this a standard of practice for your floor? It was at the time. I am no longer bedside. Are you designated a preceptor? Yes Have you been trained to precept students. No-and no hospital I have ever worked at provides this training. Does the instructor have any contact with you aside form the initial "drop off"? No- and that's the issue. Are you being compensated? You must be joking. No. And even more importantly, do you have a problem with students in general? That's down-right insulting. Or just the lack of communication?

To your second to last question. I love teaching. I would make that my focus if it would pay the bills but it won't. What I don't like is schools abdicating their responsibility to already over-burdened nurses and expecting them to be entirely responsible for their patients AND the complete clinical education of students. My patients are my priority and unfortunately that means any students I have are not and they have the right to expect to be...just not by me. They should be their instructors priority. We had a nursing school instructor here gleefully tell us that her job was easy. She just dropped off her students and then found a quiet place to do her grad school homework. How is that right?

16 hours ago, MunoRN said:

I've always understood that teaching nursing students is an integral part of the professional duties of a nurse.

Teaching yes but not being entirely responsible for the clinical education of said students. And it does not supersede patient care.

[kataraang, BSN]

I love students! ? I have rarely had a bad experience with one. To see their excitement when they learn a new skill or see something they learned about in "real life" is awesome. I'm actually getting my masters in nursing education.