What do you want to tell Nursing Students?

[jessiern]

Our latest group of students passing through prompts this question. Here are a few of mine:

1. If the nurses have no where to sit and chart, and 5 of you are sitting gossiping-GET YOUR TAIL UP!

2. If you are capable of doing it, like passing trays and answering call light, then- DO IT! Don't reply it isn't your patient. You aren't my student either, but when you ask me a question I don't make that my response, do I? Help me out, and I'll be better able to help you.

3. At your level, in and out the patients room in 3 minutes is probably not a good assessment. Especially when you tell me that the patient has a reg heart rate, and his admitting diagnosis is new onset A-Fib.

4. Reading a Stephen King book in the nurses station is a bad idea, and you look like you don't care. As does playing solitare on the computer in OUR breakroom.

5. If you have had a patient for two days, and he is your only patient, you should be able to tell me the diagnosis. You should also know a fair amount about his medications. At least read your drug guide before coming to clinicals.

I could go on and on. This new group we have takes the lazy/stupid cake!

BTW - I love having students that are motivated and are truely there to learn.

[**All Heart RN**]

You know, the minute I read the title of this thread, I knew it was going to take an overall negative tone.

I'll say first, that I am not a lazy person and I am not a lazy student nurse. I've worked my butt off to put myself through my 2nd Bachelor's degree and will go on to get my Master's from here and then who knows, the sky's the limit.

I appreciate the nurses that I work with who leave the chip off of their shoulder and realize that I am not the lazy student nurse that they encountered yesterday or last week or last quarter.

I also appreciate the nurses who give sound advice that isn't laced with contempt, sarcasm, and overall bitterness.

The thing is, we were all students at some point. As nurses you all are in the important position of being a leader and teacher to us all.

So thank you to all of you that are kind in the advice and suggestions that you have to share. After all, we're all in this for the same reason, hopefully, and that's to provide good, quality patient care.:nuke:

[Wendy_RN]

The "harm" is that the students graduate with competency as an assistant but not as a nurse. Critical thinking skills alone can only take you so far. Most lawyers should have quite refined critical thinking skills but they'd still be at a total loss in regard to how to take care of a patient.

So while doing aide work is important and not a waste of time, that experience isn't going to do more than make them great assistants. The student can use their critical thinking skills in carrying out aide work, but when it comes to higher level nursing care, without a nurse there to get feedback from, any critical thinking that they do in regard to higher level nursing care may or may not be practically effective - critical thinking needs to be applied for it to be developed and honed.

No one said that students should spend all their time doing aide work. If you read all of the posts you will see that was not the point. If the student has nothing to do there is absolutely nothing wrong with them doing other tasks. If those tasks are "typically" performed by an assistant there is no harm in the student helping.

[beachbum3]

Some things said have been what seem like common sense to me, but I have a few thoughts:

1. If you need a chair/computer to sit and chart, why not just ask the student to get up so you can use the computer? I feel like it would be a thousand times easier to say "I've got to get some charting done, so I need to use that computer" rather than get angry/resentful/frustrated and glare at the student or get angry. I'm all about spending energy on useful things, and this just doesn't seem worth the energy of getting angry.

2. Re: assessments and charting- It is my understanding that regardless of whether or not a student charts the assessments she/he has done, the RN still needs to chart his/her assessments because the student assessments don't exactly count.

3. Re: Meds/Pixis- Our instructor had to always get the meds out for us. And yes we'd have to wait in line. But there was a policy of an hour before and after, so technically we weren't late with passing meds. If you just went ahead and did it because we had to wait in line for our instructor, we would have missed out on the experience.

4. I will answer call lights if I'm not busy, but if they aren't my patient, then my answer will be "Let me go check" no matter what the need (unless its something like getting more water, fluffing a pillow, getting an extra blanket, obviously) because if they aren't my patient, I don't know if they can get up out of bed, if they are a fall risk etc.

5. I'm not taking over an aide's pt load. She/he still needs to do his/her job as if I were not there. I'm happy to help when I can, and you will never catch me running out of a room to find an aide to take someone to the toilet, wipe a butt etc. About the only time I might was if I was absolutely in the middle of something I couldn't postpone even a minute. However, don't expect me to do all the aide work, as I'm there to learn what a RN does, not what an aide does- I know that already.

As for the rest of it, I can't believe students actually do some of those things. Since when is it ok to read a book in the nurses station or play around on the internet???

[AuntieRN]

Please please please dont tell the nurse "Oh I have already done that once, I dont need to do it again" when they ask you if you want to do something. Doing it once does not make you proficient. This happened to me a couple weeks ago. I asked a student if she wanted to accompany me to insert a foley. Unfortunately for her....her CI is not only a coworker of mine but a friend as well. (It killed me to have to say something to her instructor but I dont want her working on my family member just because she has done it once already)

Now I always go out of my way to make students feel welcome and attempt to teach and explain anything and everything I can to them. But I have to agree there are just some students out there...

Now as far as doing the CNAs jobs...all I have to say is at my hospital, frequently an RN gets pulled to be an aid for the day because we are always short aids....now we have a couple newer RNs who had no clue what to do or how to do it when they got pulled...im thinking learning "aid" work can be very beneficial for times like this or when you find yourself without a CNA.

Please look up your meds before you/we go to give them...I already went to school...heck I still look up meds I don't know please dont ask me what they are for or if you have to dilute them or can you crush them. If after you look it up and you are still unsure by all means ask away but please at least show me you looked it up.

And please dont say to me in front of my patient...but arent you supposed to do it this way.....wait until we leave the room.....theres probably more then one way to do it....

I love having students I so remember what it was like when I was in school....good luck to yall

[nurseinlimbo]

From what I remember, when I was a student not so long ago, if you jumped to help an aide to do a lift, or toilet or bath someone, it was inevitable that you would be told to concentrate on medications, diagnosis, treatments, dressings etc. And if you didn't help, you were lazy.

I also remember distinctly not knowing what I should do, and being so nervous that I was scared to do much of anything. I remember asking questions and having a nurse distinctly TURN HER BACK and then look over her shoulder to see if I was still there. That same nurse later pushed a student to the floor when the student found a pt who had fallen. Wrote her up and nothing was done.

So, sometimes we started out keen and had it beaten out of us.

Nursing school was something to survive, as was preceptorship, and I know that I will personally never treat anyone as badly as some of those nurses treated us. And while we are on the topic, what about the NURSES who are surfing the internet, gossiping and snacking behind the nurse's stations, should students be giving up their chair for that?

[nurturer]

dang, when i read about some of these nsg students, i become even more appreciative of my clinical experiences in school.

and i don't think the students are at fault here.

the clinical instructors should be finding meaningful experiences for their students.

none of us ever got the luxury of sitting around or wandering aimlessly.

furthermore, the floor nurses would go to the ci w/suggestions or concerns...

never to us.

i personally asked the nurses, "what can i do? what do you want me to do?"

often, it would entail talking to a pt who was struggling w/terminal dxs, or other types of anxiety, depression, but just didn't want to be alone.

sometimes i'd shave, other grooming/hygiene tasks, look up info for those w/knowledge deficits....anything.

it was an opportunity for me to look at the forest, and not just a tree.

nsg students, this is your opportunity to make the most of your nsg education.

whether it is an aide's job, a nurse's job or even housekeeping's, jump in and just do it.

one clinical, this pt had a 24 hr stool collection ordered, and the bathroom was dis-gusting.

i got the cleaners and scrubbed that toilet area.

and btw, i still do that stuff today...

everyone else's job is inevitably, a nurse's...

if you take pride in what you do and who you serve.

whatever it takes ladies/gents, just do it.

look for opportunity.

they are there, for sure.

you just need a little initiative and a lot of desire.

all the best.

leslie

Fantastic post....Thank you. If I were a patient I would want YOU for my nurse! :nuke:

[jessiern, BSN, RN]

And while we are on the topic, what about the NURSES who are surfing the internet, gossiping and snacking behind the nurse's stations, should students be giving up their chair for that?

Yes, I do think so. The nurses are there for 12 hours, whereas the students usually just 6. And at our facility, it is very rare that you see the nurses doing the above. So, if they have time to just sit back and relax, then I believe they have every right to do so.

I'd also like to clarify that I do not believe the students should take over the aids work. But, if all the nurses and the aide are running like chickens with their heads cut off because we just got 6 admits to the floor (with three nurses, as was the case), the when a patient calls wanting a blanket, it would hurt the SN to do so. I also would not have minded a student shadowing me while I did the admit (a great NURSING learning experience, with IV's as well), but when I offered they all replied they were going to lunch in 15 minutes, and continued to sit and gossip. I would have jumped on that chance in school, even if it meant I might be late for my hour lunch.

I also agree that it is the fault of the instructor. I attended the same college these students are from, under a different CI that demanded we where on our feet learning, doing something-even if that was just helping an old lady to the bathroom. Because in doing that, you are still learning one of the most valuable nursing skills--Patient interaction. If we were not able to answer basic questions about our patient diagnosis, treatment, meds, ect-we were sent home. And our instructor rounded on all our patients, and questions us about assessment. Also showed us how ot do a proper assessment (as I have done for many students that take the time to pay attention)

I would also like to add that as a general rule, I truely look forward to students at our facility. I enjoy teaching, and enjoy assisting them. But, the last few groups have had zero interest, and no motivation. And yes, I understand this is not true of EVERY nursing student. But, at least in more area, it is starting to be the rule. To those of you that are in it to learn, congrats. Come to my facility. It would be refreashing to have you around!

[Virgo_RN, BSN, RN]

As a nurse AND a nursing student, what I would like to tell nurses is:

1) I am terrified. Seriously. I could vomit any second. Just because I work as a nurse already does NOT mean that I am not completely intimidated by this unfamiliar environment, with unfamiliar protocols and unfamiliar faces. Please, treat me with the same respect that you would like to be shown. I may *look* confident, but that is because I have learned how to "fake it til you make it" and "never let em see you sweat", as a survival tactic. On the inside, I am mush.

2) I am not here to work as an aide or simply as free labor to "help out" on the floor. I am paying for my education, I have already been an aide for years, and my instructor has specific goals for me to achieve in this rotation. Some of those goals include learning delegation, implementing care plans, performing discharge teaching, among other things. I must get checked off on these goals in order to pass my clinical rotation, and this is not going to happen if my focus is on toileting patients and passing out trays. Yes, I might be capable of doing more work than I am, but I learn better when I have the time and space to think. When I am running my tail off, I am not learning. Remember, I am here to learn.

3) Please welcome my presence on the unit, and don't begrudge me the use of the break room. By making me feel welcome instead of like an outsider, you will gain my respect and I will be more likely to cooperate with you and help you out when you need it. If you act like a jerk, I will most likely just ignore you. Also, you never know, you may be floated to MY unit, and I'm sure you would like to feel welcome if and when that happens.

[ranna&nessas mom]

I'm a new nurse-only five months experience,but I still remember clinicals,and it wasn't all that pleasant.

I always took the initiative to ask what I can help with. I am a 40-something RN and the average student in my class was 25y.o.,so I understand your frustration.BUT...If I had a nickel for everytime I took initiative and had a staff nurse ignore me, or act outwardly rude, I'd have $40K in student loans paid for.

I'm sorry...if we hadn't talked about A-fib etc...in class I may not know what to expect with that patient. It would help me a lot if you'd explain that to me.(I will agree with the 3 minute assessment.)

[ranna&nessas mom]

I guess I didn't really address what I would tell students in my last post. Here goes:

Take the initiative regardless the staff nurses' attitude and ask what they'd like you to do.

Take every opportunity to do anything and everything.I always hated that I wasn't in the right place at the right time and missed a learning opportunity. Some of my peers got to do things on a different shift that didn't occur while I was on the unit. Try not to be afraid...when you get to do a Tx,etc...you're learning.

Treat others respectfully.

[jessiern, BSN, RN]

I'm sorry...if we hadn't talked about A-fib etc...in class I may not know what to expect with that patient. It would help me a lot if you'd explain that to me.(I will agree with the 3 minute assessment.)

On that note, as a student preparing for clinicals, even if you have not covered in class you should review the patient diagnosis and be familar with it. I, nor anyone else, expects a student to be an expert, I know they are learning. But, I would at least like to see that they are a little prepared.

And I would like to add when I was a student, I was well prepared for clinicals. I studied up on primary and secondary diagnosis, all meds given (even PRN), familiar with H&P, any procedures, ect. That is the point of a nursing student going before clinicals for assignment and chart review. So IMO, a student not even knowing a patients diagnosis is unacceptable.

[ranna&nessas mom]

Please don't misunderstand me...not being aware of the dx is not acceptable. On the first day of the clinical with a new patient, I didn't always know what to expect,but I certainly made sure I knew more by the the time I returned on day two.

The ability of the CI to organize the clinical overall makes a huge difference in much of what you are talking about. Some of our CI's really knew how to deal with all of these things;others did not.