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.
Students need to learn to communicate. There are usually different levels of students and different schools rotating through the units and the nurses may have no idea that you are a first year student and are not allowed to answer call lights of patients who you are not assigned to, escpecially when upper level students or those from other schools are allowed to do so. This casts a bad light on certain students and it isnt even their fault. When you get to the unit let the nurse you are assigned to know what you can and can't do, what you need supervision for and if there is anything particular that you would love to help with. If you are not busy ask someone if they need help with anything or if you can watch them do ______. Don't just sit around and twiddle your thumbs. Yes, you are paying for this education and that is why you need to be proactive to get your moneys worth. Help the CNA's when you have the time. It sets a good example, promotes good relations between the nurses and CNA's and the staff on the unit with the students in general. Don't spend time doing tasks that are going to interfere with your learning and goals, but helping out is part of learning teamwork. You don't work there so if you are sitting for no reason and someone needs a chair, get up. If you are on a computer charting, then that is different, but don't spend time looking up info for careplans and papers etc... when someone else needs the computer. There is always something to be learned. If no one has anything for you to do, go and play with the buttons on an unsued IV pump and get familiar with the settings. Look in the supply room and see what sort of supplies are there and see if you know what they are used for. Write down the names of things to look up later. If you are on a tele unit ask if you can print some strips to take home (cut off all identifiers and make sure this is not against any rules first). Look at the reference books in the nursing station and flip through one and learn a new procedure. If you see an RT on the floor see if he/she is willing to let you watch them assess their patients on the floor. You can learn a lot. There is always something to do and something to learn, even if you have to be creative.
Unless you have first hand knowledge that the student is goofing off, try not to judge. Just because everytime you walk by the nurses station you see a student getting on the computer it may not mean that they are lazy. It might be because someone comes along and tells them to get off because they need that computer within 2 minutes of the student getting on (every time). So all day long they run over to it when they see that it is free, to try and get the info that they need for careplans and papers or to chart. Also, the phone is probably ringing and the student isn't answering it because they have been told specifically NOT to. Call lights might very well be the same thing (sad but true). Or they might have already answered the call light, but it isn't anything that they can take care of so they put it back on for the nurse. There also might be an issue going on between the students and the CNA's. Look into it. That "phone" that you see in their hand just might be a PDA and they may not be text messaging, they may be looking up drugs and medical info. The reason that they weren't in report might be because the CI had an assingment for them to do in pre-conference, so they weren't able to attend report, not because they were too lazy or slow to get upstairs on time. There are any multitude of things that look "lazy, bad, rude etc..." but on closer inspection may be anything but. Try to remember that. Now of course some people are just terrible students and don't want to do anything under the sun other than the bare minimum. But try to remember that just as all nurses aren't the "eat their young, nurse ratched" type, all students aren't the work-ducking, lazy, just in it for the money type.
I remember the feeling of not knowing what to do. That is competely understandable and expected. I have had students stand around with their hands in their pockets, nursing assistants calling for help, and the students do nothing. Some of them have commented that they are there to be a nurse, not an assistant. That is really frustrating. I wipe butts just like an assistant does. It is all a part of nursing. When you don't know what to do and you see an assitant struggling to keep her head above water, offer to help her. The same goes for nurses. When a student asks me what they can do to help it shows that they want to learn and I try to find something worthwhile to delegate to them.
When I start school this May, I plan on doing whatever I can (well, whatever is within my realm of capability and responsibility) to help out. I've worked too hard and waited too long to get into the program to do anything else. Besides, I would imagine that just standing around and holding up the walls would make things very boring. It's good to know what the nurses expect of the students who are doing clinicals.
Hmmm, I just reread what I typed and I sound like a brown noser.
Hmmm, I just reread what I typed and I sound like a brown noser.
I was a tech for three years. I spent that whole time "brown-nosing". Did so as a student too. I knew the more I was a help to the nurses, the more they were going to be willing to help me as a new grad--when I really needed them!
Wow..this post was intense, but some views did help me. So far I've only did long-term care (1st semester student), but this monday I start Acute at a Surg floor in a hospital. I know my CI has assigned us to one client, but I will make sure to ask her if it is okay to assist with other clients and to float around
One of the main problems I've seen so far on this post is miscommunication between primary nurses and the CI's. The nurses are expecting things from the students that the CI may not want them to do. So if the CI's are more clearer with the nurses on the floor about the level of the student, maybe things wouldn't seem so harsh..i dunno! :smiletea2:
Wow..this post was intense, but some views did help me. So far I've only did long-term care (1st semester student), but this monday I start Acute at a Surg floor in a hospital. I know my CI has assigned us to one client, but I will make sure to ask her if it is okay to assist with other clients and to float around
One of the main problems I've seen so far on this post is miscommunication between primary nurses and the CI's. The nurses are expecting things from the students that the CI may not want them to do. So if the CI's are more clearer with the nurses on the floor about the level of the student, maybe things wouldn't seem so harsh..i dunno! :smiletea2:
I think that's a fair assessment. My program has an agreement with the facility at which I do clinicals. We are specifically instructed NOT to answer the call lights of patients that we are not assigned to. This is a liability issue. Naturally, the exception to the rule would be if we observed a situation compromising patient safety, like a patient fall (or a potential one). We can poke our head in to see what the patient needs, but since we don't know that patient's activity level or diet orders, we should not be bringing them anything to eat or drink or assisting them out of bed. When we are in clinical as students, we are NOT employees of the hospital.
We have also been told by our clinical instructors that while we are certainly allowed to perform tasks for our assigned patients that *could* be delegated to a CNA, those tasks are not our focus, and if they take us away from practicing the skills that the CIs want us to be focusing on, then we need to delegate them.
Sometimes our CIs give us specific assignments to complete during our clinical time. An example would be to look up Patient X in room XXX, and do this heart failure case study, or answer these three pages of detailed questions about them, or identify their discharge teaching needs.
And just because the student is on the floor for six hours and you are there for eight, do not assume that the student is going to go home and throw on their sweats and relax. That student may be leaving clinical on your floor to go work a shift on their floor. When I was in my first year, I had a three day stretch every single week that consisted of six hours of clinical then eight hours of work, then home to sleep, then wake up early for another six hours of clinical, then another eight hours of work, home to sleep, then up early in the morning for class. I know all about teamwork and busting my butt on the floor.
Now, reading a novel while on the floor during clinical, obvious no-no. If you observe behavior like that, the appropriate action is not to confront the student, but to share your observation with the CI. Handling these types of situations is within the realm of the CI's responsibilities.
I have seen some nursing students who are straight out of high school and don't have idea on work ethic and the realities of the workplace. I feel like telling them to get some life experience before taking on nursing as a career because we really don't have the time to babysit them all day.
But I have also seen some very good, eager students be completely demoralised by experienced nurses. By being made to do all the dirty work, always criticised never encouraged or supported and then told 'you'll never make an RN'. I know because i was once in this situation not so long ago.
I believe it's a two way street, yes nursing students should be more prepared for the workforce, should do their reading on their patients diagnosis. But we should also play a role in encouraging them to learn as much as they can, support them in their learning and be a role model
And if you do see a nursing student do the wrong thing like reading novel in the nurses station, then acting all mighty and superior and crushing them down is not really a positive way to behave. Yes it's annoying and all that but there are better ways to get your point across to someone.
If you don't know what to do start digging around in the supply room and find out where things are, what they are called, and what they are used for. If you are in the supply room every time a nurse comes in you can get a question answered for each trip they make. As a bonus when they pull out the various procedure trays you just tag along behind and get to watch something new.
DO THE AID WORK. Don't neglect your own patient, but working hard gives you a leg up when there is something interesting going on, and they need an extra set of hands. During butt changes and baths we get our best assessment info, and you can be there as it happens, and question why a finding is important. If the aids know you are a worker they can be a tremendous resource for patient care tricks, and unit politics (Yes you need to learn unit politics to survive in your first job). Bonus- if you are totally comfortable giving a bath/transferring it's one less thing to worry about when you start out on your own and someone needs it.
Just skimmed the replies, hope I'm not too repetitive--
In addition to being prepared, and eager, here is my advice to students:
Be very straight up with your nurse about what you can and can't do, and what you wish to accomplish. This worked well for me in my LPN to RN clinicals, and it works well for me now when I precept a student. The floors see all different types of nurses from all different schools--we have no idea what level you have attained.
I appreciate something simple like "Hi, my name is xxx and I'm a second semester student at NCCC, and right now we are working on general adult med/surg. I can give po meds under your observation, but I can't give IVs yet. My instructor wants us to take two pts, do their assessment, all their personal care, and give all their po meds. I've been assigned Mr. Y in room 212 and Mr. Z in room 213. Please please please give me any constructive criticism you have, and also, if you have anything unusual or interesting, or if you just need a hand with your other pts, please let me know."
Some things specifically I like to know:
Can you give meds unobserved, observed by instructor, or observed by RN? Can you start IVs? Give IV meds? What skills do you need to practice--enemas, start foleys, start IVs, hang blood, central line dressing changes, what? Where are you at in your program, and what theory are you studying right now--if you are studying cardiac, then you can bet I will concentrate on that with you.
And if anyone offers you the opportunity to do a task, if you can, do it. I was in the ER of a level I trauma center doing clinicals, and it was me and four other students. I was the only one from my program, the others were two different levels from another program. They seriously would not do anything. They were so timid! I had quite a bit of experience (had been an IV certified LPN on a medical floor for several years) so I didn't want to hog all the experience--but eventually I just volunteered each time something came up, because the other students would just make excuses or straight up decline "I've already inserted a foley today....I don't need any practice at IVs, etc" It was crazy! We had a code, and I stepped in and did chest compressions, then later I got to help with the intubation--it was great! The director offered me a job that day...
If it is slow (I mean, honestly, there are days where there isn't that much to do, you've asked everyone if you can help and they've all declinced, etc) go through the protocol and procedure manual. Sit with the tele monitor tech and ask her to talk you through what she is doing. Follow the RT into a few rooms so that you can see what they do. Shadow IV therapy on their rounds on the floor. Stock the supply closets in the hallways and pt rooms. Ask if you can shadow the unit secretary for a while, or follow the case manager on her rounds, or the social worker; there are plenty of ancillary staff rounds that are important and interesting. If possible, always follow your pt down to special procedures, radiology, etc, to see what they are doing.
If you don't have anything to do, ask others how you can help. I've noticed that the nurses I work with who are good will ask their co-workers (CNAs included) if there is anything they can help with before they plop their butts down at the nurses station with a book.
Working as a CNA, I've got to experience and help with a lot of interesting things by just answering call-lights. If a patient notices something is wrong or off they'll often times hit the call-light.
Just wondering...have you had any positive experiences with students that you could share?
Perhaps nurses with complaints about students could request that your facility compose a list of expectations that students AND staff are asked to sign prior to the rotation so that everyone has a clear understanding of what is expected.
:redbeathe hi there ! i'm a rn student in canada (québec side) - so sorry for my english! so..i am in my 2nd year and we have each year 3 semesters ( my last for this year will start 28 april for 1 month -mental health) - so far i did medicine et surgery and i love it .. but what i want to add is that we (the students here) during our clinics (stage) we have to know for our patients the diagnostic related with his medications (+++explication during preparation of medication) +++ we have to answer to the lights if we are available (usually we have 2 patients or 3) for our patients we do all the work starting to aid and to med-surgery care. in case you did a medecin (pills or anything else ) error...oh my god .. no matter how "small" the error is... you are out .. of the practice for the year!!!!! so is no joking ! so in quebec it is tought and the end of the 4th year the license exam.. oh là..là.. it is "creepy" - 3 days exams... 1 ecos (practical exam - 16 fake patients with 2 observers..and many cases ..diffrent situations) and the 2nd and 3rd days the writing tests..(just opened questions) . so you have the right to sustain this exam just 3 times if you failed it ... all your 4 years study are bye bye for good!!!! and belive me 85% of failure is the stress stress !!!!!!!!!!!!!!!
so this is it .. i would love to work in states ,,,,
smk1, LPN
2,195 Posts
For the students:
Students need to learn to communicate. There are usually different levels of students and different schools rotating through the units and the nurses may have no idea that you are a first year student and are not allowed to answer call lights of patients who you are not assigned to, escpecially when upper level students or those from other schools are allowed to do so. This casts a bad light on certain students and it isnt even their fault. When you get to the unit let the nurse you are assigned to know what you can and can't do, what you need supervision for and if there is anything particular that you would love to help with. If you are not busy ask someone if they need help with anything or if you can watch them do ______. Don't just sit around and twiddle your thumbs. Yes, you are paying for this education and that is why you need to be proactive to get your moneys worth. Help the CNA's when you have the time. It sets a good example, promotes good relations between the nurses and CNA's and the staff on the unit with the students in general. Don't spend time doing tasks that are going to interfere with your learning and goals, but helping out is part of learning teamwork. You don't work there so if you are sitting for no reason and someone needs a chair, get up. If you are on a computer charting, then that is different, but don't spend time looking up info for careplans and papers etc... when someone else needs the computer. There is always something to be learned. If no one has anything for you to do, go and play with the buttons on an unsued IV pump and get familiar with the settings. Look in the supply room and see what sort of supplies are there and see if you know what they are used for. Write down the names of things to look up later. If you are on a tele unit ask if you can print some strips to take home (cut off all identifiers and make sure this is not against any rules first). Look at the reference books in the nursing station and flip through one and learn a new procedure. If you see an RT on the floor see if he/she is willing to let you watch them assess their patients on the floor. You can learn a lot. There is always something to do and something to learn, even if you have to be creative.