When student nurses come for clinical.....QUESTION....

[pink2blue1]

This is in NO way meant to be a put down on student nurses. I was one once too, but I do have a question.

I am an LVN. I work on a post surgical unit. We take care of patients after they are discharge from PACU to their rooms.

We get nursing students regularly. One group from the local community college, one group from the university and one group of LVN students.

Yesterday i had a BSN student assigned to 2 of my patients. After she arrived late for report, I gave her report and asked what semester she was and what could she do. She told me 4th semester and she could do all meds except for IV pushes and starting IV's. Ok. So with that I told her, ok. Let me know if you have any questions. This is my phone ## and I have these rooms, so you can find me here etc. She sayd ok. Then tells me that her instructor doesn't give meds with them, that I have to. I have to watch her give the meds. I was kind of like, well....what? Then I told her that I was an LVN so she had better ask her instructor if that was ok, being that she is a BSN student. I told her that I cannot hang piggy backs with her because it is not in my scope. Then she asked who hangs them for me and I told her the charge, so she went to ask the charge. Our charge nurse didn't want to. I personally didn't think it was my place to watch her administer meds. We are busy with 5 patients.

Turns out, I had to do a WHOLE lot more teaching with her than I thought. For a 4th semester student. She hadn't used our computer system for drug administration before. She didn't glove up before giving heparin (I reminded her) then she asked in front of the patient if I could help her because "i never know where to inject it on a skinny patient" Fine, fine. I know. They are all learning. But these are things her instructor should see, should be there to tell her why or how. I never met the instructor once. In passing she said "OH this is my instructor so and so" and they walked away.

Then at the end of the shift, she handed me a form "Preceptor Evaluation" asked me to fill it in. I told her that I didn't precept her. I didn't feel comfortable filling it out. Especially since I am an LVN. Besides, she did a few other things that I would have liked to have spoken to her instructor about. It was just wierd. Strange. The wierdest student experience I had ever had.

At the end of the shift she asked me if she SHOULD report off to me because "you already know the patients" Oh dear. Oh dear. Still....I never saw this instructor. never.

Strange??

Thoughts??

[NurseLoveJoy88, ASN, RN]

Thats terrible. As a student nurse in her first year I even know better !

On another note: Thanks for being patient with us nursing students... I know it never easy having all of us taking care of your pts. but nice nurses make a world of difference to me.

Maybe you can contact the CI and explain your concerns.

[April, RN, BSN, RN]

Definitely strange. How would the student's school know if the student was safe and competent in clinical if no faculty observes? Does your nurse manager know this is going on? It sounds like it could potentially be a patient safety issue for the floor since apparently you are expected to take on the extra responsibility of watching this student nurse along with having to care for your entire patient load. When we have students on the floor, the instructor touches base with the nurses and tells them what the student will be responsible for that day. It's usually meds, bed baths, ambulation, and the instructor does this with them. At the end of their shift, the student reports off to the real nurse. The nurse obviously knows what's going on with the patient, but it's good practice for the student and sometimes the students do have valuable input.

[honeykrown, MSN, NP]

the school program is not designed well or maybe the instructor was jsut lazy. But i think with the number of students they assign to these instructors there is hardly enough time to supervise them all. mayb the students were splitted into differnet groups and the instructor could not be there becuase this happened during my ICU rotation and i was left with the nurse. It was more like shadowing her. I just did most of the stuff she was comfortble in letting me do.The instructor spoke with her at the end of the shift for evaluations.

I am thankful for you for being so patient with this student. You must have given her some few tactics on what she has done worng she would have apprecaited it. At least u didnt scream at her like some nurses do (like they are the king of the unit)

[pink2blue1]

Oh I'd never scream at a student. Like I said, I was one once upong a time, not too very long ago! (2.5 years) but she did do some things that I wanted to speak to teh instructor about. For instance, she told an 18 year old lap appy patient on POD 1 that she should not walk. (Patient was dx'd with an ileus, vomiting bile etc. She said she should "wait until tomorrow when she was feeling better" the patients mom came to me panicked to think that someone told her daughter not to walk. I simply explained all the reasons she SHOULD walk, and as often as she could tolerate. I said this in front of the student, hoping she'd realize the mistake she made and take it with her. I never scolded her. Perhaps she hadn't been told? But I never yell at anyone. It's not my place ;-) and it;s mean!

[waitingforthedream]

We were not allowed to pass meds unless our instructor was with us. Gosh, in my last semester I was pretty comfortable doing almost everything for my assigned pt., and of course would give report when I left. As a senior nursing student, she should have know better. Not knowing where to give an injection of heparin????? And no gloves, oh my.

[rnlately]

I think you handled yourself well. I don't know how much it varies from school to school but when I was in nursing school (I'm an LPN) we were not allowed to do anything medication/procedural (other than bed baths, ambulation, toileting, vitals feeding) without an instructor around. The only exception was if our preceptor was someone that the instructor was familiar with and trusted.

[April, RN, BSN, RN]

the school program is not designed well or maybe the instructor was jsut lazy. But i think with the number of students they assign to these instructors there is hardly enough time to supervise them all. mayb the students were splitted into differnet groups and the instructor could not be there becuase this happened during my ICU rotation and i was left with the nurse. It was more like shadowing her. I just did most of the stuff she was comfortble in letting me do.The instructor spoke with her at the end of the shift for evaluations.

I am thankful for you for being so patient with this student. You must have given her some few tactics on what she has done worng she would have apprecaited it. At least u didnt scream at her like some nurses do (like they are the king of the unit)

I also had some clinicals in school where it was more like shadowing the nurse instead of doing skills with my instructor. BUT my instructors asked the nurse first if they were OK with having a student follow them for the day and they always touched base with the nurse after. It doesn't sound like this was the case with the situation that pink2blue1 was put in. If that happened to me, I would talk to my nurse manager so they could address the issue with the school.

[LaneyB]

We occasionally watched the students administer meds if the instructor was unavailable. The instructor asked us first, though, and we always said yes because otherwise the meds would start getting off schedule.

[pink2blue1]

She was not shadowing me. She had 2 patients of my 5. I was never asked by anyone if I was comfortable doing this. The student told me that we give meds with them and that is the way her school does it. But she did not shadow me. She did her own thing and had me come in for her med administration. Even if I had filled out her eval (Which I refused to sign because the signature line said "preceptor signature") How would the instructor know how she really gave meds. It could be a nurse who is super lenient and said she did great, or a super tough one who slammed her. I just chose not to comment and instead told the student I would like to speak to her instructor instead. It never happened.

[MsTn81]

Our instructors preach to us daily.. don't do anything unless they gave us the ok. Even if the nurse who has the patient ask us to do something. They have to know first and if they say we can do it they have to watch us do it.

[twow]

i don't know the answer to your concerns. but the reality is, some clinical instructors literally go the whole term without teaching their students jack. i know from experience.