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.
I agree with the above stating that the instructor needs to be giving meds and actually instructing the students in her clinical! WTH is the instructor doing? Our instructor has 8 students and is responsible for making sure things are done safely and that includes the meds. It's called time management. I can see if something comes up then of course the student can go with the nurse if both are comfortable with that. However, floor nurses are usually very busy and the last thing they need is to take more time to watch over a student. If they have the time, then great! But, the nurse shouldn't be expected to teach the student the entire shift. That is what the clinical instructor gets paid to do.
I just graduated an ADN program, and this is how it worked. We always had an instructor present, and the first few semesters, the instructors learned who they could allow to go off more on their own and who they needed to be more closely attached to. We were allowed to be one on one with a nurse from the facility if that nurse would accept the responsibility and didnt mind. I preferred it that way, because i felt like i got to do and see more if i didnt have to wait for the instructor to be there for everthing. Of course we were not able to access the PYXIS an pull meds, so a nurse had to do that, and if they were comfortable letting us, we could give all but the pushes without assistance. By my last semester, i was generally just turned loose. I would take a patient in ICU without alot of assistance, and during my preceptorship, after a couple shifts, i was allowed to do everything..if i needed anything i just had to ask. They were lenient with those of us they were comfortable with, and a little more strict with others. I happened to be one that they knew was competant, and i could half the time make better judgement calls than the nurses. I worked hard and earned the privileges i got, and their respect in the process. It paid off for me, because i am now starting my first job, in an ICU, as a new grad,and i feel like i am doing great. In no way do i think i know everything, but i do think that being alowed to have some autonomy while in school gave me a little advantage over others. I thank all those that helped me to get there, and am eternally grateful to all the nurses and instructors that allowed me to be where i am today.
This is not an uncommon occurance from what I've seen at my school. I'm in a ADN program and fourth quarter is just beginning second year. It depends on the instructor, but once you've been checked off with that instructor for lets say , an IV push you are allowed to give meds with the nurse you're assigned to. It's very hard for the instructor to give meds with eight different students. Mabye for a BSN program she could just be in her first year or so and that's why she made some of these mistakes. Thanks for being flexible and kind with her. It means more than you know!
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meluhn
661 Posts
It is not fair of the instructor to expect you to give meds with a student. It is very time consuming when students give meds.