I've been in two different hospitals in both my first and second semesters and come up against some ROUGH nurses who would rather do everything themselves than let me touch a thing.
I'm trying to wrap my head around the fact that they are BUSY, they have a TO-DO list, they have patients that NEED meds, help, EVERYTHING. But, I'm here to help. I'm wearing these bright purple scrubs not because I like the color, but because I want to learn, I NEED to learn. I will take them to the bathroom, I will bathe them, I will take their vitals, just PLEASE let me.
When I say 80% of the nurses I've followed have done NOTHING with me I am not exaggerating. Why is this? Last week the nurse I was following wouldn't even let me take vitals, VITALS!! I am in my second semester of nursing school, I think I can handle that.
Anyway, I wanted to know whats up with that! I recognize that they are busy. I also recognize the few nurses that have taken me under their wing and shown me SO MUCH. I'm thankful for that, and grateful.
To some degree you can blame the facilities for this. While floor nurses aren't making any extra money to teach you.. the facility usually is. With a few exceptions, schools pay quite a pretty penny to these facilities to be allowed to have clinicals there. The schools don't advertise this fact but MOST pay good cash for their students to have the experience. The facility expects that the nurses will be welcoming enough so that there won't be complaints... so that they won't lose this money. Doesn't always work out that way but that's the expectation.
On the other side is the nurses who often have full plates and get a constant rotation of students week after week... some of whom are competent and some of whom are seriously NOT. If it was your patients.. would you take the chance? I might not.
But we are there to 'help'- we are there to learn, and help. Although we can't complete tasks flawlessly like the nurses, I assure you there are tasks that can be done by the bottom-feeding nursing students, I swear...
I understand what patient acuity is, and I understand my abilities as a student. I have made myself more than available, and offer as much as I can. I understand that I do not have the clinical skills the nurse does, but I am willing to learn. And I have made that abundantly clear. I know I get in the way, but I know I shouldn't be treated like grandma's Chihuahua that won't stop bothering her. I'm in school and learning, I want to learn and am eager to learn.
It's such a shame the fervency and excitement of nursing students gets doused at the earliest moment in the hospital. I've heard about the nurse-eat-nurse environment and have refused to accept it, but after stepping foot into the hospital, I can assuredly say, I SEE IT!
But we are there to 'help'- we are there to learn, and help. Although we can't complete tasks flawlessly like the nurses, I assure you there are tasks that can be done by the bottom-feeding nursing students, I swear...
Your eagerness to help shines clearly in your posts, and genuinely I do believe you mean it completely.
Consider for a moment, though, that the nurse you are paired with is, by license, responsible for this patient. It is that nurse's responsibility to know all assessment data, to know it is accurate. It is that nurse's duty to report anything outside of normal limits and intervene, perhaps immediately.
Realize that a student may or may not be competent. The nurse has absolutely no way of knowing which side of the fence you fall. You want to help, but without knowing your level of skill, you may actually place the patient in more harm, leading the nurse to feel the need to hover. This no longer makes you helpful. It makes you another thing the nurse has to keep an eye on.
Perhaps you are quite skilled and you really do know your stuff inside and out. But the nurse has no way of knowing your level of skill compared to other students who may have done something terribly wrong. This nurse has a license and patient to protect.
Please, please, please don't take that personally. It is not a personal reflection on you by any means. Some nurses will be more trusting than others. Put yourself in their place - if all of this work you are doing now were put at risk by a student's mistake or negligence, you would feel nervous to trust as well.
In your eyes you are there to help, and I do believe with all of my heart that you are trying to help as much as possible. Your presence, however, is, on some levels that may not feel so large to you right now, a liability.
I highly recommend, if you struggle with getting hands on experience with the nurse, spending some time with the techs/aids. What they do will also very much be part of your job as well.
Where is your instructor in all of this? Throwing you out onto the floor and hoping that the floor nurses will teach you is highly irresponsible.
I understand both of these points of view and appreciate the feedback. It is just really frustrating to be a student paying good money to lean against a wall for six hours. I hope that in the future, when I'm a nurse, I'll be more apt to this teaching roll. I understand that not everyone is equipped to teach, and have been tossed between nurses because of this. I feel that if we are trying to create a better environment for nurses it should start at the bottom- with the students. We are the 'future of nursing' as everyone keeps touting and what better way to equip us than with teaching.
Wait until you graduate, pass the NCLEX and land your first position. Then come back and fill us in when you show up for work and hear, "Beckky, you'll have nursing student purple scrubs following you today. Be sure to let her do all vitals and baths (perfect opportunities for assessments by the nurse), do all bathroom trips (need to see how ambulation is progressing, no better time to assess lung sounds when they are sitting on the toilet!). It will be your job to TEACH her today because that's what she's paying all of this money to a school for"
Your tune WILL change. You have unrealistic expectations of what clinicals are about, and that's too bad. Not all floor nurses are horribly mean people who are secretly hoping you fail so you won't come in and steal their job away from them. The floor nurse simply CAN'T sit back and let you essentially take over while she just watches you and guides you. It is up to your SCHOOL to educate you, it's sad really that you are blaming your clinical sites for letting you down.[
QUOTE=2bnursebeckky;8642084]But we are there to 'help'- we are there to learn, and help. Although we can't complete tasks flawlessly like the nurses, I assure you there are tasks that can be done by the bottom-feeding nursing students, I swear...
I understand what patient acuity is, and I understand my abilities as a student. I have made myself more than available, and offer as much as I can. I understand that I do not have the clinical skills the nurse does, but I am willing to learn. And I have made that abundantly clear. I know I get in the way, but I know I shouldn't be treated like grandma's Chihuahua that won't stop bothering her. I'm in school and learning, I want to learn and am eager to learn.
It's such a shame the fervency and excitement of nursing students gets doused at the earliest moment in the hospital. I've heard about the nurse-eat-nurse environment and have refused to accept it, but after stepping foot into the hospital, I can assuredly say, I SEE IT!
Imagine you're a baker and you have to make 4 dozen Martha Stewart perfect, beautifully decorated cupcakes in 2 hours and if you mess up you lose your business. Now add to that your mixer is on the fritz and customers keep coming in interrupting you. Now throw in your five year old (because your babysitter called off) who thinks she can "help" because you and she have baked a few things together and she can make a mean brownie in her Easy Bake Oven. You love your five year old. She's just awesome. You love teaching her how to bake. You think she'll be a terrific baker when she grows up. You want her to be successful. You really wish you had the time to teach her right now. You feel really bad. But you. just. don't. have. time.
Specializes in Oncology, Rehab, Public Health, Med Surg.
[quote=
A lot of nurses just don't have any more to give.
I dont know why my quote is not working----
Lig---"A lot of nurses just don't have any more to give"
This. A hundred times this.
I know that you think you understand whats going on but-- you dont. What you see the nurse actually doing is the tip of the iceberg
If i were spending hours leaning against a wall in clinical, id be talking to my instructor/dean /whoever. It is their responsibilty to help you get a learning experience-- not to add one more thing to the bedside nurse
Know what skills/tasks you can do-with or without your preceptor.
Talk to the nurse precepting you at the beginning of the shift and let her know you want her to let you know if she has any tasks or procedures that you can watch. And then BE AVAILABLE so she doesnt have to hunt to find you when something comes up as she will likely not be interested in taking a lot of effort to find you.
I would ask the nurse im with if there are any tasks planned for the day-ie does the patient need a foley put in? Take out? Iv take out? Potential Ng tube? Trach suction? Tell her you will do those with your instructor.
I have found that nurses (me included) forgot what nursing students can and cant do and that they are excited to do any little thing. I remember being excited to spike my first NS bag or take out an IV. Its very simple, but something as a nursing student I could feel accomplished performing.
Remind her you are there and what you can do to help out. And, if helping out means changing a bed or bedpan. Then change it.
Its hard for nurses to have students bc the nurses also need to be constantly assessing and critically thinking. She cannot rely on your assessment bc it is her patient and she needs to report changes. This is what I find makes it difficult to incorporate students into the plan of care.
Also, You can follow her (shadow) and understand why she is doing xyz instead of abc. You can learn a lot of critical thinking in this manner just by observing. What order does she answer call lights? How does she interact w the physicians and other staff? Is the patient going down hill? How did she come to that conclusion and what interventions is she implementing?
Finally, i say she when describing the nurse only bc I am female. Your precepting nurse may be male 😊
Almost all the hands-on I've done as a student I've done without the nurse... and with my clinical instructor. Generally the nurses are much too busy to let you do something that would take them half the time. However, if they trust the instructor they are normally willing to let you work with the instructor to do certain tasks (NG tubes, IV lines, caths, changing ostomy bags, basic wound care, etc).
I had a 50/50 mix in school. I found that the further I went in the program the more I was able to do, as it should be. For my final preceptorship on an Ortho/Neuro floor I was taking care of 4 patients by myself while my nurse would just sit back and relax. Pretty much the only thing she would assist me with at that point is if we had to call a doctor, and even then she would call the doctor, explain that a student would do the talking, and I'd go from there.
If nurses are reluctant they've probably been burned by students before. It happens.
My advice would be to work hard no matter what as you may be on an unofficial job interview. When you graduate, try to get into a new grad program that does longer orientations and/or classroom training.
But we are there to 'help'- we are there to learn, and help.
I remember when I was a new nurse and, for the first time, one of my patients was assigned to a nursing student. i thought it was great. A fairly experienced nursing student (if such a thing was possible) who would assess my patient, chart on them, pass their meds, do the patients bath, etc.
Well, the nursing student could not do IV pushes. No one told me this, so the patient is about to go off the floor for testing, and I then see that the IVP meds due 2 hours ago were not given, and I had to play catch up with them before the patient could go.
The patient gets back and has a major incontinent episode. I tell the tech, "let John, the nursing student know, and he and his colleagues will get the patient cleaned up." I find out an hour later the nursing students were off the floor at lunch, had not informed anyone of that, and now the patient has spent an hour sitting in BM.
With stuff going on with my other 5 patients, I finally get a chance to check up on the student's charting and compare his assessment to mine. In his note he charted "patient taking adequate PO fluids." Fairly benign statement. Except for the fact the patient is a dialysis patient on a fluid restriction. Reviewing the charting, there were several errors/omissions and I just go a chart a new assessment and delete his rather than just signing it off.
I generally enjoy teaching student. I volunteer to be a preceptor for students. However, there are many times when the student can add greatly to a workload of a nurse. I hope the students have a great experience. I am willing to add work so I can help students learn. However, there are some days when the added work is just not worth it, and just not practical given the heaviness of an assignment to begin with. And it is really not helpful to hear about loads of money the student is spending to be on the unit.
I commend you for trying to help. I really do hope you have a meaningful clinical experience and that you learn a lot. However, depending on the type of unit on which you work as an RN, you view of students, and the responsibility of the floor nurses vis-a-vis the students' educations, will likely change. Try to keep in mind the perspective of the nurses, and realize that it is not as simple as you may think.
I love how people think on here and how we all have different opinions. Mine is opposite then most posters here. I hear you. I know your eager and want to learn and I hear your frustration. I may agree with some of the points in the above posts, but c'mon, even if, as someone mentioned, "the nurse wants to assess the pt herself, " when referring to VS, give me a break, you can do that and not be in her way and not be taking up her time. It takes 60 seconds to show you how to use the VS machine, if you don't already know how. Whether she takes the VS or you do, she can assess them as well from yours as she can from hers. VS are VS. Many mornings I will come to work and see students and go, "uhhh..." Yes they take more of your time and since I'm not a morning person, I don't always feel like going, "GOOD MORNING!!" as they do, but I give them a smile and do my best to make them NOT feel as the OP is feeling. You all, face it, students as a general rule do not get treated well and it's sad. I don't care how busy we are, we can still give off a SENSE that we are caring and thankful to have their help rather than give off "I-wish-you-weren't-here-and-in-my-way" attitude. Just be NICE. It's really not hard...
Meeshie
304 Posts
To some degree you can blame the facilities for this. While floor nurses aren't making any extra money to teach you.. the facility usually is. With a few exceptions, schools pay quite a pretty penny to these facilities to be allowed to have clinicals there. The schools don't advertise this fact but MOST pay good cash for their students to have the experience. The facility expects that the nurses will be welcoming enough so that there won't be complaints... so that they won't lose this money. Doesn't always work out that way but that's the expectation.
On the other side is the nurses who often have full plates and get a constant rotation of students week after week... some of whom are competent and some of whom are seriously NOT. If it was your patients.. would you take the chance? I might not.