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.
Eye rolling was my pet peeve, esp. when accompanied by "I already seen that."
I oriented a new grad who did that. I told her if she did it again I would super glue her eyes in place. We totally crack up about that now. Of course, I'm old enough to be her mother!
Specializes in Oncology; medical specialty website.
I was working my way through the thread, but thank you for your noticing and being so quick of your feet!
I have not been ignoring the ACTUAL NURSES. I've been studying for finals all weekend and this is my first chance to get online- forgive me if I am drawn to the POSITIVITY in these threads.
Anyway, ACTUAL Nurse Leigh, I'm sure you remember being a student, I sure hope so. As I wrote in reply to an ACTUAL NURSE, I think the lines of communication need to be opened up so I understand why I a being ignored. I am literally willing to do anything, and I have made that abundantly clear- JUST ASK!
Anyway, I'll continue to rummage around through these posts, with your approval of course, and respond to the correct ones.
Wow...that was snide. She was trying to explain the flip side of this situation, and you reply by being sarcastic.
Perhaps the reason you haven't been getting opportunities from the nurses at most of your clinical rotations has more to do with your attitude than it does with the nurses.
Specializes in Oncology; medical specialty website.
Maybe. Possibly. Probably. I felt attacked. My apologies.
I liked your comparison to the baker in your previous post. It brought a great perspective into my question. Feeling useless has got to be one of the worst feelings I've encountered (a bit dramatic, maybe), but is SUCKS.
I don't regret posting my original question, but I am so surprised (naive, maybe), and discouraged by the feedback from seasoned nurses. I have so much respect for you (they) do on a daily basis, I hope that much was related.
No, you don't, and not, it wasn't.
All you've done up till this point is complain about "seasoned" nurses while exalting new graduates. You were downright rude to Leigh, who took the time to respond to you.
If you're discouraged by the feedback, it's probably because of the vibe you put off.
@2bnursebeckky please don't feel discouraged by this post, you vented your frustrations and as I student I appreciate it because I have felt the same way. I have had some wonderful nurses and some not so wonderful. At the end of the end of the day, we are students ...here to learn to develop skills so that we come become excellent nurses focused on patient care. Contrary to how anyone feels about it, It is very discouraging to a student when you have a seasoned nurse be bluntly rude to you because she doesn't "feel like" having a student. Like I said before, if you show confidence and that your willing to learn, alot of the nurses will be glad to have you. Don't let these comments, or one person ruin your entire clinical experience! It get's better I promise you!
:banghead: Look, it isn't that nurses do not understand that you need/want to learn. Many nurses enjoy passing on knowledge * if the circumstances allow it *. Many of these situations arenot good learning environments because the nurses are too busy (really, why do some students not seem to get this?), some patients are not appropriate for students, and we don't always know what you can/can't do.
We can't change any of this. It is up to the school's educators and hospital mgmt to create situations where the instructor to student ratio and nurse to patient ratios are improved.
When a floor has students from multiple schools coming through it is difficult to keep track of what everyone can do. Also, some nurses are fantastic at explaining the hows and whys if nursing interventions while others just don't have that ability or desire to teach.
Given the right circumstances I think things would be different but until TPTB improve things, nurses have too much too do and too little time to do it in to really help students.
While doing clinicals for CNA certification I adopted the strategy of offering my services to the CNAs I was assigned to shadow and the nurses assigned to where I was. I used phrases like, "How can I assist," "I can do that for you," "I can make it easier on you by..." "I can save some time for you by..." I start nursing school soon and I intend to do the same thing. If they say no, deal with it like an adult. As a CNA I've discovered "no" is a powerful and effective word that will help your sanity. Take that last sentence as wise advice and hold on to it steadfastly.
One thing I haven't seen directly addressed, though sort of alluded to sideways, is the idea of how the student views "being helpful." Because so much of the nursing student prep for clinical involves learning lab, with its emphasis on tasks and how to perform them, that's really the only context they have for what they know to look at and think about. So of course when they see bed baths that need to be done, or vital signs, or I&O, or whatever, they see these as items to check off. Seen that way, it's hard to escape the (erroneous) conclusion that taking these tasks off the nurse's hands should be helpful.
Of course, what they don't really have any kind of grasp of, and what they really NEED to develop, is a sense of how everything we do is integrated, how every patient contact is an opportunity not just for delivering a med/changing a dressing/getting up in the chair/checking a BP, but for a far more wide-ranging assessment of many, many other factors. It takes time to learn to observe those subtleties; in truth I think a lot of nurses wouldn't be able to really put that into words. We so depend on what we think of as nursing instincts ("There's just something wrong with this guy...") that we have forgotten the many thousands of such cues and clues we have absorbed in years of practice.
Students don't know that just because they did the bed bath and changed the bed linens, they could have been picking up so many data points about this person in the bed. Chatting while bathing and changing a bed is a huge well of information.
"Will your family be visiting tonight?"
"Oh, no, I live alone/my husband is in a wheelchair/my sister helps me sometimes but she's in a nursing home after her hip surgery and won't be home for weeks."
"Oh, you live near the park? I love that park. What's your building like?" "Since the super quit we've had no trash removal and I'm afraid to use the elevator because it breaks down, so I don't go out much." "How will you get to your follow up appointment in two weeks?" "I probably won't."
"Who does the cooking?" "I do, of course. (laughs a little) My wife lost her foot to diabetes last year and she can't stand up at the stove any more." "What will you do when you are on crutches when you go home? Who will do the shopping?"
"What's this bruise on your upper arm?" (vagueness)
and so forth... which the nurse is going to have to do anyway.
Students are so far from absorbing this concept, it's no wonder they feel left out. It takes a long time to be a full guild member, in part because you haven't done your apprenticeship. And that is where you learn more than the mechanics, but the rationales and the skills, the real skills, of nursing.
I remember what it was like being a student and being ignored by my assigned nurse. There was more than one day where I felt like I was designated to holding up a wall for twelve hours. Some nurses aren't great at teaching, some great nurses have terrible days. I just had to make the best of it.
When you are with someone who doesn't like to teach, and your instructor isn't available, then can you ask other nurses/PCT's if they need help? One thing I would do (that you can do solo) was dig through patient charts. EMAR, labs, notes, vital sign trends, ect... It was helpful because I learned the facilities charting system and how to access information faster. I also really loved being able to use all of the information I found to put together a clear overall picture of the patient. I still love digging through charts!
I would also suggest you try to get a feel of the nurse you are with. Conform to their style of teaching instead of expecting them to lead you. It also helps to be friendly and nice. Suck up in any way that you can.
You can only make the best of your situation. Keep your eyes and ears open for learning opportunities, always have a cheerful and positive attitude. Constantly offer to do specific things (instead of just saying you can help). Offer to do do vitals, incontinent care, turning, bed baths,
feeding, ect.
I was recently assigned a student who is normally in her preceptorship with another nurse (she is a nurse extern). We had a horrible night. One patient in particular was confused, agitated, and restless. This student offered to basically sit with the patient and even helped walk her in the halls (calmed the patient down) while I attended to my other patients. She offered to do vital signs and clean patients all night. It was a huge relief for me. I apologized for basically using her as a PCT but she was graceful and appreciative about it. Liked her attitude so much that I e-mailed her manager. If she applies on our unit once she graduates, I will recommend she be hired.
Just an example of how much attitude, eagerness, and willingness to do small/simple tasks makes a huge impression on the staff on the unit.
I loved having a student in the ER, but a. those students were usually in their final semester and already reasonably competent at basic tasks, and b. their clinical instructors were also staff on our unit and therefore communication about expectations and competencies was excellent.
Even so, there were occasions where I did not have time. If a student shows up with a clinical instructor in tow, willing to take over some tasks under the instructor's supervision? That's a huge help. If the student is dropped off in the morning with no clear communication regarding what they a. can and b. may do? That's a giant addition to my already full workload.
Know what you can do (and be realistic with yourself- if you've never done something or only done it once in lab, you need supervision even if it isn't required) and what you may do (every school has different policies). Many units see students from a dozen schools or more and we have no idea if you're a first semester or student who has never touched a patient or are just a few weeks from graduation. Communicate this clearly to the nurse. Work efficiently when you're given the opportunity, and ask questions when you have them- I'm usually much more able to explain what I'm doing and why than I am to supervise you doing it at half the speed.
Realistically, most of your hands-on training will happen at your first job. It isn't the way it used to be, and it's not ideal, but it's the reality of nursing education these days, and when you have your own full assignment, you'll understand why.
One thing that students don't seem to realize is that they aren't really there to help. As an experienced nurse, it is much quicker and easier to do something myself than to walk a student through it. Also, patient acuity has increased exponentially as have nurse to patient ratios. This means that nurses continue to be expected to do more with less. They also have routines that are disrupted by having students. There is often no notice that the nurse will be assigned a student- they find out when the student comes on the floor. Nurses also aren't compensated to take on the additional responsibility of students. Additionally, it used to be that educating the students was the responsibility of the clinical instructor. Now, there are so many students scattered throughout that the instructor can't possibly be with all of the students, again, meaning more falls onto the nurse who isn't compensated and likely didn't receive education on how to be a nursing instructor. Additionally, not all nurses are meant to be preceptors, but have the responsibility thrust on them anyway.
All you can do is make the best of the situation, learn what you can, and approach your instructor for assistance if you think you need a new nurse preceptor for the day.
This is a great perspective. How did this happen? This sounds like a horrible system for everyone involved.
This is a great perspective. How did this happen? This sounds like a horrible system for everyone involved.
The nurses trained in the old hospital based programs tell of vastly different experiences. From what I've heard they were basically running a unit themselves by graduation.
It's a shame these programs are going the way of the dodo bird.
I think it also helped that mgmt didn't seem to heap as much ridiculousness on the shoulders of the nurses, and though they were very busy, it was usually doing pt care, not the scripted nonsense and endless and pointless checklists that do nothing to actually improve pt care.
I've only been a nurse for about seven years, but other more experienced nurses have noted a shift in how it seems mgmt wants students to be more focused on HCAPS and scripting and pt satisfaction than you know, working to improve the quality of life the patients have through advocacy and sometimes a little blunt education.
Coddling patients is not always in their best interest.
And now I've completely gone off the rails...
All this to say that changes in the education of student nurses and mgmt expectations and the high patient loads of staff nurses have made clinicals are far less beneficial all round.
Specializes in Oncology; medical specialty website.
@2bnursebeckky please don't feel discouraged by this post, you vented your frustrations and as I student I appreciate it because I have felt the same way. I have had some wonderful nurses and some not so wonderful. At the end of the end of the day, we are students ...here to learn to develop skills so that we come become excellent nurses focused on patient care. Contrary to how anyone feels about it, It is very discouraging to a student when you have a seasoned nurse be bluntly rude to you because she doesn't "feel like" having a student. Like I said before, if you show confidence and that your willing to learn, alot of the nurses will be glad to have you. Don't let these comments, or one person ruin your entire clinical experience! It get's better I promise you!
How do you feel about it if it's a new nurse saying she doesn't want a student?
:banghead: Look, it isn't that nurses do not understand that you need/want to learn. Many nurses enjoy passing on knowledge * if the circumstances allow it *. Many of these situations arenot good learning environments because the nurses are too busy (really, why do some students not seem to get this?), some patients are not appropriate for students, and we don't always know what you can/can't do.
FlyingScot, RN
2,016 Posts
I oriented a new grad who did that. I told her if she did it again I would super glue her eyes in place. We totally crack up about that now. Of course, I'm old enough to be her mother!