Working with student nurses

Ruby Vee, BSN · Oct 31, 2011

having a student doesn't have to be a burden. if you want it put bluntly: delegate your scut work to them and in return take a little extra time with your dressing changes, foley insertions, or whatever else happens to come along on your shift. if a student does something as simple as getting a juice for me or re-checking a bg then i consider them a help. if i am giving an unusual med and i have time, then i will pull the student aside and talk with them about it. but i don't let a student get me behind either.

if you intend to really teach a student and give them a good experience, it takes three to five times as long (or more) to do even the simplest tasks. having them do "scut work" isn't really teaching them anything.

Ruby Vee, BSN · Oct 31, 2011

wow you guys really jumped down my throat over that comment. lots of you took that the wrong way. i respect nursing students and it is nice to give back. i guess what i am trying to say is sometimes their input/knowledge is very textbook and at times comes off as a "know it all" attitude. sometimes it is a lot to take on a 2-3 student nurse and 7 patients and it is irritating.

sometimes students do have a know-it-all attitude . . . even students who are trying to impress us with how much they're not a know-it-all come across with a know-it-all attitude. sometimes they're polite and eager to learn. but taking a student under your wing always slows you down -- at least it does if you're doing it right. many students don't understand that, and i'm thinking they were the ones who were giving you the most flack.

Ruby Vee, BSN · Oct 31, 2011

i am currently a nursing student, and to be honest i am very kind, i am great with my assessments, and i feel bad that i might have to slow the nurse down, but to be honest with you.....as part of our passing clinical is to be assertive and tell the nurse what to do and which patients we will take, and when we will delegate....and honestly i feel so uncomfortable having this attitude b/c i feel bad for my co-assigned. but like i said its part of our assignment as a student nurse during clinical to be assertive & some what aggressive. just try your best to be patient and realize that as part of the student nurse assignment we have to fake being uncomfortable for our grade

i seriously doubt that as part of your grade you have to be aggressive and "tell the nurse what to do." that would not sit well with me -- or with any of my colleagues -- and i doubt you'd even finish your shift with us.

that said, someone who tells me that she is very kind and great with assessments and then talks about having to be aggressive with the nurse she's working with . . . . kind and aggressive don't peacefully co-exist. and people who start out by telling me how great they are get off on the wrong foot every time.

Ruby Vee, BSN · Oct 31, 2011

despite what others might have to say about that you were right to call her out. she was not only putting herself at risk but the patient as well. that is disgusting! gloves are not a new school vs old school situation they are absolutely necessary!

you're wrong. you don't have enough experience to get it, but we functioned just fine without gloves for decades. it may disgust you not to wear gloves. wearing gloves may be best practice. but it is never right for a student to call out a nurse in front of a patient.

in fact, the only time i'd call out anyone in front of a patient -- student nurse to attending physician -- is if they were about to immediately kill someone. (giving potassium iv push, for example. defibrillating artifact.)

Ruby Vee, BSN · Oct 31, 2011

i don't see why nurses would dislike student nurses. students nurses take care of 1 or 2 patients, they pass meds, they do everything for the patient the nurse doesn't have to do anything for that patient, just a routine round. i have noticed and i've been told that some nurses get annoyed when students ask questions, the reason for this is because they don't know the answers or they are just lazy. i can't imagine being a nurse, dentist, doctor, lawyer and not answering questions. if i know the answer to a particular question i would answer in a heartbeat, it will make me so happy knowing that i just helped someone, i made their day easier etc.

students don't lighten anyone's load. we have to make sure that the patient gets what they need when they need it and done the right way. that patient is our patient and our responsibility, not the student's. if my patient needs pain medication and it isn't charted, i have to track down the student and find out whether they've given it but haven't charted it yet, are in the process of getting it, or haven't gotten around to it yet. i could have just medicated the patient in about half the time it takes to do that.

as far as answering questions -- sometimes there isn't enough time for a real answer. the patient needs her blood hung now because she's bleeding and i don't have time to discuss the normal hemoglobin and hematocrit values with you, where i think she's bleeding from and why, how often a type and cross needs to be redone, how to check blood, where to get blood, what tubing to use and why and why i'd run it in this iv rather than that one. that doesn't mean i don't know the answer or that i'm lazy. it means that the patient comes first.

any student nurse calling any of my colleagues lazy -- even the ones who clearly are lazy -- would not be welcome to return. it's not your place to judge. say what you want to in your own private post clinical conference, but don't you dare let any of us hear you criticizing our colleagues.

SuperStarRN · Oct 31, 2011

you're wrong. you don't have enough experience to get it, but we functioned just fine without gloves for decades. it may disgust you not to wear gloves. wearing gloves may be best practice. but it is never right for a student to call out a nurse in front of a patient.
in fact, the only time i'd call out anyone in front of a patient -- student nurse to attending physician -- is if they were about to immediately kill someone. (giving potassium iv push, for example. defibrillating artifact.)

your response is i'm wrong!?! this is not 1819. something as simple as putting in an iv without gloves could give someone an infection that could possibly (and this may be a stretch) kill them. and my years of experience have nothing to do with anything. that is common sense. even if i were the patient i would call her out! i may not have gone to the extreme that the student nurse did but you better believe i would tell her to put on gloves.

AgentBeast, MSN, RN · Oct 31, 2011

The point of regular gloves is to protect the nurse from whatever a particular patient may be harboring not to protect the patient from what the nurse may or may not have. That is what sterile gloves are for.

charlie8025 · Oct 31, 2011

My experience so far with students has been good. I explain at beginning of shift that we have a lot of things to do and a short time to do it, so focus your questions and be tolerant if I am terse of clipped in my answers (apologize in advance). After setting some quick ground rules, we have done fine. I have had a couple of questions from the clinical educators over procedures I might do, mostly having to do with hanging blood. Overall, I like the student nurses I work with, I do find it takes longer sometimes, but it is because I try to explain procedures as I move along in a rush with limited time. I always figure I was new once too, gotta learn somewhere.

SuperStarRN · Oct 31, 2011

Gloves protect both the nurse and the patient. The only time you need sterile gloves is when performing a task that requires strict aseptic technique. Regular gloves are considered clean vs your hands which are not...anyway I could go on and break it down for you but I have better things to do and the point of my post was to say that it was nasty and I would have told her to wear gloves too. If you come on this site to spark up arguments with people because their opinion differs from yours then my suggestion for you is to get a life.

Ruby Vee, BSN · Oct 31, 2011

your response is i'm wrong!?! this is not 1819. something as simple as putting in an iv without gloves could give someone an infection that could possibly (and this may be a stretch) kill them. and my years of experience have nothing to do with anything. that is common sense. even if i were the patient i would call her out! i may not have gone to the extreme that the student nurse did but you better believe i would tell her to put on gloves.

my response is that you're wrong: the student should not have been calling out an experienced nurse -- or anyone -- in front of a patient unless that patient was in immediate danger. starting an iv without wearing gloves -- especially if she'd washed her hands (and nothing says she hadn't) did not put that patient in immediate danger. if the nurse had been about to defibrillate a patient in a normal sinus rhythm or give kcl iv push, ok. but that wasn't what was happening.

lest you jump on me about harshness towards students, i don't think anyone should be "calling out" anyone in front of patients, unless there is clear and immediate danger.

wearing gloves is, indeed, best practice. "calling someone out" in front of a patient is not.

CompleteUnknown · Oct 31, 2011

It's really surprising to me that there are some nurses who don't understand the purpose of clean gloves versus sterile gloves and the difference between them. Both will protect the nurse but only sterile gloves (put on properly, without contaminating them) will protect the patient. As has been said on here before, clean gloves are no more clean than your hands that just touched them when you pulled them out of the box. I would even go as far as saying that often they are less clean than just-washed hands.

turnforthenurse, MSN, NP · Oct 31, 2011

I have yet to experience the "having a nursing student" experience...working nights it is pretty much impossible and we do not get students on my floor to begin with. I would like to take students under my wing, but I feel like being too new (still) I would look like a fool in front of them :lol2:

I dislike those know-it-alls, though...again we do not get students on my floor, but some of our new interns sure act that way... :rolleyes: