Working with student nurses

Quark09 · Nov 2, 2011

I've been on both ends of this. I do recall being in clinical my first semester on a med-surg floor; my preceptor had a Foley to insert on a female pt and asked if I'd like to do it (of course I was like "Hellz yes!").

Weeellll, I couldn't find her urethra. I'd inserted Foleys on several males and just a couple females, but I could NOT find the correct hole. Rather than me go through another kit, my preceptor said "Okay, I'll go ahead and do it" (pretty nicely, but understandably just ready [as was the pt] for the Foley to go in). It took her a few minutes to find the spot (after we wasted another kit in the lady parts) and after running it in, she started to fill the balloon without getting a urine return. Pt was not happy; that crap hurts! After a few seconds she realized she hadn't sunk it enough and pushed til she got the urine. It was one of those situations where I was like "Do I say something?" Thankfully I didn't; in retrospect it was a minor thing that was righted almost immediately, without my opening my mouth and adding my two cent's.

I've since had students on my service. Generally I find them to be helpful, almost "unhelpfully" so :). I do recall some preceptors who were downright rude no matter the circumstance, and I've always made the effort to never be that nurse. However I also take it as an opportunity to chat with the student about "NCLEX world" vs. "real world".

wooh, BSN, RN · Nov 2, 2011

My last quarter we were expected to delegate to the techs and take a more proactive role with our patients.

And even that is iffy. I would NEVER let a student with me "delegate" to a tech. It would be, what do they need the tech to do, and if the student is advanced enough that I'm not having to follow them around every SECOND, I'd do it, or *I* would delegate to the tech. The techs are not hired to do things for students. We had a student forget that once. Not even in their senior clinicals, just their regular old ones. Went and TOLD a tech what to do. THAT did not go well.

wetzoo · Nov 2, 2011

My last quarter we were expected to delegate to the techs and take a more proactive role with our patients. We were supposed to try to organize our time more like a nurse and less like a student nurse (higher expectations on prioritizing, doing less baths and ADLs, communicating with the doctors in addition to the nurse about patient condition, etc). It was.....challenging. Delegating to a tech at whose facility we were guests was awkward and we got a lot of push backs from the techs who weren't excited about being given direction by nursing students. We were communicating with doctors as well as our nurse using SBAR, and the R of SBAR is Recommendation" so perhaps that is what that poster is referring to when speaking about "telling the nurse what to do"? Just a guess.

Same. When I did my internship, nurses on my floor regularly encouraged interns to delegate to the techs (I was even told one time to, "no offense, stop acting like a tech"). As a senior student, you know the difference between proper delegation, and telling the techs to do something just because you don't feel like doing it yourself. The latter wouldn't reflect well on you as a student nurse. But yes, there were times when delegating to the tech was necessary. They're doing things they would normally do for a patient, had the nurse asked them.

I didn't get much push back but I can recall how awkward it was when I was told to to delegate to the tech (a classmate of mine in my ABSN program who had worked as a tech on the unit on the weekends) to change the sheets on one of my patient's beds. She wasn't too happy (maybe slightly embarrassed, as I was a fellow student), but I would offer to help her and any of the other techs with patients whenever I had spare time.

Scrubrpn, LPN · Nov 3, 2011

I just graduated very recently and had to work with a few nurses who had aweful attitudes towards students. I wouldn't even have opened my mouth to introduce myself and they would already be rolling their eyes and sighing. It made clinical days really difficult to get through and I even had a few classmates leave the floor crying because of it. When I had to work with a nurse who treated me as if I was an idiot because I was a student and didn't that those letters to the end of my name yet, I made it a point to do nothing for them beyond my asigned duties of 1-2 patients and charting. I tried to avoid them as much as possible and if I had any questions went to my instructor instead or another nurse on the floor who was opened to helping students. Luckily for me, most of the nurses were very kind and enjoyed (or seemed to enjoy) having students. For them I would bathe all their patients and toliet them whenever needed because I enjoyed helping the nurse who would treat me with the basic respect every one deserves.

In my final consolidation semester we were also instructed to delegate to the personal support workers. I didn't really feel comfortable with doing that, and when I saw someone that needed to be changed or bathed I would end up doing it myself. Some of them saw this and took advantage of it, but the majority of them were very appreciative that I was willing to help. I had an amazing preceptor in my final semester who did everything she could to help the PSW's because I freed up so much of her time.

Also, several people mentioned that teaching students is not a part of their job...Well at least were I went to school we constantly reminded that "one day we will be the preceptors" and to never forget what it felt like to be a student.

I was just hired at a large teaching hospital, and I hope I never become the cranky tired old nurse that the students dread working with.....

xtxrn, ASN, RN · Nov 3, 2011

I've been on both ends of this. I do recall being in clinical my first semester on a med-surg floor; my preceptor had a Foley to insert on a female pt and asked if I'd like to do it (of course I was like "Hellz yes!").
Weeellll, I couldn't find her urethra. I'd inserted Foleys on several males and just a couple females, but I could NOT find the correct hole. Rather than me go through another kit, my preceptor said "Okay, I'll go ahead and do it" (pretty nicely, but understandably just ready [as was the pt] for the Foley to go in). It took her a few minutes to find the spot (after we wasted another kit in the lady parts) and after running it in, she started to fill the balloon without getting a urine return. Pt was not happy; that crap hurts! After a few seconds she realized she hadn't sunk it enough and pushed til she got the urine. It was one of those situations where I was like "Do I say something?" Thankfully I didn't; in retrospect it was a minor thing that was righted almost immediately, without my opening my mouth and adding my two cent's.
I've since had students on my service. Generally I find them to be helpful, almost "unhelpfully" so :). I do recall some preceptors who were downright rude no matter the circumstance, and I've always made the effort to never be that nurse. However I also take it as an opportunity to chat with the student about "NCLEX world" vs. "real world".

At least she caught it. I've had them inserted, and the balloon inflated on my internal sphincter. :down:

allnurses Guide · Nov 3, 2011

I am in transition now and yeah, I am told repeatedly I should be delegating to the tech. I take 4-5 patients and manage them very close (but not completely) on my own with supervision from my preceptor, who gets a bit more strict each day. I have three shifts left. The techs do not like it and have spun stories of me "neglecting" my patients (ie: leaving them in wet gowns, not bothering to clean them up), which are all completely untrue and frankly hurtful. I guess this is my intro to the world of no longer being the bottom man on the totem pole. Automatically mistrusted. It sucks. I make a point to thank them at the end of the day and to smile at them and I, of course, help whenever and wherever I can. Unfortunately as a nursing student who is just learning time management, my availability is not what it would be had I more experience.

As to nurses who aren't thrilled about students, I haven't really had one yet and I graduate in December. I worked with one nurse who made me feel small and stupid. Another student in our group just loves working with her. Sometimes personalities just do not gel. She was a good person and a good nurse - just not a good fit with me. No harm, no foul. I am tremendously thankful to my preceptor. She has the unenviable job of launching me from student to grad nurse status. I am doing my best not to make it thankless for her. I wish I had a million bucks and could send her to see her mom in India as a thank you gift. :)

Nightshifter57 · Nov 23, 2011

I am always willing and eager to teach new students as I too remember how horrible a shift it could be as a student to be paired with a "mean" RN. I love teaching the students who are eager to learn. However, I have a problem with the "know it all" type of student- usually this attitude comes from the mature age students who tell me they have "life experience", or they have been a CNA for years and think they shouldn't have to do showers when they are on their clinical because they've "done thousands". I also hate the students who show no interest and are just staring at the clock waiting to go home. Being paired with you only slows my day down, show some respect!

jess1018 · Dec 11, 2011

Looking back through this thread surprises me how many nurses state that teaching students is not "part of their job" come on now, there is a nursing shortage and we all might need someone to care for us one day. I'd rather teach a student as much as I can. Maybe that's also because I am graduating in 5 days and from the nurses I worked with I tried to learn as much as I can!

hiddencatRN, BSN, RN · Dec 11, 2011

Looking back through this thread surprises me how many nurses state that teaching students is not "part of their job" come on now, there is a nursing shortage and we all might need someone to care for us one day. I'd rather teach a student as much as I can. Maybe that's also because I am graduating in 5 days and from the nurses I worked with I tried to learn as much as I can!

What nursing shortage?

jess1018 · Dec 11, 2011

Ok maybe with the down fall of the economy currently there is not as much of a shortage. I am from an area where many hospitals always have RN openings. I already have a job prior to graduation. But according to my management text which is based on the research, a study by the US Health Resources and Services Administration suggests that by one million new nurses will be needed by 2020 and that all 50 states will experience a nursing shortage of some degree by 2015.

If there wasn't a nursing shortage none of my fellow graduates would even have jobs, because I would think hospitals would rather hire experienced nurses.

I guess I really can't speak for the entire US but my opinion is that nursing really is the only degree where your prospectives of obtaining a job are much hire than other degrees.

diva rn, BSN, RN · Dec 11, 2011

Read a few of the multiple threads...there is a glut of new nurses and over on the nursing news articles there is even a government survey that shows the vast overage of nurses currently and future projected......so once again...just to clarify, there. is. no. nursing. shortage!

tothepointeLVN, LVN · Dec 11, 2011

What nursing shortage?

Shhhh nobody told her yet.